REPORT ON HOSPITAL VISIT AT KIMS HOSPITAL KOCHI

-SARIGA C. S. SAJNA E. M. PRIYANKA CLEETUS ARATHY MOHAN FATHIMA N.

Acknowledgment

We would like to express our sincere and heartfelt thanks to Mrs. Jessy John (HOD of Electronics and biomedical engineering department), Mrs. Sincy P. S.(Staff Advisor) and ___________(Subject In charge) of Model Engineering College for their support and guidance for completing this work efficiently. We would also like to express our gratitude to Mr. Haris K Mustafa(ExecutiveHuman Resources, KIMS HOSPITAL) for providing information about hospital engineering in spite of his busy schedule and work. We also express our gratitude to Biomedical department for helping us learn and understand the instrumentation and other departments of KIMS hospital. 1

Finally we would like to thank Dr. Alexander George, Consultant Plastic surgery for referring us to KIMS, Ernakulam to conduct hospital visit.

CONTENTS 1. Organizational hierarchy

2. Hospital architecture (General layout) 3. Departments 4. Reception 5. Imaging sciences 6. Casualty 7. Haemodialysis 8. Physiotherapy 9. Operation theatre 10. Laboratories 11. Central sterilization units 12. Gas supply system 13. Electrical system

INTRODUCTION
KIMS which started in Cochin recently is one more addition to the multicentre hospital & clinics operated by KIMS group. With hospitals in Trivandrum in Kerala and in various places in the Middle East, the KIMS group is one of Asias most trusted health care providers. Envisioned by Dr. M.I .Sahadullah, KIMS has brought new age healthcare to millions settings standards for others for follow. The commitment to quality services and high end expertise has won the group accreditations and recognitions by national and international agencies. KIMS has to its credit the unique achievement of National (National Accreditation Board for Hospitals & Healthcare Providers - NABH), and International (Australian Council on Healthcare Standards International - ACHSI) accreditations for its dedicated healthcare of uncompromising quality. They are empanelled with Government & Semi-Government Institutions in India, Republic of Maldives, Sultanate of Oman, Bahrain, UAE, US and UK for Australian/ Canadian Visa Medicals. It has a team that specifically caters to trauma and emergencies situations. KIMS Hospital & Surgical Center in Kochi, has a team of highly qualified and experienced consultants who have proved their professional caliber at their respective fields. These professionals are supported by trained nursing professionals and paramedical staff and of course, state-of-art modern technologies. UNIQUE FEATURES OF KIMS HOSPITAL & SURGICAL CENTER, Kochi

125- bedded fully air-conditioned hospital with over 25 specialties and subspecialties Highly qualified and experienced team of consultants Round-the-clock Emergency services with state-of-art ambulances, fitted with modern ventilator and monitors Round-the-clock laboratory, Diagnostic (X-Ray, CT scan, EEG, EMG, TMT, Ultra sound etc) and pharmacy services Modern Physical Medicine Department with fully-equipped Physiotherapy unit Four State-of-art Operation Theaters and dedicated 30-bedded Intensive Care units (ICU) managed by highly qualified anesthesiologists and Intensivists. Fully-equipped blood storage Unit Highly qualified Nutrition and Dietary Services staff Fully computerized Hospital Information system Fully automated Nurse Call system Specially designed Preventive Health Check up packages International health Tourism packages

ORGANIZATIONAL HIERARCHY
4

HOS AL ORGANIS TION PIT A

DIRECTOR

MEDICAL DIRECTOR

ADMINISTRATOR

MEDICAL ST AFF

FINANCE

BIOMEDICAL

NURSING

INDUSTRIAL

Chairman & Managing Director Dr. M. I. Sahadulla M.D, F.R.C.P (Ireland), F.R.C.P (Lon), M.B.A (Hull, UK) Executive Director Mr. C H A Raheem FCA Medical Director/Consultant : Dr. Mathew Punnachalil. C. MD, DCH, MRCP (Ped), FRCP (Ireland) Chief Operating Officer G. ArunGovind

HOSPITAL ARCHITECTURE

LY A OUT

MAIN BLOCK CASUALITY MAIN ENTRANCE SUB BLOCK MAIN GATE PARKINGAREA

MAIN BL C - G O OK R UND FL O O R

RC R S EOD S AIR T G AS S /M LIFT LAB R IO AD L G OY D EPT O PS LIFT S AIR T R EPT EC IO N TMT O PS G AS S UPPY

P TIEN L B Y A TS O B E AN E NTR C

P TIEN L B Y A TS O B E AN E NTR C

C T S AN C

IP X A PH M RY AR AC Y

O P PH M AR AC Y

MAIN ENTR C AN E

HL EP DS EK

O PS

C U AS AL TY

TYPIS T

MO TU R AR Y

EMER E YENTR AC G NC AN E

MA B O K -F S FL O IN L C IR T O R

LB U AOR R O O M

LB U AOR PR E-O P

C U S LI O N EL N R O G O M

L T IF

SA T IR

CA G H N IN GR O O M

S R IC L UG A IC U

O3 T GN C Y AO L G OY O T L B U S IT AORU E T A MA RU IC U ME IC L D A IC U O1 T

SR B CU O2 T SRR E T E IL R O O M

N U IC

RECEPTION
The reception area in the hospital provides a first and help in finding out our requirement. It has a well defined record of patient data and filed charts. The staffs are well efficient in providing the proper guidance.

DEPARTMENTS
Critical Care Critical Care offers integrated multidisciplinary services offering the best possibility of survival to the patients who are acutely ill. A well experienced and qualified multidisciplinary critical care team is available round the clock consisting of critical care specialists, Anesthesiologists and Medical specialists who are ably supported by various other specialists from departments of surgery, neurology, cardiology, radiology, etc. It includes critical care nurses, respiratory therapists, dieticians, social workers and other paramedical support staff. The hospital has over 30 beds divided among highly specialized units; each ICU is equipped with advanced monitoring systems, ventilators and oxygen delivery systems and advanced testing devices and a patient nurse ratio of 1:1. A system of mandatory audits of quality indicators, close monitoring of infection control and drug safety practices and a policy of open disclosure of any adverse event is provided. Periodic training of the support teams on response to emergencies, standardized care through clinical pathways and protocols, effective communication, evidence based practices, ethical principles and cost-effectiveness without compromising on patient safety and quality of care is conducted. Perioperative care Many departments in the hospital depend on the services provided by the Anesthesiology Department for elective and emergency surgeries and procedures Several cutting edge procedures are routinely undertaken such as regional, general, anesthesia for airway surgeries, total intravenous, hypotensive anesthesia and nerve blocks, as well as combinations of these techniques. Some procedures that involve children and many of the procedures that involve airway require special care and skills which the qualified and experienced team equipped with advanced difficult airway adjuncts is adept at handling them. Well appointed post operative care facilities including a paediatric area ensure safety , analgesia and comfort. Emergencies / Codes. The department also provides backup services to the emergency room and also forms an integral part of handling medical emergency calls and is trained and equipped to rescue and handle victims of accidents & disasters. Pain services The department provides therapies for acute and chronic pain for both inpatients and outpatients.

Integrating advanced technologies like patient controlled analgesia, a team approach with physiotherapists and social workers, anesthesiologists target wellbeing and rehabilitation. Transport of critically ill An unstable patient requiring transport to the facility is assured sophisticated and skilled care in the well equipped ambulance making it literally an ICU on wheels.

Dr. Joji Antony (MBBS, MD(Anesthesiology)) Chief Anaesthesiologist

Cardiology

Major services offered: Daily out-patient clinics Medical Intensive care unit of 10 beds with modern amenities Computerised12-channel ECG. Tread Mill Test. Holter laboratory 24 hour ambulatory BP monitoring. Echo laboratory with ECHO/ Doppler study Trans-0esophageal and Stress ECHO Comprehensive Cardiac Executive Check up programs Well-equipped 24 hours Emergency room High-tech 24 hours emergency Cardiac Care ambulance services

Dr. P. Rajagopal (MRCP,FRCP(London),FRCP(Glasgow),FRCP(Ireland),FACC) Senior Consultant Physician Cardiologist

Dental Services (including Sub-specialties)

Major services offered: Dental Implants- Single tooth, multiple teeth Dental care for the diabetics Dental jewellery 9

Cosmetic restorations- Ceramic veneers Crown and bridge restorations and metal-free ceramics Gum management clinic and smile correction Orthodontic correction of malaligned teeth Orthognathic surgeries (Cosmetic facial surgeries) Partial and complete dentures Preventive dental clinic Teeth whitening TMJ pain management

Dr. Johnson Peter (B.D.S, F.A.G.E) Consultant dental surgeon

Diabetology
Major services offered: Comprehensive management of patients with diabetes including children Advanced Diabetes care Evaluation & Management of diabetes related disorders & diseases Evaluation and management of childhood and adult obesity Management of thyroid disorders including thyroid malignancy Evaluation and management of growth and puberty related disorders Management of diabetes related reproductive disorders Comprehensive management of other endocrine disorders in both adults and children Management of diabetes induced osteoporosis and other metabolic bone disorders

Emergency medical services

Major services offered:

Management of acute medical, surgical, cardiac, and pediatric emergencies by a qualified team of Emergency doctors, backed by more than 25 consultants who are experts in their own fields. Modern fully equipped 10- bedded emergency room In-house Registrars in Orthopedics and Anesthesiology (available round-theclock) Care to all trauma victims including poly trauma following RTA's, fall or assault. Poisoning management Management of disasters with a fully prepared Disaster Management Team 10

24 Hours Trauma & Accident Services with state-of-the-art ambulances fitted with ventilators and monitors 24 Hours Diagnostic (Laboratory, X-Ray, CT Scan, EEG, EMG, Ultrasound scan) and Pharmacy Services Four ultra-modern operation theaters and dedicated 30-bedded Intensive Care Unit managed by highly qualified Anesthesiologists and Intensivists. Fully equipped 24 hours Blood Storage Unit Fully Computerized Hospital Information System (HIS)

Dr. Winston Dias (MBBS, FCGP, DTM (Ireland), MRACGP (Australia)) Coordinator, Emergency Medical Service

ENT & Laryngology

Major services offered:

Voice clinic Endolaryngeal surgery &Phonosurgery(surgery for voice disorders) Botox clinic Swallowing disorders clinic Drooling corrective surgery Snoring surgery Head and neck surgery including thyroid & salivary glands Endoscopic sinus surgery Otology & Rhinology division

Dr. Jayanthy Pavithran (MBBS, MS ENT) Associate consultant-ENT & Laryngology

Family medicine
Major services offered: Executive preventive health check ups School Health programs Immunization Clinics Travel Guidance Camps

Dr. Winston Dias (MBBS, DTM, FCGP, MRACGP) Coordinator-Family medicine & Emergency services

Gastroenterology
Major services offered:

Upper GI endoscopy 11

Diagnostic Therapeutic ELV EST Glue injection Stenting Dialation Pneumatic O.G Dialation Lower GI endoscopy Diagnostic Therapeutic Polypectomy Stenting ERCP Diagnostic Therapeutic PEG Laparoscopic surgical procedures Major GI Resections

General & Laparoscopic surgery

Major services offered: Surgical intensive & critical care unit (10 beds) with modern monitoring and supportive facilities to take care of complicated surgical & trauma cases. Modern Surgical Suites with facilities for major open and minimal access procedures, equipped with the latest technology backed gadgets offering patients high levels of safety and comfort Comprehensive General surgical services with high levels of competence in managing trauma and complicated surgical problems Head & neck surgery including thyroid, parotid and neck nodes. One of the few centers offering minimal invasive & sutureless thyroid procedures with short hospital stay and surgery for cancers of head & neck. Breast care programs with clinical and screening facilities. These include imaging like sonography and mammography as well as cytopathology for detection of early cancer. Surgical options for conventional mastectomy with reconstruction, breast conservation in select cases, sentinel node biopsy etc available. Minimal invasive procedures for benign breast diseases also offered. Major gastrointestinal surgeries, painless procedures for piles including stapler anopexy & banding, treatment of fistulas and rectal prolapse undertaken Varicose vein treatment with conventional surgery, minimal invasive procedures & foam sclerotherapy available Comprehensive management of diabetic foot with supportive vascular Doppler and rehabilitation facilities 12

 Hernia management by open and laparoscopic methods with very low recurrences for even the most complicated cases Basic & advanced laparoscopic procedure for appendicitis, gall stones, hiatus hernia, reflux disease, morbid obesity, rectal prolapse, gastrointestinal cancer, spleen and hernia Thoracoscopy for diagnosis, biopsy, empyema drainage and decortications Gastrointestinal endoscopy, upper & lower, for diagnosis and therapy including management of acute bleeds Well trained, competent and qualified staff nurses to take care of inpatients in well appointed rooms with modern amenities Out patient services offered by experienced Consultants Emergency services round the clock with well designed protocols Patient outreach & education initiatives. Dr. Ramachandran T H (MBBS, MS (Master of Surgery)) Chief Surgeon

Internal medicine
Major services offered: Daily outpatient clinics 10 bedded Medical Intensive Care Unit with all modern facilities, closed system run by intensivist with excellent coordination of internists and other specialists. Comprehensive diabetic care facilities incorporating services of qualified dieticians Executive HealthCheckups (comprehensive assessment of health risks, preventive and promotive health care). Specialty Clinics for Hypertension, Diabetes and Anticoagulation.

Dr. Rajagopal (MRCP,FRCP(London),FRCP(Glasgow),FRCP(Ireland),FACC) Consultant

Laboratory Medicine
Major services offered: Pathology Hematopathology Fluid cytology and FNAC Biochemistry Auto analyzer for routine routine & special chemistry Haematology and clinical pathology Complete blood cell count by 3-part analyzer, blood grouping & typing. Coagulation analyzer Urine analyzer Microbiology and serology

13

Bacteriology - culture and sensitivity direct microscopy by gramstain, acid fast stain and fungal smears immunoserology for blood borne viruses , and other common pathogens Auto immune & allergic diseases and immune status.

Dr. Shankari R Shenoy (MBBS, MD Pathology) Pathologist

Neuro Surgery
Major services offered:

Micro Neurosurgery for all intracranial and spinal tumours Trans sphenoidal excision of pituitary tumours Microvasular decompression for trigeminal neuralgia. Surgery for intracranial aneurysms and AVMs. Excision of acoustic neuromas and other CP angle meningiomas. Surgery for congenital malformation including craniosynostosis, Chiari malformations, syringomyedia, myelomeningocoeles, atlanto axial dislocation, basilar invagination. Surgery for peripheral nerve entrapment. Surgery for spinal stabilization Surgery for spinal canal stenosis, spondylolisthesis and intervertebral disc prolapse (including microlumbardissectomy) Cervical micro dissectomy and instrumentation Surgery for Neurotrauma (Head injury and spine injury). Operation Theatre, equipped with state of the art operating microscope, C arm image intensifier and Midas Rex Pneumatic drill.

Dr. Rajesh Nair (MS, MCh) Consultant Neurosurgeon

Neurology
Major services offered:

16 channel Digital EEG machine 4-channel EMG machine for Nerve Conduction Study Electromyography Visual evoked Potential (VEP) study Brainstem auditory evoked potential (AEP) study Somato-Sensory Evoked Potential (SSEP) study Repetitive Nerve Stimulation (RNS) study for myasthenia gravis and other neuro muscular function disorders Video EEG Sleep lab-Polysomnography / CPAP titration Neuro-Intensive Care Unit (12 beds) , stroke unit 14

Comprehensive neuro-rehabilitation for stroke and other paralysed patients Physiotherapy Occupational therapy Rehabilitation Swallowing therapy Speech therapy for speech defects Counselling for Behavioural Disorders Counselling for Epilepsy patients Plasmapheresis Anti-epileptic drug level estimation in blood Spiral CT scanner including CT cerebral angiography, venography and myelography DSA for cerebral circulation study Botox Therapy for movement disorders, spasticity, headache. Thrombolysis for acute stroke.

Nutririon & Dietetics

Major services offered: The Department is staffed with efficient and dedicated dieticians in the areas of clinical nutrition, nutritional assessment, nutrition education, nutrition counseling, and management of many nutrition-related diseases and problems. The therapeutic diet is supplied to the inpatients according to their requirements and this is done under the supervision of the dieticians. The Nutrition and Dietetics Department at KIMS plays a pivotal role in making sure that nutritional care is an integral component of patient care and offers the following services. Individualized diet prescriptions and advice to patients. Critical Care providing special nutritional care . Tube feeds-Rhyles tube, Nasojejunal tube and PEG feeds. It is ensured that each patient's food requirement is fulfilled completely with necessary calories, protein, fat, fibre and suitable nutrients in the feed formulation. Customiseddiet, hygienically prepared and served to all in-patients based on their medical requirements. Diet counseling for clients coming for Executive Diabetic Health Checkup. Ante-natal nutritional counseling for gestational diabetes. Community nutrition programme, talks on food and health, awareness sessions on nutrition. Nutrition support services for corporates and industrial houses. Diet and Nutrition Clinic The clinic provides holistic diet management, which probes into the root cause of the weight disorder and offers scientific methods to attain the ideal body weight.

15

 Initially patients are analyzed about the type, time, quantity of diet followed by patient and diet modification is advised considering the disease and physical activity factor. Counselling is provided for selecting quantity, contents, type and frequency of intake of the food. The clinic caters to Clients with a variety of nutrition-related problems by tailoring a diet to meet individual health needs, such as planning diets for weight management, diabetes, high blood pressure, kidney disease, liver disease, gastrointestinal problems, elevated cholesterol levels, gout and maximizing fitness level. The Clinic helps to identify dangerous dietary habits that may contribute to the development of eating disorders. Obesity Clinic The patients' BMI (Body Mass Index) is calculated and body-fat mass of the patient and metabolic age is assessed by bio impedence. These findings will reveal the facts about whether a patient is normal or obese. Based on the findings, slab reports an individualized obesity control measures are advised for effective weight management. Dr. Leena Saju ((M.Sc, PhD)) Diet Consultant and Nutritionist

Obstetrics and Gynecology

Major services offered:

Breast Clinic Antenatal Clinic Post natal and Family planning Menopause Clinic High risk obstetrics Endoscopic facility Birth suite Transportation facility and care High risk pregnancy and fetal medicine Pre pregnancy counseling First trimister screening Screening for chromosomel anomalies Targeted anomaly scans Screening Fetal Echo Monitoring IUGR babies with fetal doppler Monitoring of MCDA twins Invasive fetal diagnosis like amniocentesis, CVS, cordocentesis and amnioreduction 16

Dr. Safeena Anas (MBBS, MD(Obstetrics&Gynaecology)) Consultant-Gynaecology

Orthopaedic surgery & sports medicine

Major services offered:

Hip, knee and shoulder replacement surgery Hip resurfacing Revision joint replacement Arthritis clinic Complex fracture fixation Pelvic acetabular fracture surgery Poly trauma management Minimally invasive fracture surgery Advanced fracture surgery 24 hours trauma care Keyhole fixation of hip fracture of the elderly Arthroscopic surgery ACL Reconstruction Sports medicine Sports injury management Paediatric Orthopedics Reconstructive surgery for congenital deformities Micro vascular surgery Llizarov limb reconstruction procedure Limb lengthening

Dr. J T Pappanacherry (MBBS, D Orth, M S Orth, MCh Orth (Liverpool)) Coordinator & Senior consultant Orthopaedics

Paediatric surgery
Major services offered:

Antenatal Diagnosis and Counselling General Paediatric Surgery Neonatal Surgery- Diaphragmatic Hernia, Intestinal Atresias, Hirshsprungs Disease, Ano Rectal alformations Thoracic Surgery-Tracheo Esophageal Fistula, Congenital Lobar Emphyssema Paediatric Urology Paediatric Plastic Surgery-Skin Grafting, Contracture Release Minimal Access Surgery-Paediatric Laparoscopy, Thoracoscopy Upper And Lower Endoscopy Paediatric Trauma Surgery

Dr. Sajan K H 17

(MBBS, MS(GENERAL SURGERY), MCh.(paediatric surgery)) Consultant Paediatric Surgeon

Paediatrics
Major services offered:

Comprehensive care for diagnosis and treatment of medical problems in infants and children Well baby check up including accurate assessment of growth parameters, mental & physical development as well as assessment of nutrition status Systematic and modern vaccination program with perfect cold chain maintenance Management of childhood problems including respiratory disorders such as asthma, growth failure & other endocrinology problems, diseases of liver and gastro-intestinal tract, seizure disorders, anemias etc. Evaluation of genetic diseases and genetic counselling Paediatric Nutrition Service Paediatric nutrition clinics on all Wednesdays 1pm - 4pm. Round the clock availability for consultation Preventive and therapeutic counselling for nutritional disorders in children. Nutrition therapy for all forms of nutritional disorders and inborn errors of metabolism Facilities for investigation and management of children with malabsorption.

Dr. Mathew Punnachalil (MBBS, DCH, MD, F.I.C.T.M, M.R.C.P, F.R.C.P.I) Medical Director/Consultant Pediatrician

Physiotherapy
Physical Therapy is concerned with helping people improve their physical function, relieve and control pain and prevent further disability. Trained physioyherapist work on improving strength, joint range of motion, coordination and endurance as a way to improve function. They use a variety of methods, including heat, ice, electrical stimulation, ultrasound, and a variety of manual (hands-on) techniques to relieve pain and optimize mobility. They use a wide range of exercises - passive, active and resistive - to improve movement and strength. Rehabilitation Associates offers expert Sports Medicine evaluation and treatment of injuries. Physical Therapists use cutting edge biomechanical information along with aggressive techniques to prevent injury and to rehabilitate injuries when they do occur. Orthopedics Physical Therapists at Rehabilitation Associates, Inc. treat a variety of orthopedic 18

conditions. Such conditions may result from overuse injuries, trauma, joint replacements, sports related injuries and accidents. Common diagnoses include rotator cuff injuries, neck and back problems, ankle sprains, knee conditions and others. Some of the more common Orthopedic diagnoses and treatments managed and offered include, but are not limited to:

Pre and post surgical care of all orthopedic conditions Postural Training Arthritis Management Back/Neck Rehabilitation Joint Pain Management Headache Management Manual Therapy/McKenzie Treatment Spinal Stabilization Muscle and Ligament Strains and Sprains Myofascial Release Knee/ACL reconstruction Ulnar Collateral reconstruction (Tommy John) surgery Rotator cuff and Labral reconstruction

Neurologic The Neurologic Rehabilitation programs at Rehabilitation Associates, Inc. are designed for individuals with a variety of neurological diseases. A comprehensive, individualized treatment plan is then developed in conjunction with our team of Physical and Occupational Therapists, Speech-Language Pathologists, Clinical Social Workers, Dietitians and consulting Physicians. The goal of the program is to maximize a patients ability to function in terms of communication, cognition and motor abilities in everyday life. Typical diagnoses treated include, but are not limited to:

Multiple Sclerosis Vertigo Stroke/transient ischemic attack (TIA) Parkinsons Disease Guillian Barre ALS Neuropathy Spinal Cord Injury Head Injury Post Polio Syndrome Dementia Headache Huntingtons Disease Myasthenia Gravis Cancer 19

Cerebral Palsy and other disorders of gait and mobility Medical and infectious disease processes which can lead to neurological damage

Plastic, Reconstructive, Microvascular & cosmetic Surgery

Major Services Offered:

Correction of congenital malformations including cleft lip, cleft palate, abnormalities in limbs like hand deformities, finger anomalies, ear & nose abnormalities, post cleftlipnose -defects. Cosmetic surgery including liposuction of abdomen,thighs,chin etc. Abdominoplasty, breast reduction, breast augmentation,Brachioplasty (Arm surgery), thigh lift, Body liposculpturing, botox injection, filler and fat injection, dermabrasion, chemical peeling Management for various tissue defects Reconstructive surgery for hand deformities and injuries. Micro vascular surgery including revascularization and replantation of amputated parts and free tissue transfers. (Dr. Jose Tarayil) Comprehensive care of burns including resuscitation, wound cover, management of contractures etc Management of Primary & Secondary Lymphoedema Scar Management:- medical and surgical management of various types of scars, Hypertrophic scar, Post operative scars, Keloid scars, post burn scars. Management of hyperhydrosis- Axillary and hand)(excessive sweating in the axilla and hand) Facial sculpturing with fat injection- hollow cheek, chubby cheeks etc, breast and buttock augmentation by fat transfer Lip Augmentation by filler injection Correction of protruding ears or large ears or bat ears by surgical setback, repair of large ear holes or torn earlobes & other ear defects Management of facial wrinkles & depressions by botox injection & fillers. Post cancer surgery -reconstruction of excised parts- breast reconstruction after mastectomy, nipple aerala reconstruction , lip, nose, ears-other defects reconstruction Refashioning of female and male Genitalia Treatment of large male breast(gynacomastia) by surgery & liposuction Treatment of sagging breast by mastopexy Management of large tattoos- surgical removal Eyebrows & moustache hair loss (Allopecia) surgical management Treatment of accessory breast + large axillary breast folds that prevents women from wearing sleeveless dresses. Removal of post acne,cheek& face scar by Dermabrasion& scar management Treatment of localised stable vitilligo patches & hypopigmentation by plastic surgery. 20

Surgical excision of corns

Dr. Alexander George (MBBS, MS(General Surgery)MCh (Plastic Surgery)) Consultant-Plastic Surgery

IMAGING SCIENCES
Computed Tomography (C T)
Medical science is constantly studying and evolving newer methods of cure and diagnosis. A quantum leap in this regard has been the development of MULTISLICE CT SCANNERS which can evaluate the various aspects of human body to detect the presence of any abnormalities in the body. It can be used as:

A screening procedure. It is highly accurate and is able to find out normal and diseased coronary arteries with great precision. To study patients with chest pain and to rule out non-cardiac causes. To evaluate coronary arteries after procedures like bypass surgery angioplasty/ stints.

LightSpeed RT

21

World-class technology. Family-friendly care.

The BrightSpeed brings you multi-detector CT capabilities with maximum convenience in an ultra-compact design. Built with LightSpeed VCT technology inside, the BrightSpeed series allows you to perform clinical applications simply not possible with a single slice detector system. All while enhancing your workflow.

Ultra-compact form With the proven benefits of LightSpeed VCT technology inside and a small footprint on the outside the BrightSpeed Series benefits both practitioners and patients. BrightSpeed maintains the optimal speed, power and resolution needed to aid in non-invasive diagnoses from colon cancer to cardiovascular disease. Plus, by reducing the size of many gantry components, it fits in the same space as many singleslice systems. An inspired cockpit Maximum versatility. Ergonomic design. Top-quality comfort. Enhance your system with the optional Freedom Workspace. Innovative hardware and software create a unique, convenient, ergonomic space. Sit/stand flexibility, designed to reduce stress and fatigue, allows you to customize your workspace. Gain new freedom and transform your daily working environment. 22

Patient-focused design Enhanced working conditions for operators can also help them provide excellent patient care.

High Resolution/Low Dose The BrightSpeed Series offers high image resolution up to 0.35 mm isotropic at an optimized dose (3D dose modulation reduces dose average by 40%, short geometry design reduces dose by 26%, and Volara Digital DAS reduces dose by up to 10%). This performance level comes from the HiLight matrix detector and GEs innovative Volara digital DAS, which boosts processing power and reduces electronic noise by 30 to 40 percent. BrightSpeed is likely to change your expectations of image quality. From osteo-articular studies to MIP lung reviews, see what an optimized dose will do for your images. Power to Perform Thanks to Performix tube performance, BrightSpeed offers high power for multiorgan acquisition, sub-millimeter slice thickness and sub-second scanning; outstanding beam quality andexceptional patient throughput. Now enhanced with SmartTube technology, the Performix tube offers improved longevity and reliability.

C-ARM
Model: OEC Fluorostar 7900
This system provides imaging in multiple applications and versatile clinical environments. A pure great images at the lowest dose.Reduce dose with exactness and precision only gained with the confidence of quality imaging. With just one image, in depth diagnosis and intervention can be accomplished through the various image- viewing capabilities of the OEC Fluorostar. concentrate of design, efficiency, and quality imaging.

23

Optimal Workflow
OEC Fluorostar 7900 offers great workflow efficiencies to store, transfer and share images.

60,000 image storage in system hard drive CD Burner for image transfer in bmp or jpeg format USB port for plug-and-play image transfer to your PC Integrated DICOM

Treadmill Test
A stress test, sometimes called a treadmill test or exercise test, helps a doctor find out how well your heart handles work. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart. It also helps doctors know the kind and level of exercise appropriate for a patient

24

A person taking the test

Is hooked up to equipment to monitor the heart. Walks slowly in place on a treadmill. Then the speed is increased for a faster pace and the treadmill is tilted to produce the effect of going up a small hill. May be asked to breathe into a tube for a couple of minutes. Can stop the test at any time if needed. Afterwards will sit or lie down to have their heart and blood pressure checked. Heart rate, breathing, blood pressure, electrocardiogram (e-lek"tro-KAR'de-ogram) (ECG or EKG), and how tired you feel are monitored during the test. Healthy people who take the test are at very little risk. It's about the same as if they walk fast or jogs up a big hill. Medical professionals should be present in case something unusual happens during the test.

Assistive equipments
BP Apparatus Cardiac Defibrillator ECG recorder

DIALYSIS

25

Principle: Dialysis works on the principles of the diffusion of solutes and convection of fluid across a semi-permeable membrane Blood flows by one side of a semi-permeable membrane, and a dialysate or fluid flows by the opposite side. Smaller solutes and fluid pass through the membrane. The blood flows in one direction and the dialysate flows in the opposite. The concentrations of undesired solutes (for example potassium,calcium, and urea) are high in the blood, but low or absent in the dialysis solution and constant replacement of the dialysate ensures that the concentration of undesired solutes is kept low on this side of the membrane. The dialysis solution has levels of minerals like potassium and calcium that are similar to their natural concentration in healthy blood. For another solute, bicarbonate, dialysis solution level is set at a slightly higher level than in normal blood, to encourage diffusion of bicarbonate into the blood, to neutralize the metabolic acidosis that is often present in these patients. There are two primary types of dialysis, hemodialysis and peritoneal dialysis, and a third investigational type, intestinal dialysis. Peritoneal dialysis
In peritoneal dialysis, a sterile solution containing minerals and glucose is run through a tube into the peritoneal cavity, the abdominal body cavity around the intestine, where the peritoneal membrane acts as a semi permeable membrane. The dialysate is left there for a period of time to absorb waste products, and then it is drained out through the tube and discarded. This cycle or "exchange" is normally repeated 4-5 times during the day

Hemodialysis
In hemodialysis, the patient's blood is pumped through the blood compartment of a dialyzer, exposing it to a semi permeable membrane. The cleansed blood is then returned via the circuit back to the body. Ultra filtration occurs by increasing the hydrostatic pressure across the dialyzer membrane. This usually is done by applying a negative pressure to the dialysate compartment of the dialyzer. This pressure gradient causes water and dissolved solutes to move from blood to dialysate, and allows removal of several liters of excess fluid during a typical 3 to 5 hour treatment.

26

In this hospital the machine used for hemodialysis is NIKKISO model DBB 27.

27

The Hemodialysis Machine and Its Parts The artificial kidney, or dialyzer,

It is the main functional unit of the dialysis machine. It purifies the blood. Syringe pump Which is used to inject the anticoagulant at a specific rate. Roller pump Which pumps the blood in an adjustable rate. Other parts you'll find on this machine include: Venous pressure monitor and arterial pressure monitor Which measure the pressure of the blood as it flows through the dialyser. Temperature monitor Which gives a warning if the dialysate solution becomes too hot or too cold.

28

Negative pressure monitor Which indicates any changes in the amount of negative pressure being used to remove excess fluid from your blood. Blood leak monitor Which gives sufficient warning if any of the blood leaks into the dialysate solution through a tear in the membrane of the dialyzer. Conductivity monitor Which measures the concentration of the dialysate solution. Air bubble detector Which detects any air bubbles that might develop during dialysis. Alarms There are visual and auditory alarms to report fault conditions.

Features of the equipment.

* Operation by touch panel with wide color LCD * Various functions for easy and safe operation * UFR calculation * TMP auto-forecast monitoring * Pump discharge precision monitoring * Profile for UF, conductivity * Graphic for piping diagram * Patient data storing * Cleaning program * Purification of dialysate * Micro-particle cut filter * Clean coupling

Room design
* Fully isolated from op * Capacity: 2 patients at a time. * Fully sterile room. * Mains and UPS supplies * Compressed air, oxygen, RO water outlets * Separate data storage system * China coat

29

OPERATION THEATRE
The main requirement of an operation theatre is that it should be spacious. It should never be crowded and must allow easy movement of staff as well as equipment. The doors must be big and must open in either direction. The door must be such that it opens up to 90 degrees. Visual panels can also be provided. The floors must be well maintained. It must be able to withstand heavy loads of the various equipments. It must also be slip resistant in wet conditions. The floors also must be antistatic. The walls and ceilings must be well polished and also designed such that it reflects light in the right amount so as to reduce shadows. Shadow reduction is an important factor that has a serious impact during surgery. There will be an exit bay for the transfer of patient from the trolley to the bed. Then there will be a scrub and gowning room where the patient is prepared for the surgery. The lighting is another important factor. The color, intensity etc are important in this respect. The light must be maneuverable, i.e. overhead lamps etc must be movable so as to point the light in the required direction. Color corrected fluorescent lamps are usually used. Skin tone can be properly distinguished only if the lighting used is proper. Many services are required in the operation theatre. It includes anesthetic gases, temperature control, X-ray, gas supply, lighting control etc. The gas supply includes lines for oxygen, nitrous oxide, air and vacuum. The temperature has to be maintained at an optimum level. All the emergency equipments required must be easily accessible. Sterilization is another important factor. All the equipments used in the operation theatre must be well cleaned and sterilized. This ensures the prevention of any infections. The operation table used is such that it can be tilted either using a motor system or using a handle system. Antistatic rubber mattresses are used. These are removable so that they can be cleaned separately.

Endoscopy
An endoscopy is a procedure in which the doctor uses a long, flexible tube with a light at the end to look into the inside of the body. It is commonly used to check the upper gastrointestinal tract (GIT) including the throat, oesophagus, stomach, and first part of the small intestine (duodenum). The lower GIT can also be examined in a similar fashion, a procedure termed as colonoscopy. The entire procedure is visualized on a TV monitor. In addition to making a diagnosis, endoscopy can also be used to provide treatment as described below. An upper GI endoscopy is done in patients having problems in swallowing, frequent heartburn, abdominal pain, chest discomfort, vomiting especially of blood or abnormal findings on gastrointestinal X-rays. Colonoscopy is performed in patients passing blood in the stools, to check for colon cancer and to remove precancerous lesions such as polyps.

As an alternative to endoscopy, barium contrast X-rays may be done which use a contrast medium (barium) to highlight the intestinal tract on X-rays.

Preparations for endoscopy

The patient has to be fasting for at least 6 to 8 hours before this procedure. Follow any other instructions the doctor gives. A local anesthetic liquid is given before the procedure to numb the throat and prevent gagging and pain. In apprehensive patients, a sedative is given intravenously to allay any anxiety. The endoscope is passed through the mouth and down the oesophagus (food pipe) up to the duodenum. Any abnormality such as ulcers, tumors or inflammation of the mucosal lining of the oesophagus, stomach, or duodenum can be seen. A small piece of a tissue sample (biopsy) can be taken for analysis in the pathology laboratory. After examining the GI tract the tube is withdrawn. The viewed images can be stored on a video cassette or a computer for archival or record purposes. The patient is kept under observation for an hour. A mild irritation or soreness of the throat may be felt after the procedure.

Benefits
Endoscopy helps the doctor to make a more accurate diagnosis of diseases of the gastrointestinal tract. In addition, endoscopy can be used to provide treatment like removing foreign bodies, benign tumors such as polyps, opening up of strictures, removing obstructed gallstones and stopping active bleeding from ulcers or from dilated veins called varices.

Risks associated with endoscopy

This is a safe procedure but as with all medical procedures, there is a small risk involved. The local anesthesia may not be effective and discomfort may be felt during the procedure. Some people may develop an allergic reaction to the local anesthetic or the sedative. There is a small risk of tear of the lining of the throat, stomach, or intestine. There is also a small risk of infection or bleeding. The equipment used in this hospital is named as STORZ-KARL STORZ ENDOSCOPE

Performance characteristics :
*Ergonomically designed control body and remote control buttons for quick procedures and reduced user fatigue *Anti loop connector :up to180 degree axially rotatable connector head improves user safety and maneuverability. *optimum size working channels *a choice of colonoscopy working lengths (1500mm or 1700mm)

*improved tip deflection for enhanced navigation and optimum views.

Technical data
Light source/color temperature : 100W xenon/<=6500K Brightness control /system : automatic/manual(91steps)0/average/peak Color correction : red/blue +/-5 steps Contour enhancement: 4 steps

Equipment specifications
Light source: 100 w xenon bulbs. Light guide: optical fiber

Stretcher
Stretcher is a fully-functional, versatile, and high-quality stretcher designed for use in the ED, OR, PACU, or any other department in your facility.

Features

500-pound patient weight capacity Hands-free hydraulic height adjustment

Ceiling Drop Hose & Hose Retractor

These versatile hose assemblies are manufactured with CGA standard color-coded medical grade conductive hose and attach to standard ceiling outlets. Female Quick-connects allow anesthesia machines equipped with a male Quick-connect, fast access to an oxygen source. Hose retractor can be mounted directly on the ceiling outlet or to the ceiling.).

Electrosurgical Unit: CONMED SABRE Genesis

The CONMED Sabre GenesisTM Electrosurgical Generator are electrosurgical generator with the basic modes of operation being conventional electrosurgical cutting and coagulation. The devices consist of a single electrosurgical generator unit for each model to supply high frequency (I-F) electrosurgical current to accessory hand pieces to produce the clinical effect. When cutting, the subject device provides the energy to the edge of the active electrode which is drawn across the tissue while electrosurgical energy is being applied.

When coagulating, the subject device provides the energy to the active electrode which may be held in contact with the tissue for desiccation or separated from the tissue by distance for fulguration to achieve the desired result.
Intended Use intended for use in open and laparoscopic surgery and in office based surgical procedures. Indications for use General-purpose electrosurgical generator used in conjunction with an electrosurgical accessory hand piece for delivery of RF (radio frequency) electrosurgical content through an accessory electrode for the cutting and coagulation at the operative site. H. Technological Characteristics The technological characteristics of the proposed device are identical to the predicate devices. Any differences represent limitations of previously cleared technology. The device has been designed to comply with numerous applicable standards. Safety Information Questions of safety and effectiveness are the same for this device as they are for the predicated devices and other electrosurgical generators on the market. There are no new technologies incorporated into the device. The device provides alarms for conditions that could pose a risk to the patient. The operator sets the appropriate mode and output settings for the device. Biocompatibility The Subject devices do not have direct patient contact. Performance Testing Where applicable, specific testing pcrformed was in conformnance with the requirements of the following standards: * IEC 60601-1:1998, Medical electrical equipment - 2 "d Ed. plus amendments I and 2 - also representing UL60601I- 1, EN60601-l- , CSA C22.2 No. 6060 1-1 except for national deviations. * EG 60601I-1-1: 2000, Medical Electrical Equipment - Part I -I General Requirements for Safety- Collateral Standard: Safety Requirements for Medical Electrical Systems. * EG 6060 1-1-2: 2005, Medical Electrical Equipment - Part 1-2 General Requirements for Safety- Collateral Standard: Electromagnetic Compatibility - Requirements and Tests. * EC 60601-1-4: 2000, Medical Electrical Equipment - Part 1-4 Medical electrical equipment Part 1-4: General requirements for safety - Collateral Standard: Programmable electrical medical systems. * EC60601-1-6: 2004, Medical electrical equipment - Part 1-6: General requirements for safety Collateral standard: Usability. 1EC60601-l-8: 2005, Medical electrical equipment - Part 1-8: General requirements for safety Collateral standard: General requirements, tests and guidance for alarm systems in medical

electrical equipment and medical electrical systems. * EG 60601-2-2: 2006, Medical electrical equipment - Part 2-2: Particular requirements for the safety of high frequency surgical equipment.L. Subject vs. Predicate Device The subject device(s) are of the same inherent technology and construction as the predicate devices. The chasis and the bezel for the devices are essentially the same dimensionally and are fabricated from the same materials. The subject devices have a universal power supply not found in the predicate devices. Performance characteristics of the subject devices are equivalent to the subject devices and have been verified to meet the requirements above as well as performance requirements defined in design inputs. Design verification and validation activities demonstrated the subject devices to be equivalent where applicable to the predicate devices. Specific differences between the subject and predicate devices are found in the substantial equivalence table.

Operation table

Series ESM1010 versions : ESM1010 5 / ESM10106

Created to satisfy surgical functionality and saving, the Electro Hydraulic Series ESM1010 allows, with the own accessoristics, to satisfy every basic and specialistic surgical activity.
ESM10105 : The table top is divided in 5 sections made of stainless steel and matting HPL which warrants the radiotransparency. ESM10106 : The table top is divided in 5 sections ( including thorax opening ) made of stainless steel and matting HPL which warrants the radiotransparency. The FRAME of the table is realized using only stainless steel The BASE : that warrants the perfect stability of the operating table is completely made in stainless steel and is available on four twin antistatic wheels provided with locking system and wheels position selector. The COLUMN: is telescopic and squared, totally covered by stainless steel; its reduced size allows the best use of Carm. Inside of the column there is the electronic card that controls all the electrohydraulic movements of the operating table. ELECTROHYDRAULIC MOVEMENTS : Up/Down ; Trendelenburg Reverse trendelenburg ; Lateral Right and Left ; Zero table top position. Height adjustment min. 680 mm max. 1.040 mm Trendelenburg 30 Reverse trendelenburg 30 Lateral movement right and left 20 MECHANICAL MOVEMENTS of the operating table: Head section inclination: +40 90 Back section inclination +90 30 Thorax opening 170 mm ( only for ESM10106) Longitudinal translation of table top of about 300 mm OPTIONAL NOT INCLUDED Reset (Automatic zero table top position) TABLE TOP SIZE: approx. 2000 x 540 mm PATIENT SURFACE approx. 2000 x 600 mm including rail sides encumbrance The ACCESSORIES HOLDERS (25 x 10 mm) are in stainless steel also, they cover all the table top length from both sides. The MATTRESSES that cover the table top removable for cleaning, antidecubitus and antistatic, they are independently removable, xrays traslucent and elastic. The TABLE TOP is prearranged for the insertion of xrays holder on all its length. Table top composition: HEAD SECTION: extractible and inclinable ( + 40 90) manual BACK SECTION: manual inclination ( 0 + 90 / 0 30). It allows the users to obtain the back section split . Size: 500 x 510 mm PELVIS SECTION: Size 500 x 480 mm with perineal cut LEG SECTION: divided in two sections independent between them and able to make the following manual movements: Opening of the two sections (right /left) of 0 90 Inclination: + 90 90 both parts are also easily independently extractables. For ESM10106 : THORAX OPENING kidney bridge of 170 mm manually

KEYPAD:

KEYPAD: It is provided with function touchsensitive keys on which is drawed the moved section.The touchsensitive key includes ON/OFF button and standby position. RECHARGE SYSTEM for storage batteries: 2 batteries 12V 9,5 A/h, sealed, free from maintenance. The batteries charge level is visible in a display placed on the operating table base. The batteries charger is electronic and provided with automatic stop at the end of charge. It can make a DOUBLE FUNCTION: recharge the discharged batteries and feeder allowing the operating table to work even if the batteries are totally discharged; this function can be made simultaneously. When the batteries are completely charged the autonomy of the operating tables is of 4 hours of continuous work that corresponds to about 5/6 days of normal operating activity. The OPERATING TABLE WEIGHT is of about 230 Kilos. The OPERATING TABLE CAPACITY is of about 250 Kilos.

The operating table is prearranged with Xrays tunnel for all the table top length without any obstacle from the head

to the legs and provided with a useful radiotraslucent space of more than 420 mm of width. Longitudinal translation of table top of about 300 mm that completely remove the column encumbrance for a maximum use of the C-Arm useful width for use of the C-Arm on the table top: more than 420 mm. OPTIONAL NOT INCLUDED: Divided in four sections (2 up /down right and 2 up/down left): independent between them and able to make the following manual MOVEMENTS: Opening of two sections (rightleft), on gears, of 0 90 Inclination of the two uppers section (rightleft), on the same mechanism, of +90 90; Opportunity of extracting the upper section (right /left) in order to insert other orthopaedical accessories (for more information ask us technical details referring to item A78) LONGITUDINAL TRANSLATION OF TABLE TOP: mechanical movement of about 300 mm that allows the total elimination of column encumbrance. The operating table can be used for orthopedic surgery because the column is prearranged for the insertion of traction group A52/AB and BX02 Bars to be insert in a high position in the electromechanical operating table top Solid structure in stainless steel Opportunity of reaching different positionments for a good traction of upper and lower limbs Free use of C Arc

Instrument stand
Features:

Removable 19 1/8" x 12 5/8" stainless tray Friction-lock height adjustment from 30"-40" 2" conductive double ball bearing casters Compact 4-caster base

Ceiling Supply Unit

By getting devices and supplies off the floor and positioned for easy access directly at the point of care, the ceiling supply unit helps make the most of available workspace. Its ergonomic design facilitates optimal workflow, unhindered patient access, improved hygiene and enhanced safety. It helps you keep cables out of the way. The result is a safer workplace and more comfortable conditions for staff and patients alike. Its at home on the emergency ward, in the operating room, on any ICU or intermediate care unit. A broad range of arm lengths, lift options, media head and columns let you put together the supply unit to meet your individual needs. It features standardised connections and ample load carrying capacity, adding additional consoles, drawers, and other components. Total carrying capacity for lifting or non-lifting versions is 120kg. Depending on media carrier we can choose from a range of different head and columns - the maximum number of electric and gas outlets range from 18-51. A column tube is available in lengths of 1250 and 1500 mm. It features three full-length stainless steel tubes plus horizontal stainless steel rails top and bottom. This allows you to mount equipment on all sides. Its lift system is ideal for situations where vertical positioning is required.

OT Light

Central Illuminace Average pattern sizes Color temperature CRI (Color Rendering Index)

160,000 lux (14,870 fc) 8.5-12" (22-30 cm) 4400K 97

R9 (deep saturated red color index) 96 Heat-to-light ratio (mW/m2-lx) Life 3.15 30,000 hrs

STERIS surgical lighting system with everything needed: high intensity, pure white light high performance suspension high definition video images single-color, phosphorcoated LEDs. They allow the Harmony LED to create a pure white, natural light that provides a crisp, consistent spot that will never cause any of the color fringing or rainbow effects of multi-colored bulbs. High intensity Exceptional deep-cavity illumination Excellent color rendition (CRI)

 Outstanding R9 value for true red color rendition Crisp, adjustable spot size Excellent shadow control Harmony LED delivers 160,000 lux of cool, white light to the surgical field.We pack all of that power into a surprisingly compact LED array, making the lighthead sleek and easy to move. Our patented Surgeon Control puts you in command; adjust the light intensity, spot size, and position, all from the sterile field. Not only does the Harmony LED deliver a powerful, natural white light, each LED is specifically engineered to provide a superior color rendering index (CRI) of 97. But more importantly, we focused on maximizing the R9 value, a specific color rendering index for deep, saturated shades of red. With an R9 value of 96, Harmony LED achieves an impressive 37% improvement over previous halogen technology. Your eyes will see every detail in exposed tissue, in every subtle shade of red, with clarity, comfort and focus. Clarity remains constant with unparalleled shadow reduction characteristics. Our engineers, using diamond-turned tooling (accurate to one millionth of an inch) created a custom profile LED lens that gathers and focuses light. All of the lenses that make up the Harmony LED lighthead are meticulously fitted, precisely aimed and overlapped to achieve a tight, round pattern. Block one LED lens or forty no matter. The surgical spot remains clear and unobstructed with no distracting shadows. An open infrastructure, camera-ready lightheads, and a sleek, modular design provide for surgical suite flexibility. Monitor extension arms come pre-wired with our new Superbundle and include 12 fiber optic cables, 9 coaxial cables, both AC and DC power and communication cables. This extra video capacity supports any current video signal type, from any video vendor, so changing from one video source to another is effortless.

LAPROSCOPIC SURGERY
Laproscopic surgery uses images displayed on TV monitors for magnification of the surgical elements. There are a number of advantages to the patient with keyhole surgery versus an open procedure. These include reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time. The key element in Laproscopic surgery is the use of a scope. There are two types: (1) a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or (2) a digital laparoscope where the charge-coupled device is placed at the end of the scope, eliminating the rod lens system. Also attached is a fiber optic cable system connected to a 'cold' light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm cannula or trocar to view the operative field. The region/part undergoing the operation is usually insufflated, or essentially blown up

like a balloon, with carbon dioxide gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in Laproscopic procedures.

Imaging System:
KARL STORZ IMAGE 1 HUB

The IMAGE 1 HUB is available with an optional storage and printing function. It has an integrated Image Capture Module (ICM) and allows the user to save pictures and videos to a USB stick. A second USB connector on the rear allows connecting a USB printer. The handling is intuitive and self explanatory. Powerful & cost effective documentation system Capture Full HD still images (1920 x 1080) Record videos in SD (MPEG4-format) Intuitive and easy to use Suitable to connect a USB printer (Plug & Play) Functions controllable via camera head buttons

KARL STORZ-Wide View HD(Medical Grade Monitor)

Lighting System: XENON NOVA 300

Product features -Noiseless and low vibration level. -LED life upto 23,000 hours. -Small and cimpact dimensions. -No heat emissions no risk of burning -High light intensity due to 300 watt xenon lamp optimized with KARL STORZ condenser system. -Drip water protected. Specifications Lamp Colour temperature Light outlets Light intensity 300 watt, xenon 6000K 1 infinitely variable

Accessories: 20 1330 28 Spare Lamp, 300 Watt, XENON NOVA 400 B Mains Cord, US version, length 400 cm 20 1340 80 Light Source Adaptor, including heat sink

Insufflations System: STORZ THERMOFLATOR

The KARL STORZ THERMOFLATOR provides a CO2-flow of max. 30 l/min for

keyhole procedures. This flow rate enables a stable pneumoperitoneum when lasers or high frequency surgery units are used, even if secretion or smoke suction is performed at the same time. It comes with gas hose and Yoke.

The mtp gas filter 031122-01 is also available as complete universal set 031222-01 with a total of 3 meters of insufflation tube. When used in combination with the adapter 03182201, the filter can be connected both to high flow devices as well as to all standard insufflation devices. When using the KARL STORZ Thermoflator, the adapter 03192201 functions as a spacer between the filter and the device.

The BM5 monitor boasts 2 IBP modules, 2 temperature modules and EtCO2 on top of ECG, Respiration, NIBP and SpO2. Its 10.4 color TFT screen displays all the vital signs in different colors for easy recognition and enables you to monitor your patient clearly even the most difficult lighting conditions.

Features
* Direct DC (18VDC) input. * Measurement of IBP (2), temperature (2), NIBP, SpO2, EtCO2, ECG. * Battery operation allows for up to 2 hours. * 24 hours of memory capacity. *2 IBP and 2 Temperature probes Built-in recorder generates real time 3-trace data * Compact and Durable: Less than 4Kg including battery

Anesthesia Machine
The anesthetic machine (or anesthesia machine in America) is used by anesthesiologists to support the administration of anesthesia. The most common type of anesthetic machine in use in the developed world is the continuous-flow anesthetic machine, which is designed to provide an accurate and continuous supply of medical gases (such as oxygen and nitrous oxide), mixed with an accurate concentration of anesthetic vapor (such as isoflurane,or servorane), and deliver this to the patient at a safe pressure and flow. Modern machines incorporate a ventilator, suction unit, and patientmonitoring devices. A modern machine typically includes the following components:

connections to piped hospital oxygen, medical air, and nitrous oxide. Pipeline pressure from the hospital medical gas system (wall outlet) should be around 400 kPa (60 psi; 4 atmospheres). reserve gas cylinders of oxygen, air, and nitrous oxide attached via a specific yoke with a Book seal. Older machines may have cylinder yokes and flow meters for carbon dioxide and cyclopropane. Many newer machines only have oxygen reserve cylinders. The regulators for the cylinders are set at 300 kPa (45 psi; 3 atmospheres). If the cylinders are left on and the machine is plugged into the wall outlet, gas from the wall supply will be used preferentially, since it is at a higher pressure. In situations where pipeline gases are not available, machines may safely be used from cylinders alone, provided fresh cylinders are available. a high-flow oxygen flush which provides pure oxygen at 30 liters/minute pressure gauges, regulators and 'pop-off' valves, to protect the machine components and patient from high-pressure gases (referred to as 'barotraumas'). flow meters (rot meters) for oxygen, air, and nitrous oxide, which are used by the anesthesiologist to provide accurate mixtures of medical gases to the patient. Flow meters are typically pneumatic, but increasingly electromagnetic digital flow meters are being used.

one or more anesthetic vaporizers to accurately add volatile anesthetics to the fresh gas flow a ventilator physiological monitors to monitor the patient's heart rate, ECG, non-invasive blood pressure and oxygen saturation (additional monitors are generally available to monitor end-tidal CO2, temperature, arterial blood pressure central venous pressure, etc.). In addition, the composition of the gases delivered to the patient (and breathed out) is monitored continuously. breathing circuits, most commonly a circle attachment, or a Bain's breathing system, which are breathing hoses connected to a anesthesia face mask a heat and moisture exchanger (HME) with or without bacteria-viral filter (HMEF). scavenging system to remove expired anesthetic gases from the operating room. Scavenged gases are usually vented to the atmosphere. suction apparatus

Equipped with 2 vaporizers namely Enflurane and Isoflurane, which can be used alternatively vaporizer has the function of temperature control, flow and pressure compensation with an induction-lamp. and easy to adjust. Flow meter range O2-N2O interlock with high precision O2:0.1~10L/min, N2O:0.1-10L/min, Air :0 1-10L/min

Integrated circuit system: power cutout protection device. UPS rechargeable battery back up 2 hours after mains supply having been cut.

Ventilator
Gas driven electrically controlled, lime switch, volume constant and pressure restriction. Monitor large screen LCD display with high brightness and wide visual angle, microcomputer control, multifunctional respiration monitor, monitoring tidal volume. Ventilatory volume, gas-feeding pressure, airway pressure, respiratory frequency. P-T and P-V waves etc

Safety Device
Alarm upon power having been cut. N2O is cut off automatically if O: is insufficient; alarm upon the excess of upper & lower airway pressure limit and ventilatory volume

Specificatiion
Suitable for: Driving Method: Ventilation modes: Tidal Volume: Max Insp: Respiratory Rate: I:E: Max pressure: PEEP: Sigh Volume: Upper airway pressure limit: Lower airway pressure limit: O2Supply Speed: Continuous work after mains interruption 35L/min~75L/min Adult, pediatrics Gas driven electrically controlled IPPV, SIPPV, SIMV, PEEP 50-1200ml Flow 18L -1~7.0Pa(=5%) 1:0.5,1:1, 1:1.5, 1:2.0,1:2.5.1:3.0 < 6kPa 0.1~1.2KPa not less than 1.5 times of Tidal Volume 1.0kPa ~ 5.4kPa 0.5kPa

PHYSIOTHERAPY SHORTWAVE MEDICAL DIATHERMY IMI - 2573

High power medicol diathermy incorporatinga high power transmitting oscillator Value $ soild state rectifiers; provides R.F.power upto 500 watts for intense deep tissue heating with out discomfort at the surface.Housed in an elegent MOBILE CABINET & designed to meet heavy wosk load ina hospital.

SPECIFICATIONS: *Frequency : 27.12MHz.

*Output. : Continous, maximum:500watts. *Intensity. : Adjustable,in 5 steps. *Electrodes. : One pair Condenser pads with felt spacer & cover. Size:15cm x25cm. *Tuning. *Timer : Manual, with tuning control knob. : 30 mintues timer with Auto-cut.

*Cooling. : With 10cm dia. instrumental fan. *Voltage. : 220-224V. *Accessories. : a, One, pair condensor Pads cable. b, One,Power Main cable. c, Spare Fuses. d, One, Shortwave Test Tube. e, Two Velcro Strap to tie/ hold condensor pads with the body . f,One, automatic voltage stabiliser

MUSCLE STIMULATOR

IMI 2601
The IC based Diagnostic cum Therapeutic unit, suitable taking S.D. Curve is a marvel of electronics. The combination unit produces four different types of stimulating current i.e Galvanic, Interrupted Galvanic ,Faradic & Surged for S.D. Curve plotting and theraprutic use Output is smoothly adjusable from 0-135 volts

SPECIFICATIONS:
*GLAVANIC. : continuous well fillered D.C upto 135 volts for a maximum of 0-75mA load. *INERRUPTED GALVANIC. : Pulse durations 0.01,0.03,0.1,0.3,1,3, 10,30,100,300 m sec . *FREQUENCY. : 6,18,30,PER MINTUE 1,3,5,10,30,50,100 per sec. *SURGED-FARADIC : Faradic pulse of 0.6 m sec durations. Contraction durations : 2-4 seconds. *FARADIC : Comprises of 80 pulse per second, each pulse of 0.6 ms width *ACCESSORIES : Inactive & Active Plate Electrodes.3, Ball tip Electrode with Handle.2 pair, Electrode WIRES.

INTERFERENTIAL THERAPY UNIT IMI 2615

Interferential current stimulation is effective upon the Nerves, Muscles, Arteries and Veins. The current is able to penetrate tissues to a much greater depth, with a soft stimulative effect, thus assuring an exclusive range of applications

SPECIFICATIONS:
Carrier Frequency *Base AMF *Sweep AMF *Spectrum *Therapy Mode *Intensity *Intensity Balance *Out-put *Timer : 2 KHz and 4 KHz. : 0 to 150 Hz. : 0 to 100 Hz. : 3 Position 1) Rectangular 1/1 s. 2) tRAPEZOIDAL 1/5 S. 3) Linear 6/6 S. : 2 pole, 4 pole vector : 0-100 MA continuously adj. : Available. : 3 digit indicater continuously indicates real patient current. : 0 To 99 minutes digital Timer.

ULTRASOUND THERAPY UNIT

IMI 4103

Solid-state, Dual frequency,Dual Head,Ultrasound Therapy unit

SPECIFICATIONS: *Out-put Frequency *Treatment Head . *Out-put Modes *Display *Timer *Power

: Two,1 MHz & 3 MHz. : Therapy HAMMER HEAD, it combines 2cm square & 5cm square Soundheads in ONE : Continous & Pulsed.(Adjustable in 5 % increments). : Digital output display. : Digital, Auto-cut & Beep : 220v. AC. 50hz.

CONTINUOUS PASSIVE MOTION UNIT

IMI - 3141

The CPM is designed for lower extremities (Knee & Hip), to stimulate the healing of cartilage in addition to the reduction of post operative swelling and pain. The solid state circuitry control panel with highly visual LED Digital readouts allows Flexing and Extending a joint through a pre-fixed range of motion and time. Proper fit of Calf and Thigh lengths are easily achieved. The necessary limb support provides a comfortable surface for prolonged contact and are washable in cold water. The light weight unit is constructed

Specifications:
*Flexion Angle *Timer : Digital display of Flextion & Extension Angles. 0 to 108 deg. : Digital Timer upto 99 minuts.

*Angle Adjustment : Two Inching knobs to adjust starting angle. *Speed : Fixed single speed.

*Right or Left Leg can be exercised by little adjustments. *Patient Safety : Patient safety switch provided

LABORATORY
Here all the sample analysis takes place. Room design * The laboratory is situated in the ground floor, which is patients and in patients. * Mains, UPS supplies. * Separate water purifier * Well equipped drainage system *Centralized air condition system. * Separate reception and data storage system. easily accessible to out

The laboratory consist of the following equipments. 1. Hematology Analyzer The machines used here is SYSMEX KX-21 SYSMEX KX-21 The SYSMEX KX-21 is a fully automated hematology analyzer, easily fitting into any laboratory and ideal as a backup analyzer to the Sysmex full differential analyzer system.

Features

Ease of system operation and maintenance - does not require highly skilled personnel Fully automatic sample aspiration, dilution & analysis for 18 parameter test results Compact instrument 'footprint' Daily maintenance is automatically performed at every start up and shut down Suitable for central laboratories, emergency rooms or physician's office laboratories

2.Chemical Analyser Cobas c 111 -Fully Automated Chemical Analyser

The cobas c111 analyzer is a tabletop system designed to set the next gold standard in automated clinical chemistry testing for small laboratories. With key components such as optics, reagents and calibrators taken from larger COBAS Integra and cobas blood gas systems used in reference labs and hospitals, the cobas c111 system joins a family of analyzers designed to deliver consistent results from the smallest to the largest system. The equipment works under the principle of ion selective electrode method. The machine shows the following specifications.

Features
Increased flexibility without sacrificing performance Automated sample and reagent pipeting allows operators to walk away for 45-60 minutes Connectivity options for testing and data management Up to 65 photometric tests/hour and 180 electrolyte tests/hour (85100 tests/hr combined) Onboard capacity for up to 17 tests at a time (3 ISEs & 14 photometric tests) Convenient and easy to use Intuitive user interface simplifies use for different skill and access levels Continuous loading and unloading of virtually any sample tube or cup

 Cooled, exchangeable reagent disks make loading flexible and efficient Software-driven operation for minimal maintenance and maximum uptime

Extensive menu

Currently more than 30 assays, with more planned for release in the near future Covers the basic and comprehensive metabolic panels, electrolyte and lipid panels, hepatic and renal function panels. Includes innovative tests such as whole blood Hb 3. Urine tester The machine used here is Roches Urisys 1100

The Roche Diagnostics Urisys 1100 Urine Analyzer is a semi-automated analyzer intended for in vitro semi-quantitative determination of urine analytes. The analyzer is designed to read and evaluate the results of Chemstrip 10MD*, Chemstrip 7, and Chemstrip 5 OB Urine Test Strips which are multiparameter strips used for the determination of specific gravity, pH, leukocytes, nitrite, protein, glucose, ketones, urobilinogen, bilirubin and blood in urine. It is a reflectance photometer. It reads the urine test strips under standardized conditions, saves the results to memory and outputs them via its own built-in printer and/or serial interface. It standardizes urine test strip results by eliminating factors known to affect visual evaluation of urine test strips, such as; variable lighting conditions at the workplace, individual skill levels at matching test strip pad colors, failure to keep the prescribed testing times, and clerical errors.

PROCEDURE 1. The test strip is placed on a sliding tray, and a stepping motor moves it under the reading head, which remains stationary. 2. The analyzer reads the reference pad, followed by each of the test pads on the strip. The reading head contains LEDs that emit light at various wavelengths. Reading is done electro-optically as follows: The LED emits light of a defined wavelength onto the surface of the test pad at an optimum angle. The light hitting the test zone is reflected proportionally to the color produced on the test pad and is picked up by the detector, a phototransistor positioned directly above the test zone. The phototransistor sends an analog electrical signal to an A/D converter, which changes it to digital form. The microprocessor then converts this digital reading to a relative reflectance value by referring it to a calibration standard. Finally, the system compares the reflectance value with the defined range limits (reflectance values which are programmed into the analyzer for each parameter) and outputs a semi-quantitative result. Each test pad is read photometrically after about 55-65 seconds. In strongly alkaline urine samples, the system automatically corrects the result of the specific gravity test. The following is a list of test principles specific to each parameter. Specific Gravity: In the presence of cations, protons are released by a complexing agent in the test pad. The indicator bromthymol blue changes from blue via blue-green to yellow. pH Test: The test pad contains the indicators methyl red and bromthymol blue. These indicators give clearly distinguishable colors over the pH range of 5 to 9. Colors range from orange through yellow and green to blue . Leukocyte Test: Granulocytic leukocytes contain esterases which catalyze the hydrolysis of an indoxylcarbonic acid ester to indoxyl. The indoxyl formed reacts with a diazonium salt to produce a purple color. Nitrite Test: Nitrite, if present, reacts with an aromatic amine to give a diazonium salt, which, by coupling with a further compound, yields a red-violet azo dye.3, 4, 5 Protein Test: The test is based on the color change of the indicator 3, 3, 5, 5-tetrachlorophenol-3, 4, 5, 6-tetrabromosulfophthalein in

the presence of protein. A positive reaction is indicated by a color change from yellow to light green/green.6, 7, 8 Glucose Test: Glucose detection is based on the enzymatic glucose oxidase/peroxidase (GOD/POD) method. The reaction utilizes the enzyme glucose oxidase to catalyze the formation of gluconic acid and hydrogen peroxide from the oxidation of glucose. In turn, a second enzyme, peroxidase, catalyzes the reaction of hydrogen peroxide with the chromogen tetramethylbenzidine to form a green dye complex. A positive reaction is indicated by a color change from yellow to green.9,
10

Ketone Test: Based on the principle of Legals Test, sodium nitroprusside and glycine react with acetoacetate and acetone in an alkaline medium to form a violet dye complex. A positive result is indicated by a color change from beige to violet.11, 12 Urobilinogen Test: Urobilinogen is coupled with 4-methoxybenzene-diazonium-tetrafluoroborate in an acid medium to form a red azo dye.13 Bilirubin Test: The detection of bilirubin is based on the coupling reaction of a diazonium salt with bilirubin in an acid medium. The reaction yields a pink to red-violet color proportional to the total bilirubin concentration.14 (Some users may describe this as a cream to peach color.) Blood Test: Hemoglobin and myoglobin, if present, catalyze the oxidation of the indicator by the organic peroxide contained in the test pad. Intact erythrocytes hemolyze on the test pad and liberate hemoglobin, which produces a green dot. Since the test pad absorbs several microliters of urine, more erythrocytes become visible than would correspond to 1L.15-19 Separate sets of color blocks are representative of erythrocytes and hemoglobin. Scattered or compacted green dots on the yellow test pad are indicative of intact erythrocytes, or myoglobin. Compensation Pad: The compensation area is not impregnated with reagent. This pad allows the instrument to compensate for the intrinsic color of urine, which may affect test results. 4. Blood Coagulation Analyser:Trinity Biotechs KC4 Delta

KC4 Delta is a semi automated coagulation analyser with a four test position providing operators with a compact easy to use system. KC Delta series instruments use micromechanical clot detection technology for clotting assays. In combination with KC4 Delta, Tcoag provides a reagent portfolio as a comprehensive solution to your choice in Haemostasis. Technology Gold standard micro volume chronometric detection Pipette auto start testing LCD display and optional printing of results Incubation area for 8 samples and 5 reagents Programmable test modes, single or duplicate testing Measuring Features Pre packed single micro cuvettes with ball bearing for easy loading Store reagent ISI values for automatic INR calculation including calibration curves Preparation area for 12 sample and 4 test positions to perform all clotting assays Suitable for STAT and routine testing Test menu for PT, aPTT, fibrinogen, factors Maintenance free operation

Centrifuge
The machine used here named as REMI

The centrifuge is used for separate the blood cells.

Principle: Centrifugal force

Specifications
1 Step less speed regulator. 2 Safety lid interlock to prevent cover opening during centrifugation. 3 Digital speed meter and0-60 minutes digital countdown timer. 4 Dynamic break for quick deceleration. 5 Imbalance detector with cutoff. Technical Data Maximum speed :4400 rpm Maximum capacity :200 ml Width x depth x height :330 x 370 x 295mm

Mini Rotary Shakers

New Design of Bench Top Rotary Shakers provides gentle mixing of fluids in test tubes & glass vessels of different capacities upto 1000ml. These shakers find applications in pathology, microbiology, chemistry, molecular biology & biotechnology. Model RS-12 R has a built in speed regulator with maximum speed of 180 RPM and it is useful for serological, VDRL tests and other tuned clinical diagnostics procedures.

RS-12R DX has additional feature of digital speed meter and speed regulator. Supply 230 Volts Single Phase 50 Hz. AC. Salient features: 0-15 Minutes digital countdown timer. 0 60 minutes platform with adjustable rollers Digital timer of 15 minutes duration. Platform Size: 8 x 11 Specifications: Overall dimensions: 270 x 260 x 125 mm ( W x D x H ) Power supply: 220-240V, 50Hz. Single phase

Cyclomixers CM-101
Variable speed mixer to eliminate hand mixing. Holding tube against vibrating rubber cup does rapid mixing of contents. Speed regulator controls the degree of vibration. A unique touch feature operates the unit when the tube is pressed on the rubber cup.Interchangeable adaptors greatly enhance the use of Cyclo Mixer for mixing in different applications. Adaptor (CM-01/01) for mixing upto 18 Micro tubes( 6 x 0.5 ml, 6 x 0.4 ml, 6 x 1.5 ml) Adaptor (CM-01/02) useful for tube, bottles or flasks upto a maximum capacity of 250 ml.

Micro Centrifuges

RM-12C These Centrifuges are ideal for growing routine application in biochemical and clinical labs, for Hematrocrit, Corpuscle Percentage contents in preblood, serum analysis and precipitate separation etc. The unit has digital speed indicator and 0-15 minutes digital countdown timer. Salient Features: Stepless speed regulator. Safety Lid interlock to prevent cover opening during centrifugation. Digital speed meter and 0-15 minutes digital countdown timer. Press Switch for quick acceleration to full speed.

Microscope: LABOMED-Vision 2000

Observation Head :-Binocular, smoothly adjustable okular tubes for interpupillary distance having graduate scale. One of the okulars provides with focussing sleeve for dioptric adjustment. All Prisms are made to high optical accuracy. Anti-fungus coated. Co-axial Focussing System:- A novel four stage reduction gear system sliding smoothly on ball bearing guideways which provides the highest degree of sensitivity free from BACK-Lash in operating the fine focussing of Optical system. Slow motion knob graduated showing 1 Div=0.002 mm

Tension Control Ring:- Enables you to adjust the tension on foccusing knob-takes care for life long problem of loosening or slipping of stage block due towear and tear. Revolving Nose Piece:- Quintuple -precisely built on ball bearing to provide life long smooth rotation with colour-coded rubber grip. Brings each objective to a perfact position every time for common field centre with a built in positive click stop. Sub Stage Condenser:- N.A. 1.3 with Aspheric Lens system to provide optimum illumination. Slideing Filter. Up & down movement through Rack & Pinion. Slot for upgradation to Phase Control Observation. Mechanical Stage:- 'Soft Feel' Low Drive Mechanical Stage with Sophisticated Ball Bearing slides for fractionaless and jerk free movement. Modular & Rigid Co-axial control stage in extra large size (125x120 mm). Low position co-axial control control provide on right hand side for complete operational conveience. Range of Movement is 76mm in X- and 45 mm in y-axis with vernier scale reading to 0.1 mm. Extra Large Base :- To suppert the robust arm, has built in illumination system with switch mode power supply (SMPS) with soft start and continusaly stable out-put fuctioning as built CVT with plastic cover and hand rests for ease of operation. Quick change bulb provision.It overcomes problems of voltage fluctuation from 180V to 260V and thus saves your bulb's life. Optics :- DIN SEMI PLAN (SPL) 4x,10x,40x(SL) and 100x(SL) Oil Imm. Eyepiece :- Extra Wide Field 10x (18 mm) with high eye point.

Shimadzu AY 220 Analytical Balances (non-Unibloc)

AY Series offers all the important features of an analytical balance.Motor-CALThe motor-driven internal calibration weight allows calibration at any time with a single keytouch.Built-in clockMeets with GLP/GMP/ISO9000 requirements.WindowsTM Direct

functionAnti-vibrationCompact body with a spacious weighing chamberDoors open wide in three directions.Level adjustment with easePiece counting function is standard.Ready for specific gravity measurements.Unit conversionMeets demands of jewelry and gold weighingOptional external battery is available.

Electrolyte Analyser :Rosche AVL 9180

Stand-alone electrolyte analyzer Measures 5 parameters, i.e., sodium, potassium, chloride, calcium and lithium Low sample size Sample type - whole blood, serum, plasma, urine dialysape, aqueous stds, qc Sample application - syringe, sample cup, collection tubes, capillary Fast analysis time

Features

Fully au Single reagent SnapPak - All reagents and waste in a single pack for simple loading and single disposable Well proven reliable technology

Customer Benefits

Simple operations Easy to use and train Low maintenance and high reliability tomated callibration

Variable Volume Pippette

Thermo Fisher Scientific Inc., the world leader in serving science, today announced the Thermo Scientific Finnpipette F3 Series, further extending the Finnpipette product family. This entry-level series includes eight single-channel models covering 1 l to 10 ml, as well as nine fixed-volume pipettes (1 l to 1 ml) for assured versatility. Offering superior accuracy and the highest levels of pipetting precision, this series of pipettes is ideal for clinical, government or educational use. Adding the F3 series completes the full range of Thermo Scientific Finnpipettes. Each color-coded Finnpipette features a revolutionary double-action pipetting push-button. The rotating upper part of the push-button is designed to prevent any accidental volume alterations while pipetting. The Advanced Volume Gearing Mechanism allows superior volume precision to two decimal places. The Finnpipette F3 Series incorporates a range of novel ergonomic features to minimize the occurrence of repetitive strain injury (RSI). The handle softly contours the shape of the users hand, and the improved widesupportive finger rest allows the user to relax their hand between pipetting actions. The smooth round-shaped tip ejector is safe to use with gloves and the wide top permits easier tip ejection. The larger display makes the numbers easier to read and allows volumes to be set quickly, so the researcher can focus on their work. As the latest addition to the Finnpipette product family, the new F3 Series is compatible with most common tips, which are available as standard, sterilized racked or refill kits

Colorimetre: AIMIL Photochem

Light from a broad spectrum LED is focused through an unique optical system a filter and test tube to the photocelL Output from the photocell is fed into an amplifier and the output of the amplifier to the Digital Panel Meter (DPM). A set of filters, enabling a wide range of analytical tests, are mounted on a turret so that the required filter can easily be selected. The amount of light falling on the photocell is controlled by a variable aperture disc for adjustment of full scale. The operation of the unit is very simple, the user needs to adjust display 0.00 OD or 100%T with blank and then take the reading of the identified standard / sample. The microprocessor based unit when opted for, provides multiple facilities within the same compact size with Auto Zero facility.

Salient Features:
. Smallconvenient, sample size of 1ml only . Longlifebroad spectrum LEDlight source . Veryfew controls for ease of operation . Compact space saving design . Available various digital models:
Photochem 5 filter, Photochem 8 filter, Photochem 8 filter mains/battery, OD only. Microprocessor based Photochem 8 filter with Auto Zero facility / OD/T / c.

Applications:

. Biochemistry
. ClinicalLaboratory . Pathology . ClinicalPathology . WaterAnalysis . ChemicalAnalysis . SoilAnalysis . Metallurgy

STERILIZATION DEPARTMENT
This department is responsible for sterilization of all hospital equipments; storage and supply. There are two methods which are used in Sunrise hospital- Gas and Steam.

Steam Sterilization
There is a double chamber auto claver which is operated 134oC or 121oC. The materials are either wrapped or unwrapped depending on its nature. The equipment used is the

Yorko Horizontal Autoclave. The equipment has two functional block. One block is used for producing the steam and other is the double chambered autoclave. The autoclave block has two pressure gauges; one for the inner chamber and other for the outer chamber. There is also a temperature to keep the temperature in check. There is a safety valve to let out the steam incase the pressure exceeds the safe limits. Sterilization begins only after the apparatus achieves optimum pressure and temperature. Plastic, rubber and sharp instruments cannot be sterilized by this method. In the case of plastics and rubber it is the high temperature which can cause it to soften or melt. The increased rate of carbonation which makes the sharpen instruments blunt. Autoclave Gauges (temperature and Pressure)

The 69 autoclave series is designed to cover a large field of applications for hospitals, CSSD and medical centers. The autoclave series has a chamber volume ranging in size from 510 to 1010 liters. The autoclave operates with saturated steam as the sterilizing agent with a temperature range of 105 C (221F) to 137 C (279 F) and a working pressure that meets AMSE and PED requirements. Each autoclave model is available with either single or double door. The 69 series is available with two door options: Fully automatic horizontal sliding door Hinged door with automatic locking

Safety Door Safety

The doors are designed with independent mechanical and digital safety features that guarantee a safe working of the sterilizer. A safety device prevents the operator from opening the door when chamber is pressurized

Steam is not allowed into the chamber when the door is open A cycle will not start if the door is open or not properly closed The door cannot open until chamber pressure reaches room pressure Sliding Door Safety -The sliding door progress will automatically stop if an obstruction is detected Double Door Safety interlocks prevent both doors from being opened simultaneously

General Safety Features:

Double Independent Monitoring: The combined digital and mechanical monitoring provides a cross reference and guarantees accurate results. The operator has two independent means to monitor temperature and pressure. Safety Valves: Both the chamber and the jacket are equipped with safety valves if the pressure exceeds the allowed limit the safety valves will discharge. Built-in Steam Generator Safety: A water level monitoring system maintains a constant water level and ensures safe operation of the heaters. Emergency Shut-Off: Easily accessible emergency switches for immediate and safe shut down of the sterilizer.

Autoclave Chamber

Gas Sterilization
The gas used is ethylene oxide. It is a highly toxic, so it must be dealt with great care. The operating temperature is 50oC, hence plastic and rubber items can be sterilized using this method. One kilogram of gas is used for a complete cycle. The items to be sterilized are placed on a special sheet. One side is micro porous paper and other is plastic. The processing time is around 8 hours. First vacuum is created and only after this the gas is introduced. The gas is maintained for about 6 hours during which actual sterilization is taken place. After this the gas is flushed out. The time between successive sterilization is about 24 hours. This is a safety measure in order to remove all toxic residual gases

Gas Sterilization Control Panel

GAS SUPPLY SYSTEM

OXYGEN GAS SUPPLY SYSTEM

The main gases administered to the patient include oxygen, nitrous oxide, vacuum and compressed air. Centralized gas supply system is used in hospitals. The cylinders for oxygen supply are of black and white color. Back up cylinders are provided. The duration of cylinders usage depends on the usage rate.

NITROUS OXIDE SUPPLY SYSTEM

Nitrous oxide is used as anesthesia. The requirement of nitrous oxide is less required. So the number of cylinders required is less. The cylinders are of blue in color.

PRESSURE REGULATOR The pressure regulator is used to maintain the pressure of oxylen at 4 bars of pressure. VACCUM PUMP

Whenever required the pump is used to provide vacuum for use in suction machines.

ELECTRICAL SYSTEM
Electrical energy is an essential source of power around which almost every function of hospital revolves. Electrical energy is required to operate every equipment in a hospital, for the functioning of sterilization department, refrigeration and laundry. The substation consists of a 3 phase transformer of 400kv capacity and is of winding type. Unipower transformer of 11KV is used. When there is any interruption of power two emergency generators each of 200KVA provides electrical energy. UPS is used when interruption of power even for few seconds cannot be recommended. Supply to chillers, patient rooms, ICU are given from here thorough different panels.