On the occasion of the 70th Republic Day on 26.01.2019, Smt. Kanchan Rakeshkumar, President,

Sneha Opportunity Services & Neyveli Ladies Club, Smt. Devahi Thangapandian and Smt. Shanthi Vikraman,

Patrons of Neyveli Ladies Club visited NLC India Hospital, distributed fruits and sweets to the

in-patients and wished them a speedy recovery.

Sincere wishes for a speedy recovery

Vol. IX Issue V April 2019

CREATING WEALTH FOR WELLBEING

NLC INDIA

2

Dr Ratanlal Rajesh Agarwala

Orthopaedic Department

LOWER BACK PAIN

Why is lower back pain such a common problem?

What are some common causes of lower back pain?

Arthritis of the Spine

There are three major lifestyle factors that may

affect your chances of developing lower back

pain : Multiple studies have established a link

between smoking and lower back pain.

Smoking raises inflammation inside the body

and hinders the body from healing itself.

Lower Back Pain: What could it be?

Your level of physical activity can also play a

role in your lower back health. While a sedentary lifestyle could

increase your risk of developing lower back pain, so can excessive

or strenuous physical activity. Check with your doctor if you are

unsure about your ideal level of physical activity.

Arthritis of the spine — the slow degeneration of the spinal joints — is

the most frequent cause of lower back pain. All of us experience

wear and tear as we age, and it is normal for your lower back to start

acting up as you get older. As the cartilage breaks down between

the spinal joints, surrounding tissues may become inflamed. The

inflammation and the thinning of cartilage increase friction in the joints,

which may cause pain in the lower back.

Back Injuries

Do you have lower back pain? You are not alone. Anyone can

experience lower back pain at any time, even if you don’t have a prior

injury or any of the risk factors. It is not always serious and can often

get better on its own. But in some cases pain is your body’s way of

telling you that something isn’t right.

A bad fall or a car accident can cause a lower back injury. But so can

Lifestyle factors

The bottom part of your back typically has just five vertebrae — fewer

than your neck and mid-back. And these vertebrae do a lot of heavy

lifting! Your lower back is where your spine connects to your pelvis,

bearing the weight of your upper body. This area experiences a lot of

movement and stress, which may lead to wear, tear and injuries.

Obesity is also associated with several types of

chronic pain, including lower back pain.

In people with high body mass index (BMI), the

stress on the spine increases, contributing to

even more wear and tear.Lower back pain can be related to cancer. In

fact, it is one of the first symptoms of prostate

cancer when it metastasis and creates lesions. Almost any cancer can

spread to the back and some, like sarcoma, can originate in the back.

Be cautious, especially if you are experiencing other symptoms

besides lower back pain. Talk to your doctor if you have additional

symptoms or concerns.

Once you know which motion or position causes your lower back pain,

try to avoid it and see if you get better. Icing the painful spot can also

Lower back pain can radiate to other parts of the body: up or down

from its place of origin. Sometimes lower back

pain can be on one side of the back, which is

also normal. If the pain is shooting from the

lower back into one or both legs, it could be

sciatica (nerve pain), but it’s not always the

case. There are many parts in the lower back

that may cause the pain to radiate into the legs,

such as facet joints, sacroiliac joints, muscles or

inflammation of the bursa.

Herniated Discs

A herniated, or bulging, disc is a disc that has “spilled out” of its lining.

This happens most frequently in the lower back. The injured disc may

not always hurt. But even if it’s painless, its contents can press on or

irritate nearby nerves, causing pain in the lower back and other areas.

carrying a bucket up the stairs. Some back injuries can be sudden and

traumatic, and some happen slowly over time. You may think that

athletes and active people get injured the most due to their active

lifestyle. “But this is not always the case. You are just as likely to tweak

your back while bending over to pick up a sock from under the bed.

It’s the everyday tasks, like holding a child that may lead to back

injuries when done improperly.

What does it mean if lower back pain is shooting into legs?

Can lower back pain be a sign of something

serious like cancer?

What can I do for low back pain at home?

If your lower back pain has just started, the best thing you can do is

rest and record your symptoms, times, dates and which activities

trigger the pain or make it worse or better. Take this information to your

doctor if the pain doesn’t resolve on its own. It will make diagnosing the

cause much easier.

3

help. And so can over-the-counter pain relievers

that help reduce inflammation. Just remember that

pain killers treat only the symptom — pain — and

not its cause.

When should I see a doctor if I have lower back

pain?

In many cases lower back pain stops on its own.

But if it doesn’t, here are some guidelines on when

you may want to start seeking professional help:

● If the pain lasts four weeks or longer

● If the pain keeps getting worse as time goes by

● If you are experiencing other symptoms, such as fever, major

weight loss or weight gain, loss of function or weakness in extremities,

bladder problems, etc.

Who should I see for lower back pain?

Your primary care physician knows you best and should be your first

contact for lower back pain. If he or she is unable to diagnose or treat

● Diagnosis specific exercises

● Refer to Orthopaedic & Spine Specialist

● Thorough History

● Prescription for Physiotherapy

● Surgery if needed

● Get help at our Orthopaedic OPD.

Comprehensive approach to lower back pain

The good news is that surgery is rarely needed for

lower back pain. “Only about one in ten patients

needs lower back surgery.”

● X ray and Biochemistry Tests

● Physical Examination

the issue, you may get referred to a specialist.

These specialists practice a comprehensive

approach to lower back pain, and can diagnose

and treat a variety of conditions that have lower

back pain as a symptom.

Contd. from page 2...

Blood Cell Counts

Red Blood Cells are the oxygen

carrying cells using Hemoglobin to

hold the oxygen until it is exchanged

for carbon dioxide. Hematocrit is a

measure of the volume of whole blood

taken up by the red blood cells and

expressed as a percent. MCV, MCH, MCV and RDW all reflect the

size, shape and contents of red cells.

White Blood Cells (WBC) represent the body’s immune system and

the various kinds of white cells have specialized functions.

Lymphocytes are mainly for defense against virus and cancer cells,

while Polymorphs are primarily defending against bacteria.

Monocytes are the second line of defense and finish the job started by

the lymphocytes and polymorphs.

They are seen in higher numbers when

there is infection or inflammation.

Basophils primarily function as clean

up for a l lergy react ions and

Eosinophils perform a service when

toxins, allergens and parasites attack.

Platelets are special cells in the blood that help form clots when repair

is necessary.

A microscopic examination is used, if indicated, to confirm suspicious

findings of the basic urine analysis.

Urine analysis

(Concluded)

The urine is analyzed to determine a number of things including how

concentrated it is through Specific Gravity, which tells us how

“heavy” it is compared to water. The pH is very important because it is

a good measure of how acidic or alkaline the tissues of the body are.

WBC Esterase tells us whether there are white blood cells in the urine

and Occult Blood indicates the

presence of blood (may be due to

menstruation). Nitrite is a sign of

infection, while Glucose in the urine may

indicate diabetes. Ketones can also

indicate diabetes, but may be due to a

low carbohydrate diet or fasting. Protein

may “leak” through the kidney and show

a possible weakness in that organ.

Bilirubin is normally eliminated through

the bile and its presence in the urine

may be an early sign of liver problems.

Urobilinogen is a by-product of intestinal

activity and may suggest a lack of proper bowel flora.

High WBC count Low WBC count

Dr Srinivas Suyam Prakash

HOD/Pathology

UNDERSTANDING A BASIC LABORATORY REPORT - III

(Continued from previous issue)

4

Ocular examination by slitlamp revealed an undulating vermiform

mass by a live worm on the temporal quadrant of left eye under bulbar

conjunctiva at the fornix with localized congestion. Rest of the ocular

examination was with in normal limits and her uncorrected visual

Abstract

Ocular zoonotic infections by filarial worms are not uncommon. Most

of them are caused by the genus Dirofilaria. The disease is zoonotic in

nature; sporadic cases of human dirofilairsis have been reported from

various parts involving eyes, face, chest wall and lung parenchyma.

CASE REPORT

A 47 year-old lady presented with complaints of severe pain over left

orbital region and irritation of left eye since last two hours on

3rd January 2019 around 3.30 pm to the EYE OPD, NLC India

Hospital. History of travel from her native place from Pollachi 10 days

back where she gave history of contact with pets like dogs and cats in

her farm. She also mentioned that she had injury of an insect (vellai E)

in her left eye which recently migrated after Kerala rains.

We report a case of subconjunctival dirofilariasis in a 47 year old

female who had foreign body sensation and severe pain in left eye.

Thus early diagnosis and treatment in this patient helped in preventing

various serious ophthalmic complications.

Condition of eye on 1st Post op day Condition of eye on 3rd Post op day Condition of eye on 7th Post op day

acuity was 6/6 in both eyes.

The haematological and biochemical test results were normal and

no microfilaremia was seen in blood smears. When the worm was

coiled the patient was asymptomatic and when it started moving it had

produced immense intolerable pain.

Patient was reviewed every week for a month. She was started on

tapering topical Antibiotic steroid eye drops to treat the allergic

reactions produced by the dirofilarial worm.

Surgical removal of the worm was carried out immediately under

topical anaesthesia. Symptoms resolved immediately following the

surgical removal of the worm.

Grossly the worm was intact on extraction, without damaging its

structures a whitish motile worm of 20 cms in length by 0.5 mm in

breadth was removed and preserved in 10% formalin for identification.

Ocular Dirofilariasis may progress to serious consequences like

damaged vision, floaters, glaucoma, retinal detachment, vitreous

opacity, loss of visual acuity and even blindness.

This case was diagnosed much earlier in the disease process even

before the complications occurred and was treated and relieved of

pain within one hour of diagnosis at our NLC India Hospital.

Dirofilarial worm preserved in 10% formalin container

Surgical removal under topical anaesthesia

Dirofilarial worm seen in conjunctiva (Pre op)

OCULAR DIROFILARIASIS

Dr Rathnakumar

Ophthalmology Department

The event was witnessed by Shri S.R. Sekar, CGM/TA, Dr. M.K. Jha,

CGS/Medical i/c, Dr. Venmal Devi, CMO/Medical and also incharge of

Laundry Unit, Doctors, Para Medical Staff and employees of Medical

Branch.

Shri R. Vikraman, Director/HR, NLCIL commissioned an automatic

and a semi automatic heavy duty washing machines at the laundry

unit of NLC India Hospital on 23.02.2019. These automated

equipments, with a capacity of 25 kg each, purchased at a cost of

Rs.12.50 lakh replaced the 15 years old manual washing machines.

Shri R. Vikraman, Director/HR, NLCIL inaugurated the Electronic Token

System facility at the Pharmacy of NLC India Hospital on 23.02.2019.

The new facility, installed at a cost of Rs.1.50 lakh enabled to streamline

the crowd in the pharmacy and to speed up the drugs disbursement.

This facility also gives a great relief to both pharmacists and patients

as the waiting time is considerably reduced in the counters.

Dr. M.K. Jha, CGS/Medical i/c and Dr. J. Ilango, ACMO, Incharge of

Pharmacy, Pharmacists and employees of NLC India Hospital

witnessed the event. After commissioning the new facility, Director/HR

gave valuable suggestions to improve the drug issuing system.

While NLCIL observed Swachhta Pakhwada (Clean India Fortnight)

between 16.08.2018 and 31.08.2018, NLC India Hospital also

observed it in an effective manner. An exclusive Committee was

constituted by Dr. M.K. Jha, CGS/Medical i/c, and the event was

organised in a systematic way. Apart from cleaning activities in

Hospital premises and school areas, the NLC India Hospital team

created awareness on cleanliness among general public, students of

Neyveli Township and nearby villages in a planned manner.

NLCIL is encouraging the units / factories / offices that are

well-maintained, by presenting awards and this time, significantly,

the team NLC India Hospital won a special award and a certificate

of appreciation in the offices category. Shri V. Thangapandian,

Director/Power and Smt. Devahi Thangapandian presented the

special award and certificate to Dr. M.K. Jha, CGS/Medical i/c and

the team NLC India Hospital during the Republic Day Celebrations at

Neyveli on 26.01.2019.

5

HOSPITAL DIARY - Q4/2018-19

New washing equipments commissioned

Electronic Token System introduced in NLC India Hospital Pharmacy

Clean efforts brings commendation

6

NLCIL Education Dept., has organised a ‘Parents Counselling Programme’ for the parents of +2 students at NLCIL Boys’ Higher

Secondary School, Block-10, Neyveli on 29.01.2019. Dr.S.Narmadha, an eminent counselling Psychologist from Neyveli addressed about

200 parents. Shri R.Mohan, CGM/HR (CSR, Education, Sports & Culture), Shri S.Vinayagamoorthy, DGM/Education and

Smt. M.Rajeswari, Headmistress of the School also spoke on the occasion.

PARENTS COUNSELLING PROGRAMME

One day Clinical Workshop on Arrhythmias Date : 12.01.2019Resource Person : Dr. Jaisankar, Director & Mentor, Cardiology and Electrophysiology StudyMIOT Hospital, Chennai

Recent Advances in Programmatic Management of Tuberculosis

Date : 09.03.2019Resource Person : Dr. R. Pajanivel

Professor & HOD, Pulmonology Department, Mahatma Gandhi Medical College &

Research Institute, Puducherry

Methods of Ventilation : Invasive & Non-Invasive

Date : 15.03.2019

Resource Person : Dr. Ali Hasan Faiz Karnam,

Incharge of Emergency Medicine,

PIMS, Puducherry

CONTINUING MEDICALEDUCATION PROGRAMMES

In-house credit hours one day

workshop on Infection Control in

Health Care facilities for Nurses

Date : 04.01.2019

Resource Persons : Mrs. P. Vasanthi,

Mrs. G. Malarvizhi, Associate Professors

& Mrs. D. Vanitha, Asst. Professor,

OPR Nursing College, Vadalur

CONTINUING EDUCATION PROGRAMMESFOR PARAMEDICALS

Work Culture pertaining to

Hospital Change Management

Date : 05.02.2019

Resource Person : Shri Harish Kumar,

Reputed Trainer from Erode

Special Training Programme on

Universal Precaution & Infection

Control for Clinical Lab Technicians

Date : 05.03.2019

Resource Person : Dr. Rachna Williams

Technical Expert, Technical Support Unit

TANSCAS, Chennai

7

Special Lecture on

Universal Precautions &

Infections Control for Nurses

Date : 13.03.2019

Resource Person : Dr. Rachna Williams,

Technical Expert, Technical Support Unit

TANSACS, Chennai

During the last quarter of 2018-19 (January to March 2019), NLC India Hospital had organised 4 medical camps in the peripheral villages with the

approval of Dr. Kala, Joint Director, Health Services, Cuddalore, Government of Tamil Nadu. In all the four camps, Doctors of various

Departments of NLC India Hospital viz., General Medicine, Eye, ENT, Pediatric, Maternity, Chest Clinic, Skin and Dental screened the patients

and distributed medicines. In all the camps, hearing aids were presented to beneficiaries.

At Indira Nagar : About 300 people from the locality of B1 and B2

Block Rehabilitation Centres benefitted at the comprehensive medical

camp held at Government Higher Secondary School premises, Indira

Nagar on 20.01.2019. Dr. M.K. Jha, Chief General Superintendent/

Medical and Shri Sivakumar, ADGM, Land Acquisition Department

inaugurated the camp.

At Oomangalam : The 4th Comprehensive Medical Camp was

organised by Team NLC India Hospital at Government Higher

Secondary School premises, Oomangalam on 27.01.2019.

Shri Samidoss, HM of the school and Dr. Packiya Mary Jerome,

DGS/Medical, NLC India Hospital inaugurated the camp, in which

around 450 people were benefitted.

At Perperiyan Kuppam : The 5th Comprehensive Medical Camp of

this financial year was organised at Government Higher Secondary

School Premises, Perperiyan Kuppam on 17.02.2019. Smt. Senthil

Nayagi, HM of the School and Dr. M.K. Jha, CGS/Medical i/c

inaugurated the camp. As many as 350 people benefitted through

this camp.

At Uluthoor : The 6th Comprehensive Medial Camp was organised

at the St. Anne’s Church premises, Uluthoor on 10.03.2019.

Shri R. Mohan, CGM/HR (CSR, Education, Sports & Culture),

Dr. M.K. Jha, CGS/Medical i/c, NLC India Hospital and Rev. Fr.

Sahaya Nathan, Parish Priest of the Church participated in the

inaugural function. About 350 people benefitted through this camp.

NLC INDIA HOSPITAL ORGANISES COMPREHENSIVE MEDICAL CAMPS

Medical Camps at Rajasthan

The Management of our Barsingsar Mine cum Thermal Project, Rajasthan had organised 3 medical camps during the fourth quarter of 2018-19

under Corporate Social Responsibility Activities. Doctors and paramedical staff of Occupational Health Centre, Barsingsar Project screened the

patients and distributed medicines. All the three camps were organised in the presence of Shri E. Esaikkimuthu, Project Head, Barsingsar &

Bithnok Project, Shri D. Sridharan, General Manager/Barsingsar Thermal Power Station and Senior Officials.

At Barsingsar Village : In the Medical

Camp conducted on 12.02.2019, about

570 people of the village benefitted.

Free medicines have been provided to

them.

At Swaroopdesar Village : The Free

Medical Camp was organised on 25.02.2019

in which free medical treatments/medicines

have been provided to 570 people of the

locality.

At Lalamdesar Village : The camp was

organised on 11.03.2019 in which 410

people from in and around the village

were benefitted. Doctors Screened the

patients and provided free medicines.

NLC Tamilnadu Power Limited

(NTPL), one of our Subsidiary

Company at Thoothukudi had

conducted a Free Eye camp at

NTPL Township for the general

public, in Association with District

Blindness Control Society (DBCS),

Thoothukudi on 17.02.2019.

Shri V. Thangapandian, Director/

NTPL organises Free Eye Camp at Thoothukudi :

Power, NLCIL inaugurated the

eye camp in the presence of

Shri Shajee John, Chief Executive

Officer/NTPL. 181 persons were

benefitted. Out of which, 11 persons

were recommended and identified

for the Surgical Treatments and

66 persons were recommended for

Spectacles with various vision

errors.

MEDICAL CAMPS ORGANISED IN OUTSIDE PROJECTS

Annua l Med ica l Examina t ion

programme for Special Children of

Sneha School for the academic year

2 0 1 8 - 1 9 w a s c o n d u c t e d o n

26.02.2019 in SNEHA School.

A team of specialist doctors from

NLC India Hospital, comprising of

P h y s i c i a n s , P a e d i a t r i c i a n s ,

Dermatologist, Ophthalmologist, ENT

and Dental surgeons

a n d P s y c h i a t r i s t

screened children to

a s s e s s t h e m f o r

h e a l t h p r o b l e m s

pertaining to their

specialty domains.

Health records were

updated with findings

o f med ica l examina t i on and

recommendations of doctors for

compliance by parents in terms of

seeking early medical intervention in

the case of children diagnosed with

problems.

Smt . Kanchan Rakeshkumar,

President SNEHA Opportunity

Services Society, graced the occasion

a n d i n q u i r e d t h e

doctors about health

status of each child and

requested the doctors

to treat the children in

NLC India Hospital

who are diagnosed with

c h r o n i c m e d i c a l

conditions.

SNEHA School – the trail blazing institution sets benchmark in

rehabilitation programme for mentally challenged children (Special

Children) for similar schools in the Cuddalore District to adopt its

best practices. In terms of promoting sports among special children

which is gaining momentum in recent times, SNEHA took the

initiative to conduct a District level sports meet jointly with the

Sports Development Centre of

NLCIL and the NLC India Hospital on

20.02.2019 at the Bharathi Stadium.

The mega event was a big draw as

it attracted a larger than expected

participation of 177 children from

12 schools across Cuddalore

District. Smt. Shanti Vikraman,

Patron of Neyveli Ladies Club

flagged off the event in the presence

of Shri R. Ramesh, DGM/Sports,

NLCIL, Shri Raghava Reddy, Secretary, Sneha Opportunity Services

Smt. Kanchan Rakeshkumar, the

President SNEHA Opportunity

Services Society was behind holding

this mega event for the first time in

Neyveli which contributed to

enhancing the image of NLCIL as a

corporate citizen committed to the

cause of holistic development of special children.

and Smt. Salma Philip, Principal of Sneha School. The event featured

both athletic and team games as the children participated with flair and

flamboyance. Winners were encouraged with trophies and medals. But

the ultimate winner is the event itself as the children competed in right

spirit and were united in the goal of celebrating sports in true spirit and

in appreciation of each other’s talents. The event offered a never before

experience of enjoying camaraderie

with one another and show cased their

skills in a perfect ambience which

Bharathi Stadium offered.

A SPECIAL PAGE FOR THE SPECIAL CHILDREN

ANNUAL MEDICAL CHECKUP

SNEHA HOSTED THE DISTRICT LEVEL SPORTS MEET FOR SPECIAL CHILDREN

1. Housemates of “Anandam Illam” celebrating New Year 2019 with CMD and Directors of NLCIL and Smt. Kanchan Rakesh Kumar (01.01.2019)

2 Shri S.R. Sekhar, CGM/TA administering polio drops to a child during the 25th National Intensified Pulse Polio Programme – 2019 at Block-20, Health Centre, Neyveli. 4723 children were given Polio drops (10.03.2019).

4. Dr. S. Vijayakumari, Psychiatrist, NLC India Hospital handling a session

3. Smt. Kanchan Rakesh Kumar and the Members of Australian Team viewing the Yogasanas demonstrated by the students of Sneha school (11.01.2019)

6 Dr. S. Vijayakumari, Psychiatrist & ACMO/NLC India Hospital addressing the students of Kendriya Vidyalaya, Neyveli at the one day Workshop on ‘Substance Abuse’ (11.02.2019).

on “Health & Hygiene in Adolescence stage” at the Young Student Scientist Programme-2018 organised by Tamilnadu State Council for Science & Technology, Dept. of Higher Education, Govt. of Tamilnadu at Jawahar Science College, Neyveli (05.01.2019).

5. NLC India Pavilion which displayed the handicrafts made by Sneha Children at the Udyam Samaagam Trade Fair organised by MSME Technology Development Centre at Coimbatore (24.03.2019)

NEWS IN BRIEF

PhotoNews

NLCIL Sports Development Centre organised a Mini Marathon

“Run for Health” at Neyveli on 17.02.2019 for the cause of Good

Health and Fitness. Shri Rakesh Kumar, CMD, NLCIL flagged off

the Marathon at Bharathi Stadium in the presence of

Shri V. Anbuchelvan, Collector, Cuddalore District, Shri Nadella

Naga Maheswar Rao, Director (P&P)

and Shri Prabhakar Chowki,

Director (Mines) of NLCIL.

About 2400 Citizens from all

walks of life in all age groups

participated in the Marathon.

Along with CMD, Collector

and Directors, our Senior

O f f i c ia l s , ve te ran spor t s

personnel of NLCIL, employees,

family members, school and college

students, CISF personnel and

general public enthusiastically

participated in the event.

Shri T.D. Rajendran, a veteran

sports super senior citizen

f r o m S i v a k a s i g a v e a n

encouraging speech before the

start. After a circuitous route of

5 km, the marathon came to a finish

at the starting place. NLC India Hospital

made all the precautionary measures and sent ambulance vehicles

along with the participants. Earlier, homage was paid to the martyrs

of the terror strike in Pulwama and the run was dedicated to the

martyred CRPF Jawans.

News Letter of NLC India Hospital (for private circulation only)Published by NLC India Limited, ‘Navratna’ - A Govt. of India Enterprise, Neyveli 607 801, Tamil Nadu. Website : www.nlcindia.com

LIGNITE LIFE LINE

RUN FOR HEALTH