IMA INTERNATIONAL FAMILY TOUR mid May 2017 Place: Paris or Hong Kong - Details in our Website CME on

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1 IMA INTERNATIONAL FAMILY TOUR mid May 2017 Place: Paris or Hong Kong - Details in our Website MARCH 2017 CME on CME - Practice Beyond Paediatrics on Organised by the Central IPA, IMA erode, Erode Paediatric Association International Women s Day Celebration - Inauguration of IMA Family Club & Culturals on , EIMA Hall Dr. K. Soundara Raj President Dr. E. Thangavelu Vice President Dr. P. Jayanth Kumar Hon. Secretary Dr. V. Sachitanandam Finance Secretary

2 MAARUTHI MEDICAL CENTRE AND HOSPITALS 300 BED MULTISPECIALITY HOSPITAL OBSTETRICS AND GYNECOLOGY DEPARTMENT OBSTETRIC UNIT : 24 X 7 obstetric service by a team of richly experienced Obstetricians Water birth Painless delivery Obstetric Day Assesment Unit HIGH RISK OBSTETRIC UNIT : State of art Obstetric High Dependency Unit by Experienced Obstetricians Obstetric Anaesthetist Intensivist Physician & Surgeon Cardiologist GYNECOLOGY UNIT : Well women clinic Benign Gynecology work up Gyne Oncology & Urogynecology Geriatric gynec & Menopausal Clinic Colposcopy Cosmetic Gynecology GYNE- ENDOSCOPY : Laparoscopic & Hysteroscopic work up including Diagnostic and Therapeutic OFFICE Hysteroscopy INFERTILITY UNIT : IVF & IVF LITE Blastocyst & Extended embryo culture Cutting edge facilities in Cryo technology Regenerative Medicine Third party Reproduction facilities

3 Dear Colleagues, You are cordially invited for IMA-AMS & CGP monthly CME meeting Dr. K. Soundara Raj President INDIAN MEDICAL ASSOCIATION Erode Branch Date : Sunday Time : 5.30 pm pm Venue : IMA TRUST A/C Hall, Sampath Nagar, Erode. Programme at a Glance: pm : International Women s Day Celebration - Inauguration of IMA pm : IMA Prayer Family Club & Cultural s President Address by Dr. K. Soundara Raj Secretary Report by Dr. P. Jayanth Kumar pm : Topic - Oncology Basics Dr. Bharath Rangarajan MD., DM, ECMO, PDCR, Consultant Medical Oncologist, Hemato-Oncologist & Stem Cell Transplant Physician pm : Topic - Appropriate Antimicrobial Prescribing pm : Discussions Dr. K.P. Ravi MD (General Medicine)., FNB Critical Care Consultant Intensivist & Physician 8.30 pm : Vote of Thanks - Dr. V. Sachithanandam 8.45pm : Dinner Academic Grant By Mylan & GSK Kindly Attend and Grace the occasion Dr. P. Jayanth Kumar Hon. Secretary Dr. V. Sachithanandam Finance Secretary

4 Message from Editorial Board EIMA - President Respected Seniors, Friends and my Colleagues, EIMA - Hony Secretary Warm greetings & Happy women's day wishes from our Erode IMA new Team Last month we had three CME programs. Special lectures on Robotic Surgery and Liver Transplant surgery in our monthly EIMA CME was well presented and helped to update our knowledge. We also had CME on Basic emergency Life support & Practice beyond Paediatrics. We EIMA along with National IMA opposed NEXT (National Exit Test) for MBBS graduates. Unity will strengthen our Doctors community and IMA is one of such platforms to show our strength and fight for good causes. In the mid month of May, EIMA is Plans to organise International IMA Family Tour to Paris or Hong Kong. We are looking forward for active enrollment from our members and their families to make this trip successful & memorable. Details about the tour will be available in our web site. Next weekend, EIMA has special plans. We will be celebrating international women's day, Inaugurating our IMA Family Club and also organised cultural program. Look forward for active participation our members and their families. Truly Yours Dr. K. Soundara Raj President, Erode IMA Publisher, EIMA News 4 Long Live IMA, Sweetly Yours Dr. P. Jayanth Kumar Hon. Secretary, Erode IMA Editor, EIMA News Address for Correspondence: Dr. P. Jayanth Kumar, Hon. Secretary, EIMA Lotus & Care 24 Hospital HIG 1064, Manickampalayam Housing Unit, Erode Tamilnadu. India Mobile: / E mail: erodeima1949@gmail.com / drjayantheima@gmail.com

5 OUR TEAM 2017 Dr. M.V.Madhan Kumar Imm. Past President Dr. K. Soundara Raj President Dr. E. Thangavelu Vice President Dr. P. Jayanth Kumar Hon. Secretary Dr. V. Sachithanandam Finance Secretary Dr. Chakravarthi Mailer Ravindran Joint Secretary I Dr. S.T. Prasad Joint Secretary II Dr. T. Vijayakumar Asst. Secretary CONTENTS Acute Emergencies Protocol (HYPOTENTION) Current Update on Management of Acute Pancreatitis 08 Interesting Abstract 09 EIMA Congratulates 10 Photo Gallery 11 Care 24 Ad Alpha Diagnostics Center Ad 14 ABCD of Breaking Bad News Diagnostic Imaging Center-Erode IMA National Social Security Scheme Community Activities 21 Imayam 22 EECH Ad 23 SIMS Ad 24 IMA LIFE MEMBERSHIP FEE Life Membership for Single - Rs. 12,800/- Life Membership for Couple - Rs. 21,100/- For More Details: Contact: Dr. P. Jayanth Kumar, Hon. Secretary, EIMA. Mobile No: or Mr. T. Arasu, EIMA Manager, Mobile No.: To download application form log on to : 5

6 6ACUTE EMERGENCIES

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8 CURRENT UPDATE ON MANAGEMENT OF ACUTE PANCREATITIS: TOP 10 PRACTICAL POINTS Dr.S.Easwaramoorthy MS FRCS (England) FRCS (Glasgow) FRCS (Edinburgh) 1. Consider Acute Pancreatitis in any patient presenting with severe upper abdominal pain 2. Though in vast majority of cases, the cause of pancreatitis is either alcohol or gall stones, remember the rare causes like trauma, infection, hyperlipidemia 3. Serum amylase more than 1000 units is diagnostic. Serum lipase can also be measured. But we should remember amylase level is not an indicator of severity of pancreatitis. Also in some chronic alcoholics with recurrent attacks, amylase level could even be normal. 4. Amylase level above 100 and below 1000 is called pseudo hyperamylaesemia and can occur in following conditions (remember the pneumonic ABCDE ) a. AAA( leaking or ruptured aortic aneurysm) b. Biliary pathology: cholangitis, cholecystitis/bowel Ischemia c. Chronic renal failure d. Diabetic ketoacidosis e. Ectopic pregnancy 5. Acute pancratitis needs only medical management except in cases of complications due to severe necrotizing pancreatitis 6. Enteral feeding, and prophylactic antibiotics in selected cases of necrotic pancreatitis, adequate hydration and oxygenation and pain control are the essential aspects of management 7. No role for octreotide or somatostatin. Waste on money! 8. Only patients with severe acute pancreatitis are prone for organ failure and local complications like pseudo cyst and necrosis and abscess formation and hence Suspect severe pancreatitis if more than 3 of following criteria are met( Ranson's Criteria, Glasgow score, Apache II score etc are available) a. Age more than 55 b. High blood sugar c. High white cell count d. Low serum calcium e. Raised ALT and LDH f. Hypoxia, acidosis g. High C reactive protein h. High Haemotocrit >44 9. Though US abdomen is useful, Contrast CT scan is essential to assess the severity of necrosis and to identify the complications like pseudocyst, abscess formation etc. 10. Surgical intervention is better delayed as late as possible and that also need to be minimally invasive to minimize morbidity and mortality. References: 1. UK guidelines for the management of acute pancreatitis, Gut 2005;54; Practice Guidelines in Acute Pancreatitis Am J Gastroenterol 2006;101:

9 The predominance of a naive T helper cell subset in the immune response of experimental acute pancreatitis. Schmidt AI1, Kühlbrey C1, Lauch R1, Wolff-Vorbeck G1, Chikhladze S1, Hopt UT1,Wittel Ua2. Pancreatology Feb 22. pii: S (17) doi: /j.pan [Epub ahead of print] Abstract INTRODUCTION: In necrotizing acute pancreatitis (NAP), systemic inflammatory response syndrome (SIRS) and the compensatory anti-inflammatory response syndrome (CARS) decide overall outcome and mortality. In patients, low lymphocyte counts were found, but T- helper cells seemed to conversely increase. Our aim was to further categorize T-helper cells within the context of NAP induced SIRS and CARS. METHODS: NAP was induced by injection of sodium-taurocholate into the common bile duct of male BALB/c mice; sham treated animals received saline infusion. The animals were sacrificed at 6, 12, 24 and 48 h later. Lymphocytes from blood, liver and spleen were isolated and examined by flow cytometry. Staining was performed for CD4, CD8, CD19, CD45RB, CD25, CD69, and CD152. CD4+ cells were sorted for their CD45RB expression and sought for gene regulation associated to TH1/TH2 cells by quantitative RT-PCR. RESULTS: In NAP, CD4+ was solely increased in all compartments. CD8+ remained without substantial alterations. CD45RB showed significant expression in RBhigh in T-helper cells, confirmed by the CD45RBhigh/lowratio (Liver, 24 h: NAP 2.2, SHAM 0.6; p < 0.001). CD45RBhigh and -low cells were not associated to patterns of TH1/TH2 expression. In NAP, CCR4 expression was significantly decreased within RBhigh cells (fold change: 0.04, p < 0.05), while TLR6 showed significant overexpression (fold change: 2.36, p < 0.05). CONCLUSION: INTERESTING ABSTRACT T-helper cells increase in NAP, leaning towards CD45RBhigh expression. They resemble naive T-cells, in which NAP leads to expression profiles associated with an innate immune response. This suggests new findings in immunological pathomechanisms of NAP. 9

10 EIMA CONGRATULATES 270 Children of Sengunthar Nursery & Primary School,from Ist Std to V std, donated Rs.80,000 to IMAYAM Home. Really a wonderful job by them. Thanks to Correspondent Thiru.VGT.Velu and Secretary Thiru.Sivanandan, Head Master. Mrs.R.Elamathi, Staff and Parents of the Children. Dr.S.S.Sukumar, Chaired a session during All India Ophthalmological Society Conference in Jaipur on Feb 2017 Dr.P.S.Radhakrishnan,Dr.Mrs. Nirmala Radhakrishnan, Dr.Chandramohan, Dr.J.Elavarasu, Dr.N.V.Govindaraju, Dr.V.Panneer Selvam, Dr.S.S.Sukumar Attended, All India Ophthalmological Society Conference in Jaipur during Feb Monika Diabetes Center - Camp MMCH - Eye camp Dr KM Abul Hasan has been unanimously elected as the Vice Chairman of PPLSSS of IMA TNSB for the year Dr. K. Soundararaj Elected as Erode District Co-Ordinator PPLSSS 10

11 PHOTO GALLERY MARCH CME No to NEXT EIMA Signature Campaign protest, 1st February 2017 World Cancer Awareness Rally 4th February 2017 CME-Basic Emergency Life support for Paramedics 5th February 2017 Free Health camp Mariyalaya home for the aged at erode on 24/02/2017 Leadership training program for IMA West & IMA south zone at hotel vivera grande,dindugal,tamilnadu

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14 ABCD of Breaking Bad News Dr.S.Easwaramoorthy MS FRCS (England) FRCS (Glasgow) FRCS (Edinburgh) 'This 35 year old Business executive presented with dyspepsia and weight loss. Endoscopy and biopsy showed he had Large Gastric cancer with liver secondaries.he was accompanied by his wife and father in law.' 'This 30 year lorry driver came with history of dysphagia and weight loss. Endoscopy and subsequent CT chest and abdomen showed he had metastatic Ca esophagus. He was accompanied by his friend.' Scenes like these are not going to be unusual in our clinical practice. Breaking bad news is never easy. It is an art to be mastered. We also know that bad news cannot be converted in to good news! Following are the common questions in our mind while trying to communicate any bad news. HOW TO TELL? HOW MUCH TO TELL? WHOM TO TELL? WHEN TO TELL? We all know that communication is not just words alone. Our tone and body language also matter. We need to show compassion and empathy to the bereaved family members. We should master the art of listening more than talking! People Don't care how much we know, but they know how much we care. by the way we listen! So we need to understand all these facts and try to improve our communication skills Here are the 4 important stages of communication. So next time when you are about to tell a bad news to some one, Just remember the alphabets, ABCD.. A: Advance preparation B: Build a therapeutic environment C: Communication Act D: Deal with their reactions Art of breaking bad news is like performing an act in a film. But unlike in movie, here every thing is real and you have to perform the act in 'One take'. You never get a second chance to make a good first impression. Is n't it?. A. Advance Preparation (Prepare the dialogue) Review Details of patient Clinical: Review the Case sheet/investigation reports etc Social history: Family background, work Rehearse what to tell(mentally) Words to use Words to avoid 15

15 B: Build a therapeutic environment( Set the scene) Privacy Key family members to be around Allow time No phone call/ no interruption C: Communication Act (Perform the Act) Ask what patient/family already know Understand how much they would want to know Gradually tell the facts. Never lie. Be Frank and compassionate Allow for silence and tears etc Ensure every one has understood what you have said D: Deal with their reactions (Show Empathy & Compassion) Explore what the news means to patient Arrange other relevant staffs to help Arrange for review for any further discussion and help Anticipate emotional outbursts: Anger/Disbelief so on Do not criticize colleagues So in short, Simple language (Avoid medical jargon) Accuracy of information (Never lie, but put the facts across gradually& gentlely) Address their concerns & understand their feelings See whether everything is understood Offer Support Know your limitation( eg:don't give estimate of how long he/she will live & soon..) Let us all strive to become great compassinate doctors. Good Day! New Members Life Members Transfer Member FSS Members Dr. A.R. Vivek Dr. G. Madhu Shankar Dr. K. Sindhu Dr. R. Sadasivam Dr. D. Saraswathi Dr. T.Vijayakumar 16

16 DIAGNOSTIC IMAGING CENTERS - ERODE Dear Doctors, We take this opportunity to thank you all for your esteemed referrals for Imaging Studies. Managements of Imaging Centers held a special meetingat Erode as per the guidelines of IRIA TAMILNADU and PONDICHERRY Chapter. After due deliberations, taking IRIA Tamilnadu directives, MCI regulations andreferring to different court judgments from 2010 onwards & in the endeavor to maintain uniformity in the services provided and fees collected, the fees for various commonly used imaging studies are revised. The revised fees structure is detailed as follows. The new charges are applicable from onwards. CT SCAN PLAIN CONTRAST BRAIN ORBIT ORBIT Plain and Contrast 3600 TEMPORAL BONE PNS PNS Plain and Contrast 3300 NECK NECK Plain and contrast CHEST CHEST Plain and contrast HRCT 4000 ABDOMEN PELVIS PLAIN 3D 4000 ANY JOINTS PELVIS 3500 FOOT 3D 3200 HIP 3D 3800 FEMUR 3800 SHOULDER PLAIN 3800 WRIST 3200 CT ANGIO 6000 PERIPHERAL ANGIO 7500 CORONARY 10,000 17

17 MRI SCAN PLAIN CONTRAST Additional Rs. BRAIN JOINT SINGLE STUDY SPINE SINGLE STUDY ANY ADDITIONAL Screening MRI Abdomen With MRCP MAMMOGRAPHY HSG ULTRA SONOGRAM ABDOMEN & SMALL PARTS OBG DOPPLER ONE REGION / ONE SYSTEM CAROTID DOPPLER Extra fee of Rs.500/- is chargeable for all studies done between 10pm and 7am. NEW Erode IMA Notice Board Doctors Classified Ads Dear EIMA members, we are introducing classified ads section in EIMA Magazine from this month onwards for the benefit of our members. Details Contact: EIMA Secretray, Dr. P. Jayanth Kumar Fee: Rs. 300/- per advertisement Accountant & Computer Designer Wanted Contact:

18 IMA NATIONAL SOCIAL SECURITY SCHEME (IMA NSSS) A Wing of IMA (HQ) New Delhi ELIGIBILITY IMA life member upto 60 years For 40 to 60 years, Member has to Complete 3 years of ilfe Membership IMA NSSS AS ON Total Members 16,420 Last Death Fund Contribution (DFC) Paid to Nominee Rs. 10,70,510/- Total DFC Paid Rs. 36,85,95,749/- Help given to number of families of deceased members 791 BE A MEMBER OF IMA NSSS IMA NATIONAL SOCIAL SECURITY SCHEME IMA NSSS) 2nd Floor, AMA House, Opp. H.K. College, Ashram Road, Ahmedabad Phone/Fax: (079) / Website: / imansss1@gmail.com, contact@imansss.org Download Membership Application From our Website: Indian Medical Association Tamilnadu State Branch: Scheme Types For more details log on to : 1. Professional Protection Linked Social Security Scheme 2. Hospital Protection Scheme 3. Family Benefit Scheme of PPLSSS 4. Family Security Scheme 1) Professional Protection Linked Social Security Scheme (PPLSSS) website link : Helps you to counter Consumer Protection Act (CPA). Coverage from the day of enrollment. Guidance & Safe guarding from day one of receiving notice. Compensation upto Rs. 10/- Lakhs for 5 years. Immediate Financial grant Rs.30,000/- in case of demise of a member (5 yrs membership) Rs. 10,000/- for membership below 5 yrs. PPLSSS New Members SUBSCRIPTION (Block of Five years) Category Compensation 5 Lakhs Compensation 10 Lakhs per block of 5 years per block of 5years GENERAL PRACTITIONER NON SURGICAL SURGICAL ANAESTHETIST Rs.6000/- Rs.7000/- Rs.8000/- Rs.11000/- Rs.13000/- Rs.15000/- 19

19 Any two facilities All three facilities and More FBS New & Renewal REVISED FBS SUBSCRIPTION (for a block of 1 year): FROM AS PER MCM MEETING RESOLUTION Age Upto 45 years years years Rs.9000/- Rs.15000/- 2) Hospital Protection Scheme (HPS) website link : The Scheme will take up notices / cases against the hospitals enrolled and pay the compensation awarded against hospitals but not against the individual doctors. The Hospitals should be members of IMA Nursing Home Board. HPS New & Renewal SUBSCRIPTION (Block of three years) Category Compensation 5 Lakhs per block of 3 years Compensation 10 Lakhs per block of 3 years PRIMARY LEVEL Rs. 4,000 /- Rs. 7,000/- SECONDARY LEVEL Any One facilities (ICU/ /Theatre / Labour Room, X-Ray, Scan, Lab) Rs.6000/- Rs.12000/- (ICU / Theatre / Labour Room) Rs.18000/- Rs.30000/- 50 beds and more with all facilities - Rs.30000/- and TERTIARY LEVEL 3) Family Benefit Scheme (FBS) website link : Scheme shall reimburse Rs. 1.2 lakh for the Hospitalization expenses incurred in that year for the member, spouse or children below 18 years and not exceeding Rs. 60,000/- per Hospitalization for the members or their nominee. Age Upto 30 years 31 to 50 years 41 to 60 years 51 to 60 years Annual Fee Rs. 3,500/- Rs. 4,500/- Rs. 5,500/- Family Security Scheme Fee Non Refundable Deposit Rs. 3,000/- Rs. 10,000/- Rs. 50,000/- Rs. 1,00,000/- Age Upto years years years Annual Fee Rs. 6000/- Rs. 6,500/- Rs. 7000/- 4) Family Security Scheme (FSS) website link : We are happy to inform you that the Family Security Scheme of IMA TNSB was launched during 239th State Council Meeting at Erode on This Scheme is aimed to help the IMA members family in the event of death of a IMA Doctor who is a member of this Scheme. Annual Advance Faternity Contribution Rs. 9,500/- Rs. 9,500/- Rs. 9,500/- Rs. 9,500/- 20

20 Community Activities AAO GAON CHALEN At Swaminathapuram 250 Patients were treated in the month of February Our IMA Members took part in it. Screening Camp was Conducted at SKM Sevai Maiyam, Saminathapuram. SATHYA SAI Sri Sathya Sai Seva Samithi Erode Conducted General Camp. Total Number 140 Patients. Our members participated in it. ERODE GH Patient Welfare Society - Speciality Ward, Govt Head Quarters Hospital, Erode February Total no of Free Endoscopy - 45 Patients BLOOD DONATION CAMP In February 2017, 80 Blood Donation Camps were held. Total of 3025 Units of Blood were Collected. ARASAN EYE HOSPITAL 47 Free eye camps, 2831patients screened, 640 Free surgeries performed, 52 pairs of eyes collected. MAARUTHI MEDICAL CENTRE AND HOSPITALS Erode Diabetes Foundation functioning in Maaruthi Medical Centre and Hospitals, and Aravind Eye hospitals Conducted free Camp for detection of Diabetic Retinopathy and other Eye complications on in the Auditorium of the hospital. Dr.A.S.Senthilvelu gave Audio Visual presentation on Early detection and prevention of Diabetes. Blood glucose estimation done for around 300 Diabetic patients and for other potential diabetics. OBITUARY Dr. K.R. Balasubramaniam Passed Away on Dr. S. Kandasamy Passed Away on Dr. AJS. Ramesh Kumar Passed Away on May their Soul rest in Peace 21

21 IMAYAM Mrs Dhanalakshmi, Erode M/s. K.Govindasamy Naidu Medical Trust,Coimbatore Mr M.C.Ramkumar,USA,C/o Dr.V.P.Sundaravadivel,Erode Dr R Palanisamy,Vice President, IMA West Zone, Coimbatore Mr Purushothaman V, Shalimar Agencies, Erode Mr Mahadevan K S,Bharani Pattu Centre, Erode Dr Thiruganasambantham.A ATS Hospital Erode Dr T Sadagopan, Vellore Rs.5000 Rs.3110 Rs.2500 Rs Rs.2000 Rs.1000 Vegitable expenses Rice We request all our members to take active part in this noble cause by way of liberal contributions to run this project. Rs.2000/- can be contributed for one day expense on special occasions like Birth day, Wedding Day, Hospital day, etc... Or onetime payment of Rs.15,000/- with a specified date so that we can allot that day every year. Cheque / Demand Draft may be drawn in favour of IMAYAM TRUST payable at ERODE. Cheque / Demand Draft to be Sent to Dr.S.S.Sukumar, Secretary, IMAYAM Home, Sri Raghavendra Eye Hospital, 72, Mosuvanna Street, Erode , Tamil Nadu, India. Ph: , , , , sssukumar@gmail.com "Donations are exempted under section 80G of the Income Tax Act 1961 as per letter No C.No.227(31) CIT-II / CBE/11-12 Income Tax - II, Coimbatore - 18 IMAYAM TRUST PAN No : AAAT14388K Dr. K.M. Abul Hasan President SHARE & CARE Join Share & Care to serve our EIMA Member s Family Dr.S.S.Sukumar Secretary Dr.C.N.Raja Treasurer Dr. C.N. Raja, Secretary SHARE AND CARE, EIMA ANNAI ENT & HEAD & NECK CARE CENTRE, 12D, Palaniappa st, opp. federal bank, Perundurai Road, Erode Cell: Dr. A.P.J. Abdul Kalam s Manimandabam Construction Completed at Erode Imayam 26

22 E R O D E C A R E EMERGENCY H O S P I T A L 3/1, Veerappampalayam Pirivu Road, Thindal, Erode erodeemergencycarehospital.com 28 year old rushed to ER post RTA. Primary survey revealed silent chest, GCS 8/15, thready pulses. RSI intubation, B/L chest drain insertion, haemorrage control was done. SDH with a midline shift noted in CT brain. Neuroprotective measures f/b immediate surgery was done. Discharged home post complete recovery on day 12. Prompt & holistic team approach saved this patient. For 24 x 7 Help Consultant ICU OUR SPECIALIST TRAUMA TEAM(24*7) PICU & NICU Fully Equipped Theatre ORTHOPAEDICS Dr. V.S. Senthilvelu MS ORTHO Dr. V. Sachithanantham MS ORTHO EMERGENCY AND INTENSIVE CARE Dr. Gautham Ganapathy MD Dr. S. Boopathi MD, DNB, MRCPCH GENERAL SURGERY Dr. S. Kaligoundan MS Dr. John Baskar Arthur MS Dr. A.R.B. Jothikumar MS NEUROSURGERY Dr. A. Selvaperumal MCH NEUROSURGERY PLASTIC SURGERY Dr.T.C.Gnanasekaran MS, MCH (Plastic Surgery) ENT Dr. C.N. Raja MS ENT, DLO,FRCS RADIOLOGY Dr. S. Sangeetha DNB Radiology 3D CT Scanner Besides them we have a great team of specialists providing 24*7 Emergency & ICU care. We welcome specialist from all specialities to utilise our tertiary care facilities & to treat your patient 2 x Ventilator Ambulance Dr. Gautham Ganapathy MD Emergency & Intensive Care Specialist has started his full time service at EECH and team EECH wish him all the best and Welcome him.

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