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Department of Physical Medicine & Rehabilitation Website


Medical Services in the PMR dept

On this page:

Introduction:

Outpatients:

Inpatients:

Operations & Investigations:

Service Statistics:

 

Photo of the front of the PMR outpatient department

Entrance to the PMR Outpatient department in the Hospital.

Medical Staff:

Education:

Research:

Equipment:

Links:

Contact Information:

Introduction

This page is dedicated to describing the medical services offered by the PMR department in the Christian Medical College, Vellore. Links to other services in PMR can be found below at Links.

There are currently ten specialist doctors working in the Physical Medicine and Rehabilitation department and two on study leave. There are also three post-graduate registrars and up to three non-post-graduate registrars. The doctors are involved with inpatient and outpatient services in the hospital and some community services, a summary of which is given here. The range of medical disorders seen by the doctors is described further in the Patient Information section.
The doctors are now divided into two teams as follows:

PMR I

Drs Ashish Macaden, Henry Prakash

PMR 2

Drs George Tharion, Jacob George, R. Suresh, Raji

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Outpatients:

Consultant Timetable for Outpatients:

Monday:

Drs George Tharion, Jacob George, R. Suresh, Raji

Tuesday:

Drs Ashish Macaden, Henry Prakash

Thursday:

Drs George Tharion, Jacob George, R. Suresh, Raji

Friday:

Drs Ashish Macaden, Henry Prakash

Side view of PMR department

Entrance to the PMR
Outpatients from casualty
(click for larger view.)

Outpatients services are held within the PMR block, in the hospital campus four days a week and have been busy. Over the year 2004-5, 68,632 patients were seen.  In addition to this regular outpatient service, the formal interaction with other departments has continued through regular joint clinics. Patients wishing to be seen must register before 11am and then come to the department at the specified appointment time.

The PMR outpatient area underwent a major modification after 40 years. The therapy area that previously used to treat inpatients has been moved into the wards so more space has become available in the OPD area. Additional consultation rooms have been added and the whole area redesigned so there are now rooms for 4 consultants and 2 registrars. The electrotherapy area has been centrally air conditioned and designed to improve the comfort and reduce the waiting time for patients who come for physiotherapy services.

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Joint Clinics:

The PMR department runs several joint clinics that are detailed below. Patients must be referred from either the PMR OPD or the other specialist medical service that is part of the joint clinic. All Patients who have been referred must register before 11am that day. Statistics for these clinics can be seen below: Service statistics.

Traumatic Brain Injury Clinic

For patients who had an accident that caused brain injury/head injury

Haematology Orthopaedics PMR clinic

For patients with haemophilia or Christmas disease

Neuromuscular clinic

For patients with diseases of muscle or nerves like Duchennes Muscular dystrophy, Beckers dystrophy

Pain Clinic

For patients whose pain is difficult to control

Geriatric Clinic

For patients over the age of 65yrs with rehabilitation needs

Amputee Clinic

For patients wanting an artificial limb, needing it checking etc

Traumatic Brain Injury Clinic

The brain injury clinic forms part of the new services looking after people who have had a traumatic brain injury eg from a road traffic accident. The hospital is trying to provide care from casualty to community with twice a week combined rounds (neurosurgery and PMR), increased staff and inpatient services on the new Rehab Institute first floor wards and therapy areas. There is also the new trans-disciplinary Brain Injury Clinic on Wednesday afternoons with consultants are Dr Ashish Macaden from PMR and Dr Mathew Joseph (Consultant Neurosurgeon). The Brain injury clinic is multidisciplinary and provides follow up to brain injury patients by Neurosurgery and PMR. We are grateful to Dr Mathew Joseph, Professor of Neurosurgery, who has been instrumental in supporting and organising this work with us. A brief summary of the various services for people with acquired and congenital brain injury is available in Brain Injury Services.

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Haematology – Orthopaedics – PMR clinic:

The Haematology – Orthopaedics I – PMR clinic is held every Thursday at 2.30p.m. This clinic is mainly for people with Haemophilia who have had bleeds into their joints or muscles.

We would like to thank Dr. Mammen Chandy and Dr. Alok Srivatsava, Professors of Haematology, Dr. Vernon Lee and Professor of Orthopaedics for their dedication and enthusiasm. Dr Raji is now back from the UK and has joined Dr Ashish Macaden in the team. Dr Judy John has gone to Canada for study leave.

Neuromuscular clinic:

Photo of the shoulder muscle of a man with muscular dystrophy showing wasting

Photograph of
wasted muscle of
a patient with
muscular dystrophy

The Neuromuscular clinic is held regularly on Thursday afternoons at 4.00p.m. Patients come to the clinic from PMR or Neurology services. The clinic is designed to help with the diagnosis and multidisciplinary care of patients with neuromuscular diseases such as Muscular Dystrophy, Spinal Muscular Atrophy and Freidrich's Ataxia. Dr. Mathew Alexander, Professor of Neurology, Dr. Suresh and Dr. George Tharion have been instrumental in nurturing this clinic. Dr. Sumitha Danda, Clinical Geneticist, has also joined the clinic which helps us to advice the patients better.

PMR – Developmental Paediatrics Clinic:

A PMR – Developmental Paediatrics Clinic with Dr. M.C. Mathews, of the Developmental Paediatrics Unit, is held on a Tuesday afternoon in the Developmental Paediatrics outpatient clinics. Children with disabilities are reviewed at the clinic with their parents and a multidisciplinary team including doctors, occupational therapists, physiotherapists and speech therapists.

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Pain Clinic:

Some types of pain can be very resistant to treatment. The Pain Clinic is one of the newer joint clinics and is held every Friday at 4.00p.m. with the Departments of Anaesthesia, Clinical Pharmacology, PMR, Psychiatry and Radiotherapy. Dr. Deepa Braganza, Consultant Psychiatrist has been a key figure in ensuring quality service in this joint venture.

Many different approaches to pain can be used including medicines, physical treatments such as heat, ultrasound and TENS, plus local injections.

Geriatric Clinic

A Geriatric Clinic providing care for elderly people was started in 2003. Dr. George Tharion, PMR, Dr. Alka Ganesh, Professor of Medicine and Dr. Prasad Mathew run the clinic. This clinic offers a comprehensive assessment by a team consisting of medical personnel, nursing staff, an Occupational therapist and Physiotherapist.

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Community Clinics:

The interaction with the community orientation rehabilitation programme of Community Hospital and Development (C.H.A.D). has continued through our participation in the weekly disability clinic by Dr. Jacob George (every Thursday) in the base Community Hospital, CHAD, in Bagayam. People who have been seen by doctors or occupational therapists in the community or the community hospital can be seen there.

Our interaction with the C.S.I. Cerebral Palsy Centre, Sainathapuram has continued and Dr. George Tharion and Jacob George have been able to visit them regularly for detailed evaluation of the children and for treatment planning with other professionals. Dr Henry Prakash continues to visit children in Nambikkai Nilayam once a week. Nambikkai Nilayam provides care for children with learning difficulties, many have cerebral palsy. They are admitted into Nambikkai Nilayam with their family to provide therapy for their mental/learning difficulties eg poor concentration, behavioural problems. some of these children also have physical problems which PMR are able to help with.

Neuroradiology Meeting:

A joint meeting between Physical Medicine and Rehabilitation and Neuroradiology is held weekly. MRI scans, CT Scans and other relevant investigations are discussed for inpatients and outpatients to help clarify the diagnoses and decide on the best management for the patients.

Amputee Clinics:

An Amputee Clinic has also been started in the PMR outpatients in the hospital. It is run by Dr. George Tharion, Dr. Suresh and Dr. Jacob George. Patients are seen immediately after their amputation to help people get back on their feet as soon as possible and to supply appropriate prostheses (artificial legs). This clinic offers comprehensive care by a team of Doctors, Engineers, Prosthetists, a Physiotherapist and an Occupational therapist.

Multidisciplinary Clinics for people with Amputations continue to be held twice a week in the Prosthetics and Orthotics Laboratory in the Rehabilitation Institute. These clinics are only for people referred there for, or who already have, an International Committee for the Red Cross (ICRC) limb. New patients are assessed for International Committee for the Red Cross limbs and patients with limbs are reviewed so that repairs and adjustments to the limb can be planned (many being done on the same day). 

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Inpatients:

Patients come from all over India and South Asia to these services as there are few other centres in South Asia. Inpatients are cared for on the hospital campus and the Rehabilitation Institute. Patients requiring acute medical care or major surgery are admitted to beds in the main CMC hospital campus. The Q3 ward in the main hospital now has 20 beds. We hope that with these new beds our waiting time for patients would be effectively brought down and we will be able to serve more patients.

The Rehabilitation Institute, or Rehab as it tends to be called, provides comprehensive physical, psychological and socio-vocational rehabilitation for severely disabled patients. The expansion of the Rehabilitation Institute is almost complete, with just minor tasks remaining, and the majority of the beds are now in use - a total of 82. There are more general beds and for the first time with have air-conditioned single private rooms/suites available. Pictures of the new facilities are on New Rehab Facilities.

photo of doctors doing an urodynamic study

Doctors doing
a CMG in Rehab

Doctors Activities

The medical staff are actively involved in planning and implementing the programme of care for patients and in evaluating outcome by providing leadership through case conferences, group therapy and continuing education. During any year, about 626 inpatients are discharged after rehabilitation 403 from the Rehab Institute. The increase in discharges is due to the additional beds available in Rehab.

The majority of the inpatients have recently had a spinal cord injury. Many such patients arrive with complications such as pressure sores which need to be healed up before their rehabilitation can really begin. Surgery is often required for the pressure sores. Inpatient services are also offered to people with cerebral palsy, amputations, contractures from post-polio residual paralysis and brain injury. The commonest forms of brain injury are traumatic brain injury (head injury) and stroke (cerebrovascular accident) and we now have dedicated services for both outpatients, as above, and inpatients in the Canon David Marriott Acquired Brain Injury Rehabilitation. You can read about the new facilities in the Rehab Institute's New Facilities.

We are very thankful for the new facilities in Rehab. This has allowed us to expand our services to people with various forms of brain injury and start to develop a team dedicated to work with them. So far we have paid for half of the development costs. If you would like to help pay for more of this development please go to our New Horizons section. The final phase of the project is to build a hostel for PMR staff, especially the therapists.

Operations and investigations:

Photo of PMR doctors doing an operation

PMR doctors
operating in the
main hospital.

Nerve Conduction Velocities and Electromyography evaluations and Nerve blocks with Bupivacaine or Phenol continue to be done by PMR staff. PMR doctors do ultrasonic evaluations (ultrasounds) of the kidneys and neurogenic bladders in Rehab. Cystometrograms/Urodynamics (CMGs) can also be undertaken in the Rehabilitation Institute for patients who need them. Joint urodynamic studies with Paediatrics surgery are now conducted every Saturday with Dr. Sudipta Sen.

Major operations are performed in the Operation Theatre on Wednesdays (shown right) and we are particularly grateful to Dr. Manickam Ponniah and his colleagues for the assistance with anaesthesia for our patients. We are also grateful to the Theatre staff, particularly the Nurses in OR III and and CB2, for their wholehearted support. Minor surgical procedures are done in the Rehabilitation Institute on Tuesdays as usual but the new theatre in Rehab allows us to do more operations in Rehab on other days as well, so hopefully our waiting list will be reduced. Further details of these procedures can be found at Patient Information

General Hospital Information

Booking Appointments etc

Details of how you can book an appointment, times and places for different tests, where the cash counters are etc can be found here: CMC Hospital Information.

Cost of PMR Inpatient Services

The cost of inpatient services can be found here: PMR inpatient service tariff
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Services Statistics:

The tables below give a rough guide of the number of patients seen in clinics and number of procedures and operations done each year.

Discharges, Procedures, and Prescriptions

Number of Patients in clinics

Service Annual

Inpatients Discharged

 

Hospital Campus

200

Rehabilitation institute

400

Total

600

Treatments & Tests

Nerve Conduction Velocities
& Electromyography

300

Major Operations

100

Cysto-urethroscopic evaluations

100

Diagnostic ultrasound

250

Urodynamic

180

Prescriptions

4,300

Drugs

11,000

Clinic Annual

PMR Opd

 

Private

5000

General

4000

Total

9000

Joint clinics

Haematology –
Orthopaedics

380

Neuromuscular

282

Pain Clinic

177

Geriatric Clinic

450

Amputee Clinics

393

Brain Injury

192

For more details of the annual statistics please see the PMR Statistics Summary.

Medical Staff:

A list of the doctors working in the PMR department can be found on Medical Staff.

A brief summary of the doctors biodata, where they trained and their areas of specialisation, can be found here: Doctors biodata. In September 2007 Dr. Suranajan Bhattarcharji took on the post of hospital director. This means he will no longer be professor and head of the PMR department. He will be unable to do any clinical work until 2012 so he will not be in clinics or on the wards till then.

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Education

The MD (PMR) started in 2001 with one candidate per year so there are now 3 doctors training for this in PMR. The first MD student successfully completed the course in 2004. The Postgraduate D.N.B. training programme in PMR temporarily ceased but one seat per year restarted in 2007.

There is an extensive programme for Continuing Medical Education (CME) within the Physical Medicine and Rehabilitation department which includes Journal reviews, case studies of gait analysis and ongoing updates using relevant textbooks covering the Physical Medicine and Rehabilitation syllabus. Doctors are also able to attend conferences as appropriate.

The Medical unit is also involved in teaching final year Occupational Therapy and Physiotherapy students and in taking a few classes and clinics for under graduate medical students. Orthopaedic, Neurology and Neurosurgery Registrars are posted with us for four weeks each. The in-service self learning programmes include weekly journal reviews and discussions.

There is more information about education within the department here: Education

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Research

For details of past and present Medical research activities please go to our section on Research.

Equipment

Electrophysiological studies:

Used to look at the electrical activity in nerve and muscle:

Electromyography, sensory and motor nerve conduction studies (NCV's), F wave, H reflex studies.

Mystro computerised Medelec EMG/EP Machine

Oxford metrics Ambulatory EMG system

Movement Analysis System:

Used to study patterns of walking and eating

Selspot 3-D Gait analysis system

Kistler force plate

Morgan Oxylog

Operating on and Investigating the Urinary system

The Urinary system includes the kidneys, ureters, bladder and urethra.

Fibreoptic and rigid cystourethroscopes and stone punch

Used to investigate and treat urinary problems associated with paralysis.

Diagnostic ultrasound with abdominal and transrectal probes

Used to evaluate neuropathic bladders and problems with urinary incontinence

Urodynamic Equipment - Dantec computerised cystometrograms system

Used to measure the bladder volumes and pressures, and the effect of treatment, in neuropathic bladders

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Job Opportunities in PMR

Vacancies arise within the PMR department at regular intervals. Medical, OT, Physio, speech therapy, orthotics and prosthetic posts and internships are all handled by the principal's Office. Contact details below.

Links

Links to the rest of the PMR web pages are in the column to the left. Hover over (mouse over / move the mouse over) the titles and see more information about the page – double click on the page you want.

Contact Us

Patient care enquiries for PMR: please contact Dr. Debbie Skeil:

Email: pmrcmcv@gmail.com

Appointments

Email: appointments@cmcvellore.ac.in

Phone: 0416 - 307 3429 / 0416 307 3430

Patients coming back to CMC and who have a CMC hospital number can book appointments online.

Page: http://clin.cmcvellore.ac.in/index.asp#new

Job and internship enquiries

Enquiries about working as a doctor, therapist or nurse and internship enquires: please contact the principal's Office:

Email: princi@cmcvellore.ac.in

Office Phones & Postal Addresses

The numbers into the hospital and college are by Direct Inward Dialling (DID). Callers can get most telephone extensions inside the hospital without involving the operators,

The code for India is 91, the Vellore area code is (0)416.
Simply dial 307 then the extension you need or 421 then the extension you need .
If you need operator assistance then dial 2222102.

PMR Office

Extension

Physical Medicine and Rehabilitation
Christian Medical College, Vellore. 632004. India

2158

Rehabilitation Institute
Christian Medical College, Bagayam. 632002. India

 

Main Office

4549

Nurses station ground floor

4302 / 4506

Nurses station, first floor

4580 / 4544

Eg Ringing Physical Medicine and Rehabilitation office from India:

0 416 307 2158

More detailed contact information can be found at Contact Us

We hope this information is accurate; if you have any additional information that may be useful or spot any mistakes, please let us know.

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Last Edited Jan 2008


Department of Physical Medicine & Rehabilitation Website