Choithram Hospital, Indore

Our beacon of hope A brief history of 25 years of Choithram Hospital & Research Centre Published by : Choithram Hospital & Research Centre, Indore Manik Bagh Road, Indore - 452014 (M.P.) Ph.: (0731) 2362491 - 2362499, 4206750 - 59, Fax.: 91 - 731 - 2470068 EMail.: medicine@choithram.org Web site : www.choithram.org Publishing year : 2006

Disclaimer This book is a property of Choithram Charitable Trust, published on th the occasion of 25 year celebration of Choithram Hospital & Research Centre. The information published in this book compiled from various reliable sources, is correct, and up to date to the best of our knowledge. However there may be some discrepancy or misquoted statements. The readers are advised to inform the publisher of any such discrepancy. Neither the editor nor the publisher accepts any responsibility or legal liability for any consequences from application of the information printed in this book. No part of this book is allowed to be reproduced, reprinted, or stored in a retrieval system or transmitted, in any form, or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. Publisher: Choithram Hospital & Research Centre, Indore, INDIA For reprint Contact:- Medical Director Choithram Hospital & Research Centre, Indore Manik Bagh Road, Indore - 452014 (M.P.) Ph.: (0731) 2362491 - 2362499, 4206750 - 59, Fax: 91 - 731- 2470068 EMail.: medicine@choithram.org Website : www.choithram.org

Seth Shri Choithram Vishandas Pagarani 1874-1939

Preface The journey of a thousand miles begins with a single step. We believe, it's th been this “first step” taken on 16 July 1979, which became the architect of our success. Time and tide wait for none. As we look back at the year 1985, many emotions well up. There is that sense of achievement we feel strongly. That single year had seen many milestones crossed; it was indeed a quantum leap. We cherished the satisfaction of nurturing a mission and being true to it. Since then we have continued to have steady progress, many new targets identified and accomplished. The sad demise of our beloved Baba Sahib Pujya Seth Thakurdasji Pagarani in 1992, was a big set back for us. It was the loss of a mentor, who had been a guiding force all these years. But this loss made us more determined. It made us stronger in resolve. Under the captainship of Shri Satish Motiani we could overcome this difficult phase. We believe that future never has a blue print for any body. It's the consciousness of our past alone that can make us understand our present. 1 Interestingly, the knowledge of our past balances the apprehension of “ how far we have to go” with the satisfaction of “ how far we have come.” This book is about the making of “Choithram”. It's about, how a thought of giving Central India, the most modern medical facilities became a reality. It's also about all those people, without whom we wouldn't be reading this book. As we take you for a stroll back in time, step by step the tale of our journey will unfold. There are many stories of grit and stories of those endeavors that have shaped Choithram Hospital and Research Center. You will read about those real but unsung heroes, who selflessly strived towards a dream that was theirs. This is their story. They lap the honor. We deeply admire them and acknowledge their role in building this edifice. Sifting through these pages, it's now for you to judge “who we are and why we are, the way we are? To us it's a story of success after success. For one peak conquered, it's time for another -The Editorial Board

Table of Contents 1. Our Torch Bearer Our Founder 05 2. Dawn - The Beginning 31 3. Trail Blazers - Our Trustees 40 4. Administrators 53 5. Our Hospital 58 6. Departments a. Twenty five years of Department of Surgery 79 Dr. C.S.Chamania b. Evolution of “Burn Unit” 85 Dr. Shobha Chamania c. Minimum Access Surgery 90 Dr. Amitabh Goel d. Urology 93 Dr. S. Thatte & Dr. Sushil Bhatia e. Development of Plastic Surgery 95 2 Dr. Prakash Chhajalani f. Dental Surgery 96 Dr. Abhijeet Mitra g. Surgical Oncology 97 Dr. Sanjay Desai h. Paediatric Surgery 98 Dr. Manish Patel 7. Cardiology & Cardiothoracic Surgery 100 Dr. Vidhut Jain 8. Neuro-Sciences 109 Dr. Dakwale & Dr. Kathpal 9. Obstetrics and Gynaecology 114 Dr. Neelu Soni 10. The Department of Ophthalmology 118 Dr. V. Kalevar 11. Department of Otolaryngology 122 Dr. Sudhir Bhargava 12. Department of Orthopaedics 127 Dr.Yeotikar & Dr.Wadhwani 13. Department of Anaesthesia 134

Dr.Meenu Chadha & Dr.V. Palsule 14. Laser programme & development 141 Dr.N.S.Bhagwanani 15. Promotion of Excellence 146 Dr. Savita Inamdar 16. The Neonatology Unit 153 Dr. Savita Inamdar 17. The department of Medicine 154 Dr.Bhatia, Dr.Sharma, Dr.Geed 18. Gastroenterology 158 Dr. G.Naik & Dr.A.jain 19. Nephrology & Renal Transplantation 161 Dr. A. Sepaha & Dr.P. Salgia 20. Laboratory Medicine 172 Dr. D.S.Chitnis & Dr.S.P.Joshi 21. Nuclear Medicine & Radiology 179 Dr. M.K.Soni, Dr.Gokhale, Dr.Karnik & Dr. Tyagi 22. Nursing 185 Mrs. Usha Ukande 23. In Fond Memories 190 Dr. Kamna Jain 3 24. Down Memory Lane 191 25. Vision Twenty Twenty 193 Dr. A.Jain, Dr.K.Vaidya 26. Mission Impossible Acknowledgement 195 Col. Kamlakar Vaidya

A Tribute to... SHRI THAKURDASJI PAGARANI 4thJuly, 1914 - 19th March, 1992

Our Torch Bearer Pujya Seth Shri Thakurdas Choithram Pagarani “A cloud does not know why it moves in just such a direction and at such a speed.” Thakurdas was the third child of Shri Choithram Pagarani. Born on June 4, 1914 at Masughot District, Hyderabad, Sindh. Thakurdas was very naughty in his 5 childhood. But his father had high hopes for him. Looking at his broad forehead and charming personality, the doting father predicted that his son would be a great man, some day, and thought “Thou art a jewel that will outshine the sun one day…”Thakurdas received his basic education in the village of his birth and the comparative lack of education was compensated by keen observation and uncanny understanding of human nature. He was a business oriented man and started taking an interest in business from a very early age. In 1937, he left his hometown to explore the opportunities in Free Town, Sierra Leone, West Africa. He stayed there for a while, but he returned to Sindh following the death of his father in 1939. Sitting at home was unthinkable for him. He initially went to Indonesia, then to Gibraltar, and finally returned to Free Town. During these years, he created a simple, honest business strategy. Buy the material from a wholesale dealer, transport it to the place of demand and sell it at retail price. In 1944, at 30, Thakurdasji opened his first confectionery and grocery store at Free Town. His drive for success started from here onward. This, then, was the beginning of unparalleled success he achieved and enjoyed in life. For this reason he always had a special love and affection for that country. Thakurdas was a very ambitious man. He never grew roots in one place, at least not for more than a couple of months. Constantly traveling to different parts of the world to expand his business interests. His skilful management, relentless drive

and uncompromising standards enabled him to open an extensive chain of retail outlets in numerous countries. Within a decade the company achieved total domination of the consumer market. A large number of confectionary factories started in the mid 60s, supplying the local market and neighboring West African countries. “A journey of a thousand miles starts with a single step” - Tao Te Ching Seth Thakurdasji wanted to spread his business to London, which he visited many times. Finally, in 1960, his company “Natco” was launched in UK. This was to meet the needs of Asian community. He came to understand good business opportunities at Dubai. He visited Dubai in 1971-72 and finally decided to open a branch there, five years later. During 1970s, rapid expansion of his business took place, with a number of shops, supermarkets and pharmacies, being successfully opened in Liberia and export offices set up in Hong Kong, Japan, Taiwan, and New York. Trading operations were started in Las Palmas, Tenerife and Spain, specializing in electronics, novelty and non-food products. 6 In 1975, the group expanded its operations into the UAE where it now has the leading chain of more than 35 supermarkets and departmental stores. It also operates large wholesale, catering and export divisions. The expansion spread to Oman, Bahrain and Qatar. In late 80's trading operations were extended to Togo and Cameroon, Ghana, Benin, Tanzania, Oman, Azerbaijan, Vietnam, Guinea, and India. By now, businesses carried on by Thakurdasji were outstandingly successful and spread widely across the world. These were usually named \"T. Choithram and Sons\", often known simply as \"Choithrams\". In 1989, Thakurdasji brought most of his business under one umbrella organization and used some of his companies, particularly T. Choithram, International S.A. and Bytco International S.A., as his bankers. He did not draw profits out of the companies but built up credits on accounts with those companies. He also established joint accounts in his own name and the name of a family member. In consequence, after his death, individual family members became the sole owners of their respective accounts. He had clear intention of leaving a substantial amount of the remainder of his wealth to charity. He was a true patriot at heart, an Indian by birth and attained most of his success from Sierra Leone. Therefore, he gave credit for his success to both countries. And obviously, he had an internal desire to do something for them. The first Choithram Charitable Trust was established in Indore, on Dec 29, 1970. The

trust activity included the smooth running of Choithram dispensary, established in November 1972. Within six month “T. Choithram Foundation trust” was formed. This trust activity included the individual working of Choithram School, established in 1972. In 1978 “Tirath bai Kalachand School” was added to the T.Choithram Foundation trust. Mrs. Tirath bai was his aunt and child widow due to the early demise of his uncle Mr. Kalachand. She was very attached to Thakurdasji, and especially concerned about his education. He gave all credit for his success in life to his father and to this aunt. As a tribute to his aunt “Tirath bai Kalachand” school for secondary education was opened and named after her. In 1979, Choithram Hospital was added to Choithram Charitable Trust. Most of his establishments are named after his father. The T.Choithram Foundation trust activities were further expanded and two schools added after his death. A Choithram Memorial Hospital was opened in Free Town, Sierra Leone. He also wanted to establish a world class Eye Hospital at Sierra Leone. He was appointed as Counsel General of Sierra Leone to India. In 1990, Thakurdasji established a third trust; “Choithram Fountain for Humanitarian Services Charitable trust”, at Indore, for rural masses. The last trust; “Choithram International Foundation”, 7 was established just before his demise. Philosophy: A Karma Yogi True to his name “Thakur das” meaning “Servant of God”, devoted all his life in the service of mankind. He had specially chosen two areas for human services Education and Health. He would always say, “I am only a custodian of the money, given to me by God Almighty.\" As a faithful servant of God, he wanted to return the money to the poor and underprivileged. Never an ungrateful man, he always remembered people who had helped him in times of need. He never wanted his name mentioned anywhere in his entire establishment just as a true “Karma Yogi”. The following verse from the Bhagavad Geeta explains his philosophy of life. \"'In action alone is your claim, never in its fruits at all. Letting go of the fruit of action, the intelligent of unified intuition, liberated from the bondage of birth, go the way free from misery. Geeta, chapter 2: 47 - 51 (English version by Sanderson Beck- Internet) Trusts:

Four Charitable Trusts were established during his lifetime with equal shares in all. All these trusts have common objectives. 1. Choithram Charitable Trust: This trust was established on Dec 29, 1970. It runs: A. Choithram Dispensary (Est. in 1972)· The Trust runs Choithram Dispensary where patients avail the facility not only free OPD, but also Free medicine. Investigations are carried out at highly subsidized rates. l The trust incurs expenditure of Rs. 15 lakhs per annum. l About 75,000 patients are treated every year. B. Choithram Hospital & Research Centre Indore (M.P.), India (Est. in 1979) Aims at providing world-class medical facilities at affordable cost to the people of Madhya Pradesh in general and Indore in particular. l Choithram School of Nursing was established in 1982. It was started to cater to the needs of nursing staff for the hospital. l Choithram College of Nursing in 1996: There are 240 students under training for B.Sc. Nursing, and eighteen students in M.Sc. Nursing in five specialties (Medical Surgical Nursing, Psychiatric Nursing, Community 8 Health, Obstetrics, Paediatric Nursing). 2. T. Choithram Foundation: This trust was established on May 24, 1971. It runs: A. Choithram School l The school has about 2500 students. It is one of the best School in M.P. l It is the first and the only school to have permanent affiliation to C.B.S.E. spread over 22 acres. It has a staff of 300 teachers. l Rs.10 crore has been invested by the Trust so far in its development. B. Tirath Bai Kalachand School l It is a 10+2 School registered under the M.P. Board. l There are more than 1000 students, and a staff of 75 persons. l It is meant for the people of lower and middle-income groups. l School situated at Palsikar Colony, Indore. C. Choithram International (IB): Established in 2004, it has authorization for an education system based on International Baccalaureate program. It is first of its kind in central India. The IB aims to assist schools in their endeavor to develop and nurture the individual talents and teach students to relate the experience of the classroom to the realities of the world outside, so that they may grow as critical thinkers, lifelong learners, and informed participants in local and international affairs in the world /all around. Forty staffers keep the students in academically fine fettle. Spread over six acres of land at Manikbag Road the school has 300 students and nearly four crore have been spend on

this project by the trust. D. Choithram School North Campus (CBSE): Established in the year 2004. It is an extension of Choithram School for the northern part of the city of Indore. It has CBSE affiliation with 1000 students and a staff of 80. It is spread over an area of 10 acres and around Rs.8 crore have been spend on its development. 3. Choithram Fountain of Humanitarian Services Charitable Trust: This is a rural trust for the needs of the rural public, such as free eye treatment and free dispensary. Every month about 350 free cataract operations are done. It provides free education and agricultural research. It runs Choithram Fountain Hospital and Choithram Fountain School (about 1000 students). 4. T. Choithram Foundation International: The main umbrella organization looking after all the trust's activities. {{{ 9 Fond Memories of ....... By his daughter: Ms. Dhanwantari Pagarani Shiva devotee... Once while opening a branch at London he needed money. While travelling he phoned a bank manager, telling him that he needed bank finance, giving him 2 hours time. He got bank clearance before he reached London. The credit for this he gave to Lord Shiva. In another incident, he was very depressed due to some business loss. At that time he prayed to Lord Shiva and got out of the bad situation. Since then, he became a Shiva devotee. He had Shiva temples constructed at Choithram hospital and at his Godha Colony residence. His father, Shri Choithram was a Krishna devotee. By association with saints, All filth is removed, Pride is effaced, Divine knowledge is revealed, God is known to be near, The mind is free from illusion, Man feeleth not enmity for anyone, Man becometh very pure, Man abandoneth all self conceit, Man's faith is completely established, Man shall be happy in this world and the next, God is seen in every heart….

Cleanliness... He was obsessed with cleanliness and was very strict about this. He was extremely short tempered and was irritated seeing dust on office furniture. The only thing he used to observe keenly during his visits to the hospital was cleanliness. At his home, he insisted on cleanliness. If the servants did not come, he himself would start the cleaning, even the bathrooms. Once Baba visited the Pathology Department of our hospital. The news of his visit had already been announced. The department was thoroughly washed and cleaned. During his visit, Baba went to the Autoanalyser room of Dr. S. P. Joshi, and asked for a chair. He stood on it and felt the dust on the top of the Godrej cupboard; it annoyed him to see the status of cleanliness. (Narrated by Dr. S. P. Joshi, himself the eyewitness). He was a great lover of nature and loved gardening. The beautiful gardens of the Choithram campus are testimonials of his taste. He would enjoy sitting on the lawn near the canteen of the hospital, during his daily evening visit to the Choithram hospital. He had a beautiful garden at his residence. A simple man, he never believed in pomp and show. He was never proud of the money he earned and 10 once said to his friends that he would die as a pauper. That meant he wanted to donate a large chunk of his money to the poor community especially for health and education. He earned money from his trade business and spent his profits on building hospitals and schools. An Unassuming personality... He had another very good habit of inquiring about the well being of his employees. During his visits to the Choithram Dispensary, he would pay for his OPD card sitting in the queue unnoticed. He was such a simple man that almost all the time he went around unrecognized by the staff. He would mark hard working staff members and would personally go to them to enquire about their needs. My India: Once a British citizen mentioned to him that that all British citizens travel by British Air. Being an Indian he decided to travel by Air India only. He used to say; “India is great, though it is Ram Bharose” (Mera Bharat Mahan!). He was true patriot! {{{

Seth Shri Thakurdas Choithram Pagarani

Fond memories……. By Dr. R.C.Varma Choithram Fountain of Charity... One fine morning, sometime in 1990, Baba and Mr. Mitra visited Dr. Varma's Union Hospital at Dhar Road. They had a sheaf of papers with them. Baba used to visit this place once a while for Yoga exercises. Mostly, he used to call Dr.Varma at his residence for exercises, whenever he was in town. So this was a surprise visit, the purpose was unknown. Mr. Mitra explained the purpose of their visit to Dr.Varma. Baba wanted some papers to be signed by Dr.R.C.Varma. When asked, what it was all about Mr. Mitra explained that these papers were in fact, a trust deed with the name \"Choithram Fountain of Humanitarian Services Charitable Trust\". Baba wanted Dr.R.C.Varma to accept the role of Managing Trustee. The situation was unexpected and Dr.Varma was not mentally prepared for it. He asked for two days to go through the papers and discuss the matter with his family members. Baba agreed to wait for two days. After two days, Mr. Mitra visited Dr.R.C.Varma. Dr.Varma accepted the terms and conditions with a slight modification. Dr.Varma being an old man wanted his family members to be included as members in the trust. Baba gladly agreed to this demand and signed a cheque of Rs.50 lakhs to be deposited immediately in the bank, for the purchase of at least 100 acres of land. 13 Mr. Ashwini Varma, the younger son of Dr.Varma and a very dynamic person, immediately purchased 60 acre of land and construction of a rural school building and an eye hospital started. Baba was not satisfied at the speed of the work. He always used to say; “Doctor, are you not interested in more money”? He was in a sort of a hurry to finish the project as fast as possible. He wanted to see the normal functioning of the trust in his lifetime. He deliberately named it The Choithram Fountain of Charity. He made it very clear to Dr.Varma that money is no consideration. In fact, at one time, he indicated that, nearly Rs.50 crore were to be spent in the project in the next 10 years. He told them that the trust was like a fountain of charity for the rural population and will not dry up. During his stay in Indore, every evening he would call Dr. Varma and Mr. Ashwini to know the progress. He used to guide Mr. Ashwini and gave him many practical tips in purchasing goods and the art of negotiations for purchase. Baba hardly visited the actual site once or twice but the trust is a reality and will keep on functioning on the unlimited \"Fountain of Charity\". “Service can have no meaning unless one takes pleasure in it. When it is done for show or for fear of public opinion. It stunts the main and crushes his spirit.” Gandhiji. “Life is real! Life is earnest

And the grave is not its goal Dust thou art, to dust returnest Was not spoken of the soul…\" These oft quoted lines of H.W.Longfellow reflect the essence of Seth Thakurdas Choithram Pagarani, who believed in the dictum service before self. He was a man with a vision who believed in creating something for the betterment of humanity. He was a true philanthropist. {{{ Fond memories……. By Dr. N.S. Bhagwanani (Retd.) Ex-M. D. - 1988-98 Baba spent six months in the year at Indore. He would visit the hospital twice daily. In the mornings he would spend an hour or two in our office. Evenings were meant for a walk around the hospital after which he sat for about an hour in /on the lawn. He was very fond of the hospital and would always like a daily report. He used to arrive in an old Fiat, dressed in simple dhoti and kurta, often with wooden footwear, smoking a beedi. No one could ever imagine that he was a billionaire, with a business empire that spread over twenty odd countries. He hated publicity, 14 and never met any officers, VIPs and photographers. I recall some interesting important episodes. A hard taskmaster... One evening as we were sitting on the lawn a lady slipped on the steps of the hospital. Baba saw this and lost his temper; “Are you blind?, Don't you care for the people? Patient's attendants/families are preoccupied about their sick relatives and are often in hurry. You must provide a small nonskid ramp”. Next day he came and asked; “Why is the ramp still not made”. He gave the civil engineer hell. Sure enough, work was completed rapidly. He was a kind-hearted but an impatient man, a hard taskmaster. “Life's like a play: it's not the length but the excellence of the acting that matters.” Dr. Idnani Vishramgrah... On May 18, 1988 Dr.N.B.Idnani, our former Medical Director left for his heavenly abode. He was a dedicated man and had endeared himself to all. He had not only established the hospital well, but had also planned a road map for future development. It was a great loss and shock for all of us. I particularly felt very sad. Some months later, one evening I asked Baba to sanction Rs.20, 000/- as a corpus fund, I wanted to institute a yearly award, in the name of Dr. Idnani, for the best paper presented/published from our hospital. Baba gave me a dirty look, immediately got up. He walked up to an area next to the canteen, where we had an engineering workshop shed. He ordered; “Shift this junk out from here and

construct a nice big dharmshala in his memory”. Soon, we had the Dr. Idnani Vishramgrah which could accommodate about hundred families -attendants/ relatives of patients\". He was a big-hearted man. “Unselfishness is more paying. Only people have not the patience to practice it.” \"To hell with bloody millions...\" One morning he was sitting in my office when a telex was received from Liberia. T. Choithram & Sons had a supermarket there. He asked me to read it out to him. - \"Civil War is raging in Liberia; our supermarket at Monrovia has been completely looted costing a total loss of X' million US $. Baba just didn't react at all. So I repeated 'X' million $. He shouted impatiently to read on and said; “Hell with bloody millions, are all our men safe”? It was not the money, but men who were important to him. Within a few months, he started new departmental stores in Oman and Muscat to rehabilitate his staff. You jolly well do it... One evening, sitting with him. I said; “We are holding many conferences and seminars and need a good auditorium”. He got up and walked to our medical store building and ordered, \"Niju (my first name), measure the area. I marched along the length and breadth of the building.\" He quickly calculated the area (2 1/2 ft. per step) and said it should suffice comfortably for 250 people. He ordered to build 15 an auditorium on top of the medical store building. A day later, he questioned the engineer; “ Why haven't you started the work?”. Engineer pointed out that; “roof span is big, it may not take the load, we have to get the architect to make drawings & get it approved by corporation”. Baba shouted; “Once I say construct the auditorium, you jolly well do it, make supporting columns in the stores. I am least interested in the architect and his drawings. The corporation permission you can manage later”. Well we soon had a nice auditorium. Such was the style of his working. I felt he was a combination of a Sultan and a Field Marshal! He said “ I expect to pass through life once. If therefore, there be any kindness I can show, or any good thing I can do to any fellow being, let me do it now, and not defer or neglect it , as I shall not pass this way again……” Is it all essential? In June 1991, I went to his house, along with few consultants, with a big list of equipment and their use for modernization of the hospital. I read out the list required - Colour Doppler, Holter Monitor, Computerised Tread Mill; EMG Evoked Potential Machine, Mobile Image Intensifier 'C' arm, fully automatic Operation table, 500 MA X-ray machine, a set of flexible Endoscopes with Camera, different types of Ventilators, Infant Incubators, Dental chair, Blood Gas Analyzer, one more ambulance. The total cost was about Rs. 4 crore. He asked one question \"Is it all essential for the best treatment? We said \"Yes\", and he said \"OK\". The whole

thing took less than five minutes. When we came out, our Managing Trustee Mr.Motiani joked; “Even the Government of India cannot print that much money in 4 minutes!”. Baba was very clear in his mind; his goal was to provide modern, state of the art medical technology and the best medical care to people of Central India. His' OK' meant go ahead no further paper work, formal proposal and sanctions required. I have yet to come across a philanthropist with such unlimited generosity. When I think of him, these lines resound in my mind; The man of life upright Whose guiltless heart is free From all dishonest deeds, Or thoughts of vanity; The man who's silent days In harmless joys are spent Whom hopes cannot delude, Nor sorrows discontent: Good thoughts his only friends, His wealth a well-spent age, 16 The earth his sober inn And quiet pilgrimage…. Fond memories……. By Mr. M.L.Naik {{{ School fee... The incident dates back to the time when Tirath bai Kalachand school building was almost ready and the school staff selection in progress. One day, late Trustee Shri Lekhrajji Pagarani was asked by Seth Thakurdasji , \"What should be the tuition fees for the school children?\" Shri Lekhrajji replied that it should be according to the expenses incurred by the school. Humble Seth sahib was awe struck; this school is for the students belonging to poor families. He said, that they should get free education with provision of mid-day meals. Shri Lekhrajji had his reservations, but had to agree on the middle path of only Rs.10/- as monthly school fees and mid-day meals. These tuition charges continued for a long time. So caring was our Seth sahib. Power Saving.. “He who will not economize will have to agonize”. Confucius One day Seth Sahib gave the Godha colony trust office a surprise visit during

lunchtime and found only few peons present in the office. The other staff had gone home for lunch. During that time, only a few people were on the staff roll. Seth sahib asked the peons, why the lights and fans were on in the office, when there was nobody there. He asked them whether they would do the same at their homes. The peon immediately realized and rectified his mistake and promised that this would never happen in future. This wasteful expenditure never happened after that day. So simple and farsighted was our Seth sahib. He taught us, “Power saved is power produced”. Staff as one family... The incident dates back to the year 1972. Shradhpaksh was on and Seth Sahib ordered that all his staff should attend the Shradh Puja followed by lunch. The office staff reached on time. He enquired why one person was less (that is I). He was informed that I had gone for the sales tax date. He immediately ordered, that I be informed to reach his house once I am free from my work. When I reached his house he gently asked me if I was hungry, as I was away the whole day on official work. When I told him that I did not have my lunch, he immediately summoned Sadhu-baba (the cook) to prepare lunch for me. Seth sahib, considered the whole staff as one family. 17 Fond memories……. By Dr.Bakliwal, senior Orthopaedic Surgeon Invisible Giant... {{{ I was fortunate to be the first Medical \"Doctor\" attached with Choithram Trust. I joined the trust in 1972. Being the first medical person I was in close association with Thakurdasji Pagarani. He was very punctual, and disciplined. He never took any undue advantage of his post and position and was very simple in his day-today life. His routine clothing was, a white kurta and pajama with a black bandi on the top. Due to his simplicity he was practically unknown to the staff of the Choithram dispensary. Very few people knew him by face. But he knew everything about the staff working for him in the dispensary. I have learned a lot from him. Punctuality... I distinctly remember a few instances regarding his sincerity and punctuality even 30 years later. One fine morning, I received a phone call from Mr. Mitra, secretary to the trust, seeking an appointment for Shri Thakurdasji, at my convenient time next morning. I fixed an appointment for 8:00 am next morning at his residence. Due to some casualness on my part, I was late by 15 minutes. I was surprised to see Shri Thakurdasji patiently waiting for me. I knew I was late, but Shri Thakurdasji only pointed a finger towards his watch to make me aware of my delay. He did not

utter a single word about it. I finished his examination and wrote a prescription. Very frankly, he told me that he takes medicine prescribed either by Dr. S.K.Mukherjee or Dr. G.L.Sharma. He just wanted to get a routine examination done by me. When I was about to leave the house, secretary Mr. Mitra gave me my consulting fee in an envelope. He never took advantage of his position or status. I was impressed by his gesture, and decided to be punctual. \"If I can afford, why should I take charity?\", this was his attitude. There was another instance. One day I was in my chamber looking after OPD patients. All of a sudden I found Shri Thakurdasji standing front of me. He had made his OPD card and was patiently waiting for his turn to come. Since he was very simple looking person, no one knew him by face. After the examination and prescription was over, I tried to accompany him up-to his car. He refused immediately and asked me to continue my work of seeing other patients and not to bother with formalities. This was another sign of his greatness. Once he was admitted in the hospital. He 18 paid the entire bill. He said; “When I can afford the treatment, why should I take charity”? “ The purpose of life really is a life of purpose. But in order to be in a position to add real value to other people and contribute to the world as best as you can, you must first come to know who you really are as a human being.” Fond memories……. By Dr. Santosh Choube I/C Choithram Dispensary 1978 I have done no charity... {{{ With regard to charity, Thakurdasji used to say, “I have done no charity, it was of the public and for the public and I am just a co-sharer of it” .To put forward his point, he once narrated a story. Once upon a time there was a jagirdar, who ruled over a small territory. One fine day, he renounced his powers to lead a poor man's life with his wife and children. His wife said; “you gave away everything in charity and now we are left with nothing to eat”. She repeatedly kept asking him to visit Maharaja Vikramaditya for help. This was their daily routine. At last, the poor jagirdar got ready to meet king Vikramaditya. His wife gave him five chapattis and pickle to eat. On the way he halted near the bank of the river Kshipra to eat his food. As he was about to eat, a lean, dirty dog came and stood before him with pitiful eyes. The poor jagirdar felt sympathy and gave it one chapatti. After eating this, the dog still stood there. So

one by one the jagirdar gave all the chapattis to the dog, and filled his stomach by drinking water only. Finally, he reached Maharaja Vikramaditya's palace, he requested the guards there to present him in the durbar. The poor jagirdar narrated his whole story to the king and requested for help .On hearing this, Maharaja Vikramaditya ordered his ministers to look into the personal history and find whether the charity he had done had reached God or not. The minister after looking at the jagirdar's history said, “He has done no charity as such, but he fed a hungry dog, being himself hungry. And because of this he should get half of the kingdom. So Maharaja Vikramaditya gave a large part of land to the jagirdar. The moral of this story donations of worldly things cannot be included in one's charity whereas when you help a needy person by scarifying your own comfort. It is a charity in the real sense. “Charities that soothe, and heal, and bless, lie scattered at the feet of men like flowers”. Fond memories……. By Prof.G.C. Sepaha 19 \"Sab Bhangwan Ki Kripa Hai, Aap To Kam Chalu Rakhe...\" {{{ Like many senior physicians of the town, Dr. Sepaha was also one of the advisors to this hospital. The original budget was Rs.15 lakhs only. But as the work progressed, more and more money was needed to complete the project. It was decided by senior consultants to work out the ultimate budget, so as to plan accordingly. It was a total surprise to the advisory board that there were no final budget limits. The advisory board was in dilemma as it could not decide any final limit because whenever the board members approached Baba, he would say; “Sab Bhagwan Ki Kripa Hai, Aap To Kam Chalu Rakhe”. That was Baba's way of saying 'yes' to any proposed expenditure. Finally, when the hospital was commissioned in 1979, it had such equipment which were either the first in the country or there were only two / three of its kind. Even Dr.S.J.Mehta was surprised to find the list of equipments purchased (under the able guidance of then medical director, Dr.B.N.B.Rao). They were not available even at Jaslok Hospital. “ Let every hand give comfort to all living beings and let it be the giver of health to the whole mankind.” Fond memories……. Mr. P.D. Asawa (first secretary to Choithram Charitable trust, & Choithram Foundation Trust - 1970 -1972). {{{

How Far he will Go? Mr. Asawa was working with Mr. Kalani, an industrialist, and was in Pipe manufacturing business at that time. Seth Lekhraj was in Pipe fitting business. They were known to each other. On the request of Seth Lekhraj ji, Mr. P.D.Asawa joined the Choithram trust as its first secretary in Feb.1970. The trust deed was already made but was not registered at that time. Being a young man, and worried about his future, Mr. Asawa asked Seth Lekhraj ji; “How far this charity work will go”? Lekhraj ji replied, I really don't know how much The Big Seth has, but it is certain that he will go too far, which we cannot imaging at the moment. This gave a sigh of relief to Mr. Asawa. Seth Thakurdas ji was a very jovial and a caring person. He always use to look after the personal problems of his employees. What is Wasteful expenditure? One fine morning in the year 1971, Mr. Asawa was reporting the trust activities to Seth Sahib. The meeting was interrupted by a family member, who asked for a few thousand rupees for the purchase of some fancy ornament. The Seth Sahib got angry and started giving a lecture on how to save money. The topic stopped then and there only. Next morning, there was a meeting with the members of the trust. The initial 20 expenditure for the building of the hospital was Rs. 12 lacs. The new architect gave a new budget of Rs.25 lacs. With this sudden doubling of the proposed expenditure, Seth Shri Thakurdasji gladly accepted and ordered to go ahead with the new plan. Few thousand rupees at home was wasteful expenditure, while any amount spent as charity was no problem. His unconditioned respect for his father: Seth Thakurdas ji had great respect for his father. He wanted to keep the names of all his establishments on his father's name. There was a rumour that the new hospital, which was going to come at south-west part of Indore, would be named as T.Choithram Hospital. When Mr. Asawa asked him the reason, he curtly replied;” What is there in a name? I am doing things for my satisfaction or others. I have tremendous respect for my father. It was his express desire that the new hospital should be named as Choithram Hospital. Against Publicity: Why should people know me? What is there in publicity? Whenever he used to be in Indore, he was in a habit of going for a morning walk on Manik bagh road. People who were regular in their morning walk could never know that the simple looking man is the owner of the upcoming hospital. People used to get confuse and think shri Lekhraj ji as the owner of the hospital. He was such an unassuming personality. It has never bothered him. It used to make no difference to him, whether people know him or not. Once Mr. Asawa, was

enumerating the advantages of being known in the society to Seth Sahib. He simply retorted; “I do what I like, I do it for myself. I don't need anybody's help for my charity work. Why should people know me”? There was no prescribed form for any loan or financial help. Almost all the charity was done on verbal commands. They were not even recorded in the trust activity. Excellent Management: Sitting at home, every night he used to get telephone calls from all parts of the world. He was managing his show from his house. All his relatives, cousins, and son - in-laws were heading top posts in his vast empire. He used to work like a Chairman and enjoy the position. No business matter was ever discussed in the trust office. Most of the office work was only trust related work. Since a School and a hospital were under construction, all discussions were restricted to the local project only. It was a known fact that whenever he used to get happy with the work of any employee, he would offer him a job in one of his various companies out side India. The offer was given to Mr. Asawa, who declined it for personal reasons. Any delay in the work assigned, used to make him very upset & loose temper. He would shout but would not threaten them of any consequences. 21 Fond memories ………By Mr. D.L.Patidar (secretary since 1972 still continuing) Mr. D.L.Patidar also joined the trust on the recommendation of Mr. Asawa. He too was working with Mr. Kalani, before joining the trust. {{{ What is wastage? The trust office was close to the residence of Seth Shri Thakurdasji. One summer morning, Seth sahib, got up early and found that the light bulb on the staircase remained lit for the whole night. He visited the trust office at the usual time and fired every body for the misuse of electricity. Every one became conscious and scared. It so happened that, once on a winter morning, when it was still dark, nobody dared to put the light on. Seth Thakurdasji was very quick to note it. He enquired about this. He called every one and explained that, he is not against the use of electricity but he is against the misuse of it. The Morning round: Seth Shri Thakurdasji used to take the round of the hospital twice a day, whenever he was in Indore. Usually he would come alone. The morning rounds were basically silent but very watchful. He used to observe the difficulties felt by the general public in the hospital. The rounds were never administrative. He was too much concerned about the patient's inconveniences in the hospital. Since very few people knew him by face, so his job was very easy. He used to observe the working of the hospital, un-noticed. Toilet cleanliness especially in the general wards was his obsession. He would personally check each and every place and would give a good dressing to the responsible persons.

Beautiful gardens: Seth Thakurdasji was very eco-friendly. He wanted greenery, fresh air and beautiful gardens all around the buildings. Once he noticed some wild grass growing in the garden in front of the main building. He immediately ordered the garden to be dug, and instructed to maintain the garden lawns with proper kind of grass. He believed in the role of environment in healing of diseases. Identification: Once Mr. Patidar was talking to Seth Thakurdasji on telephone. He identified himself as Mr. Patidar. Seth Thakurdasji did not say any thing at that time. Later he called him and suggested him a practical tip; “It is a good habit if you identify as Mr. Patidar from Choithram Hospital. This makes sense, as there can be N numbers of Patidars in the town”. It was very simple tip of working especially in public relation and administrative jobs. 22 Pujya Seth Thakurdasji left for his heavenly abode on March 19, 1992 after a protracted illness (lung cancer) in London. That was the saddest day. We lost our beloved benevolent donor. His body was brought to Indore and cremated in a beautiful garden in the hospital compound. It was a problem getting his photograph. Finally we found his face in a group photograph taken 15 years earlier during his daughter's wedding. This has been enlarged and placed in our hospital foyer. He will live on in millions of hearts who received medical care and succours from CHRC. “ You are led through your lifetime by the inner learning creature, the playful spiritual being that is your real self. Don't turn away From possible futures before you're certain you don't have anything to learn from them. You're always free to change your mind and choose a different future, or a different part……………” {{{

Recollecting the final days… I finally did it and now everything is for them …\". Witnesses, who were present near him during his last days recollect him as having said \"I now give all my wealth to the Trust\" or \"I have given everything to the Trust\" or \"I'm handing all my gifts, all my wealth, all my shares, to the Trust\" or that he made a declaration of a gift of \"his shares and wealth to the Choithram International Foundation\". He repeatedly said that he had done his bit that he had given all his wealth to the Foundation and there was nothing more for him to do. On March 8, 1992 (say the day before he was admitted to the ICU at the Wellington Hospital) he had said; \"I have given up everything and I feel very happy now. What I was wanting to do, I finally did it and now everything is for them …\". “Behold, I do not give lectures or a little charity, when I give, I give myself….” Anonymous 23 “It was our Founder's policy to treat all of our employees like a worldwide Choithram family and it is the continuing aim of today's Board of Directors that people should spend their entire working lives in whatever capacity they operate happily and successfully with us once they join”. Shri Kishore Pagarani The majority shareholder of the Choithram Group is a Trust. A part of the Trust's objectives is to work for humanity, which is basically to provide medical care, education and environmental solutions for the less privileged amongst us. Shri L.T. Pagarani

A Brief Account Of Choithram School By Manish Tanna Director, Choithram Group of Schools Choithram School Indore is one of the premier institutions of Madhya Pradesh, and has been rendering yeoman service to the public of Indore for the last 34 years. The school has a well-maintained campus of 26 acres with adequate facilities for its 2600 students to play and flourish in a peaceful and unpolluted atmosphere. The Pre Primary Section Choithram School can proudly hold its head high for having one of the best pre- primary sections, which is popularly known as the Montessori Section. It has 6 Montessori sections. No section has more than 22 children. Each room is built to a special specification of 20 ft. x 40 ft. to accommodate the Junior and Senior Montessori children who sit in groups separately. It is amazing that both groups carry on their study schedule without disturbing each other. One big advantage of this system is that the Junior Montessori students get exposed to the Senior Montessori schedule and interact with them which helps their growth and development. Each Montessori Room has teaching aids worth almost 40,000/- . All learning in the Montessori Section is related to Child Activity. Computer Department 24 We have an ultra modern Computer Department which was established in 1986. Over the past two decades the department has made steady progress. The training in computer application is imparted to students from classes I to X as regular part of the timetable. In +2 stage Computer Science, Web designing Multimedia, Informatics Practices are offered as elective subjects. A Junior Computer Lab. has been provided in the Montessori building for classes I to V. It also has 20 machines with all peripherals. All departments of the school are connected through local network and most of the communication is through network. The school website www.choithram.in is very interactive and provides links to all group websites. School Library: The School has a well-equipped Open Shelf Library which contains more than 40,000 Books. Every year hundreds of Books are added to the already rich store of books which cover a wide spectrum of subjects ranging from fiction to Encyclopedia and Gardening to Interior Decoration. The Library is open to students during school hours and is one of the most popular departments for boys and girls of the school. There is a junior Library for students up to class V in the Junior School building. School Tiffin: We provide a wholesome and nutritious lunch to our students and staff at a nominal cost. Not only does it facilitate things for parents, but also plays a vital role in fostering the feeling of brotherhood and harmony among students.

Children of all the castes and creed sit together and eat with a feeling of unison and oneness. In just forty minutes, 3000 persons have lunch everyday. The same dining hall caters to the Boarders for their breakfast, evening snacks and supper. Co Curricular Activities School has a regular time slot for both indoor and outdoor activities for classes up to X. There are three hobby hub hours every week that provide children opportunities to learn and enjoy activities like clay modeling, dramatics, cookery, gardening, woodwork, science and eco projects etc. During the Annual function of the school, the talent of the students comes to the fore. The unique feature of the school is that more than 500 students appear on the stage in one or the other programme. Transport & Communication The school has a massive fleet of 13 buses which helps transport students and teachers with clockwork precision. Games & Sports There is also ample scope for Games and Sports in the school. There are Basketball Courts, Tennis Courts Volleyball, Football and Cricket fields. Table 25 Tennis and Badminton are also there. School students regularly bring medals at the CBSE tournaments right up to the National level. Indoor sports like Chess, carrom-board, etc. are also quite popular. Games are also compulsory up to Class X. A swimming pool has been recently added for the school as well as hostel students. There is Scouts and N.C.C. for boys and girls. Academic Performance Our students have been giving a commendable account of themselves at the Board and Public examinations. The results are usually cent percent with a sizeable number succeeding at the PET,PMT, IIT JEE, AIEEE, CPMT and other Examinations; our best students usually score more than 90% and there are around 10 students every year who get CBSE Merit certificates. Choithram School North Campus Continuing the untiring efforts of Late Seth Thakurdasji Pagarani in the field of education and healthcare, the trustees have given yet another bounty to the city of Indore. Choithram School North Campus, is affiliated to CBSE. It is an attempt of the Trust to reduce the travel time of the children residing in this northern region. The school is right now from Nursery to Class IX and has all the regular features of the Manikbag School and is fast growing. Choithram International It was inaugurated on 30th June, 2005 by the then director of IIM Dr. Rajan Saxena and it has never looked back since then. Parents across the town have noticed the

change in the personality of their children with this formative exam system. One classic comment “I am surprised that the child is not watching TV but sits on computer or collects material for the projects in the evenings.” It covers classes from Nursery to XII (2007-08). The school is authorized International Baccalaureate world school and also Cambridge International Examination Centre. It is one of its kind in whole of Central India. CI had an important landmark achieved last month with the Pre Authorization visit from the Regional office at Singapore. The Associate Regional Manager Mr. Patrick Ritter was with us for four days. He not only did the pre-authorization documentation, but also conducted whole school training for the MYP teachers i.e. those for Classes VI to X. At this juncture, let me explain the functioning of IBO. According to their system, a new school is provided a lot of handholding. Starting from the in-school training, IB workshops and also on the Web. Trainers, Officials from IB keep on visiting the school for first 4 to 5 years. A teacher is expected to attend a training session at least once in two years. They become the assets of the school. Hostel The school has offered the residential facility to boys of class V and above in its new hostel from this session. The current strength is 46 and the final capacity is 128 26 students. It has all the facilities available at home and a few more. The playgrounds, the library and the computer lab add to the meaningful routine of the hostlers. They celebrate all religious and national festivals in a total family atmosphere with their teachers who stay along with them. Choithram Center for Life skills Learning (C2L2) Choithram is the only institution in the State with a progressively functional Guidance and Counselling department since 1987. The department used to render all the essential services to children ranging from Career Guidance, conducting of Aptitude Tests, attending to Referral cases as also providing all essential information regarding various scholarships available in India and abroad. Also, information regarding various courses available in India and abroad is made available to students. Parents also referred the psychological problems of their wards to the Guidance and Counselling Department. Its new avatar C2L2 Choithram center for Life - skills Learning came into existence in the year 2000. As its name suggests, the Centre aims to equip people at large with skills needed to have a healthy, productive and successful life. The department began the year 2005 with Teacher's Effectiveness Training (TET) programmes. In the month of May the department conducted a 3-dayTeacher's Effectiveness Training Workshop for the teachers of Sarafa Vidya Niketan, Indore. Second TET workshop conducted by C2l2 was the two- day programme at Scholars' Public School, Morena. In the month of June the center conducted in -

house Teachers' Effectiveness Training Workshops for the Choithram group of th th schools. This was the first-ever workshop of its kind and was held from 10 to 12 June. 120 teachers of the Choithram groups of schools attended this three-day residential programme. Month of June had been a very busy month for the C2L2 cell. Another TET programme conducted by it was a three-day workshop at Sendhwa Public School, Sendhwa, which was well received by all the 24 participants. C2L2 conducted another TET workshop in Raghuvanshi Public School, Sendhwa on 4th and 5th of September, which was attended by 17 teachers of that school. C2L2 has also conducted two workshops on the parenting skills. C2L2 Department also organized a career awareness programme and a career fair. A number of colleges and educational institutes participated in this fair and students got first hand information about different courses and careers open to them. C2l2 conducted ASSET exam, in which 430 students from all the three schools participated. The driving force behind the astounding progress of Choithram School is indeed it's ebullient and dynamic Managing Trustee, Mr. Satish Motiani. With his charismatic personality and 'never-say-die' attitude, this enterprising ' go getter ' has infused 27 new ' life-blood ' in the main-stream of Choithram establishment. He cheerfully talks himself into investing millions in progressive, far-sighted projects without batting an eyelid: his ardent desire to enhance the status of the school and his irrepressible zeal to put it on the map of India act as a constant source of inspiration to everyone concerned with the all-around progress of the school. Integrated life and action is education. Integration does not come about through, conformity to a pattern, either one's own, or that of another. It comes into being through understanding the many influences that impinge on the mind; through being aware of them without being caught in them. The parents and society are conditioning the child by suggestion, by subtle, unexpressed desires and compulsions, and by the constant reiteration of certain dogmas and beliefs. To help the child to be aware of all these influences, with their inward, psychological significance, to help him understand the ways of authority and not be caught in the net of society, is education. Education is not merely a matter of imparting a technique which will equip the boy to get a job, but it is to help him discover what it is he loves to do. This love cannot exist if he is seeking success, fame or power, and to help the child understand this, is education. Self-knowledge is education there is neither the teacher nor the taught, there is only learning; the educator is learning, as the student is. Freedom has no beginning and no ending; to understand this is education. - J. Krishnamurti on Education

Choithram Fountain School & Choithram Fountain Hospital By: Ashwini Varma The School was started in the year 1993 with the primary school. Today it is a high school. The total constructed area in the school is about 55,000 sq ft. It has proper play grounds, audiovisual facility, music, fine art, indoor games, computers, band etc. The total number of students coming to the school is nearly 1250. The school has Six school buses for the transportation, It has a proper facility of mid day meal with a proper state of an art dining hall & modern kitchen. The school fully equipped Physics, Chemistry, Biology & Computer Labs The Trust has adopted 22 villages from where the students are being admitted in the school. The school is affiliated to Madhya Pradesh Board. It has both English & Hindi medium. The total staff of the school is 52 teachers, 6 drivers, 6 conductor, 8 sweeping staff, and 2 peons. Primary Health Centre: - Under this project two general doctors are appointed by the Trust so as to treat the patients with the general problems. All the medicines are distributed free of cost. 28 The beneficiaries are near by farmers. Under this project we have a provision for free vaccination for the children below the age of five. Two camps are conducted every week in different villages to screen the patients. Under the primary health programme we have a complete set up of Dentistry & ENT. Eye Hospital:- Eye Hospital was established in the year 1992. Initially the response was poor. Today it is number one eye hospital in the town as far as number of surgeries are concerned. The total number of operations performed in a month is between 300-350. 90% of the operations performed are IOL's. Eight Ophthalmologists are giving their services to the Trust; the hospital is equipped with state of an art technology & equipments. We have two operation theaters with three operating microscope one phaco machine, one A-scan machine; three slit lamps, one keratometer, one autorefractometer, Laser machine, 15 sets of operating equipments etc. We have a fully equipped pathology to support the hospital. {{{

North Campus North Campus North Campus North Campus 29 North Campus North Campus North Campus Choithram Fountain School

South Campus - Old South Campus - New South - Boys Hostel Hostel Computer Lab 30 Dining Hall Swimming Pool I.B.O. I.B.O.

The Beginning By - Dr. S. L. Mangi No army can withstand the strength of an idea whose time has come - Victor Hugo “Life is no brief candle for me. It is a sort of splendid torch which I have got hold of for the moment, and I want to make it burn as brightly as possible before handing it on to future generations.” In 1970, Seth Thakurdas Choithram Pagarani had desired to establish a hospital only for women at Indore. The Choithram Charitable Trust was duly formed under Shri Lekhraj Pagarani as Managing Trustee in late 1970. Dr. S.K. Mukherjee and Dr. G.L. Sharma were advisers to the Trust, while Mr. P D Asawa was working as the secretary with Mr. Gupta as assistant secretary to the trust. A charitable dispensary on an OPD basis was started at Pagnis Paga, in 1972. The same year, Seth Thakurdas Pagarani pledged to donate Rs. 15 lacs for construction of a modern, well- equipped hospital for providing excellent health services to the poor masses. The 31 Trust approached Shri P.C. Sethi, then Chief Minister of M.P., through Seth B. K. Muchhal for allocation of land at MOG lines. A preliminary drawing was prepared by a local firm M/s. Naik and Matkar, architect and engineers and submitted to the government. The M.P. Government agreed to this but put forward some conditions, which were considered an obstruction in the smooth functioning of the Trust. It was decided to buy our own land. A piece of land was identified and finalized (not purchased yet) at Manik Bagh Road, in 1972, and M/s. Sheo Dan Mal, architect and engineers from Nagpur, provided fresh drawings. Three drafts were prepared, following lengthy discussions with senior consultants of the town. When the groundwork of the hospital was about to start, Dr. Mangi visited Jaslok Hospital, Bombay Hospital, Beach Candy Hospital Bombay, PGI Chandigarh, and A.I.I.M.S., New Delhi, for a better understanding of the infrastructure required for a modern, well equipped hospital, on the insistence of Seth Thakurdasji. At Jaslok Hospital, he met Prof. Shantilal J. Mehta, who was the Medical Director of the hospital and Dr.R.D. Lele, chief of Radiology and Nuclear Medicine departments. Both these gentlemen have contributed much to the establishment of Choithram Hospital and Research Centre at Indore. The original building plan, however, was found very inadequate and was duly disposed off. On the recommendation of Dr.S.J.Mehta, Dr.Mangi went to Delhi to

invite M/s Kothari and Associates for a new building plan and design, in January 1974. On their recommendation more adjoining land was purchased (the present location of hospital and school), about 50 acres of land was purchased during 1973- 4. The building maps were submitted to the Municipal Corporation and approval was granted in November 1974. The construction of the hospital started thereafter, according to the design supplied. The cost of the construction, initially proposed, was Rs. 12 lakh, by Naik & Associates. It went up when M/s Sheo Dan Mal proposed Rs. 22 lakh in 1972. Kothari & Associates proposed Rs. 66 lacs. But when the construction was completed with all equipments, the Trust had spent nearly Rs. 2.5 crore. Dr.Mangi was a practising consultant as well as principal of the Dental College. Shri Thakurdasji visited him at his Jail Road clinic as a patient. After a few visits, Thakurdasji requested Dr. Mangi to join his organization. He was planning to build a hospital at Free Town, (Sierra Leone) West Africa, while Dr. Mangi expressed his inability to visit Free-Town. Thakurdasji then informed him that he was planning to open a hospital in Indore itself, he accepted the offer as thus would improve the medical facilities in Indore where there was a better chance to 32 develop medical science in the central India. It was a great sacrifice on the part of Dr.Mangi to leave a secure government job, where he was working at the elevated post \"Principal, College of Dentistry\", and had another 9 years of service left. When he tendered his resignation to the Health Secretary of the M.P. Government, he was discouraged and was advised by well-wishers not to leave the job. Looking at the dedicated intention of Seth Thakurdasji, Dr.Mangi made up his mind, left the job and joined the Choithram dispensary in 1973. This gave him sufficient time to meet the Donor and mutually discuss future plans with him. The previous panel of advisers was dissolved. Dr. Mangi met some senior professors of the town and setup a new panel of advisors. These were Prof. G.S.Grewal; Prof. G.C.Sepaha; Prof. A.C. Jain; Dr.D.P.Mukharjee; Dr. Upadhyay (Pioneer Lab); Dr. S.R.Jain; Dr. Harish Sahni and Prof. Ahaluwalia. Dr. Mangi was regularly in touch with these professionals for advice and guidance, until 1978. The area was app. 100,000 sq.ft . Similar stretch of land was reserved for ancillary buildings. The initial layout and department requirement was advised by Dr. Mangi, Dr. Upadhyay, Dr.A.C. Jain (neurologist), and Dr. S.R Jain. The cost of building this hospital with nurses' hostel, doctors' quarters, and resident's hostels was approximately Rs.2.5 crore in 1979. Mr. Thakurdas Mulani was the project manager, Mr. Shah the executive engineer and Mr. Mattai the assistant engineer. The contractors were Mr. Badrilal Gorelal, Mr. S.K. Taose, Mr. Rambhai B Patel. Mr. Lele of Rajkumar mills was taken as consulting engineer for electro

mechanical work. By this time, Mr. Mitra replaced Mr. Asawa who was secretary to the Trust in 1972. The construction of the hospital commenced in late 1974; the project was earmarked to be completed by the end of 1977, but due to conflicting advice the project was delayed. On the recommendation of the then owner of Santokhba Durlabhji Hospital Jaipur, a post of full time Medical Director was advertised in 1976. Padhmashree Prof.B.N.B.Rao joined as the first Medical Director. Mr.R.B. Lal, who had retired as a senior officer from the Directorate of Health Services, Bhopal, joined the hospital as a full-time secretary to handle all administrative work. Choithram Hospital had the most modern equipment at the time of its inauguration. These were purchased on the recommendations of Dr.B.N.B.Rao. (All credit for the surgical setup goes to him.) When the building was taking shape, a new board of \"would be\" consultants was formed. This was the time when Dr.K.L.Bandi, Dr.Mrs. Inamdar, and Dr. Manudhane, joined the hospital. This was late 1978, early 1979. Dr. S.J.Mehta was surprised to see the list of equipment CHRC had, which were not even available at Jaslok hospital. Dr.R.D.Lele established the department of Radiology and Nuclear Medicine. On the recommendation of then owner of Santokhba Durlabhji Hospital Jaipur, a 33 post of full time devoted Medical Director was advertised in 1976. Padamshree Prof.B.N.B.Rao joined as first Medical Director. Mr.R.B.lal, who retired as a senior officer from the Directorate of Health services, Bhopal, joined the hospital as a full time secretary for all administrative work. Choithram Hospital had most modern equipments at the time of its inauguration. These were purchased on the recommendations of Dr.B.N.B.Rao. All credit for surgical setup goes to him. When the building was taking shape, a new board of \"would be\" consultants was formed. This was the time when Dr.K.L.Bandi, Dr.Mrs. Inamdar, and Dr. Manudhane, joined the hospital. This was late 1978 and early 1979. Dr. S.J.Mehta was surprised to see the list of equipments CHRC had, which were not even available at Jaslok hospital. The department of Radiology and nuclear medicine was established by Dr.R.D.Lele. The department was so well equipped that it was rated among first few departments in the country. Dr.Sudarshan Lal Tirath Ram Mangi, born on July 10, 1926, at Lahore, Punjab. Entered in College of Dentistry at Lahore in 1946. but completed his B.D.S. degree from Sir C.E.M. Dental College, Bombay in 1950. Dr. Mangi joined as lecturer at M.G.M. Medical College Indore in 1951 and took voluntary retirement from the post of Principal, College of Dentistry, Indore, in 1973. He was the key person in separating dentistry from General Surgery, and establishing the College

of Dentistry at Indore, in 1966. During his tenure at medical college, he went to the School of Dentistry, Indianapolis, Indiana, USA for his master's degree in operative dentistry, in 1957 58. He joined Choithram Charitable dispensary in 1973, was promoted as administrator in CHRC in 1979. He was on this post till 1984. He continued to work as senior Dental Surgeon at the hospital till 2004. Dr. Mangi is the only person who must be credited for establishing two independent institutions single-handedly in one life span. College of Dentistry and Choithram Hospital. Padhamashree Prof. Basavapatna Narayana Balkrishna Rao (1910 1993): Was not only a great surgeon but a brilliant teacher. His simplicity, his sense of humor and intellect are only underscored by his humanity. He was Prof. & Head of Surgery, 1945-47, Mysore, Prof. & Head of Surgery, and later dean, GRMC, Gwalior, 1947-64, and Prof. & Head of Surgery, 1964-72, AIIMS, New Delhi. He worked in Choithram Hospital in 1976 and retired in the year 1978. 34 Padhamabhushan Dr.S.K.Mukherjee (1898 1996): Born on September 6, 1898 at Guwahati. He passed his medical degree in 1923 from Calcutta Medical College. On March 4, 1925, he joined King Edward Medical School, Indore. In 1930, he passed his MRCP from Royal College of London, and returned to Indore in 1931. He retired as Prof. of Medicine in the year 1958 from M.G.M. Medical College, Indore. He was decorated as Rai Bahadur in 1936, and MBE in 1944, by the British Government. He was awarded the Padhamashree in 1962 and Padhamabhushan in 1971 by Government of India. Dr. Mukherjee was a lifelong friend, philosopher and guide to Seth Shri Thakurdasji. While the construction of the building was going on, the time had come for the appointments of consultants and the type of contracts. There were many disputes in the hospital policies at the time and the basic question was: Whether to keep all full time consultants or only honorary. A system, where senior honorary consultants and young budding registrars, who would later on be promoted, was also in consideration. “Trust yourself. Create the kind of life you will be happy to live with all your life. Make the most of yourself by fanning the tiny, inner sparks of possibility into the flames of achievement.”

There was no clear answer to this basic question. Dr.B.N.B. Rao was of the firm opinion that there should be all full time consultants. While Dr.S.J.Mehta and Dr.Mangi, with all other consultants wanted to have a two tier system. Finally Dr.B.N.B.Rao resigned and left towards the 1978.( by this time Dr.N.B.Idnani has already entered into the scene) He was a very able administrator and a competent surgeon. Advertisements for Full time consultants were already in the national and international newspapers. And the list of applicants was short listed. Equipments were ordered and shipments were received. The list of equipment short listed, was sent for import permission of the govt. of India, which in turn sent back to the MP state govt. for recommendation and finally again sent back to Local Health authorities. This was taking too much time and effort, as govt. of India was very selective on allocation of foreign exchange. As the funds for CHRC were coming in foreign exchange hence Mr. Lal's efforts made it possible for us to import the needed equipment easily without need of any import license and free of duty. That was the most important contribution of Mr. Lal in the starting of the hospital in time. A German Firm “Begeca” was instrumental in purchasing equipments for the hospital and subsequently gifting them to the hospital. The payments were made by the trust directly to the firm. 35 This was the time Dr.N.B.Idnani joined the institution in late 1978. The whole system got geared up. Interviews of senior consultants like Dr.M.C.R.Rao as chief in surgery, Dr.T.Suryarao as Neurosurgeon, Dr. Rebbero as Chief Radiologist. Dr. Ajay Dashottar as full time chief consultant in Medicine, Dr. Anil Mishra in Obst.& Gynae, Dr.J.K.Sharma as Nephrologist, Dr.J.S.Kathpal as neurologist, Dr. Pannilal Dhand as chief Pathologist, Dr.Taranath Shetti in Pathology, Dr. D. Chitnis as Microbiologist, Dr.S.P.Joshi as Biochemist, Dr. R.M.Chouthe as Chief th 16 July, 1979 Choithram Hospital & Research centre.

anesthetist. These were all full time posts. Dr.K.L.Bandi, Dr.Harish Sahni, Dr. Mrs. Inamdar, Dr. B.N.Jangalwala, Dr. Manudhane, Dr. Grewal, Dr.Mrs. V.V.Nadkarni, Dr.R.P.Dhanda, Dr.Natu in pathology (blood bank), Dr. D. Mukharjee as cardiologist, Dr. Kamal Singh as Gynecologist, and Dr. W.P.Thatte, joined as honorary consultants. All the interviews were taken on the first floor where the OHU unit is situated at present. Dr.Matwankar joined as assistant Medical Superintendent. Dr. N. B. Idnani Dr. Harish Sahni Dr. S. J. Mehta Mr. R. B. Lal 36 Although the appointments were given but the exact date on which the hospital was supposed to be commissioned was far from sight. Interviews for post of registrars were also taken and appointments were given. Mr. Suresh Carlton joins as a medical record officer in Oct.1978. The first Registrars to join were Dr. C. S. Chamania and Dr. Mrs. S.Chamania in surgery in the April month of 1979. This was followed by Dr. S. C. Jain and Dr. Mrs. Kamna Jain in pediatrics, Dr. S.K.Bhargava (ENT) and Dr.Mrs. Nisha Bhargava Obs & Gynae), Dr. Atul Lokhande in anaesthesia, Dr. Achal Sepaha (medicine nephrology), Dr. Vinod Naneria, and Dr. Pradeep Bhargava in orthopaedics, Dr. Mrs. Meena Bhargava in Gynae, Dr. Davendra Bhargava and, Dr. Vivek Palsule in anaesthesia, Dr. Artwani (medicine) Dr. Sudhir Parwani (Ophthalmology) Dr. Ramesh Tharwani (medicine cardiology), Dr. P.Shivalkar in radiology, joined as registrars in various departments. Mr. Rishi appointed as chief security officer. Mr. Jamunalal Yagnik as P.R.O., Mr. Budhwani as legal advisor, Miss Chandra as PA to Medical Superintendent, Mr. Shyam Patel as Store Officer. Mr. Chandra Sekhar as C.S.S.D, In-charge and Mr. John as O.T.Superintendent. Sister Roy was our First Matron, worked just few months and was replaced by Mrs.Shanta Nair. Most nursing staff joined as couples. Mr.& Mrs.Rao, Mr.& Mrs.Nath, Mr.& Mrs. Shally, Mr. & Mrs. Ukande, Mr.& Mrs. Pansare. It was the management policy to appoint couples as a long term planning, as for as possible. The construction work was going on at full scale under the leader ship of Mr. Murli Pagarani as chief engineer with a team of dedicated assistants like Mr. Ashok

Dube, Mr. Sunderlal Mulchandani, Mr. Thakural as electrical engineer, Mr. Lalwani as civil engineen, Mr. Govind and Mr. Chandru Mirchandani, Mr. Rajani and Mr. Vishnu Kuray. The account department was looked after by Charted account Mr. N.K.Jain and helped by Mr. Kamal Khatod, and Mrs. Premlata Vyas. Mr. Narayan das was our canteen contractor( present nephrology ward) and M/s Vishal Chemist ( present general health check up room) was given the contract of medical shop. Mr. Jakhetia as purchase officer, Mr. Shyam Patel as store officer, Mr. Pradeep Joshi in establishment deptt., and Marriyappan as EEG technician, Mr. Kashiram Balgi as plaster technician, Mr.M.K. Narote was in-charge of PBX system, Mr. Kushwaha as C.S.S.D. assistant, Mr. P.Y. Samuel as Office assistant cum typist, Mrs. Manda, Mr. & Mrs. Jonathan, Mrs. Jyoti Kango, Mrs. V. Palsule Mr. Shyam, Mr. Pradeep, Mr. Sharad, Mr. Girija shankar ambulance driver, Mr. Suresh, Mr. Lalta Prashad as OT technician and many more. Almost 96 persons who joined the institution in the year 1979 are still on the pay-roll of the hospital. Many have changed the contract and are still providing their services to the hospital. Due to the shifting of OT complex from ground floor to the first floor, the space for OPD consultation chambers were very few. Temporary construction of Surgical and Medical OPD were added on ground floor. The administrative block (present 37 OHU) was shifted to another temporary construction (present Old surgical ward). The initial divisions of wards were: Male general ward, Female general ward, and private wards. The Semiprivate ward category was added later on. The Physiotherapy block was under construction and the space above it was marked for administrative block. Before the hospital was commissioned, the daily activity of most of the newly appointed registrars was to unpack the instruments and help in making inventories. To keep every body involved weekly lectures were arranged. Mr. L.G.Pagarani was our first Managing Trustee. Mr. R.B.lal was as secretary to the hospital, Dr.S.L.Mangi as Administrator, Dr.N.B.Idnani as First Medical Superintendent, Mr. Murli as Chief Engineer. Mr. N.K.jain as Chief account, Mrs. Nair as Chief Nursing superintendent. There was lot of uncertainty about the exact date of inauguration. But it was due th to hard work and excellent administration of Dr. Idnani that 16 July 1979 was finally chosen to start the Hospital. The hospital had 130 beds with 3 beds in ICU. 4 major OT, 1 minor OT, with emergency department. On 16th of July 1979: A yagna was organised in main hospital foyer at about 11am. The rituals were performed by Seth Shri L.G. Pagarani in presence of family members and the whole hospital staff. And the hospital was declared open for public. “Take up an idea. Make that idea your life; think of it; dream of it; live on it…….”

Choithram Hospital 1979 Building Reception 38 Private Ward General Ward Operation Theater Dental Dispensary Canteen

Choithram Hospital 2005 Building Private Ward 39 Delux Ward General Ward Cath lab Dental I.C.C.U Nursery

The Trail Blazers “The fragrance of flowers goes only with the wind, but the fame of good men goes even against the wind” 40 Shri Satish P Motiani

Shri Satish P. Motiani has acted as a “Burden Bearer”, in the true sense. To run a charitable hospital amicably, making it self sufficient and independent institution was a herculean task, especially after the death of “Baba”. Not only the Choithram hospital, but the Choithram School also made a tremendous progress in the last 20 years. New dimensions were added to the hospital and new schools were opened to fulfill the desire of our beloved “Baba”. In Shri Satish Motiani we have found leader of top quality, self-assured, with a confident spirit that is untiring, unassuming, benevolent, kind hearted at the same time a tough taskmaster. He is a man of few words who avoids publicity. His story is a story of amazing success. Editorial Board Shri Satish Parumal Motiani joined the institution on November 1, 1984, in response to a request made by Mr. Kewlani (son-in-law of Seth Thakurdasji). Born in February 1954, he was just 30 years old, when he took-up the responsibility of this institution. The Motiani Family belonged to Mirpur Khas district of Sindh province (now Pakistan). Descendants of Mr. Motiram, (hence Motiani) they were rich landlords. These wealthy Motiani zamindars and traders lived at old Mirpur and later shifted to Mirpur Khas where they owned vast tracks of land and farms. They were very influential people and had cotton mills at both Mirpur Khas and at 41 Pathora. Their offices were at Mirpur Khas, Karachi and Bombay. In 1947, Seth Parumal and Seth Roopchand were members of Mirpur Khas Municipality. th Partition of the country was a big tragedy for the undivided India in the 20 century. Most affected, were the people living in the northwest part of India. People from Sindh, had no “Promised Land” in the new country. Most of them were uncertain of their future in India as well as in Pakistan. Those who could afford kept double establishments in both countries. The Motiani family had their establishment at Karachi, Mirpur Khas, Bombay and Jodhpur. They had their “cotton gaining” factories and frequent traveling between establishments by family members controlled the business. In 1947, a part of the family shifted to Jodhpur. They temporarily stayed there before going back to Mirpur Khas. Primary education of young Satish up to Class VII took place at his native town. As a routine, all young members of the family were moved to Karachi for further education. So, it was with Satish in 1966. He joined St. Patrick's college at Karachi, the same college from where Mr. Lal Krishna Advani had his education. He later joined National College of Engineering. Due to some family problems could not complete his education and had to join the family business. In 1977, at a young age of 23 he shifted to Jodhpur, India. Satish Motiani moved between Jodhpur, Bombay, and Surat for better business opportunities. He was married to Saraswati, the youngest daughter of Seth Thakurdas Pagarani

in June 1983. He was blessed with a daughter, Bhavna and a son, Dushyant. After his marriage, he was an occasional visitor to the Choithram Hospital. This was the time when on the request of Seth Thakurdasji, Mr. Kewlani approached him to accept the responsibility of this institution as a Managing Trustee. It was not an easy decision. Mr. Satish Motiani was born and brought up in a business class family. To sit at one place was not in his temperament. Knowing the institution, its potential, and the respect for his father-in-law, made him to take up the challenge of joining this place. These words of Winston Churchill echo with what our trustee is made up of: “ Sure I am that this day we are masers of our fate, that the task which has been set before us is not above our strengths; that its pangs and toils are not beyond my endurance. As long as we have faith in our own cause and an unconquerable will to win, victory and success will not be denied us.” On November 1, 1984 he officially joined as a head of the institution and since then he has not looked back. Taking the lead from his predecessor Dada Seth Lekhraj ji Pagarani, the youthful Mr. Motiani watched the working of the hospital before 42 joining for some time. He observed that many small or even critical decisions were delayed for unknown reasons. People were scared of publicity. Files used to move at snail's pace and there was too much dependency on people coming from outside as advisors. This was all OK for a system working for more than four-five years. But this was not acceptable to a young blood such as him. As a Managing Trustee, he put a full stop to unnecessary paper work. He was a one-man army and it's commander-in- chief. He was bold enough to take combined responsibility for his actions. With his attitude, files started moving fast. The old advisory board was quietly dissolved. The results were soon becoming visible, and 1985 saw a tremendous movement. Right from January till December, we had many state and national level conferences. He was like a breath of fresh air and brought in a gamut of changes. In January, the Ophthalmology took the lead, under the guidance of Prof. Dhanda and Dr.Kalever, a workshop on Corneal Transplantation was organized jointly with Geeta Bhavan Hospital. On February 10, the third Annual conference of the M.P.Chapter of Orthopedics was organised by Department of Orthopaedics. On February 18, 1985 with the first Open Heart surgery of the central India being performed by Dr.Rajsekhar Devineni, the Cardio-thoracic unit became fully functional. The first “PCNL” workshop was organized on February 22-24, 1985. Dr.Shrikant Vaidhya and Dr.Walter O'Donnell and associate from the USA conducted the workshop, with live demonstration of the surgery on CCTV.

On March 24-25, a workshop on “Stapedectomy & Vidian Nerve Surgery” was organized by Department of ENT, under the leadership of Dr.Manudhane and Dr.Shrikant Phatak. Dr. Kirtane from KEM, Bombay was the course director. Choithram Hospital was one of the first few centers in Central India to acquire a Ultrasound Scanner in 1985, when an ATL MK-600 Machine was installed. Dr. Sudheer Gokhale and Dr. Vidyut Jain, were instrumental in starting the Abdominal and Cardiac Ultrasound in the hospital. On September 14, 1985, the first Renal Transplant was done with the help of Dr.M.H.Kamat. The team consisted of Dr.K.L.Bandi, Dr.R.K.Lahoti, and Dr.C.S.Chamania. Even the concept of separation and development of Burn Unit was conceived during this year. These are just few landmarks to be enumerated in the overall progress in various field of medical science at Choithram Hospital and we were the leaders in most other branches. “Far away there in the sunshine are my highest aspirations. I may not reach them, but I can look up and see their beauty, believe in them and try to follow them.” There was no blueprint for any future planning for this hospital from the very beginning, neither was there any plan for expansion of the building. The hospital was designed to provide medical facilities to the citizens of Indore and nearby areas. It was all the time dependent on the trust money to pay the monthly salary to the staff. From 1985, the hospital started generating its own money. But, for 43 further development we were still dependent on the trust for finances. This situation continued till 1992, as long as “Baba” was alive. It was only after his demise, the situation changed. There were technical problems in getting money for expansion. We had to learn to be independent. It was difficult to begin with, but it worked. This was the time we learned the role of Marketing and Publicity. We approached corporate sectors for entering into a contractual provision of health services to their employees. Unnecessary expenditure was cut down. Some money did come from the trust, but it was a very difficult time for the whole hospital. In spite of this, free treatment for needy patients never stopped. The Choithram dispensary for free patients continued as it was, and more facilities were added to it. There was a suggestion to start a medical college but Mr. Motiani firmly declined the suggestion on the plea that the hospital was not in the money earning business for the trust. The whole idea was to serve the people with “quality care”. He was of the opinion that there was no need to run for patients from the government sector, as was a routine for most private sector hospitals to get government recognition for reimbursement of medical expenditure of their employees. Mr. Motiani believed in providing quality care that would assure automatic inflow of the patients. “The sun makes the flowers blossom, the moon spreads its light and the clouds cause rain without being asked for, so do virtuous people do good to others unsolicited” Anon

Different Mood's 44

His philosophy and comments on the current issues: We must be technologically sound: Mr. Motiani is positive, helping, and a persuasive personality. He has never discouraged anybody for his or her individual progress. His whole idea is that, we should not lag behind in any medical facility. Keeping this in mind, hospital consultants have regularly visited leading centers all over the world as fellows and observers. He believes that, to be in the competition you should strive to be number one. He assures that finances will never be a problem. He promises that he will never stop acquiring new technology merely for want of finances. He insists on quick planning and decision. Though he is not a dreamer and does not believe in predicting what will happen to the institute 15 years from now. He is very positive about the future. Now we have the financial backing of the trust, and we are also self-sufficient. Why we should be lag behind as far as modernization is concerned? In his opinion, deteriorating “bed occupancy” is no parameter to judge our progress. In fact, the bed strength has remained the same over the last five years (year 2000 2004). We have fared better than other institutions, which are also 45 facing similar situations. There are other factors to be considered vis-à-vis, facilities have improved in peripheral places and many other institutes have come up with modern facilities. There is competition in the medical field. Competition improves quality, takes away lethargy and from the patient's point of view makes us conscious of the escalating cost of medical care. He believes: “See what you focus on in your life- grows, what you think about- expands, And the things you invest your attention in- grow in importance. Happiness is nothing more than a state of mind that you create by the way that you process and interpret the events of your life.” We have a good future because: l The corporate sector will come to us as we are a totally transparent organization. l The Insurance companies will come to us due to our credibility. l Our billing system is totally transparent. l Our credibility will hold us in good stead. l Patients will come directly to the hospital. We provide quality care at economical rates and all facilities are available under one roof. Our basic aim is not to cater only to the affluent class, but to provide “Quality care” to all irrespective of the class.

Mr. Motiani is a very compassionate man. He just cannot reject any poor patient's request for free treatment. Previous trustees were scared because the fear of being exploited by the common public. But this does not bother him. He is not scared of getting cheated by a few. He wants to treat patients free of cost who genuinely need help. He says; “We spend nearly Rs. 50 lakh in free treatment of poor patients annually”. Over and above that, he really cannot refuse to any one. Even when there was some financial problem after the death of Baba, the facilities of free investigations and treatment at Choithram dispensary not only continued but many new facilities, like X-rays, sonography and other laboratory investigation facilities were extended. Future expansions. The trust has incurred an expenditure of Rs. 5 crores in the last three years. There is a lot of money with the trust and Mr. L. T. Pagarani is very positive in his approach. We are ready to acquire any latest equipment necessary to provide modern medical treatment to our patients and we have already identified certain areas for expansion. On staff motivation he concedes, “We do agree that we have failed to motivate the staff due to some communication gap.” We know, it is the “man” behind the machine rather than the machine itself.” 46 He has directed administrators about staff motivation being the key factor in the smooth running of departments. Mr. Motiani insists on punctuality. If it is your OPD day, then you should be in the OPD. He doesn't like patients waiting out and grumbling. It is the same for the afternoon OPD. The concerned person should be on his seat irrespective of the number of or the lack thereof of patients. He gets upset when this breach of contract occurs. \"'There is no intuition for the undisciplined; and for the undisciplined no concentration; and without concentration no peace. Without peace, where is happiness? Geeta, chapter 2:66 Human Resource development: He feels we are lacking here. We have to use modern methods of handling human resource development. We should have a professional approach towards our employees and they should feel proud in joining the institute and being proud of it once they leave it. The communication gap must be filled. This will also help us in getting maximum output from our employees. They will also get the maximum satisfaction for the work done. Our problem: Mr. Motiani believes that our inability to retain our trained nurses is our main problem. Nurses leave because most of them go to the US after appearing for the CGFNS examination. We are short of trained nursing staff and are not able to retain trained people. To solve this problem he is working on the CGFNS course at Indore. The eligibility for the course will require 2 years of experience after

B.Sc. degree. He will spend 15 lakh rupees annually and bring in intelligent and dedicated nurses. The selected candidates will stay with us for a total period of four years after they get their B.Sc. degree. That will change the scene, as far as trained nurses are concerned. Nurses are not leaving for want of money. He doesn't mind paying more money, but people are not coming forward. He feels that we are lacking in persons with leadership qualities, especially in nursing. Rating of our hospital: Mr. Motiani rates the hospital at 6-7 on a scale of 10, barring the aesthetic value of the hospital. He has visited many hospitals. He has observed their working. He does not think, we are inferior to anyone. Delay in billing, or some lapses on the part of working staff are acceptable everywhere in India. Most of the private sector hospitals are commercial organizations with a clear concept of earning money. We are running a charitable, service orientated hospital. We must remember that difference. Therefore, we should have high a rating for our hospital. “ Few will have the greatness to bend history itself but each one of us can work to change a small portion of events, and in the total of all those acts will be written the history of this generation.” Public Relations: Mr. Motiani cautions us about our public relations. We should 47 watch our overall market reputation. Reputation went down because of loose talk by our own doctors. Those who are not connected with us may say anything; we have no control on them. But the doctors of our own institution must have a sense of responsibility and loyalty. If they behave properly, our public image will automatically improve. Free OPD and Paid OPD: Most of the time, the rich class does not want to stay in the queue. Free OPD is also detrimental towards bringing in rich people to this hospital. They avoid coming to our OPD and visit the consultants of the institution in the morning hours. To tackle this situation we are going have paid OPD during morning hours for those who don't want to queue-up. We are going to run a parallel paid OPD simultaneously. There will be a provision for a secretary giving appointments and a summary. So there will be no more free treatment and no queue for the paying class. The space taken by the present X-ray department will be modified for the paid OPD. In the long-term this will surely work. On incentives and punishments: Mr. Motiani does not like to praise anybody by sugarcoated words. He has his unique way of dealing with concerned persons. Incentive means uplifting a deserving department. Any demand for new equipment made by them will be sanctioned without any question or delay.

- Rajshree Rantidev (Mahabharat) {{{ Philosophy 48 The desire is neither kingdom, nor heaven not even moksha (salvation), {{{ The desire is to- relieve the mankind of suffering & pain.

Different Occasions Exhibition Neurocon First Corneal Surgery Workshop Endosurgery Conference College of Nursing 49 First Choithram Journal In Germany With Prokhorov Laser Conference

50 Seth Shri Lekhraj Gyanchandji Pagarani 1914 - 1986

First Managing Trustee: Seth Shri L.G. Pagarani By - Mr. D. L. Patidar Seth Shri Lekhraj Gyanchandji Pagarani born in 1914 in Sindh, he was first cousin to Seth Thakurdas ji Pagarani. He completed his primary education in his hometown, and was later trained as an accountant. He struggled hard to finally become the Managing Director of T. Choithram & Sons. His journey upward included working as a postman, an accountant and a tax consultant. He served in business organizations in Japan and other Far Eastern countries as an accountant. In 1948-49 he joined his first cousin Thakurdasji Pagarani in Freetown, Sierra Leone, West Africa. He continued to work in the company till 1964. Finally, upon retirement he shifted permanently to Indore. In 1970, Seth Shri Thakurdasji decided to open two public welfare trusts, he was appointed a Managing Trustee of Choithram Charitable Trust and T. Choithram foundation. All the groundwork for the starting of Choithram School and Choithram Dispensary in 1972 was done by him. Mr. P.D.Asawa, a very talented young man helped him in this venture. Seth Lekhrajji was a very jovial and social 51 man. At times he would crack jokes in front of his office staff. He was very simple and an easy to please man. He did not have any ego problem. All the official as well social trips for construction of the hospital were undertaken by him without any hitch or ego problems. He went to Bhopal to meet Chief Minister Mr. P.C.Sethi to persuade him for procurement of the land at MOG line, Indore. He went to Jaipur for a personal talk with the owner of Santokhba Durlabhji Hospital for the requirement of a full time Medical Director for the Choithram Hospital, a post, which was later, filled by Prof. B.N.B. Rao. Sincere in his approach, he visited New Delhi several times to meet M/s. Kothari & Associates regarding the finer points of the hospital construction. Throughout this period he was assisted by his able son Mr. Murli Pagarani. Dressed in a simple white dhoti, a silk kurta and a black jacket, he used to come to the hospital twice every day in a Tonga. He remained as a Managing Trustee till 1984. He left for his heavenly abode on 3rd. Nov. 1986.

52 Felicitation of Dr. S.J. Mehta Board Meeting Managing Committee

Our Administrators By - Mrs. Deepa Tanveer What good are pleasant environs of a historic place if things are not pledged to a monument? What good can an institution be if it is not steered by a competent captain? Here on the northwest outskirts of Indore all that seems to have come together to create a fine institution with the finest professionals. Today, as Choithram Hospital stands tall celebrating twenty-five years of dedicated service to humanity - I fondly remember the administrators who contributed in their own respective ways, with their experience, skill and abilities in the development of this organization. Surgeon Commander Dr. N.B. Idnani Deeply concerned by the dismal conditions of hospitals, the donor of Choithram Hospital, late Shri Thakurdasji's dream to provide the best of modern technology and expertise in health care easily available to a common man became a mission for Surgeon Commander Dr. N.B. Idnani, the first Medical Director of Choithram Hospital. He was a great visionary and proved to be an ideal choice to lay the solid foundation of this institution. Handsome is what handsome does; Dr. N.B. Idnani was strikingly handsome, charming and charismatic. Choithram Hospital was his baby and to nurture an organization from infancy was definitely challenging. He was totally dedicated, devoted and worked relentlessly to bring up this 53 organization. A meticulous planner, each year he introduced a new dimension in the medical field. It is only because of his vision that Choithram Hospital became a pioneer in Central India, for, Haemodialysis; finest Gamma Camera for nuclear imaging; highly sophisticated and computerized pathology lab; an excellent microbiology lab; Cardiac Cath lab, Open heart surgery unit, Renal Transplant unit, Total hip replacement surgery unit were his brainchildren. As an administrator, he had his own style of working. He never dictated his terms or imposed his views on the workers. Rather, he put them forth in a gentle manner. He inculcated values and believed that mutual trust, honesty and confidence is required in building up an organization. He understood the human psyche and so made each worker realize his own work, thus, building up a family atmosphere, which was required for a strong foundation. He hardly ever lost his cool. He gave me these words - 'Temper is a valuable thing do not lose it.' In lighter moments he enjoyed good music and was fond of theater. His love for acting landed him a role opposite the great actor Vijayanthimala 'Aas Ka Panchi', but he was rejected because he spoke Hindi with a Sindhi accent. However, the 'Aas Ka Panchi' had much more to give to the society. Many dreams were to be fulfilled and many projects were in the pipelines that were to be executed. (Col.) Dr. P.J. Matwankar Dr. N.B. Idnani was supported by his colleague (Col.) Dr. P.J. Matwankar, the Medical Superintendent. He was a thorough gentlemen, simple, down-to-earth but firm in his routine administration. Fate has its own ways. Dr. Matwankar left

Choithram Hospital and Dr. N.B. Idnani passed away. It was a great loss to Choithram Hospital and shocking for me, personally, I missed him a lot because Public Relations was a new concept in the Hospital, He insisted me to join in and placed all his confidence that the department would be successful. I am grateful that he gave me an opportunity to serve humanity. Air Commodore Dr. N.S. Bhagwanani After the untimely death of Dr. N.B. Idnani, Air Commodore Dr. N.S. Bhagwanani succeeded him as the Medical Director. In fact, Dr. N.B. Idnani had brought Dr. N.S. Bhagwanani, and helped him settle down in the new environment. The strength of a man does not lie in his work. Dr. N.S. Bhagwanani was very intelligent, myriad minded, multifaceted, well-informed with varied interests. An expert in trekking, mountaineering, skiing, gliding, gardening, nature study & a philanthropist; One cannot imagine the lean person was so dynamic. He had won laurels for his excellent performance in the Air Force. In 1962, he was awarded the Vishisht Seva Medal & Ati Vishisht Seva Medal in 1965, by the President of India, Order of Kingdom of Laos by the King of Laos. 54 He was a member of the first Indian Expedition to Everest in 1960 and had the longest stay - 22 days at Advance Camp 21,200 ft. (a world record then). He commanded the Para Medical Team for five years, and made a para jump at 8000' ASL in 1956 at Gulmarg. (another world record then) He at the time received the “Award of Excellence” at the National Hospital Convention by the Indian Hospital Association on November 15, 1996. Very ambitious only for himself but also for the organization, he wanted Choithram to grow internationally and, true to this Choithram achieved great height in research projects during his tenure. He developed the Medical Laser Centre at Choithram Hospital and Research Centre with 12 different units under the National Laser Programme, in collaboration with Centre for Advanced Technology, Indore. His special work was in Low Level Nitrogen Laser Therapy in Pulmonary Tuberculosis and wound healing. He was also the founder President of Indian Association of Laser Surgery & Medicine (IALSM), always encouraging the young doctors to take up research work. Dr. Bhagwanani was never too harsh, in a way quite lenient with workers but was very particular about unnecessary wastage of resources. He was more like a father figure. He was well versed with Urdu and Persian and he enjoyed ghazals and recited couplets of Ghalib. It was not always work, but he introduced a tradition of get-together and entertainment programmes to keep workers happy and de- stressed. His love for Nature was reflected in the beautiful garden that today Choithram takes pride of. He planted rare trees picked from various places. He

wanted to give a beautiful and soothing ambience to the patients and their attendants. Whenever tired or perturbed he would go to the garden to find peace and rejuvenate himself. Once, he brought a bulb of daffodils from abroad and when they bloomed he was thrilled. I was fortunate to see those golden daffodils. He was very sensitive about poor and needy patients and was involved in a lot of charity work. Brigadier Dr. M.V. Asolkar Brigadier Dr. M. V. Asolkar Medical Superintendent compensated Dr. Bhagwanani's mild administration. He was a strict disciplinarian, and very particular about cleanliness. Full of life and energy, he was jovial and had a very good sense of humour. His sweet tooth was ever ready to enjoy Rasmalai from Madhuram. That's how I remember him. He emphasized on Computerising of the Hospital, thus setting up the EDP (Electronic Data Processing) department. Implementing the Hospital Infection control programme, Dr. Asolkar insisted on monitoring the surgical site infection. In spite of difference of opinion the duo worked together for the benefit of the organization I think this was the golden period of Choithram Hospital. Col. Dr. Ravikant Saxena 55 The old order changed giving place to new. After Dr. Bhagwanani and Dr. M.V. Asolkar retired, (Col.) Dr. Ravikant took charge as Medical Director. Young, upright, very knowledgeable, he had already carved a niche for himself in the Army. Initially, he was a bit aggressive and short tempered but soon mellowed down. He never minced words, and was very straightforward in approach that was difficult for some to take. He wanted to bring more discipline and professionalism. Statistics, Planning and Design was his major interest. He wanted to develop the hospital for all super specialties. He started the Hospital Management Programme, he promoted young doctors as he felt the future lies on their shoulders. He had all the potential of an able administrator but before he got himself rooted, it was unfortunate that he left. Some lines from his diary “Mai Akela Hi Chala Tha, Janebe Manzil Magar, Log Saath Aate Gaye, Aur Karavan Banta Gaya.” Colonel Dr. Kamlakar Vaidya The Caravan (Karvan) moved on instantly, Col. Dr. Kamlakar Vaidhya took charge as the Medical Director- a very bold and outspoken disciplinarian, short- tempered, impatient and, above all, a tough taskmaster. It is really difficult to convince him. Interestingly he has a soul of an artist; he sings well. Hospital continues to progress under his able leadership - Bio Medical Waste Management Conference, Effluent Treatment Plant (E.T.P.) or releasing a manual for infection control are all his innovative contributions.

All these men may have their differences, their weaknesses, their virtues and vices. But it is creditable that they all leave behind an impact. How beautifully Longfellow says - Lives of great men all remind us We can make our life sublime And departing leave behind us Footprints on the sands of time. OUR ADMINISTRATORS: CHRONOLOGICALLY Dr. BNB Rao, Medical superintendent from 1976 1978 Dr. S. L. Mangi, Medical Administrator from 1973 - 1984 Surgeon Commander Dr. N. B. Idnani, M.B.B.S., Medical Superintendent from 16-10-1980 to 07-04-1987 Medical Director till 18/5/88. Dr. P.J. Matwankar; Jt. Medical Superintendent 1980 1987. Air Comdr.Dr. N.S. Bhagwanani, VSM, PVSM M.B.B.S., MS (Gen Surg.); Medical Superintendent from 07-04-1987 to 31-08-1990 56 & Medical Director from 01-09-1990 to 15-04-1999. Brig. Dr. M.V. Asolkar M.B.B.S., MD; Jt. Medical Superintendent from 16-08-1988 to 31-08- 1990 & Medical Superintendent from 01-09-1990 to 31- 05-1998. Col. Dr. Ravikant Saxena, M.B.B.S., PSC; Medical Superintendent from 01-06-1998 to 13-04-1999 & Medical Director from 14-04-1999 to 18-04-2003. Col. Dr. Kamalakar Vaidya M.B.B.S.; Medical Superintendent from 08-02-1999 to 18-04-2003 & Director Medical Services from 19-04-2003 to date. Lt. Col. Dr. R.C. Gajaria M.B.B.S., Dip. in Anesth., M.Phil (Hospital Management) Jt. Medical Superintendent From 07-01-2002 to 06-01-2003 &Jt.DirectorMedicalServicesfrom07-01-2003todate. Dr. Sunil Chandiwal M.B.B.S., DA, MHA; Asst. Director Medical Services from 07-06-2004 to Till Date. Dr. Ajay Jain MD, DM Gastro, Consultant Gastroenterology; Hon. Director Development & Planning from 02-04- 2003 to Till Date

Dr. B N B Rao Dr. S L Mangi Mr. Mitra Mr. R B Lal Dr. N B Idnani Dr. N S Bhagwanani Dr. P J Matwankar Dr. M V Asolkar 57 Mr. P D Asawa Mr. D L Patidar Mr. M L Naik Dr. Ravikant Dr. K Vaidya Dr. Ajay Jain Dr. R C Gajria Dr. S Chandiwal

Our Hospital “Carry the light and the life to every door.” The ever so exigent transformation of a dream to a viable reality began in1973-74, when the Choithram Charitable Trust purchased approximately 50 acres of land. The original vision was that of a hospital which would further aid in making Indore a safer and a healthier city. At present, however, the city has been blessed with a grand hospital and a school that has reserved its own special place in the hearts of the Indorians. The road starting from the main gate, with lavish palm trees, divides the complex into the Choithram Hospital and the Choithram School. The hospital complex encompasses nearly 22 acres of land. The constructed area is roughly 2,42,9382 feet, and the tin shed covers an area of 34,5682 feet. The building was constructed in many blocks and new segments were constructed, as and when the need arose. What prompted this great social venture? The account goes like this - Towards the beginning of 1970, one of the close relatives of the Pagarani family fell critically ill. The patient was admitted in the only available hospital at that time, i.e. M.Y. 58 Hospital under the care of the Professor of Surgery. An exploratory Laprotomy was planned. The family requested a second opinion from Dr. S.K.Mukherjee, who was Prof. Emeritus at M.Y.Hospital. The request was, however, turned down. They then decided to discharge the patient from the hospital and consult Dr. Mukherjee and Dr.A.C.S.Jain. A diagnosis of Budd-Chiari syndrome was made. Seth Shri Thakurdasji was not in Indore at that time. He flew to Indore by the next available flight and took the patient to Central Middlesex Hospital, London under the care of Dr. Avery Johnes. After a weeklong stay, doctors in London had to agree to the diagnosis made at Indore. Seth Thakurdas made-up his mind and The “Choithram Charitable Trust” was formed on December 29, 1970, and a process started to set up a modern, fully equipped hospital for the common public of Indore. A piece of Land was identified at MOG lines and a process of acquisition started simultaneously as this was a government land. By the month of March 1971, quotations from the architects were invited. The first draft came from a local firm Naik & Matkar, architect and engineer. Later, the acquisition process was dropped and a new land was identified for the hospital and a charitable school, the present location. M/s Sheodanmal & Co, Architect and Engineers from Nagpur, gave the first design of the main building complex for approval to Puj Seth Thakurdasji, in March 1972. This puts an end to speculation about the construction of the main building. It simply meant that the construction of the hospital was decided much earlier than commonly thought.

However in January 1974, Kothari and Associates were contacted for a fresh look at the proposed site. The land was found inadequate, and the design defective. So charge of construction of the hospital was given to Kothari and Associates. By November 1974, the actual construction work on the design supplied by Kothari and associates started. In early 1979, the construction of main building along with north and south blocks was completed. “ Our wounds ultimately give us wisdom. Our stumbling blocks inevitably become our stepping-stones. And our setbacks lead us to our strengths.” The Expansions - Sign of Growth Expansions are an essential part of any growing institution - “A stagnant business is not a successful one”. Choithram Hospital is no exception. From time to time, expansions went on and still are going on to accommodate the current need. The Physiotherapy and the administrative building design were approved in 1974. However the block was completed in 1980. The open space near the Orthopaedic OPD was converted into a dialysis ward in 1981 due to requirement. The place marked for car parking close to the front boundary wall was converted into the Dharamshala in 1978. This too was considered an essential part of the 59 hospital and therefore going against the original plan, a provision for this dharamshala was considered more important than the car park. By now, we have three Dharamashala on the hospital premises. The North Block extension was approved for construction in 1987. (the New Surgical wing, and pediatric wing), the construction completed in 1988. A canteen with provision of supplying food at subsidized rate to inpatients was built in the North Block (present Nephrology ward). A new canteen building was added on March 23, 1986. This gave relief to outstation patients and their relatives, as well as an additional dharmshala was also added on its first and second floor. The place of the sambulance parking was converted into Dr. Idnani's dharmshala in 1989. The Main Porch extension and the Radiology extension were done in 1987. The Pathology extension both in the ground floor and the first floor was accepted on December 7, 1988. New construction for Nephrology unit near the pathology department is going on. The South Block: The present ICCU was added in 1988. The construction of the New OT complex is still going on. The Step-down ICU was constructed in 1994. With this the total bed strength went to 350. North Block expansion of the labor room with new labor OT and an attached labor ward was added in 1994. The Cath lab expansion is being undertaken in 2005. The second student nurses hostel was added in 1982, to accommodate the

students of school of nursing. Since B.Sc. nursing was added in the year 1997, there was shortage of residential accommodation. The third nurse's hostel was added in 2001. The College of Nursing building was added in the year 2000. The statue of Seth Choithram Pagarani and the Shiva statue were added in 1985. That was originally the registration counter. Mr. R.D.Jariya painted the wall painting in 1988. A new registration counter, MRD and PBX were subsequently modified. Free Registration Fee for the underprivileged An elucidation of the fact that Choithram was not only a business but a social program too was that the OPD registration fee was only 25 paise, which was later increased to 50 paise and then to Rs.2/-. There was no fee for cross-references and there was no demand consultation fee. The OPD was run in to two shifts. From 8 am to 1 p.m. and from 2 pm to 4 pm. The registration fee later on was raised to Rs.5/-, Rs.10/- and finally to Rs.20/- to accommodate the cost of paper and printing. The Donor had refused to increase the cost of registration fee from the inception of the hospital. The General Health check-up scheme To cater to the rich 60 Like in all metros, a comprehensive general health check-up was started to cater to the rich class and business executives of Indore and recently upgraded industrial towns of Dewas and Pithampur in the 1984. Along with GHCS, we now have a tie-up with many organizations for an inpatient facility. Patients from these organizations are admitted on credit: Paramount Healthcare; MD India Healthcare; Med Save Healthcare; Medicare Services; Unit Trust Of India; Narmada Hydroelectric Development; Airport Authority of India; Inter University Consortium; Gas Authority of India Ltd.; Army Group Insurance; State Bank Of Indore; State Bank of India; Bank of Baroda; Steel Authority of India Ltd.; Indian Institute of Management; Kinetic Honda Motor Ltd.; National Fertilizers Ltd.; L&T Case Equipments Ltd.; Videsh Sanchar Nigam Ltd.; STI India Ltd.; Punjab National Bank; Western Railway; Indian Airlines Ltd.; Union Bank of India; and Idea Cellular. The Bed Strength- Indication of Workload The bed strength is always an indirect method of gauging the volume of work in the institution. We started with a bed-strength of 110. The number of surgeries in the first year were just 960. But, by the end of 1980, we had doubled the OPD attendance as well as the surgery and inpatients number. The curve was rising steeply (almost exceptionally) and soon there was difficulty in accommodation. Although the staff was sufficient to take care of a 350-bed strength hospital (thanks to Mrs. Nair and Dr.Idnani for the school of nursing), it was felt that the right time had come for expansion in accommodation. In the year 1980, with the

completion of the new administrative and physiotherapy building, the space left over was immediately converted into a “surgical ward”. The 4 bed ICU near the Cath lab was extended to a 17 bed ICU in the space now occupied by the Nephrology ward. With the start of OHU in 1984, Ophthalmology was shifted to the third floor. The new Cardiac ICU with four beds was started. The new surgical wing and new paediatric ward was added in 1987; the bed strength rose to 250 and subsequently with the addition of new labor ward, new ICU and step down ICU and new female general ward, the final bed strength reached 350. That was a remarkable progress. In a span of 15 years from 1979 1994 we have tripled our bed strength something that the institution is really proud of. Laundry Laundry was established since the inception of the hospital for bed strength of 110. On the starting date the laundry had three washing machines, two hydro extractor, two driers and one calendar press. One punch press and one washing machine were earmarked for only infected clothes. Mr. Bhagat was the first Laundry Manager. Mrs. Benson took over after his retirement. When Mrs. Benson left, Mr. O.P. Joshi took on this responsibility; with Mr. Hariprasad Solanki is his assistant. With the expansion of the hospital, the bed strength increased to 350 by 61 1995, some more facilities were added. Now we have three ultra modern washing machines, three hydro extractors and one modern additional calendar press. Central Sterilization & Supply Department (CSSD) The modern concept of a sterilized supply organization was developed during the World War II. The first was established around 1945 in America and in 1957 in UK at Cambridge. In India, CSSD were established at the Safdarjung Hospital, New Delhi and at CMC, Vellore in Chennai, around1957-60. Before this, steam sterilizers were used only in OT, whereas in other departments / hospital wards, instruments were sterilized by boiling. In Central India, the Choithram Hospital was among one of the very few hospitals which had the CSSD department established on July 16, 1979. Dr. CS Chamania, with the help of Mr. Chandrashekhar, and OT staff took the responsibility of CSSD. Mr. Chandrashekhar worked for six years, before handing over charge to the present incumbent Mr. Kushwaha. To start, there were two steam autoclave machines. In 1982, an ETO machine, 10\"x10\"x18\", was established for sterilization of cardiac catheters. In 1988, a large manually operated EO gas machine was procured for sterilization of various types of PVC tubings, catheters, and surgical hand-gloves. In 1997, a water distillation plant was established. This plant supplies 150 liters of distilled water daily. In 1999-2000, another autoclave machine was added. In the year 2003, due to the requirement of the latest system and to avoid

environment pollution, the management decided and purchased automatic an ETO machine of the largest capacity of PCI. Account Section In any organization the Accounts Section has its singular important functioning. Mr. Narendra Kumar Jain established this Section in the hospital in 1979. Since 1982, Mr. Ajay Nahar has been working as the Chief Accountant, ably assisted by Mr. Shyamal Pal, Mrs. Pramila Vyas, Mr. Nitin Sharma, Mr. C.S.Chourey, Mr. Premsingh Gehlot, Mr. Sandeep Bhargava and Mrs. Sevanti Patidar. Choithram Hospital was first one to have a computer in 1988. All the purchase bills and salaries of the staff are handled through computer department. In 1995, a new computer 486 with Window 3.11 and a Laser Printer were added. Internet To keep our doctors updated and in sync with the world, the management decided to have membership of NICNET. Dr. Shikhar Jain went to New Delhi for online training for this system. In 1996, Mr. Shailendra Mandloi and Mr. Rajesh Barve were sent to New Delhi for training from NIC, Delhi for MEDLAR (NICNET). It was a very cumbersome procedure. First it was necessary to contact the Collector's 62 office to get Internet connectivity. They, in turn, connect the “dedicated telephone line” to the modem. Only after this, it was able to gain connection to MEDLAR. The data were DOS-based with no graphics, and transfer rate was very slow. Through growing relationship with the CAT, we came to know that it has Internet connectivity. Some of the doctors, especially Dr. Mrs. Shobha Chamania, approached the Managing Trustee, Mr. Satish Motiani, for a lease line for Internet connectivity through CAT, on an annual payment of Rs. one lakh. Mr. Motiani readily agreed to get a lease line. Mr. Jitendra Sharma, in-charge, Computer section Choithram School, took a lot of pains to install the First Internet browser “Netscape 2.1”, on our computer system. In 1998, when VSNL started its server at Indore, we dissociated ourselves from CAT and got our own direct Internet connectivity at a much cheaper rate. The computers of the department were also used for Power point presentations, thesis work, printing on film for overhead projectors by the doctors. With the purchase of a LCD projector, most of the medical work shifted to PC owned by the doctors of the hospital. Department of Electronic Data Processing (E.D.P.) We are privileged to live in an era where science and technology play an important part. Effective utility of such provisions will enhance approbation of time and money. To keep pace with modernization, the Choithram Hospital took a decision in 1996 to computerize the whole working system of the hospital. However, the first computer was purchased in 1988.

The hospital entered into an agreement with M/s Suvi Pvt. Ltd., Indore for the development of a Unix-based Informatics Data base for the in-house data base system. Software was developed after studying the existing system, keeping in mind the requirement of the hospital in future. The system is working well till date. The EDP department was established under the guidance of Medical Superintendent, Brig. Dr. M.V.Asolkar, who must be credited for computerization of the hospital. Ms. Vidhya Phulwani was appointed as the first officer in-charge. Mr. Jitendra Sharma, who was a very talented and hard working person, replaced her, becoming the system manager for the hospital. Installation of essential hardware was done under his direct supervision. When Mr. Jitendra Sharma left, Mr. Ashok Sharma took his place... A job well started is half done. The department of EDP had the specialized services of Ms. Vidhya Phulwani, Mr. Jitendra Sharma, Mr. Ashok Sharma, Shailendra Mandloi, Mr. Shailendra Carpenter and Mr. Deepak Kamle In the year 2002-03 the hospital installed two punching machines for computerized attendance system. All the employees were provided with an ID 63 card and a CAMS No. The machines were connected to the EDP computer. I T Department Since 1996-97 all the operations of the hospital have been controlled by Unix based informatics database. The department of EDP has been managing the whole software. This department has been responsible for addition, alteration and maintenance of the software. The world is growing fast. The I.T. industry is growing even faster. After 7 years of installation the software looks like an age-old one, it's a normal event in I.T. Industry. It is felt that new windows based software is needed. The new software will be fast and able to control all the operations of the hospital in a more efficient and effective manner. Many software companies approached the hospital but none of them fulfills its requirement. It is difficult for any software to match the procedure (operations) of a 25 years old leading institute, where all the 'procedure are well tested, self- developed and having maximum flexibility. So a decision of complete in-house Development of window-based software was taken. M/s Arogya Soft Company was given the responsibility of software development. The company has started its office in the hospital premises. Mr. Rakesh Singh, the directors of company along with 20 other programmers are working day and night since Oct. 2004, to prepare the software. . Around 85 low and high end terminals will be installed (as against 33 in present

system). These will be distributed at each and every nursing station and departments. The hospital is spending around Rs. One crore on hardware and software. Around 400 employees will receive an intensive training to run the software smoothly and successfully. The development involves in depth study and understanding of each and every operation (process) of every department. So as to prepare a compatible and flexible software. The software is almost perfectly specific and sensitive. It will be tested exhaustively before it replaces the old system. To add to the efficacy of software many processes of the hospital are streamlined. Medical Records Department From the very beginning the hospital worked in the pattern of an institution, a general nursing home in a private setup. To keep track of all medical activities an MRD had been earlier planned. Mr. Suresh Carleton joined the hospital as the Medical Records Technician in 1978 when the flooring work was going on. It took around three to four months to plan the entire working system of the hospital, including the designing and planning of various forms required. We adapted systems that were accepted internationally. The Medical Records 64 Department started with the modern colour-coding filing system of out patient medical records, Coding of Diseases and Operations according to the WHO International system. It was a laborious business and the whole system was shifted to computers in 1997. The Medical Records Department has been providing statistics to the hospital management, vital information to the various government agencies and helping our consultants and junior doctors in preparing their academic and scientific papers for state, national, and international conferences and workshops. We would like to proudly quote here an interesting incident concerning M/s. A.F.Fergussons of Mumbai. The only consultants in Hospital Management and Planning, they were invited to design the hospital system including Medical Records and accounts. Having seen the system proposed by us, they commented, \"We cannot recommend any better system than what has been proposed by Mr. Carleton & Mr. N.K.Jain\" Community Outreach Programme: “Health is not mainly an issue of doctors, nurses and hospital. It is also an issue of social service and social justice.” Choithram Hospital and Research Centre and College of Nursing have been extending health services to the public at the grass root level, through their regular Community Outreach Programs, where the high technology, professional services and assistance to poor and under privileged are applied. Rural

population and people residing in slums in and around Indore have numerous health problems brought in by ignorance, poverty and non- availability of adequate health services. Professionals of the Choithram family recognized this and Community Outreach Program to provide comprehensive them with health services. When we look back at the history of Choithram Hospital, we find that there has been large number of projects undertaken for the health of people in their own surrounding. Some of them have been recorded. A few are listed below- Medical camp at Jhabua: Dec. 17, 1995 Multi Disciplinary Diagnostic camp, Jaora: Nov 3, 1996 Medical camp at Alirajpur (Jhabua) Feb 23 1997 Superspecialty Health camp, Depalpur: Feb 17, 2002. Superspecialty Medical camp, Ratlam : Sep 28, 2002 Health Camp, Shajapur: Nov 22, 2002 Superspecialty Health camp, Khandwa: March 2, 2003 Second Superspecialty Health Camp, Shajapur: Feb 7, 2004 Super Specialty Camp, Mandsaur: Feb 20, 2005. 65 “May we, what time we live, be blessed with healthy limbs and body, that we may glorify the 'Lord'.” School Health Program: College of Nursing students, with the help of doctors from Paediatrics, Obstetrics & Gynaecology, and Family Medicine also organized general health checkup camps at the following schools: - Kasturba Gram Hr. Secondary School, Sharda Vidhyalaya, Jeevan Jyoti Residential Hr. Sec. School, Advanced Academy Hr. Sec. School, Shaskiya Hr. Sec. School, Sindhi Colony, Shaskiya Madhyamic Vidhyalaya, Indore. The health checkup of children from these schools has been carried out annually over the last 15 years. They organized either wholly by the College of Nursing or in collaboration with non-governmental organization like the Gramin Mahila Sangh, Lions Club and Rotary Club of Indore Pulse Polio program Students from the College of Nursing regularly carry out pulse polio programmes in collaboration with Govt. officials. They accompany govt. health officials in mobile vaccination vans, which cover whole of Indore, far off slum areas, to every nook and corner of Indore. Health care in urban slums of Indore College of nursing faculty and students has adopted the following slums for

providing health care and to spread health awareness: Shukla Nagar, Harijan Colony, Marthand Nagar, Gangaur Nagar, Barabhai, Arjunpura, Joshi mohalla, Mundi, and Bhadkiya. Health care in rural areas All B.Sc. (Nursing) fourthyear students of the College are posted in rural areas for community field experience. This in collaboration with Kasturba Gram Trust, Catholic Mission Rural Health and Choithram Fountain of Humanitarian Services for one month every year in Dhani, Depalpur, Panigaon, Hanumanpura and 16 other villages Ravanpura, Shreeram Talawali, Kalariya, Auragpura, Dhannad, Dharawara, Chirakhan, Gawla, Maachal, Nawda, Sindhoda, Himmatgarh, Sirpur, Bisnawda, and Jawahar Tekri. Health care activities Besides the usual care as is being provided to the people in urban slums, in rural areas patients requiring specialized or tertiary health care are referred to Choithram Hospital where subsidized treatment is provided. Patients are also referred to Choithram Fountain, Talawanli. In-service education is also provided to the anganwadi workers and traditional dais. 66 “ Great dreamers' dreams are never fulfilled, they are always transcended” Prayas: As the hospital and Department of Pediatrics progressed, the need for a centre to assess of children with all types of disabilities was felt. With the encouragement of the management, Dr. Kamna Jain, senior Consultant in Pediatrics was involved in establishing 'Prayas' in March 1993. It was the first in central India, with a complete multidisciplinary team of experts for a comprehensive assessment and management of all types of childhood disabilities. The team of experts comprise of: Mr. M. K. Acharya (Clinical Psychologist), Mr. Sudhir Kothari (Senior Physiotherapist) Ms. Madhvi Tiwari and Ms. Shweta Bulani (Special Educators) along with Dr. Kamna Jain and consultants in Neurology, ENT, Ophthalmology, and Orthopedics. The centre's activities are spread over: 1. Development Assessment of all high-risk newborns at 3, 6, 9, 12, 18 and 24 months. An early Interventional Program whenever the need arises. 2. I. Q. assessment. 3. Complete evaluation, management plan for children with a) Mental retardation b) Cerebral palsy; c) Behavioral problems; d) Speech & hearing problems. 4. Evaluation of poor scholastic performance including learning disability a

remedial education plan is drawn up. 5. Regular classes for mentally retarded children between 9 - 11.30 am (Mon.- Fri) 6. Regular awareness and training sessions for parents and siblings of handicapped children. In the last decade, more then 1000 children have been registered and are supervised training held at the centre. A number of seminars on parent education and training, dyslexia and poor school performance, mental retardation management, and workshops for siblings of handicapped children have been organized by Prayas. These have helped in creating and awareness in society. Thalassemia Day care Centre Thalassemia is a disease which requires life-long blood transfusion, the treatment is costly. Nearly 3.5 lakh children suffer from this disease and accordingly, Thalassemia Day Care Centre was started in Department of Pediatrics in 1986 to provide blood and blood products at a subsidized rate to needy patients. At present we have the capacity to register 200 Thalassemia patients in our Day Care 67 Centre. Patients are also registered in the Thalassemia and Sickle Cell Society of Indore. The Day care centre is functions upto 1 p.m. Monday through Saturday. Ten Children receive transfusions simultaneously and each one receives approximately two blood transfusions (Packed cells) once in two to three weeks. The aim is to maintain Hemoglobin at - 10 gm %. The activities of the centre include 1. Facilities for transfusion at a very subsidized cost. 2. Screening of all family referrals and antenatal diagnosis of Thalessemia. 3. Monitoring the growth and development with special emphasis on Adolescent period. 4. Organize community awareness Programmes. 5. Analysis of useful data from registered patients for research purposes by various concerned departments is going on. Three projects are under taken to understand the disease process and a treatment protocol is getting finalized to minimize the sufferings of these patients. Academic growth:

P R A Y A S 68 C A M P S

Dr. Shikhar Jain, Director Academic, Prof. & Head, Department of Paediatrics. Academics have grown with the institution over the years. The hospital was recognised for internship (four subjects) and house job (nine subjects) by MCI and the University of Indore since 1985. DNB recognition was obtained in 1990 in medicine, surgery and the paediatric and anaesthesia. In 1994, Obstetrics and Gynaecology & Ophthalmology were added. Recognition was obtained in ENT 2003 and Orthopaedics the following year. Superspecialty DNB recognition in Neurology came in 1994. Neurosurgery in 2001 and Gastroenterology in 2005. Dawn's ICMCH diploma in Child Health (Dip.CH) and Obs & Gynae. (Dip.OG) since 2000. Success in DNB exams started trickling in from 1997. So far 12 candidates in paediatrics, three in medicine, two in surgery, three in anaesthesia, two in neurology, and two in Obstetrics & Gynaecology have acquitted themselves well. DMLS course affiliated to DAVV was run from in 1991 to 2003 and 300 students have passed so far. Ph.D. students are being enrolled in Microbiology and Biochemistry, 13 students have done Ph.D. in these subjects respectively. CHRC has opened its doors for practical training in several paramedical subject. Dietetics, Hospital Management, Laboratory Medicine, Physiotherapy, 69 Biotechnology Dialysis, Ventilation, Imaging, OT Management are some important specialties in demand from students of prestigious colleges of Indore within MP and outside. Overseas students have also opted for their training here. Undergraduate (BDS) dental students have been getting their practical training in Medicine and Surgery here since 2003. Post MD/MS doctors have also opted for training in various sub specialities including Paediatrics, Cardiology, Surgery and Dialysis. Formal fellowship in pediatric critical care has also been started since 2004. An academic committee was formed in 1997 and a research committee one year later. Looking at the need and demand, a separate ethics committee was formed in 2002. About 100 research projects have been reviewed and cleared, including eight multicentric international projects. Formal teaching designations were started in 1998 for DNB teaching departments. Since then three teachers have become DNB examiners Dr.S.Inamdar (Paed), Dr.Shikhar Jain (Paed), and Dr.N.Soni (Obst. & Gynae). CHRC has been the venue for several international, national and state level conferences, CME and workshops: Percutaneus Lithotripsy; Minimal Access Surgery; Perinatal Update; LBW; Learning Disorders; Critical Care; Joint Transplant; Renal Transplant; Ophthalmology; Cochlear Implant; Rhinoplasty; Neuro-Trauma; Burns; Lasers in Medicine; Endoscopy; Medical Ethics and

Beyond Medicine lecture series, to name a few. Distinguished guests from all over country and outside have visited CHRC in all specialties. CHRC has a 250 capacity auditorium, and three classrooms with audiovisual aids including LCD projector & closed circuit TV. CHRC faculty has been in forefront of academics, with most attending international and national conferences as guest speakers, chairpersons and speakers. Several have organized these academic events as chairperson and/or organising secretaries. Hundreds of papers have been published and presented in international and national indexed publications and fora. Many have won prestigious awards. In brief, Choithram Hospital today holds a prominent position in the country in fields of training medical specialists, nurses and paramedical workers, in the dissemination of knowledge and in research. Hospital Infection Control Department “Prevention is better than cure. 70 Hospital acquired infection is a serious hospital health hazard in the world today. Prevention of infection, acquired in a health care setting remains a major goal for all health care personnel because these infections add to complications, leading to additional hospital stay and expenses. With increased public awareness, acquisition of blood borne infections such as HIV, Hepatitis B&C have become a serious concern. Further, safety of health care workers and community at large becomes a part of the responsibility of the hospital infection control team. Infection Control Department started in our hospital in 1993. Our First Infection Control nurse was Ms Dipti Joseph. Choithram Hospital and Research Centre is one of the first hospitals in Central India to establish a full-fledged Infection Control Department in 1996. An active infection control committee formulates the policies and helps in implementation of the same. Infection control nurse (ICN) had always been the key person in carrying out day-to-day activities of this department. Some of our very efficient ICNs were Ms. Rachal Thomas, Ms. Vijyalaxmi Nair, Ms. Upasana Roy, Ms. Mona Maliekal, Ms. Maitreyee Bhattacherjee. The Infection Control Nurse co-ordinates infection control activities under the guidance of the Microbiologist, Matron and Director of Medical Services. The departmental activities are: l Daily distribution of disinfectants l Screening and Prophylactic vaccination program for health care workers and prevention of occupational hazards. l Regular monitoring of air samples for culture from the OT and Renal

Transplant Unit. l Regular monitoring of sterilization procedure. l Potable water used in the campus is rigidly monitored for chlorination and proper disinfection. l Continuous education to all categories of staff on the issues related to infection control is a regular feature. l ICN also monitors the Hospital's Waste Management Program. l Formulation of infection control policies and checking of day-to-day procedures, carried out in varies units. Setting up of the Effluent Treatment Plant, in 2002, was a milestone. About 3 lakh liters of effluent treated daily generates more than 2.5 lakh liter of treated effluent is used for gardens and sanitary purposes. The department organized two national conferences; the IV National Conference on Infection Control in 1997 and National Workshop on BMW Management in Feb 2004. Extensive research work in areas of Infection control and BMW Management. In fact, it has earned a reputation as a model hospital for BMW Management and a list of publications in national and international journals. The department receiving national attention has published the Manual of SOP's for 71 infection control. The department provides a great support to quality health care services in the hospital. Biomedical Waste Management Hospitals are meant for promoting and maintaining the health of the community. However, every hospital generates a sizeable amount of waste with a potential for infection hazards to both staff and community. Hence, in 1998 rules and regulations for handling and management of bio-medical waste were framed in India. Infection control department has shouldered the responsibility for the coordination and management of bio-medical waste at our hospital. Exhaustive waste audit carried out at our end revealed that 1,275 kg of waste is generated daily. Out of this, only 125 kg is infectious waste. If the infectious waste gets mixed up with the general waste, the entire 1,275 kg waste is likely getting contaminated. Thus, it calls for proper segregation at the source. The segregation, transport and treatment protocol for BMW management has been set and implemented rigidly. We are proud to mention that one of the first incinerators in the state of M.P.was installed in our hospital in 1979. The technology of incinerators adds a heavy financial burden for hospitals in developing countries. The idea of solar heat disinfection also germinated at our end, to offer an economic way for disinfection of BMW. Liquid waste from hospitals has not yet received proper attention in the biomedical waste management in many hospitals. Over 3 lakh litres of liquid waste is

generated at our end, which contain multidrug resistant pathogenic bacteria. This can pose a great public health hazard if mixed with the municipal sewer system. The problem was put up to the managing trustee Mr. Satish Motiani, who immediately sanctioned Rs 14 lakhs for the commissioning of an effluent treatment plant ( ETP). Our ETP yields about 3 lakh liters of safe water that is used for the irrigation of the green belt and for sanitary cleaning purpose. In addition, it also yields 5,000 kg/month of sludge, which is used as manure. Among BMW, sharps pose a great threat of transmitting of blood borne infections. Disinfection of sharps and needles containing blood with hypochlorite has its limitations. Therefore, we have implemented autoclaving of the sharps before they are disposed off in a secured cement pit. Since health for all and all for health is our vision and this obviously cannot be achieved without a healthy environment. Department of Dietetics When the hospital was commissioned in 1979 there was a provision of supplying food to all the indoor patients. The canteen was fully equipped with the latest modern cooking gadgets. Later it was found that this facility was not practical in 72 the present setup and the type of patients to whom the hospital was catering. So the idea was dropped. The hospital canteen was situated at the place where the Nephrology ward is at present. In the original planning of the hospital, there was a kitchen attached to the canteen where today we have the Nuclear Medicine department. The first dietician was Mrs. Sheela Divgi, wife of Dr.Chetaniya Divgi, a nuclear medicine consultant. When Dr. Divgi left the hospital in 1982, she accompanied him after this, for a long time there was no Dietician in the hospital. A partially functioning department started in 1985-86 with just one Dietician, who used to prescribe a special diet only to referred patients. Special clinics were functioning - Obesity clinic; Well baby clinic and special diet instructions to the Burn unit patients. Teaching nursing students for the School of Nursing started in 1988 and the department was recognized for internship / training for two students in Nutrition and Dietetics in 1989. Regular department was formed in 1991 with one more dietician joining. Since then, there has been no looking back. More than 80 students are being trained every year. In 2003, a policy decision was made. The dietician was asked to take compulsory rounds of all indoor patients, and advise accordingly. The workload increased to 150-200 patients per day. A Food Office department was then started in 2003 to provide meals to all admitted patients referred from CAT. The department got recognition by M.P. Bhoj Open University, Bhopal for Post Graduate Diploma in Dietetics and Applied Nutrition the same year.

The department is actively involved in academics like attending annual conferences and presenting papers. Many papers received awards. Further, many papers published in national journals of Nutrition. The Indore Chapter of Indian Dietetic Association was formed in 2000 at CHRC. This was the only chapter in the whole of state of M.P. Choithram Dispensary As a first major activity of the Choithram Charitable Trust, the Choithram Dispensary started functioning on Nov 13, 1972 in a rented building in Bairathi Colony, and Dr. J.K.Bakliwal and Dr. (Mrs.) Siddique were the first ones to join. In 1973, Dr. S.L. Mangi, retired as Principal of College of Dentistry, joined as Administrator. At a minimum registration fee of 25 paise patients received better quality care as well as effective medicines free of cost. Availability of better care at an affordable price attracted more patients each day. Child specialist, Dr. Ashok Porwal, joined to extend his services. Dr. Mangi along with Dr. J. Kaur started providing dental care. With a team of many, the dispensary became a polyclinic. Then, due to the ever-increasing number of patients and increasing health care facilities, a new building was rented at Pagnispaga. Thus, a routine medical OPD was started. 73 During this time, Dr. (Mrs.) Siddique went abroad and Dr. Hemlata Dubey replaced her. Later, to render specialized care, Surgeon Dr. G.P. Patidar, Physician Dr. M. C. Ajmera and Dermatologist Dr. V. K. Agrawal, were appointed. This was the time when Dr. Santosh Choube joined hands in expanding the dispensary. At that time our daily OPD attendance was 60 to 70 patients per day. On July 16, 1979 as the new hospital was established, the medical unit situated at Pagnispaga was about to be closed and the staff to be shifted to the new hospital. One of the local representatives on hearing this message, met Seth Thakurdas Pagarani, and requested him not to close the dispensary. Seth Thakurdas Pagarani was convinced and he decided to run the dispensary for 6 months with one physician and one gynecologist. It is due to the magnanimity of the Donor the dispensary continued functioning and catering same number of patients till today. In 1986, on the insistence of Seth Thakurdas and Mr. Satish Motiani a T.B. clinic was started. Because of free health care services the flood of patients continued. Dr. Nalini Zaveri was appointed the new gynaecologist in the year 1980 and Dr.Bharati Dubey as the paediatrician. In 1995 the E.N.T department was opened and this responsibility was given to Dr.Vinay Vaishampayan, a resident from the Choithram Hospital. Slowly its services were extended, an eye department was opened under Dr. Mrs. Shreya Thatte and presently there are 11 consultants in this dispensary.

Departments like X-Ray, Pathology, Sonography and E.C.G. provided facilities so that patients could get their investigations done at 1/3 the market price. Operations for cataract are done at a minimum cost of Rs. 1800. Registration fee has been raised to a yet affordable amount of Rs. 2. The physician and staff worked as a team for the betterment of humanity. The trust is spending Rs. 15 lakh, annually, for the smooth running of the dispensary. 74 Dr.Kaur, Dr.Porwal, Dr.Agrawal, Dr. Ajmera, Dr. Bakliwal, Dr. Mangi, Dr. BNB Rao, Shri L.G.Pagarani, Mr. Mitra, Mr.RB Lal, Dr.Patidar, Dr.Mrs. Yadav Therefore when thou doest thine alms, do not sound a trumpet before thee, as the hypocrites do in the synagogues and in the streets, that they may have glory of men. Verily I say unto you, they have their reward. But when thou doest alms, let not thy left hand know what thy right hand doeth. Mathew 6:2-3

“ Most people live whether physically, intellectually or morally in a very restricted circle of their potential being. We all have reservoirs of life to draw upon, of which we do not dream.” Beyond Medicine: Dr.Prakash Chhajlani. M.S., M. Ch., Cosmetic Plastic Surgeon The idea of having lectures on interesting subjects from various walks of life gave birth to the Beyond Medicine lecture series. The concept started taking shape in my mind some time in Jan 1997. The idea was to get a group of like-minded people together every few weeks and have a talk on some interesting subject, not related to the medical profession. With this in mind, I spoke to Mr Mukesh Arora of Shreemaya Hotel. He agreed to give a hall once every month free of cost and to provide tea and snacks to the gathering. A very kind gesture on his part and we were all set to embark on this mission. It was at this juncture that Dr Shikar Jain a renowned paediatrician was appointed as the Dean, Academics, at Choithram Hospital. One day, in a general discussion he came to know about this idea of starting lectures on various subjects at the Shreemaya Hotel. He was fascinated by the idea but suggested that we start at Choithram Hospital. I informed him of Mr. 75 Arora's the gesture. Dr Jain replied that the same thing was possible at Choithram Hospital. He spoke to Mr. Satish Motiani the Managing Trustee who agreed in principal and this gave birth to the Beyond Medicine lecture series. We were given the hospital auditorium, centrally air-conditioned with very good acoustics and audio-visual facilities. The name Beyond Medicine was conceived because the lectures were to be held at Choithram Hospital but as mentioned were not related to medicine. The first lecture was on June 3, 1997 at the hospital auditorium. Mr. Vishnu Chinchalkar, a renowned artist gave a talk from 1 to 2 pm on Art from Nothing on a Saturday afternoon. This set a series of events and henceforth all lectures were held on the first Saturday of the month. I had no idea as to how often we would be able to hold the lectures .We tried every month to get a good speaker on diverse subject. Today, we are, on the verge of completing eight years this year and have already had 78 lectures'. This has been a unique lecture series in Indore, going on consistently. Initially it was difficult to get speakers but as the time went by we started getting offers form aspiring persons. Our policies for the lectures were clear we did not want this to be a political or trade affair. The speakers had to be thorough in their subject and could talk only on this, not about the organization they represented. A team of three did the selection of the speaker and the Director Medical Services, Dr Shikhar Jain and I went through the details of the talk and took the decision.

The speaker was informed and we acquired his C-V and a set of photographs and, if possible, the hard copy of his talk. Which all became a part of the filing system. The poster was then made and Mr. Sanjay Vyas a graphic designer at Naidunia typeset the poster of Beyond Medicine, which has become a trademark. Set in a special font, made on A3 paper these posters were pasted in the hospital 3- 4 days prior to the talk. The PRO sent the order for the bouquet and the memento, to be given to the guest speaker. Mr. Maoker and his team at the auditorium made arrangements for the audio-visual. At 12.30 p.m. on Saturday the announcement was made for the lecture in Hindi and English on the hospital paging system. We acquired the tape-recording facility around 2002 which allowed us to record lectures. So far we have been recording from the 48th lecture. Some of these recordings have been converted to CD. Once this series started and many interesting lectures were held, people in the city looked forward to it and every month there would be queries about the topic for the next lecture. We started getting offers from people who were aspiring to give talks to be accommodated in the series. This also inspired other institutions to start lectures on similar lines. M.G.M. Medical College started it whenever they could get a speaker. SGSITS the 76 engineering college - also started it as 'Beyond Engineering' and I was invited to give the first talk. Besides this the Rotary, Lions and other service clubs whenever they were looking out for a speaker would approach us to suggest names or contacts for an effective good speaker. It was our good luck that we could get very good speakers without any funding. This journey would not have been possible without their support that, only on a telephone call agreed to give a talk. Their efforts have gone a long way in inspiring so many of our esteemed listeners. Statistically speaking in the last eight years there have been 78 lectures. This has been one of most consistent lecture series in the city. More than 20 thousand people have attended the lectures so far and many institutions inspired to start- to-start lectures on similar lines, i.e. M.G.M. Medical College, SGSITS. We had 23 lectures on self-improvement - Managing Emotions, Managing Knowledge, Action Impulses, Stress free living, Controlling Anger etc. There were five talks on health like Ayurved, Homeopathy, Unani; seven on places like Himalayas, Kargil, Antarctica, Mansarovar, and Egypt; five on Nature like Photography, birds around us, snakes, a further five on Yoga. There were talks on personalities like Gandhiji, on a Subhashchandra Bose. A varied mix of subjects covered on hobbies and art like; Art from Nothing, Appreciation of Hindustani dances and music, three each on religion and environment like Water Conservation, Project tiger and 11 on miscellaneous subjects. Physiotherapy:

Department of Physiotherapy was an integral part of the hospital from its inception. Originally planned in front of the Orthopaedic OPD, and close to Radiology, due to the installation of the Orbix Machine, the physiotherapy had to be shifted to the ground floor of the administrative building. This change allowed more space, a necessity for any modern physiotherapy department. The hospital purchased all basic equipment in year 1979. A few equipments were added later. When Joint Replacement Surgery became a routine affair, the Knee CMP machine was added to the armamentarium. Mr. Kanti Kumar was first the Physiotherapy In-Charge, which was working under the Department of Orthopaedics. He left for better an opportunity outside India and was replaced by Mr. Chelani, who has been helped since then by Ms. Neelu Wadhwani and Mrs. Durga. This was time when Mr. Pratap Singh Jangir joined the department. He stayed on for a long time. Meanwhile many physiotherapists of the town joined the department for a short time and left. Mr. Sudhir Kothari joined in 1986 and since then he has been assiduously for the 77 department. Incidentally, it became the official caretaker of the international cricket matches played at Indore. Looking at the sedentary lifestyle and overweight problems we added a treadmill to handle fat and obesity. Backache cases increased tremendously and so we added long wave of 2 short waves such that patients could quickly be relieved of pain. The department gets maximum referral from the neurology and neurosurgery facility. It has a complete range of equipments to deal with \"any pain anywhere in the body.\" The staff presently is Mr. Sudhir Kothari who is the HOD and has completed his Masters from Mumbai in 1986. He has completed various courses and training from Japan and the US. Under him are four physiotherapists, two trainee students and 3 ward boys. Students internship commenced in 2002 and since then, we have many students from Bhopal. Various camps are organized mostly for knee and back awareness from time to time. Patients in the wards and ICU are given bedside physiotherapy for limbs as well as chest physiotherapy regularly to avoid chest complications and to enhance recovery. Prenatal exercises are given to the expectant mothers for a normal delivery, and postnatal exercises in the department to the mothers to ensure good health.

The Hospital library: “Some books are to be tasted, others to be swallowed, and some few to be chewed and digested.” Like all good things, the library had a small beginning. Mrs. Palsu1e was the first librarian and she began her work in 1979 in a 10 X 15 feet room near the main OT with four steel and glass cupboard. Initially, all the manuals and booklets, which came with the various equipments to the new hospital, were indexed and stored in the library. Newspaper cuttings of the news related to the hospital were also stored here. In 1980, a larger room was allotted and Mr. Tapasvi a retired librarian of Holkar Science College was appointed as librarian. Medical and surgical books and journals were purchased and slowly the library started taking shape. In 1986, Mrs. Vinita Godbole was appointed and she has continued till date. In the early 1990's, the number of books and journals increased and the library was shifted to a larger 3-room complex near the main gate. In 1995, a consultant from the hospital was appointed consultant in-charge of the 78 library to be able to reflect the needs of the doctors. The first was Dr Shikhar Jain (Paediatrics), then Dr. Ajay Jain (Gastroenterology) and the third Dr. Gouri Passi. In the last few years there have been continual changes. The library budget has been regularly increased to afford good quality international journals. A computer has been installed to maintain records and to help post-graduates in their presentations and thesis work. Internet access is also available making a great difference in helping doctors stay up-to-date. Library hours have also slowly increased from 9 am to 10 pm to help students prepare for examinations. A photocopy machine has recently been made available to improve utilization of new books and journals. So far, about 1331 books, 22 international journals and seven national journals are available in the library. Doctors from other institutions are also free to utilize library services at a nominal fee. Future plans in the library include broadband Internet access, more computers and Sunday services. \" Every library is a nerve centre of an institution and books are its backbone\" “Here is where people, One frequently finds, Lower their voices And raise their minds”

Twenty five years of Department of Surgery By - Dr. C. S. Chamania “You who would accomplish little must sacrifice little; you who would achieve much must sacrifice much; you who would attain highly must sacrifice greatly.” 8th, April 1979, I can still remember very vividly; when we stopped at the main entrance of the hospital to enquire about our accommodation. We were appointed as registrars in General Surgery Department and were supposed to join on that day. It was a new experience for me and my wife Shobha. Instead of usual activities of a busy hospital what we could see was only construction activity going around. No nurses, no ward boys or resident colleagues; this peculiar environment made both of us uneasy and nervous. We guessed thoughtfully we shall be here, at the most one or two years. Then we were told by the hospital security that our accommodations were not yet ready here were accommodated in the staff nurses hostel. Next day we were taken around the hospital. We were impressed with the general outlay and sophistication. Contrast between an over crowded, congested 79 overburdened Government teaching hospital and well planned, spacious and luxurious private hospital was self evident. We were introduced to then administrator Dr. S. L. Mangi. Some how he developed instant affection and liking for both of us, his informal and frank nature led us to seek his guidance from time to time in future. We were informed that the hospital will take few months to start, our job will be to unpack equipments and furniture which has been ordered and put them in proper place. Working hours will be 9.00 am to5.00pm with one hour lunch break. No ward work, no emergency duties, it looked like a second honey moon. But being fresh surgeons remaining away from O.T. made us uneasy and despondent. Very soon we were joined by Dr. Shikhar and Dr.Kamna Jain in pediatrics department, Dr. S.K. Bhargava in ENT Dep't, Dr. Mrs Nisha Bhargava in Obst. & Gynae. Dep't. And Dr. Lokhande in anesthesia dep't, all as postgraduate registrars. As days passed by, equipments and instruments were delivered and unpacked we could sense that we are going to be a part of one of the most sophisticated and well equipped hospital of the central India. Newly appointed Medical Superintendent Dr. Idnani, Dr. K.L.Bandi, Dr. Mangi, Dr.Harish Sahni and Dr. Mrs. Inamdar who were advisors as well faculty finally decided that we shall start hospital from 16th July 1979. This made us work very enthusiastically. I took responsibility of setting of C.S.S.D. Dr. Mrs. Chamania and Dr. Lokhande took responsibility of setting up operation theatre. By this time Dr. Palsule had also joined as registrar in anesthesia and Dr. W.P. Thatte and Dr. Chouthe joined as consultants in anesthesia.

Hospital started on 16th July but every department was not staffed with nurses, technicians or ward boys. I volunteered to work in C.S.S.D as In-charge till we could get a responsible person. I was sent to Jaslok Hospital Bombay to understand working of a C.S.S.D. which at that time was a new concept for Indian hospitals. Human nature is such that if you want some thing to run smoothly and properly you don't mind doing a duty not appropriate to your position or education. Boredom and idleness of a nonfunctional hospital made us so desperate and nervous that I did not mind for a first few months work like a technician making sets, trays and dressing materials. Fortunately I did not have to do this work for long. Two retired ex army technicians Mr. Chandrasekhar and Mr. John took over from me completely. As soon as hospital started late Dr S.K. Sharma joined as third surgical registrar and Dr. M.C.R. Rao joined as full time consultant. Before finishing this Para I will like to mention that our first managing trustee, late Shri Lekhraj Pagarani was a very compassionate person. Regularly he would empathetically enquire from us about our difficulties and problems. It made us feel very important. It gave me a lesson in the life that loyalty from an employee in not bought from money alone, it is earned from employee by giving him a feeling that managements cares about you. Man apart from perks also needs respect, 80 recognition and responsibility to stay in the organization. Work started picking up soon; reasons for this were quite obvious. Choithram Hospital & Research Centre was the best equipped institution of the central India; secondly Dr. K.L.Bandi who had Resigned from medical college was the most talented and versatile surgeon of his generation. He was a general surgeon in real sense, who could perform any surgery except open heart surgery with perfection. I used to admire his skill and adroitness while assisting him, at the same time used to pray can I ever pick up his skills. I had a long inning with him as a registrar then as a junior consultant. Gradually I realized what made him different from others. He was daring and dexterous; he would be exceptionally calm in the event of complications, and he was decisive. It gave me another lesson: A decisive person always succeeds, as he is able to rectify his wrong decisions very soon. In contrast to that an indecisive surgeon is not able to take even a right decision. Dr. Bandi was technology friendly person. He always persuaded the management to acquire new technology before others could think about it. With his leadership and wisdom our hospital was first to start percuteneous renal surgery, renal transplantation and laparoscopic surgery. While he was the head of surgery dep't; we saw induction of Dr Rajendra Lahoti as second urologist, Dr. G.P. Patidar as general surgeon, Dr. Gandhi as cardiovascular surgeon, Dr. Prakash Chhajalani as plastic surgeon, Dr. Arun Agarwal as cancer surgeon, and Dr. Ashok Laddha as colorectal surgeon. I, and Dr. Mrs. Shobha Chamania and late Dr. S.K.Sharma were also promoted as consultants. Dr. Bandi also persuaded us to pick up our subspecialty. He never encouraged groupism in the department, never felt threatened by newer

appointments as most of us do. I still remember his words.” If you have guts then never feel threatened”. He retired in the year 2000. Department and the institution will remain highly indebted to his contribution. Dr. Rajendra Lahoti who joined institution in early phase, was instrumental in development of Urology as a specialty in the department. I had the privilege to work with him also as an associate. He was very methodical, academically oriented surgeon. He encouraged us to attend national and international conferences and write and present papers. Apart from this he was very sociable and gregarious person and got along with every one which contributed significantly in maintaining harmony and congeniality in the department. Both Dr. Bandi and Dr. Rajendra Lohoti were my mentors. When I joined the institution, I was immature and novice. Like Eklavya I used to observe these two great masters closely. With great perseverance I have tried my best to incorporate their qualities and skills in my personality and in the end I still feel like a decimal in comparison to these two great giants. Dr. Dheeraj Gandhi joined initially as thoracic and vascular surgeon. After joining of Dr Rajshekhar as cardiac surgeon, cardiac surgery started in full throttle. Even after Dr.Rajshekhar and others who joined later and left Dr. Gandhi sustained the dep't. single handedly. He has done largest number of valvular and aortic 81 aneurismal surgery in central India. He was a gifted surgeon and it was a pleasant and envious experience to see him operating. Looking at his surgical adroitness I used to think even the God is biased in distributing the talents. At this point I shall not hesitate in saying that a harsh tongue and inability to get along with subordinates can undo all good work one has been doing. I will like to pay my tribute to Dr. G. P. Patidar who initially worked at Choithram Dispensary. He joined the institution as plastic surgeon and finally with Dr. Mrs. Shobha Chamania decided to work exclusively in Burn Unit. Both of them brought Choithram Hospital's Burn Unit to national and international recognition. Ill health lead to his early demise but department. and the institution will remain indebted to his contribution. Dr. S. K. Sharma joined immediately when the institution stated. He was one of the founder pillar of the department. He was known for his punctuality. He was a strict disciplinarian. Till his untimely death at a very young age he contributed significantly in day to day running of the department. Dr. Sharma's demise was a personal loss to me. He was my close friend, associate and we shared common dreams about our children. Nature has made us strong as well as cruel enough to bear great personal losses without permanently damaging our psyche. People come and go, they join; and leave for better prospects. But a unit or department whose initial foundation is strong attracts young, energetic and enthusiastic persons who continue to carry newer and unfinished work. Once first generation of surgeons laid down solid foundation of the department, second

generation of surgeons started developing super specialities and sub specialities. Dr. Manish Patel joined in the year 1997, till, that time Dr. Mrs. Shobha Chamania used to entertain pediatric surgical cases. Recently Dr. Kutumble has joined as full time pediatric surgeon. Our pediatric surgery unit performs all major neonatal and pediatric surgical operations. They are well supported by versatile pediatrics dep't, and two neonatal and pediatric ICUs. Dr. Shekhar Thatte joined in the 1989 as a urologist. Gradually urology separated from general surgery. Subsequently Dr. Sushil Bhatia joined in the year 1998 as a full time urologist and urology unit raced ahead with a faster pace. Now we have one younger, soft spoken, humble and dynamic urologist Dr. Anil Bandi in the unit. At present it is the busiest unit in the city of Indore. All major endourological, oncourological and percuteneous surgeries are performed in the unit. Dr. Prakash Chhajalani who joined as a plastic surgeon in very early phase of the institution. He is a pleasant personality with numerous talents. At present he is conducting a “Beyond Medicine” programme once a month for last 6 years. This programme is the most widely attended programme of our institution's activities. For more than two decades Dr. Chhajalani handled all cosmetic and reconstructive surgeries alone. Recently Dr. Anil Garg, who is also a micro vascular surgeon and Dr. Sanjay 82 Kucheria who is a brilliant cosmetic and plastic surgeon joined plastic surgery unit. We can boast that presently our plastic and reconstructive unit is best in central India. Oncosurgery was also one of the superspeciality to develop in very early phase of the institution. Initially Dr. Arun Agarwal and Dr. Digpal Dharkar managed the dep't. For more than a decade. Now this unit is managed by a young enthusiastic surgeon Dr. Sanjay Desai. His expertise in head and neck and esophageal surgery is well recognized. He is frequently sought after by our gynecological colleagues, ENT surgeons and general surgeons. As super specialities branched out some of us decided to nurture subspecilities in general surgery. After joining of Dr. Girish Naik as gastroenterologist in late eighties, institution became referral center for liver diseases. Before sclerotherapy and banding became established, portasystemic shunt surgery were the only options for bleeding variceal bleeding. Our institution was the only centre with the largest experience in shunt surgery in central India. Finally I decided to pursue hepato-biliary pancreatic surgery as major area of my interest; now we have the largest volume in this field in our state. I am supported in his field by a young, sincere and hard working surgeon Dr. Neela Oza, who incidentally also is the first DNB student of the department. Dr. Mrs. Shobha Chamania is one of the rarest breed of surgeons who has chosen Acute Burns as major area of interest. Despite facing problem of non availability of another faculty to help her, she has brought Burn unit of the institution to national and international recognition. In late eighties charismatic then young Dr. Amitabh Goel joined as a

Dr. S. K. Sharma Dr. G. P. Patidar Dr. R. K. Lahoti Dr. K.L. Bandi Dr. M. C. R. Rao Dr. Laddha Dr. Bapna Dr.A. Agarwal Dr. Kucheriya Dr. Anil Garg 83 Dr. Vandana Bansal Dr. Neela Ozha Dr. D. Dharkar Dr. R. Kutumble Dr. Dheeraj Gandhi ...., Dr. Siddique, Dr. C.S. Pandit, Dr. A.Shrivastava, Dr. Pathak & Dr.P. Jain

resident in cardiothoracic unit. Soon he switched to General Surgery. He is the brightest feather in the dep't. of surgery. He pursued laparoscopic and thoracoscopic surgery as main area of interest. He was later joined by a dynamic young surgeon Dr. Vandana Bansal. Both of them are recognized nationally in their expertise in the field of laparoscopic and thorocoscopic surgeries. Two and half decades of progress also saw procurement of sophisticated technology like carbon dioxide and ND YAG lasers, CUSA and harmonic scalpel etc. I will like to mention here some of the registrars who worked with us have now attained prestigious positions. Dr. Kanitkar is a renowned plastic surgeon at Ruby hospital; Pune. Dr. Nitin Kekre in professor of Urology at CMC Vellore. Dr. Pal is chief of urology at Holy Family Hospital New Delhi. Dr. Aneesh Shrivastava is professor of urology at SGPGI Lucknow .Dr. Sengar and Dr. Aiyengar are Professors of neurosurgery at Gwalior Medical College, Dr. Alok Shrivastava is a faculty in the field of Robotic Surgery at Vatticuty Institute of Urology USA. At the conclusion, I would like to say a seed was sown by DR. K.L. Bandi, Dr. M.C.R.Rao and Dr. G.P.Patidar in year 1979, now it has become a banyan tree with strong stem of general surgery and blooming branches of superspecilities like cardiac surgery, pediatric surgery, plastic surgery, oncosurgery and urology. 84 Major Milestones First Centre to start Renal transplantation. First Centre to start Open Heart Surgery. First Centre to start Percuteneous Renal Surgery. Conferences and workshops held National workshop on percuteneous renal surgery in 1985. National conference of Burns Association of India in 1993. West Zone USI conference in 1995. Central Zone conference of IAGES in 1999. Workshop and CME on MAS for family physicians in 2001. International workshop and conference on MAS of IAGES 2003. Honors to the faculty Dr. K.L.Bandi : West Zone USI president Dr. Rajendra Lahoti : West Zone USI president Dr. Shobha Chamania : National president NABI Dr. Amitabh Goel : Vice president central zone IAGES

Evolution of Burn Unit By - Dr. Shobha Chamania “ God moves in a mysterious way. He has wonders to perform; He plants his footsteps in the sea, and rides upon the storm.” When I was a postgraduate student in Surgery, burn patients used to be the most neglected ones. Patient and their family members waited for the inevitable end for major burns. If they had minor burns, they survived with deformities and disabilities. Burns was then a chapter in the surgery text books and the pathophysiology was poorly understood. Research is still going on to fully understand the impact on human physiology by this injury. The research till date has however been able to revolutionize the approach to burn patients and has changed the dismal scene to optimism for moderately burnt today and has promise for major burns in future as the technology advances. Modern day burn care is provided by a multidisciplinary team of surgeons, anesthesiologist, physicians, psychiatrists intensivists, psychologists, physiotherapists, occupational therapists, dieticians, specially trained nurses and technicians. Burn care in India started getting some importance in selected metros in late 85 sixties. Our state was not keeping pace with what was happening in this field. This was very little discussed in most conferences and the journals and text books shied away. 1979-84 burn patients in our hospital were treated in private wards by all the surgeons. There was neither specified protocol for their management nor any special care for better attention. I had returned from training in Pediatric surgery and was focusing on developing that specialty. I soon realized that there were more burn patients who were inadequately treated and there were very few pediatric surgical patients. Dr G.P. Patidar and I decided to start a special area for burn care. Our then Head of the Department Dr. K L Bandi was more than happy to allow us to start this separate unit. 1985: We were given a vacant hall with attached bath, next to mortuary, for starting the unit. This was disconnected from the main hospital building for fear of hospital infection or want of space. 1986: We met Dr. M H Keswani, then Chief of the burns unit at Wadia children's hospital, Mumbai. We learnt a great deal of preventive and acute burn management from him and his devoted team. The first lesson of building a burn team was learnt there. He encouraged us to visit several other centers in India and abroad which helped us tremendously in designing and planning a unit here and outlining our method of managing these patients.

1987: I visited three centers in USA: Shriners Burn center in Massachusetts, Boston, State of the art burn center in Durham North Carolina and Los Angeles county and University of Southern California medical center. Met their teams, saw operative procedures and their day to day management and returned fully charged to start a new unit in Dec 1988.This was a six bedded unit to begin with and was expanded to 12 beds later. Burns association of India Indore branch was started by us and we started conducting preventive programs in schools, through social organizations and through all media. One fine day I was told to meet our Donor, Shri Thakurdasji in the Shiv temple of the hospital. I was not given any agenda of this meeting. He asked me if I was looking at burns for making profit or good business. When I told him that my intention was to improve burn care in our hospital, he gave me a number of his hotline and he told me that I can contact him on that number any time and ask for help. He assured me that the demands of this unit will be fulfilled. I later came to know that his mother passed away following burn injury and he had emotional links to encourage better care for the burned. This episode also introduced us to 86 his sensitivity to the needy and generosity for the suffering mankind. 1990: We had several international faculties visit us. Dr. Andrew Munster from Johns Hopkins, Baltimore stayed with us for seven days and taught us how best to manage hand burns and how to begin research in burns. Dr. JWL Davies , editor Burns journal, gave a lecture on how to do basic research and encouraged us to go ahead with tangential excision and grafting as a routine. I would like to express my personal gratitude to this gentleman, who motivated us precisely to accept the change in the treatment and showed us the way to take one step at a time and move slowly to master this technique. This one step brought about a radical change in the lives of the burn patients as they started getting better much faster, with less agony less deformities and disabilities and at a much less expense. This enabled them to get back to their work earlier and needed much less attention for rehabilitation than before. This revolutionized the outcome in burns and we started watching our statistics and prognosticating the outcome predictably. Dr. John Gower Chief of Burns center, Birmingham Hospital, Birmingham, conducted a workshop on contracture release and grafting. Two weeks nurses training program was organized with the help of two Australian nurses. Janice Clayton along with sister Savitri from Mumbai conducted this program. This was very much appreciated by the participants.

This gave us the impetus to move forward in improving the burn care. We took tiny steps to start early enteral nutrition, early surgery, manage critically ill patients in the unit by improved critical care, ventilator therapy, improved nursing, Pain relief, Psychological support and physiotherapy to ultimately improve survival and quality of life in survivors. Patients were not very welcome in the general physiotherapy unit because nonburned patients were frightened to see a burned patient next to them. So, a physiotherapy area was made in the bright and sunny landing outside the unit, which has been a boon to the patient's recovery. This is not a technologically fascinating branch and requires a lot of input in terms of service, communication, dressings, supervision, long surgeries, and long follow ups in addition to the legal hassles. This obviously was not everyone's cup of tea. Professional help was scarce. So we trained multipurpose workers and groomed them to take care of mundane jobs like dressings, physiotherapy, splint making, pressure garments' care etc. These workers have become the pillars of the team in support with the nurses. Each team member is trained in their work, is then given fair amount of independence with supervision. Each member feels proud to have contributed to a good recovery of a patient and feels frustrated if he is not able to help. The team 87 spirit gets further nurtured by having some social activities together. 1993: National Conference of the Burns Association of India was organized. Dr. Manu Desai, Director Burn centre, Houston Texas was the invited speaker in addition to several national faculty members. I will always remain personally indebted and the burn team will cherish the fond memories of a quiet leader of the team, Dr. G P Patidar. He always was the pillar support for the cause of burns and for the team. He showed us the way to harvest skin grafts from less common donor areas and always was able to give a lot of skin grafts to cover burn wounds. His untiring zeal to work in Burns motivated the team to support him in improving the burn care. He promoted juniors to learn, participate in research, express their opinions and establish their identity without imposing his position. “ The world is my country, all mankind are my brethren, and to do good is my religion.” Research projects undertaken: 1991- Low level lasers were introduced by Russian physicians for treating MDR tubercular cavities. Center for advanced technology, Indore then developed a nitrogen laser machine for clinical use. Intensive research was conducted in vitro and in vivo in our hospital. Gratifying results were seen in MDR infections on burn wounds and other acute and chronic wounds in >2000 patients till now. This was published and presented in international laser conference in Argentina. The

procedure is continued to be used clinically. Various biological dressings were tried on superficial burn wounds and on the donor areas for reducing pain and providing the best environment for expediting wound healing. To name a few: Boiled potato peel bandage, banana leaf dressing, Fresh porcine skin, homografts from organ donors, amniotic membrane, Collagen in all forms has been used with excellent results. I must express at this juncture that hospital management extended their whole hearted support by providing a piggery, experimental lab for harvesting skin, planting hundreds of banana trees to enable ample supply of leaves and the support of pathology department for microbial surveillance. 2000: Pediatric surgeon Dr. Collin Lazarus from East London, South Africa visited our hospital and was impressed by our innovations in making the treatment cost effective. He invited me to the South African Burns conference to share these methodologies with his countrymen. I was conferred the honorary membership of the South African Burn Association. 88 2002: Invited by the European club of Pediatric Burns to Hong Kong, for conducting a workshop on managing large burns in children and for presenting the problems of managing pediatric burns in India and Alternative medical therapies popular in burn management. I was also invited to contribute to a manual for training paramedics in Pediatric burn management in the developing world. This manual will be published by Oct 2005. I was conferred an honorary membership of the European club of Pediatric Burns. 2002: Visited first Army Burns research institute, Beijing, China to learn their method of salvaging major burns and research. I presented to them a talk on Burn care in India. 2003: Held an exhibition on Burn Prevention. A video film on Burn prevention for public awareness was made by a local TV network. Prospective randomized controlled drug trial for USFDA approval of a topical debriding agent: Debrase as a debriding agent a comparison of standard of care in Burns was conducted in 2004.It was a global trial. 2004: Produced Posters on safety with fire for community education and conducted such programs though the camps organized by the hospital. Dr.H Rode Pediatric and Burn surgeon from Cape Town South Africa visited us and shared his experiences of managing large burns in children. 2005: Twinning with Swansea Glasgow in pipeline for exchange of education and

training of all members of the team. Future plans: l Organizing National conference of Academy of Burns India 2006. l Increasing awareness on donating skin and then establishing a skin bank to help salvage major burns. l Nurses and multipurpose workers training programs in Burn management. l Requesting to upgrade the present burn facility. l Interactive nurses education weekly with Australian burn nurse through internet. l Focus on Burn prevention and collection of burn incidence data. l Providing oral morphine for better analgesia l Focus on rehabilitation to make them aesthetically acceptable in society and functionally independent, thereby enabling them to live a happy fulfilling life. l This has been possible by total commitment to improve the care of the burned by all the members of our team and appreciating and acknowledging their contribution from time to time. Our cherished dream is to have a scarless recovery in the burnt patient. 89 “Let us have but one end in view, the welfare of humanity, and let us put aside all selfishness in the consideration of language, nationality and religion.” The Team

Minimally Access Surgery at CHRC By - Dr. Amitabh Goel “ God moves in a mysterious way. He has wonders to perform; He plants his footsteps in the sea, and rides upon the storm.” The pioneer of the Laproscopic surgery in whole of the Central India was Dr. K. L. Bandi. He did the first Laproscopic surgery at CHRC in the year 1992. Since then more than 10,000 minimally access surgeries have been performed in this hospital. Initially the number of surgery was less due to various factors. Patients were not aware of the advantages of the minimally access surgery. The referring surgeons sitting in private setup were not well informed and like any new change, there was an atmosphere of skepticism. Keeping this in mind, a Zonal conference on MAS was organized in the year 1999, by the young dynamic organizing secretary Dr. Amitabh Goel under the able leadership and guidance of Chairman Dr. K. L. Bandi. The conference was a great success. Dr. Pradeep Choube, who is surgeon to the president of India, and head of the MAS at Sir Gangaram Hospital New Delhi, was the chief guest. The name of 90 the CHRC registered on the international map. Choithram Hospital has remained in the forefront of the continuing medical education since the beginning of 1985, in various departments. Keeping with the tradition three more conferences and workshops were organized in the MAS since 1999. The management of the CHRC played a key role by helping in all possible ways to bring the department up to date and a state of art in the Central India. 2001: CME & Awareness programme with live demonstration for general practitioners. 2003: International conference cum workshops on the basic and advance MAS with \"Hands on Endo-trainer\". 2005: Midterm zonal conference / workshop with CME & surgical update for postgraduates. These continuous activities have brought the department of MAS from the stage of crawling to standing and now ready to walk &\"RUN\". It goes without saying that these types of quantum leaps are not possible without a dedicated team and guidance from the seniors. Dr.Goel attended advanced training in the laproscopic surgery at Singapore National Hospital in the year 2000. He went to UK for the advance training in MAS in 2003. He also attended most of the international conferences and workshops organized in India since then. In these conferences he was either invited as a faculty of was asked to deliver a guest lecture.

Dr.Amitabh Goel and Dr.Vandana Bansal were invited as trainer in the SAARC International conference in MAS at Shri Lanka in the year 2003. Dr. Amitabh Goel is a member of Society of American college of Endoscopic Surgeons(SAGES), and Endoscopic Laparoscopic Surgeons of Asia(ELSA), Europian Association of Endoscopic Surgeons (EAES) in centra India Surgeries Performed Routinely 1. Diagnostic Laparoscopy. 2. Laparoscopic Cholecystectomy 3. Lap. Appendix 4. Lap. Hydatid cyst of the Liver & Lung 5. All types of Hernia. 6. Lap Urosurgery (a) Nephrectomies (b) Uretric Stone 91 (c) Pyeloplasties 7. Lap Perforations. 8. Lap Diaphragmatic hernias. 9. Thoracoscopic surgeries which includes (a) Diagnostic (b) Theropeutic 10. All Gynae surgeries 11. All G.I. surgeries. 12. Endoscopic Vartebral biopsies & Spinal Surgeries 13. Endoscopic drainage of Dorsal Tubercular abscess. Choithram Hospital has been officially recognised as a Training centre by Indian Association of Gastrointestinal Endo Surgery (IAGES). This hospital is the only training centre in M.P. and Chattisgarh. All courses are organised quaterly: for 7 days which include, Endo Trainer, Basic Laparoscopic Course, Suturing and Hands on surgery along with theory classes.

Chairman giving guidance to the secretary Chief Guest, Dr.Choube Surgery in progress Inauguration Zonal Conference,1999 92 Chairman's Address Dr.Goel with Prof. Cuchri Dr.Goel with Prof.Fingerhut Dr. Goel In Exhibition

Urology Department By - Dr. Sushil Bhatia & Dr. C. S. Thatte “ Hope springs eternal in the human breast; man never is, but always to be blest.” Urology services were started as part of the department of General Surgery, since the inception of the hospital. The department was fortunate to have state of art equipments, which were rare to find even in nationally reputes urology centers. Dynamism and clinical acumen of Dr.K.L.Bandi soon took the Urology services to highest standards. The hospital was very well equipped at its inception. An Ultra-sound Generator was also purchased by the hospital, which was first of it's kind in India. It was used to break bladder stones only in those days. According to Dr.S.J.Mehta, Medical Director, Jaslok Hospital, Bombay, we were better equipped than the Jaslok hospital at that time. Dr. K.L.Bandi was already doing Trans Urethral Resection and other endoscopic procedures. The Optical Internal Urethrotomy was added after his visit to USA, and learning the procedure there. 93 In 1981, he went to Down State Medical Clinic, Brooklyn, USA, which was then the biggest renal transplant centre in the world. After returning from USA, he kept on requesting Dr.Idnani to start Renal Transplantation, but due to various reasons it got delayed till 1985. Dr.R.K.Lahoti joined the department in 1982 and the presence of this super-specialty started being felt all over. Dr. Bandi also attended a PCNL(Per-Cuteneous Nephro-lethotripsy) and ESWL ( Extra- corporeal shock wave lithotripsy) in 1984, organised by Dr.Peter Alken at Mainz, West Germany. On his insistence, hospital agreed to purchase equipments for PCNL. Dr.Anil Karnik who was Chief Radiologist at that time, was then send to USA for training in “PCNL”, for 6 weeks. The first “PCNL” workshop was organized on 22 24 Feb. 1985. Dr.Shrikant Vaidhya and Dr.Walter O'Donnell & associate from USA conducted the workshop, with live demonstration of the surgery through endoscopic camera obtained from West Germany, for the first time in India. Collection of the money for the workshop was a herculean task. But with great enthusiasm Dr.N.B.Idnani went door to door with Dr. Bandi to collect the money for this national workshop. It was a unique scene when delegates started dancing in the auditorium upon seeing the stone being broken through the Nephroscope. This was very well attended by many Professors and HOD of big institutions like AIIMS New Dehli, and PGI Chandigarh etc. This brought Choithram hospital, Indore in the list of advanced Urology centers of the country. We were having one of the largest no of cases of PCNL in country. Many small scale workshops were organized subsequently. A workshop on Urinary Incontinence was organised and conducted by Dr.Walter O'Donnel &

Dr.Shrikant Vaidhya. Another workshop was also organized on Penile Prosthesis Implantation in the year 1987. This was also conducted by Dr.Shrikant Vaidhya. This was also a new procedure in the country. Dr Kirit Vora from USA also demonstrated the use of Internal Urethrotome, Dr. Jayant Radhakrishnan demonstrated a highly complex operation of reconstruction of Bladder Neck along with augmentation cystoplasty and reimplantation of ureters. A Golden Chapter of Renal transplant programme was added on 14th Sept. 1985, with the help of Dr.M.H.Kamat of Mumbai. After first few transplantation, the surgical team of the hospital took over the job independently. The team consisted of Dr.K.L.Bandi, Dr. R.K.Lahoti, & Dr.S.C.Chamania. Since then more then 450 transplants have been done with internationally matching results. Dr.B.C.Bapna, who was considered as a father figure in Urology joined the hospital as Senior Honorary Consultant. Dr. C.S.Thatte joined in the year 1989. The Endo-urology procedures started in the department. Urodyamic Machine by Weist, Germany was purchased in Feb 1992. It gave tremendous boost to many complex diagnostic procedures. For many years it was the only machine available in the Central India. 94 West Zone Urology conference was organized in the year 1995 with Dr.C.S.Chamania as Organised secretary. In 1996 a new chapter was added in the form of “Dornier Nd.Yag. Laser”, amongst first few in the country. A workshop was organized by Laser doyen Dr. Harshad Punjani from Mumbai. Many Laser endo- urology procedures have been done since then and it remains as one of the prize possession of the department. Dr.Sushil Bhatia joins the department in Feb. 1998. Some new surgeries like stress incontinence procedures and for difficult A.V. Fistula were added. In the year 2002, department added Laproscopic surgery to its armamentarium. Many intra and retroperitoneal laproscopic procedures have been done. Dr.Anil Bandi joined the department in 2003 and carrying forward the legendary work done by his father Dr.K.L.Bandi. Many new advanced Endoscopic instruments for Ureteroscopy, PCNL, & Paediatric urology have been purchased by the hospital and regular up-gradation is being done. Barring the facilities for Extra corporal Lithotripsy, the department is fully geared for all types of world- class diagnosis and therapeutic modalities. Choithram Hospital has great contribution in my personal, and professional career for which I will always remain indebted. R.K.Lahoti After my return from USA, I was badly depressed seeing the facilities available at Indore. Working at CH&RC was a great satisfaction. K.L. Bandi “ There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow”

Plastic Surgery By - Dr. Prakash Chhajlani “If eyes were made for seeing, then beauty is its own excuse for being.” The Department of Plastic Surgery has completed twenty-five years. It was set up with the inception of the hospital in 1979. Dr G.P. Patidar a general surgeon with a keen interest in Plastic Surgery moved in from the Choithram dispensary to join general surgery and manage plastic surgery and burns. He was assisted by Dr Shobha Chamania. In November 1986, I was a formally trained Plastic surgeon (MS, M.Ch.) from Mumbai University I came into Choithram Hospital to start an independent department with a mutual understanding that Dr. Patidar would continue to do plastic surgery in his areas of interest and would head the separate Burns unit along with Dr Shobha Chamania. In a time span, the management helped in getting all the equipment needed and the work started. It was for the first time that a department of Plastic Surgery was set up in Indore; only one before this was at Gandhi Medical College Bhopal. To promote the speciality in the city-state, the department started organizing workshops in 95 Plastic Surgery so that general surgeons could be knowledgeable as to what all was being done by plastic surgeons. In all 10 workshops were organized in a span of 11 years. Workshop on Cleft lip and palate (1988), Skin and muscle flaps (1989), Maxillofacial surgery (1989), Rhinoplasty (1991), Contractures (1993), Body- contouring surgery (1994), Occuloplasty (1996 ), Rhinoplasty (1997), Body contouring surgery (1998), and Lasers (1998 ). Papers of mine were published abroad by Dr Prakash Chhajlani in national and international journals, including BJPS, and European Journal of Plastic Surgery. The department does about 90 to 100 cases annually. The spectrum of surgery changes from time to time. Initially we did a large number of cancer reconstructions, though none now. We still have a fair number of lip and palate surgeries and post burn contracture release and flaps for upper and lower extremity trauma. Micro-vascular re-implantations of the digits have also been done occasionally. The department has had a fair number of maxillofacial injuries, although the number has been significantly reduced in last three-four years. Two more plastic surgeons joined the department in February 2003. Dr Sanjay Kucheria, a graduate from Baroda, with interest in micro-vascular surgery and Dr Anil Garg a graduate from Ajmer and Jaipur. He, too, is a very keen micro- vascular surgeon; they both have taken training in micro-vascular surgery in India and Taiwan. With this came the advent of a new era of free flaps in the department. “ The moment one gives attention to anything, even a blade of grass, it becomes a mysterious, awesome, indescribably magnificent world in itself.”

The Dental Surgery By - Dr. Avijit Mitra “The body has become diseased; the hair of the head has become grey, the gums have become toothless. Such an old man slowly moves with the help of stick, still, alas, he does not give up hope!” The dental department of CHRC started from the day of inception of the hospital At that time Choithram hospital was the only private super specialty hospital to have a dental department. and this was due to endless efforts of Dr. S.L.Mangi, the father of dentistry in central India. He was instrumental in setting up the department which was not only well equipped with the state of art dental instruments and equipment. The department have two dental units of J. MORITTA Japan, one of the best at that time. The department began with two doctors with Dr. Mangi as the head and Dr. Sushma Tarte. By and large the department undertook various dental procedures pertaining to all the branches of dentistry. Because this was the only private hospital providing dental facility, the number of patients gradually increased so did the number of procedures. Doctors also changed Dr.Tarte left Dr. Vrinda Kawthekar joined. As 96 the work progressed newer procedures were included. There-after Vrinda left and Dr.Avijit Mitra joined the department. This was when the department felt the need of expansion and another dental unit was installed in the department. Newer procedures of maxillofacial surgery were started in the department. Another dental surgeon was inducted. Today after 25 glorious years of existence of this hospital, we have the most well equiped operatory with Doctors - Dr.Avijit Mitra, Dr.Seema Bulani, Dr.Girish Karandikar, and Dr.Rachna Dubey managing efficiently. Dental Chair

Department of Surgical Oncology By - Dr. Sanjay Desai “ To the sick, while there is life there is hope” Surgical oncology procedures were performed in Choithram Hospital from the time it began by senior surgeons of the institute. The credit of giving it a separate identity as a Department of Oncology goes to Dr. Arun Agrawal, M.S., D.N.B., who joined as surgical oncologist on May 15, 1985. Many procedures of surgical Oncology were carried out for the first time in the hospital. The department's growth was clear and to reinforce the armamentarium, Dr. Digpal Dharkar joined as surgical oncologist in 1988. They were together till late 90s. A further face-lift came with the joining result oriented Sanjay M. Desai, M.Ch. (Surgical Oncology) in 2002. To establish this department, it takes many years, phases. The present team of consultants is committed to provide quality care to needy patients. Most of the oncological procedures require a team approach Medical oncologist, Radiation 97 therapist, Plastic reconstructive surgeon and specialists in various fields. Choithram Hospital has almost every facility except Radiation Therapy. Since we have the complete required \"tools of the trade\", so to speak, and a congenial atmosphere, our results of onco-surgery are comparable to world standards. With the facility of Radiation therapy, the department will be composite and well managed one in the private sector. “ The hopeful man sees success where others see failure, sunshine where others see shadows and storm…….” Limb Sivage Surgery for Malignant Tumor

Department of Paediatric Surgery By - Dr. Manish Patel “Children are like wet cement. Whatever falls on them makes an impression.” When I joined the department in 1998, Paediatric Surgery was a complex, growing branch with the problems prevailing mainly in the low socio economic class. In the private sector, this branch was not yet established. Initially I got a desultory and a cautious response from my colleagues. But, gradually, results improved and the incidence of referrals increased. Especially in Neonatal Surgery, the reaction of the paediatrician changed from a reluctant nod for surgery to a positive affirmation, a liking for surgery and The Surgeon. During the last seven years, results of surgical neonates and children improved to enviable levels. The survival of Tracheo-oesophageal fistula, Intestinal obstructions, Imperforate anus, Hirschsprung's disease, Necrotizing enterocolitis and P.U. valves is above 90 percent with long term results also showing a vast 98 improvement. The outcome of Paediatric solid malignancies is encouraging, while routine cases like Paediatric Hernia, Hydrocele, Umbilical Hernia, Hypospadias, Undescended testis and various urological, thoracic, and neurosurgical procedures showing an excellent results are easily comparable to international standards. A shift meanwhile has occurred from a period of Neonatal Surgical survival as a prime target to one where a surgical neonate is subjected to multiple surgeries, kept on a ventilator, long-lines being inserted and provided with long- term nutritional support for an optimum outcome. We have the rare privilege of successfully separating an omphalopagus conjoined twins. The department has been enriched with the joining of the young, energetic, Paediatric Surgeon Dr. Rajneesh Kutumbale in 2003. We are pioneer in central India to start with an Antenatal Clinic (along with Radiologists, Obstetricians, and Paediatricians). We have successfully performed various Paediatric laparoscopic procedures. There are various reasons for this success at CHRC. One of the foremost reasons is an excellent Paediatric setup, and the positive attitude of the management. In this journey of establishment and concrete success, I had the full cooperation from the Paediatrics, Obstetrics and Gynaecology department, and Anesthesiology. Here, I would like to extend my sincere gratitude to all other surgical colleagues, especially to Dr.(Mrs.) S. Chamania who acted as my friend, philosopher, and guide. I am equally grateful to the excellent nursing staff, ancillary staff, helpers and all the residents for their positive contribution to the successful journey of the department of Paediatric surgery. There comes a special moment in everyone's life, a moment for which that person was born.

That special opportunity, when he seizes it, will fulfill his mission a mission for which he is uniquely qualified. In that moment, he finds his greatness. It is his finest hour. We have held a number of workshops and conferences. During the last eight years, a number of Paediatric surgeons of international repute have visited our hospital and have had a lot of praise for the institution, our surgical results and the facilities we possess. The doctors who visited us have been Prof. D.G. Young (Glasgow, Scotland), Dr. Grahme Pitcher (Johannesburg, S.A.), Dr.Colin Lazarus (East London S.A.), Mr. Peter Raine (Glasgow, Scotland), Dr. Pirigi (Italy), Dr. Juan (Madrid Spain), Dr. Heinze Rhode (Capetown, SA.). The future of Paediatric surgery lies in development of various sub-specialities like Paediatric urology, Endocrinology, Neurosurgery and Laparoscopic Surgery etc. With vision and team approach, I am sure all this is achievable. “ Children are hopes. Feel the dignity of a child. Do not feel superior to him, for you are not.” 99

The Department of Cardiology and Cardiothoracic Surgery By - Dr. Vidhut Jain “A kind and caring heart is foundation of gladness, making everything in its vicinity freshen into smiles.” The Founder trustee and management of Chiothram Hospital always cherished the dream of bringing the super specialist health care to this part of India, which was lacking facilities for large population. Before the inception of this hospital management had lot of deliberation and serious consultation with senior physicians of city, who also felt the need for developing Cardiology and Cardiac Surgery in Indore city in addition to other specialties. This was the era, when Cardiology and Cardiac Surgery was just at the beginning of acceptance even in metro cities of India; and big impact still was needed all over India. It was some where in 1979, management decided to start the Department of Cardiology. Dr. D.Mukerjee and Dr.S.R.Jain were specialist consultants in the 100 Cardiology, and ably assisted by Dr.R Tharwani. At that point of time city of Indore was in need for good Intensive Coronary care unit and this hospital started 4 - bedded ICCU where all requisite facilities for patient care were installed. And as time passed over other facilities were added including Bicycle TMT, Telemetry unit and etc. Encouraged by the number of patients availing the services of Cardiology department further development was planned. In this chain Cardiac catheterization and angiography lab was considered to be needed so Dr. Mukerjee and Dr. Bisaria, Cardiac Surgeon visited couple of cardiac centers and Cardiac machine was finalized in 1982. Some where in late 1982 when I was working at Jaslok Hospital, Mumbai in Cardiology Department, Dr.S.J.Mehta, Medical Adviser of Jaslok hospital and also of Choithram Hospital introduced me to late Dr.N.B.Idnani who was Medical Director of CHRC, who discussed the prospect of Cardiology in Indore with me in this institute and it was felt by me that I should join this Hospital. I joined the existing team of Cardiologist in 1983, and tried to understand with my colleagues about the future planning. While Cardiac catherization was under installation. New ICCU with 18 beds was commissioned wherein for first time in Central India. Central monitoring of all cardiac parameters including Invasive intra arterial B.P., Pulmonary artery pressure by Swanz Gains catheter, were also available.

New Pacemakers, Ventilators were also procured for taking care of more critically ill patients. In 1983, Closed heart surgery procedures like B T Shunt, PDA ligations and Close Mitral Valvotomy procedures were started by Dr. Dheeraj Gandhi, a Cardio Thoracic Surgeon, who was full of enthusiasm and ready to accept challenges. Our initial results were gratifying. This was the first functional cardio thoracic unit of Central India. Almost at the same time Cardiology Department acquired Doppler echocardiography. This was first of its kind in state. With addition of this Non Invasive diagnostic facility, many complex cardiac diseases could be diagnosed and later definitive treatment could be offered. By year 1984, Cardiac Catheterization lab was commissioned wherein Angiographic procedures in adults and babies were started. In same year first Permanent pacemaker implantation and first Interventional Cardiac procedures i.e. Baloon Atrial septostomy in neonates, was done by me along with my colleagues. Almost at the same time Dr.Rajshekhar Devineni joined as Cardiothoracic Surgeon. He was a student of MGM Medical College, Indore. After passing his 101 master degree in surgery in 1977, he left for his advance training in Cardiac surgery to England and then to Canada. He was working as a consultant cardiac surgeon at University Hospital Ontario, Canada, before joining Choithram Hospital on 25th Feb 1984. He was well trained surgeon with experience of nearly 2000 cardiac surgery. All the requirements for Open heart Surgery were planned properly. A team of dedicated paramedical staff was selected for training and sent to Apollo Hospital Chennai. Mr. and Mrs. Rao were among them. Contribution of Mr. Richard Leydon an Indian (Calcutta) born Canadian citizen, Cardiac Perfusionist can not be forgotten. He came to Indore and stayed with us for three months and trained our staff perfusionist Mr. Lotlikar and other team members. After organizing and overcoming hurdles of various kinds, Dr. Rajshekhar and his team performed the first Open Heart Surgery on 18th February1985, successfully, comprising Dr.Dheeraj Gandhi, Dr. M.K.Chadha and Anesthetist Dr. K.G.Vijayan, and assisted by Senior Staff Mr. Shashi Rao. In the same year we did about 46 Open Heart Surgical procedures including Valve replacement, Dissecting Aneurysm, Repair of Congenital Heart defects in babies and even challenges of complex CHD like Fallots Tetralogy, Tricuspid Atresia were accepted with good results. In Oct 1985, first time C.A.B.G. surgery was successfully performed on a patient who came from Bombay for coronary angiography to me, as possibly no one from Indore believed on us till then. He underwent 4-graft surgery successfully. There after most of the cardiac surgical procedures were being done routinely and

patient form near by states also saw hope in this institute as all these procedures were done in very low cost, one may laugh at us if he comes to know that at that time procedures like CABG and valve replacement surgery were costing only Rs.16,000/, which was inclusive of all Disposables, Drugs, Valve, Surgeon's fee, food and hospital stay of 18 days This was made possible only because every one involved in team was so dedicated and philanthropic outlook of Managing Trustee Shri Satish Motiyani, who could convince Shri T .Pagarani Founder Trustee about our mission, so all these services were highly subsidized. Dr. Rajshekhar got a good opertunity in USA and he left.however Dr. Dheeraj Gandhi continued the Open heart programme and he was joined by another good Surgeon Dr.Ashok Sharma who almost worked for two years but was lured by good offer from New Zeeland, which he could not resist. This was the initial period of Cardiac surgery and Cardiology and can be considered to be of reasonable standard and comparable to most of the cardiac centers in India of that time. The proof: Out of first 7 patients who underwent CABG surgery in 1986 by Dr.Rajshekhar, 6 patients are still alive [18 years] without any hospitalization for cardiac problem. As these patients are still under 102 my fallow up. And they are thankful to us. Some how momentum could not be maintained due to various reasons. Later on, cardiac surgery had services of Dr. Ramesh Bafna, Dr.Modh, and Dr. Prateek Bhatnagar, Dr. Dhoble, Dr. Kapadia and Dr. Deepak Malhotra, who in their capacity did the good work and programme of cardiac surgery was still continued but at tardy pace due to various reasons. At present Cardio Thoracic Surgery Department have services of Dr. Mukesh S. Modh, M.Ch. who has vast experience of 15 years in the field including 5 years training in U.K. He is always available to accept the challenging surgical task in critically sick patient too. Cardiology Department was further upgraded in 1990 by acquiring Computerized Tread Mill, Ambulatory Holter monitoring and Color Doppler Echocardiography. As time passed out Dr.S.R.Jain and Dr. D.Mukerjee retired but department was further Strengthened after Dr. G.Kawathekar and Dr. C. B.Chabra also joined the existing team. Dr. Kawathkar performed first coronary intervention and valvuloplasty procedures in this institute. It is convenient to describe recent history by decades although changes initiated in one decade often produce their major effects in the later one. Nevertheless certain major trends became so obvious in retrospect that one feels to compel to identify the time with them .As of today, the gold standard of the success of the department of CVTS is judged by the amount of coronary artery bypass work, nevertheless

surgical challenges of Congenital Heart defect repairs and valvular surgery which requires more skill, aggressive approach and team work, also merit recognization more so when rewards are meager while serving socio economically deprived group. Some how this recognization was lacking for CHRC team who had performed first successful CABG programme way back in 1985 and patient is still surviving. The fact is that, this particular group of patients remained less convinced for CABG done locally for unknown reasons. Our strongest supporters are our patients, their families and friends .We have to learn that quickly, applying the benefit of the new technologies a large number of the patient can be attracted again. A small but important step is already underway. We can find our way back. This will require a changed mindset- “By doing the right thing the right way every time, in time then only we can meet and possibly exceed our own expectations”. While a sound foundation is already laid by hard work of the past, a dedicated medical teamwork with backup from management can help this hospital to restore its past glory. 103 The Golden Moment : First CABG One fine morning some where in October 1985, while I was in my office, Dr.Idnani, asked me to have a cardiac check up of his close friend Mr. Premchand Lalwani, who had come from Bombay. After all routine check up, I felt that this patient is suffering from disabling Angina following Myocardial Infarction and should go for Coronary Angiography. Accordingly I suggested him the same and instructed him to get Angiography done at Bombay on his return. This patient was very humble and he asked me; whether his angiography can be done by me at our hospital. I answer affirmatively. I did his angiography on a Sunday morning, and informed him that he needs a CABG surgery at earliest. Since he was residing right in front of Beach Candy Hospital, Bombay, I suggested him to get his surgery done at Bombay. I even suggested names of some good cardiac surgeons of Bombay. This patient was adamant and he refused any possibility of getting his surgery at Bombay. Next day morning, Mr. Lalwani, asked me about the possibility of getting his surgery at Indore. He made enquiries about Dr. Rajshekhar and his competency. He was told that; Dr. Rajshekhar is a competent surgeon, and has done 600 similar operations out side India. But he has not done any CABG surgery at Indore till that time. He will be our first case, if he insists on getting his surgery at Indore. Mr. Lalwani did not buzz off. He insisted for a personal meeting with Dr.Rajshekhar. The meeting was arranged and after satisfying himself, the date

th for surgery was fixed on 12 October 1985. Operation and Postoperative period was uneventful. The patient was discharged on 9th P.O. day. As usual Mr. Lalwani thanked Dr.Rajshekhar and me. Then he asked us to pose for a photograph. After taking the photograph, he thanked us again and left my office. When we started the Open Heart Surgery Programme, I made a request to our administrator that we will not go for any newspaper publicity until we operate at least 50 cases. This condition was accepted on ethical grounds, and the promise was kept. Smooth sailing of Open Heart Surgery and Angiography encouraged us in our hospital. By Now we had done about 40 cases of surgery with acceptable results. This was speaking high for teamwork of Cardiac surgeons, Cardiologists, Perfusionist, O.T., I.C.U. nurses, and technicians involved in respiratory care and Cardiac Angiography. Involvement and encouragement given by the management, and administrators is worth mentioning. On the third day following Mr. Lalwani's discharged from the hospital, a report in the local news paper was published about the first successful CABG operation at Choithram Hospital on a patient came from Bombay. The news had a photograph 104 of the patient with Dr. Rajshekhar and myself. I was bit upset with the news, as I felt it was premature to go into the press. I thought that Dr.Idnani must have given the news. I contacted Dr.Idnani. He expressed his innocence. He enquired the matter and informed me that Mr. Lalwani directly went to the newspaper office and released the news. It was a unique experience that we had our first case of CABG, which was successful and patient who in fact demanded for this surgery was an affluent class of businessman from Mumbai. “ Happiness lies in the joy of achievement and the thrill of creative effort” “In the world's broad field of battle, In the bivouac of life, Be not like dumb-driven cattle! Be a hero in a strife!”

Dr. Idnani, Dr.Devineni Dr. Jain with Mr. Leydon Dr.Gandhi & Dr.Mukherjee Dr. D.Mahrotra Dr. Ashok Sharma Dr. R.Tharwani Dr. Mrs.Chhabra 105 Mr. Shashi Rao with perfusionist Dr. G. Kawthekar Dr. Paresh Shah Dr. Rajshekhar Dr. Mukesh Modh

Golden moment : First Open Heart Surgery Open Mitral Valvotomy Dr. Mukesh Chadha On 16th March 1985 history was created in the annals of medical profession in Central India, the event being successful execution of open mitral volvotomy. It was the foresight and the high tech Savoy thinking as also the desire to provide quality medical services to inhabitants of Central India, that the honorable Managing Trustee Mr. Satish Motiani and medical director Dr. N.B Idnani took pains and planned for months that an open-heart unit was established at CHRC. The O.T. and nursing staffs, Mr. Shashi Rao and Mrs. Rao were send to Chennai for a month long training and Dr.K.G.Vijayan was send to C.M.C. Valoor for training in cardiac anaesthesia, Dr. Raj Shekar Devineni MS, FRCS, a practicing cardiac surgeon in Canada with his roots at Indore had joined the hospital as Chief Cardiac Surgeon and was selected as captain, he brought along with him perfusionist Mr. Leydon, the surgical team had Dr. Dhiraj Gandhi Consultant CTVS surgeon and Dr. M.K. 106 Chadha as registrar. Dr. K.G. Vijayan as Consultant Anesthetist, Mr. Shashi Rao as O.T. incharge, Mrs. S. Rao as CTVS ICU incharge. Mr. S. Lotlikar as perfusionist. A lot of others including respiratory technicians and staff nurses were in the team. Patient Heeralal was admitted to CHRC with complains of severe breathlessness and was unable to do even normal work. He was investigated fully and found to have a case of rheumatic heart disease with severe mitral valve stenosis. Usually this disease requires surgery and the patients were regularly sent to Bombay for the same. Now with the establishment of cardiac unit at CHRC, the surgery could be planned at Indore itself, saving the patient a lot of financial and physical burden. A formal decision for open mitral volvotomy was taken. His surgery was planned on date 16th March 1985 at 8:00 am. In the last few days before surgery everybody concerned with the patient's care was amused and enthralled to see the execution of open mitral volvotomy. Everyone wanted to see how the heart lung machine works, to observe how the cold cardioplegia works and how the defibrillator will restart the heart beats again. As all these technological feats were being observed for the 1st time. Many physicians and registrars present were deeply involved and thrilled by the endeavor. The O.T premises wore a market look at 8'o clock. It was full of doctors with medical director Dr. N. Idnani was present to oversee whatever was happening inside or even outside. The main team of doctors both physicians and surgeons

The Open Heart Surgery Heart with Mitral valve stenosis Mitral Stenosis seen through Atrium Heart is on bypass After Commissurotomy-dilatation 107 The First Open Heart surgery First Heart-Lung Machine Photographs of the Original Surgery Published on 5th May 1985 - Naidunia

were inside the operating room. Dr. Raj Shekhar and his team Dr D Gandhi and Dr. M.K. Chadha had already done meticulous checking of each and everything even remotely concerned with the successful performance of the surgery. The successful performance of open mitral volvotomy was of utmost importance in everyone's minds. I am sure sinus tachycardia of at least 80-90 per minute was rampant in one and all concerned with this patient. Patient was wheeled inside the theatre, diesel generating set was started to ensure uninterrupted continuous power supply. Anesthetist and head of department Dr. K.G. Vijiyan started with his work of arterial canulation and CVP line insertion. The other members took care of positioning of ECG leads and rectal probes. The endotracheal tube was placed in trachea and general anesthesia started. Now it was the time for the surgical team to take the charge. Cleaning and draping was done, light music was running in the background to alleviate the tension. Median sternotomy was done, aortic and venous canulation was done. Heparnisation was done before canulation to prevent clotting of the blood in the heart lung machine. After the canulation was confirmed heart lung machine was started and patient put on the machine and cooled down. Cold cardioplegia was given through aortic route and lo and behold there was a straight line on the 108 monitor, with it everyone present in the operation theatre also missed a beat, with a big question in their mind is the heart going to start beating again or not? . Left atrium was opened mitral valve visualized and volvotomy done by cutting the commissures. The opening was assessed and once found adequate and no regurgitation the closure was started. An hour had passed without anybody noticing it. Protamine reversal for heparin was done and patient slowly warmed. The heart responded to defibrillator and started beating again. This was the moment when smiles could be seen allover. The non-operating staff congratulated the surgical team and claps could be heard. The message that the surgery is successful was immediately passed to the medical director eagerly awaiting this message. Managing trustee was also immediately informed. At about 10:00 in the morning the patient was shifted to OHU ICU by the full team of surgeons, anesthetists and physicians. Patient was put on ventilatory support. On examining his heart sounds by both physicians and surgeons there was no murmur, which meant success. He was off ventilatory support by 3 in the noon. He was then kept pain free throughout his stay in ICU, which was being managed by staff on 8 hourly routine. Truly this day was a day of rejoicing. Sweets were distributed. Everybody in CHRC congratulated all those concerned with the successful performance of the surgery. A surgical feat was thus achieved for the first time in Indore, which was then informed to media for proper coverage. “ Have a heart that never hardens and a temper that never tires, and a touch that never hurts….”

Neuro-Sciences By - Dr. Dakwale & Dr. J. S. Kathpal “We live for ourselves only when we live for others” The Department of Neuro- sciences was a part of the hospital since its inception on th 16 July 1979 with a Neuro- surgeon Dr. T. Suryarao and two neurologists Dr. (Mrs.) V. V. Nadkarni and Dr. J. S. Kathpal, and a highly talented house officer Dr. Apoorva Pauranik, all state of art equipments for neurophysiological diagnosis and a trained technician Mr. Mariappan. The management was fortunate to have visionaries like Padhambhushan Dr. B. N. B. Rao, who wanted it to be a centre of excellence for Neuro-sciences, with all its ancillary branches. 109 The Department of Neurosciences in Choithram Hospital was the first complete department of neurology and Neurosurgery in the state of M.P. Dr.B.N.B.Rao then the Medical Superintendent of the hospital planned the department in a high tech manner, right from the beginning the department of Neurology was well equipped with neurophysiological investigations. The department had a 10 channel gross EEG machine and a Disa-1500, 4 channels EMG-Nerve conduction machine that was the state of art machine at that time. In 1986 a whole body CT -Scanner was added to the department. Prior to this a 600 mA Orbix machine was available for angiographies, tomography's and PEG'S and a motorized machine for myelography. . The department of neurosciences has never looked back and was constantly updated. The Diva-1500 machine was replaced by Nickolet Viking-II machine- a 4 channel state of art EMG, Nerve conduction and evoked potential machine at that time, purchased in 1991 and now, the art 4 channel EEG, Nerve conduction and evoked potential equipment. Another 16-channel EEG machine was added quite sometime back and just 3 years back video EEG-21 Channel machine was purchased. Neuro-pathology backup was available for the department. A free OPD in neurology was being run every day, which is continued till date. There are simultaneous 2 consultants sitting in OPD every day. Dr. Mrs. Nadkarni and Dr.J.S.Kathpal were there for number of years initially to man the department. Dr.Sunil Athale joined later in the year 1991. Proudly, to write Dr.Dhanraj Panjwani who joined as a consultant in the department was one of the first DNB

candidate of the department. Department of Neurosurgery was initiated by, Dr.T.Surya Rao and later on Dr.Dilip Kiyawat and Dr Shadangi were part of the department for a couple of years. Initially Dr.Gajendra Sinh, a renowned neurosurgeon from Jaslok Hospital Bombay rendered a helping hand from 1980- 84. After this, Dr V.G.Dakwale, who is presently the Head of Neurosurgery, joined the department in 1984 and later Dr. Rakesh Gupta became a consultant in the department in 1996. Both of them have a tremendous backup support of Dr.Y.Rupayana who is a clinical assistant for the Neurosurgery department for number of years. The department of Neurosurgery is well stocked with all the paraphernalia required by the neurosurgeons. The Cloward's anterior fusion instrument set was imported from USA in 1984, both for cervical and lumbar spine surgery on the recommendation of Prof. Gajendra Sinh. A state of the art microscope OPMI 6 for performing Neurosurgery has been added by another state of the art microscope Moller 3000-1 meant for Neurosurgical operations costing around Rs. 25 lacs. The department took up stereotactic surgery and functional Neurosurgery about 10 years back. A lesion maker was added immediately after this. Just a year later to 110 this CUSA was purchased to make the yield of Neurosurgical procedures better. There is no end to the instruments for Neurosurgery available in operation theatre. The Department of Neurosurgery has constantly added to its expertise by learning new procedures. Dr. Dakwale went to Stockholm for training in Stereotactic and Functional Neurosurgery. Dr. Rakesh Gupta visited Tokyo on a education trip. The Consultants and clinical assistant have regularly attended various Micro neurosurgery, Spine Instrumentations workshop, Endovascular and Cerebrovascular surgery workshops. There is hardly any Neurosurgical procedure, which is not tackled by the department of Neurosurgery. The armamentarium now includes all spine procedures including spinal instrumentations, CV junction surgery, and Endoscopic spine surgery. The cranial surgery includes all general neurosurgical procedures, endoscopic pituitary surgery, stereotactic brain biopsies and heamatoma evacuations, cerebrovascular surgeries, Complex brain tumor surgery with craniofacial approaches and neuroendoscopic brain surgeries. Accreditation for DNB The real feather in the cap for the department of neurology came when with the efforts of management of the hospital and Dr.R.S.Mehta, Dr.V.V.Nadkarni and Dr.J.S.Kathpal the department got recognized for imparting super specialty training in the subject of neurology in this institute. The 1st batch candidates Dr.D.Panjwani and Dr.Deepak Jain cleared the exams in flying colors. The course is ongoing and training is ongoing. DNB accreditation in Neurosurgery

department also followed in year 2001. Today the department is fully recognized for imparting training in the field of Neurology and Neurosurgery. Starting of subspecialty clinics In accordance with the need of the hour, the department started 4 more out patient clinics: 1. Movement disorders 2. Headache 3. Epilepsy 4. Muscle and nerve disorders Department organised a full fledged: A. Seminar on epilepsy B. Workshop on surgery of Trigeminal Neuralgia C. Workshop on Endoscopic Brain surgery D. Neurology update E. A session on stroke, workshop on Botulinium toxoid injection F. Organized guest lectures both by national and international faculty from time to time. th G. 7 National Neuro-trauma Conference in 1998 th H. 4 National Conference for Stereotactic and functional Neurosurgery in 2000. nd I. 2 MP Neurocon in year 2001 were organized along with Neuro club of Indore rd J. 53 annual Conference of Neurological Society of India in December 2004. 111 K. Organized Neurology camps for rural population of M.P. from time to time and consultants have visited remote places including micro interiors. The futuristic goal is to see that the treatment of all neurology, Neurosurgical and Psychiatric treatment for patients is available in this hospital of international standard and at lowest possible cost. Department of Neuropsychiatry and Psychology Dr. J. W. Sabhaney started the department of Neuro-psychiatry at CH&RC in April 1984, when he came to Indore, after his retirement from the Armed Forces Medical Services. Many qualified Psychiatrists have joined the department since then for short period of time. Dr. Bharti Phadke in the year 1984 - 88, Dr. Vijay Bodhale in the year 1993 - 1997, and late Dr. Rajesh Sanghvi are notable ones. The Indian Psychiatric Society Central zone conference was held in CH&RC in the year 1989, when Dr. J. W. Sabhaney was felicitated and installed as the president. The management was kind to sanction the post of a clinical Psychologist, when Mrs. Renuka Sanghvi and later Mr. Mahendra Acharya joined the hospital. Dr.Deepak Mansharamani joined as the junior Psychiatrist, in the year 1997. The department of Neuro-psychiatry therefore developed as a full-fledged independent department, with Dr.Sabhaney as Prof & Head, and later Professor Emeritus & adviser with Dr. Deepak Mansharamani and Mr. Mahendra Acharya as the lecturers.

For both out-door and an in-door patient, particularly “Liaison” psychiatry, has been actively practiced at this department. It has become a popular specialty and department of the hospital. Two Electro-convulsive therapy (ECT) machines were purchased and the patients received this treatment, as and when indicated. Neuro-psychoanalysis was also being regularly performed. The teaching and training for the post graduate students of Indore School of Social-Work; College of Nursing CH&RC; and other allied institutions have been provided regularly. Dr. J.W. Sabhaney retired at the age of 75 on 1st April 2004. Now Dr. Deepak Mansharamani, as psychiatrist and Mr. Mahendra Acharya as clinical psychologist, manages the department efficiently. 112 Steriotectic Sergery in Progress

rd 53 Annual Conference of Neuro-sciences 2004 Dr. J.W.Sabhaney Dr. Mansharamani Dr. Mrs. Nadkarni Dr. R. Gupta Dr. D. Panjwani 113 Mr. Acharya Prof. C.S.Agrawal with Dr. Sunil Athale Dr.Rupayan The Microscopic Surgery in progress Dr.Destandau with Dr. Dakwale

Obstetrics & Gynaecology By - Dr. Neelu Soni “Past is not just narration of some thing which happened. It inspires you, teaches you, satisfies you and also guides you. It is rightly said that, if you forget history, history will forget you”. The department of Obstetrics & Gynecology was part of the hospital since its inception. It commenced at a small scale with 7 beds. It was headed by the illustrious, workaholic Prof. B. N. Jangalwala, with his team of dedicated doctors like Dr. Mrs. Kamal Singh as Junior Consultant and Dr. Mrs. Nisha Bhargava and Dr. Mrs. Meena Bhargava as registrars. Dr. Anil Mishra joined as a full time consultant department. But with the retirement of Dr.B.N.Jangalwala after a year the scene changed. Dr.Mrs. Kamal Singh was promoted as senior consultant. Dr. Meena Bhargava joined Government services and Dr.Nisha Bhargava left for private practice. This was the time when Dr. Mrs. Vijaya Naneria, who was working at Choithram dispensary, was asked to join the main hospital as registrar. She was later promoted as consultant. The duo continued to work as a team, till Dr.Mrs. Neelu Soni joined the department in the year 1983. Many senior consultants 114 joined and left within short period of time. To name a few, Prof. Ahilya Mukherjee, Dr.Mrs.Veena Bapat, and Dr.Mrs. Poornima Bhandari. Dr. Mrs. Dashore, who joined the department as registrar in 1988, was promoted as full time consultant in March 1992, & Dr. Mrs. Kamal Gajaria who joined as clinical assistant in 1992 was promoted to junior consultant in 1993. Although the department of Obst & Gynae started on a small scale, it was very well designed to be self-contained and comprehensive consisting of a labor Room, with a labor O.T. and attached wards. Choithram was the first hospital in whole central India to have a “Cardio-tocography” (CTG) machine for external and internal foetal monitoring. Due to the concerted team spirits of the staff members, the department has progressed from 7 beds in 1979 to 45 beds in 1990 and reached 50-bed strength in 2002. The department is very well equipped with the best possible modern equipments such as two CTG machines, a portable USG machine, and a critical care unit, coupled with round the clock availability of competent registrars, anaesthetists, and on the toes working paramedical staff. The 24 hours availability of blood and blood products has changed the reputation of the department from a primary care to a tertiary care center. This led to a marked improved in the out come of complicated high-risk pregnancies. Cases of PIH, hepatitis with pregnancy, malaria with pregnancy, cardiac compromised, severe anaemia with pregnancy, BOH, post partum DIC, HELLP syndrome, PPH, and post partum eclampsia are routinely referred from every corner of the M.P. and near by states. Along with Obstetrics, we have grown up in Gynaecology as well. Apart from

routine minor and major surgeries, we have facilities of performing all types of Laproscopic surgeries like, TCRE, LAVH, Adhesiolysis, Ovarian drilling, and Cystectomies etc. Modern gadgets like Balloon therapy for DUB are routinely done. We have the facilities of various OPD procedures like HSG, Sonosalpingo- graphy, IUI, Pap's smear, Cryo-cautery, interventional USG and radiological procedures. With the introduction of Laser to CHRC as a treatment modality due to the efforts of Dr. Bhavalkar from CAT (Centre for Advance Technology) and Dr. N.S. Bhagwanani (Medical Director), the department became first in the central India to use this modality in Gynaecology. The Nd: YAG Laser is used for ovarian drilling in PCOD, the CO2 Laser for Cervical erosions, and He-Neon Laser is used for PID cases. We are also first to form a “Foetal Monitoring Society” with the help of Paediatrics, Paediatric surgery and Department of Ultrasonography. Dr. Neelu Soni was nominated as founder president with Dr. Sudhir Gokhale as founder secretary. Monthly meetings of this society are held on for the discussions on complicated cases and their remedies. 115 The department also runs many speciality clinics: l Antenatal clinics l Infertility clinics l Adolescent clinics l Menopause clinics The Obstetrics & Gynaecology department is recognized for two seats in DNB courses and two seats in Dip-GO by Indian College of Maternal and Child Health (ICMCH). Various conferences, CME and workshops were organised by the department from time to time. Large numbers of eminent and renowned national figures were invited for CME and workshops. Dr. R.P.Sonawala from Breach Candy Hospital Bombay, Dr. Kamal Alimchandani from Jaslok Hospital Bombay, Prof. Swaraj Batra from Maulana Azad Medical College New Delhi, Prof. Indu Gupta from PGI, Chandigarh, Dr. Sonia Malik, A specialist of Infertility from New Delhi, Dr. Alka Kriplani, Dr.Deepika Deka from A.I.I.M.S., New Delhi, Dr. Vineet Mishra, a renowned Hysteroscopist from Ahemdabad, Dr. Mangeshikar, a pioneer of endoscopy, from Bombay, and Prof. I.C.Verma from Gangaram Hospital New Delhi, have visited our department and appreciated the infra structure of work of the department. Workshops and CME: - 1. Workshop on Laser oriented programme 2. Workshop on Laser in Medicine 3. A two days workshop on Endoscopic surgeries, under the auspices of IAGES. 4. Workshop on Hysteroscopy. 5. Workshop on Endoscopy and Hands on training on Endotrainer

6. CME on update in perinatal care 7. CME on updates on Congenital Malformations 8. CME on Osteoporosis and Backache. Our consultants and residents are regularly participating and updating themselves from time to time by attending various national and international conferences, workshops and CME. Every year 3 4 research papers are presented in these conferences. Many were subsequently getting published in national and international journals. Department is regularly providing services to adolescent girls, Gynae check-ups, and antenatal services to under privileged and rural areas of the society. Various Cancer detection camps are being organised by the department. Devoted and persistent work efforts of all the staff members have paid rich dividends. This has made the department recognized as one of the most prestigious department in the country. A Child's Angel: -By Erma Bombeck Once upon a time there was a child ready to be born. One day he asked God: \"They tell me you are sending me to earth tomorrow, how am I going to live there being so small and helpless?\" 116 GOD replied, \"Among the many angels, I chose one for you. She will be waiting for you and will take care of you.\" \"But tell me, here in Heaven, I don't do anything else but sing and smile, that's enough for me to be happy.\" \"Your angel will sing for you and will also smile for you every day. And you will feel your angel's love and be happy.\" \"And how am I going to be able to understand when people talk to me, if I don't know the language that men talk?\" \"Your angel will tell you the most beautiful and sweet words you will ever hear, and with much patience and care, your angel will teach you how to speak.\" \"And what am I going to do when I want to talk to you?\" \"Your angel will place your hands together and will teach you how to pray.\" \"I've heard that on earth there are bad men. Who will protect me?\" \"Your angel will defend you even if it means risking its life.\" \"But I will always be sad because I will not see you anymore.\" \"Your angel will always talk to you about me and will teach you the way for you to come back to me, even though I will always be next to you.\" At that moment there was much peace in Heaven, but voices from earth could already be heard. And the child in a hurry asked softly: \"Oh God, if I am about to leave now, please tell me my angel's name.\" \"Your angel's name is of no importance, you will call your angel: 'Mom'.\" - From Internet

Dr.Singh Dr.Gajaria Dr.Dashore Dr.Jhamad The Team 117 Labour Room Fellowship of F.O.G.S.I. Triplet Dr. Mrs. Singh & Dr. Mrs. Maru

Ophthalmology By - Dr. V. Kalevar “Our eyes are the mirrors of our Soul” The institution was established in July 1979. Dr.R.P.Dhanda, who had came back, after retirement to Indore from Gujarat Govt. services, was approached for organizing the department of ophthalmology. The first registrar in the department was Dr. S.K.Parwani, a fresh M.S. (Ophth). Dr.Khasgiwala and myself joined the department. Resigning from professorial post at the P.G. Institute of ophthalmology, Ahemdabad to join as Honorary Consultant at CH&RC was not quite the easiest decision. However, things happen when they have to and perhaps for better. I was appointed as Honorary Consultant in January 1980 with contractual conditions till age of sixty. Having being in full time Government service since 1960, it was a good change. Coming back to Indore after twelve years was good for more than one reason. To be amongst old associates and friends was satisfying. 118 The first surgical procedures in CHRC OT were two Retinal Detachment surgeries performed by Dr.R.P.Dhanda and Dr. S.R.Khasgiwala, on the day of inauguration, 17th July 1979. Ophthalmic department was at its peak from 1979 80 to late eighties. We had a separate ward on first floor. I had not seen or met Shri Thakurdasji for quite a long time after joining the CHRC. One morning I had gone to the dental OPD for attending an outside telephone call, (the ophthalmic OPD did not have an extension then). Dr.Mangi was talking to a simple looking elderly person. Dr.Idnani was also with them. I could guess that the person was an important one. I had to wait till they all talked out. I waited a few more minutes till Dr.Mangi returned. I asked Dr.Mangi about the visitor and to my utter surprise, I was told that the person was the DONOR, Shri Thakurdasji. Later “Baba”, as everybody addressed him became informal and friendly. He would come to our OPD to check his IOP / vision but more to spend time talking and asking for the needs in the department. He always wanted us to improve the patient care and that patients did not have to wait unnecessarily. He was the Father Figure the hospital in general and for ophthalmic department in particular. th We had organized 13 M.P. State conference in 1987. Baba and Dr.Idnani readily agreed to hold it in CHRC and supported us throughout allowing use of the halls, school stage and all that we needed for scientific sessions, trade exhibition, entertainment programme, inaugural function etc. We approached him for his presence at the inaugural function. He strongly refused to attend the inauguration of the conference even though the then Governor of M.P., Prof.Chandy had come for the ceremony. Dr.Khasgiwala in her speech mentioned

Baba's support and thanked him for all the organizational help. He had listened to the goings on quietly, un noticed and later pulled up Dr.Khasgiwala for mentioning his name and talking about his help. He was the most unassuming person I ever met. A man who believed in remaining in the background but doing more than was necessary or expected from him. We had two week's Corneal Surgery Training Workshop for senior Eye surgeons in 1985 & 1988. In the 1985 workshop, Dr.Idnani helped in lot of planning and actual work. Even taking extra pains to instruct the canteen staff during lunch time. He was fully involved. The anaesthesia department staff and OT staff under the able guidance of Dr.W.P.Thatte and Dr.Vijayan helped streamline the surgical sessions without waiting periods. The CCTV arrangements made by Mr. Ravi Jairath were excellent and supervised meticulously by trained personnel. Organization of conferences became a habit with the hospital staff. Ophthalmology department perhaps topped the list. The Central Zone Ophthalmic conference in 1992 had delegates not only from all over M.P. but many attended from Rajasthan and U.P. The chief guest was the then A.I.O.S. president Dr. Jaiveer Agrawal from Chennai. A grand silver jubilee conference of Indore divisional ophthalmic society in 2000 was a milestone with Dr.Daljeet Singh of Amritsar as chief guest. 119 Dr. Idnani's demise in May 1988 was a blow to the institute. We lost a good administrator, a disciplinarian and a person who encouraged and admired good work. One more tragedy was waiting in the wings. Shri Thakurdasji, our Baba, left us in March 1992. The institute sustained an un-repairable loss by these events. Mr. Satish Motiani, who had taken over as Managing Trustee from Mr. Lekhraj Pagarani in 1984, worked towards fulfilling Baba's wishes for the future of CHRC. I remember how he would allow us to buy instruments at the conference trade exhibitions. Once I told him, I did not get certain item because I did not have the management sanction. He immediately said, \"Do you think if you would had bought, I would not have reimbursed? It felt good to have that kind of free hand. We needed a “Haag-Streit” 900 slit lamp because the one bought initially in 1978- 79 was not quite the best for corneal work. The Eye Bank account (central Govt.) did not have sufficient funds. I approached Mr. Motiani. He discussed the matter and immediately sanctioned the deficit amount. Dr. Bhagwanani who had followed Dr.Idnani helped to get a Laser and Fluorescent Angiography equipments. CAT had a significant role in procurement of Laser. Dr.R.P.Dhanda completed his tenure, I did too. Dr. S.R.Khasgiwala and Dr.Sudhir Parwani manned the department now. Dr.Khasgiwala, a full time consultant earlier continued as honorary consultant and Dr.Parwani, the first registrar is a consultant and heads the department. Registrars came and went. One of them, Dr. Shreya Thatte was appointed in 2001 as a full time consultant and continues to do good work.

Memorable events: 1985 Corneal Surgery Training Programme th 1987 13 M.P.State Ophthal. conf. Inaugurated by Governor Prof. Chandy. 1988 Corneal Surgery Training Programme 1992 Central Zone Ophthalmology conference. 1994 Recognition for DNB course in Ophthalmology: Dr. Gopal Arora, registrar ophthalmology was first candidate to pass his DNB 2000 Silver Jubilee conference of Indore divisional of Ophth. Society. 1985 Dr.Kenneth Kenyon, Boston, USA, and Dr. Akira Momose, Kiryu, Japan visited CHRC and conducted sessions of live demonstration of Corneal and Intra-Ocular Implant surgery. 1988 Ad hoc meeting of Eye Bank personnel held at CHRC to form “Federation of Eye Banks of India”, later in January 1989 established as “Eye Bank Association of India”. Publications: 1. Text Book on Clinical Ophthalmology - R.P.Dhanda - V.Kalevar 1987 Updated 1992. 2. Cataract Monogram R.P.Dhanda S. R .Khasgiwala 1992. 3. Book “Corneal Surgery” updated edition R.P.Dhanda- V.Kalevar 1994. 120 (Originally published by Little, Browne & Co. Boston 1972) M.P. State Conference - 1987

Dr.R.P.Dhanda Dr. Khasgiwala Dr. S. Parwani Dr. Mrs.Thatte Department of Ophthalmology Ophthalmology Conference 121 Inaugurations of Scientific Exhibition Padmashree Dr. Mahashabde Dr. Kalevar at Corneal Surgery Workshop Central Zone Conference

Otorhinolaryngology By - Dr. Sudhir Bhargava It is with great pleasure, and pride we are highlighting the achievements of ENT Department. in the Silver Jubilee years of CH&RC. On the day of inauguration of the hospital, the department of Otorhinolaryngology (ENT), and Dr. Sudhir Bhargava had the honor of examining the very first registered patient of the hospital. Dr. G.S.Manudhane and Prof. G.S.Grewal were appointed as honorary consultants in the department from the very beginning. Dr. Sudhir Bhargava was first resident ENT surgeon of the department. Thereafter Dr.D.Duncan from Jabalpur joined as registrar in the Department. Miss Mala Mehta from Bombay joined as first full time audiologist and speech therapist. The department was very well equipped with first of its kind, sound proof Audio and Speech therapy room in the central India with Middle Ear Analyser (Impedance Audiometry) and the availability of an experienced Audiologist. The 122 department had state of art modern diagnostic and therapeutic facilities of that era for Micro-ear, Micro-laryngeal, Micro-nasal, Cryosurgical and Aero-digestive endoscopic surgical procedures. Due to these facilities, the department soon got established and became a referral centre for removal of “Foreign bodies” from aero-digestive tract. The department started catering patients not only from M.P., but also from neighboring states. Tympanoplasties, Ossiculoplasties and various types of Mastoid surgeries and Otogenic brain abscess were routinely performed using Zeiss Operating Microscopes with excellent results. Micro-laryngeal procedures like removal of vocal card polyps, nodules, leukoplakias, papillomas etc. were also started routinely with great success. As a part of Continuous Medical Education, as well as for Public Awareness Programmes, the first “Micro-ear workshop on Stapedectomy and Viridian nerve surgery was organised at Choithram Hospital in the year 1982. Prof. M.V. Kirtane, from KEM, Bombay, was the chief guest. This workshop was first of its kind in the whole state of M.P. This was followed by similar workshops in the year 1984 and 1985. The surgeries were displayed on CCTV for the benefit of the delegates, who came to attend from all corners of the state. These workshops helped us in establishing our hospital as a safe place for “Middle Ear Surgeries”. Padhambhushan Dr. L.R.Hiranandani, a legendary ENT surgeon, visited our hospital many times and operated few patients for the benefit of young surgeons. He was very much impressed with kind of ENT setup we had at that time.

Workshop - Stapedectomy Dr.Vineet Gupta joined the department as consultant in the year 1981. Dr.Deepak Chaudhary joined as an honorary consultant in the year 1985. Dr. Shrikant Phatak, who joined the department as registrar in 1985, was later promoted as consultant in 1991. In between Dr. G.S.Grewal left the hospital. Dr. Manudhane left the hospital in 1991, and Dr. Sudhir Bhargava was promoted as Head of the department. At this time Dr. B.Baser also joined the department. This was an indication of the workload and the number of patients we were catering at that time. Recently Dr.S.Nivsarkar has joined as junior ENT consultant in the department. Dr.Reena Arora has joined the department in the year 1996, as registrar on a permanent basis. With the passage of time and at par with the global advancement in the field of ENT surgery the department also started pioneer development. The boost came to the department when the “Center for Medical Applications of Laser” was started at CH&RC in the year 1990 under the national Laser Programme, with all support and guidance of “CAT”(Center For Advanced Technology). The first indigenously developed CO2 Laser machine of our country was handed over to 123 CH&RC on 26th May 1990. The department organized a workshop on CO2 Laser surgery for the first time in India for ENT diseases in Dec.1990.This workshop was conducted by Prof.D.G.Cherskin and Dr.A.N.Nasedkin, eminent surgeon from First Moscow Medical Academy. There were live demonstration of excision vocal nodule and excision of Sub glottis Stenosis by laser. The work with CO2 laser in the department pickup and the same team again conducted another workshop on Laser in 1992 in which live demonstration of various ENT conditions were treated. These workshops were attended by many consultants of the town and from all over M.P. and were highly appreciated. The work with Laser in ENT deptt. Increased and CO2 Laser started extensively in management of Leukoplakias, Erythro-leukoplakias, Orophyreangial polyps, warts, Laryngeal papillomas, nodules, polyps, sub-glottic, Laryngo-tracheal Stenosis ect. Became a routine and only choice. Seeing the excellent results of CO2 laser and feasibility of operating under local anaesthesia as OPD procedures in mucosal lesions of Otorhinolaryngology, we started and became pioneer to use CO2 Laser in Oral Sub-mucosal Fibrosis, causing restricted mouth opening, bloodless ablation of Tonsillar tags, Tonsillar ablation under LA/sedation in high risk adult patients, where conventional tonsillar surgery was contraindicated or hazardous. We also started using CO2 Laser in cases of Snoring, with sleep Apnea, by doing Laser assisted Uvelo-paletoplasty (LAUP). To familiarize and popularize Laser in our country with a view to orient and train ENT Head & Neck consultants, other discipline of TWO laser oriented courses were conducted as CHRC in Oct.1996

and 1997, in medical application of lasers. These courses were attended by many delegates from all over the country and were much appreciated. International workshops on Medical application of Lasers on Multi disciplinary and Multicentric workshops sponsored by national laser Programme and International center for Theoretical Physics, (ITCP, Italy) were organized by CAT, CHRC, and IALSM, from 27th January to 8th February 1997 covering different discipline like PLDD, Lasers in GIT, Head & Neck and ENT at CHRC Indore, SCTMST, Trivendram, Tata Memorial Hospital and AIIMS, New Delhi. These workshops were conducted by best expert in the fields of Laser from all over the world and also experts from CHRC. These workshop were grand success and put CHRC and ENT deptt. on Laser Map of the world. Noble Laureate Prof. Allexzender M. Prokhorov (noble prize for Laser invention in 1954) from Moscow visited our center at CHRC on 5th Nov. 1993. He saw our ENT work of CO2 Laser and was impressed, and complimented on our achievements. Under the collaboration with USSR, ILT programme, through department of science and technology (DST), Government of India, an exchange programme of various consultants between CHRC and USSR, First Moscow Medical academy 124 was started in the field of Laser. Dr.S.K.Bhargava had the privilege along with Dr.Vivek Palsule to visit USSR, Moscow for six week to study application of Lasers in 1993 at various center. Audio-Visual Research center, (AVRC), DAVV, Indore made a special Video film on “Lasers In ENT”. This film was telecasted on Door Darshan under UGC programme and National TV network many times, and was highly appreciated throughout the country. Dr.S.K.Bhargava was invited to deliver a guest lecture on “Lasers in Head and Neck Surgery in surgery update- 1996”. This was organized by Molana Azad Medical College Delhi. He was also invited for guest lecture at AIIMS, New Delhi and was also invited for “Lasers in treatment of Laryngeal Stenosis by Indian Society of Laryngology Bombay in 1998. He was a regular guest speaker for city and state level conferences. Various articles on Laser were published in Newspapers magzines at local, national and International levels. Dr.S.K.Bhargava published a monograph” Lasers in Otorhinolaryngology”, which was much appreciated by Indian journal of Otorhinolaryngology (IJLO) in 1996. The above laser developments greatly increased the professional image of ENT department which was well much established and it popularized the medical application of laser throughout the country. Dr. Reena Arora, senior registrar, working with Dr.S.K.Bhargava, worked on “Pre-cancerous oral lesions and their management with CO2 laser”. She submitted her thesis for DNB-Otorhinolaryngology. Her thesis was accepted and was highly appreciated as an original work. AVRC of DAVV Indore also made tow films under

Dr.Baser Dr.Phatak Dr.Arora Dr.Nivsarkar At the release of Monograph on Laser First Workshop on Middle Ear Surgery 125 Annual Function of Indore branch ENT Laser Oriented Course Dr. Shrikant Phatak Dr. Sudhir Bhargava

its UGC programme and was telecasted on Door-Darshan network. These films were made on “Functional Endoscopic sinus surgery”, and on “dangers of ear discharge”. In last 25 years the department has organized many national and international conferences. We have organized three (FESS) Functional Endoscopic Sinus Surgery, workshops from 1996 to 1998. One of these workshops were conducted by Dr. S. K. Kaluskar, from Cleveland, Ireland. The other was conducted by Dr. H. Luckhaupt from Germany. A annual conference of AOL, India, Indore branch was organized on 25th Dec. 1995, under the chairmanship of Dr. S. K. Bhargava. Although the conference was of city chapter but it was attended by more than 150 delegates from all over the state. Three National Rhinology Updates were organized under the guidance of Dr.B.Baser. The faculty included eminent surgeons from the country and abroad. Dr. Baser was awarded Dr.RAF Cooper Gold Medal of AOI, India. Dr.Baser also was awarded Ranbaxy VICC award, Dr. W.G.Atre gold medal at AOI Pune. Dr. Baser has conducted many CME workshops at Kolahpur, Belgam, Delhi, Pune and 126 Dhulia. Dr. Baser is first Indian author of a book ”Aesthetic and Functional Rhinoplasty”. The book has been sold in 30 countries of the world. The department has regularly published articles. More than 50 articles have been published in various national and international journals. The staff is regularly getting updated by attending most national and state level conferences. Recently the department has organized a national workshop on Cochlear Implants. An audio-visual live demonstration of the surgery was done. Dr. Trephan from Greece conducted this workshop. National update on Voice disorders and Phonosurgery for awareness and training of doctors. The department is planning to have a regular clinic for Cochlear Implants and Voice disorders with the help of modern Stroboscope in near future. Today the department is equipped with three Ziess operating Microscopes, including the latest model (Muller 1000) with CCD camera. It has whole range of Nasal endoscopes, paediatric endoscope, Three Chip endoscope's camera (Storz), Micro-debrider (Xomed), CO2, Nd Yag laser, and ultrasonic Harmonic scalpel. Equipped with these instruments we are now in position of under taking almost all variety of ENT surgeries.

Orthopedic Surgery By - Dr. G. Yoetikar & Dr. Arjun Wadhwani The department of orthopaedics started with Dr. Harish Sahni as head of the department with Dr. Vinod Naneria and Dr. Pradeep Bhargava as registrars on 16th of July 1979. First orthopedic surgery was excision of head of radius by Dr.Harish Sahni. With in few days, after the commission of the hospital, all the consultants working at Choithram Dispensary joined as junior consultants and Dr. J.K.Bakliwal was incorporated in the department.Dr. R.C.Varma joined on the special request of Seth Thakurdasji in the year 1981. He joined the department as part time consultant in the afternoon hours.Dr. Naneria was promoted as full time junior consultant in the year 1981.Dr.S.N.Goyal joined as an honorary in the year 1985 and left the institution with in a year.Dr. Prakash Bangani joined as an honorary consultant in the year 1988. He continued to be on 127 panel of consultants till year 2000.Dr.Anant K. Jinsiwale, who was working as a registrar since 1984, was promoted as junior consultant in the year 1990.Dr.Arjun Wadhwani was also promoted as consultant in the year 2001. Dr.Wadhwani joined the institution as registrar in the year 1993.Dr. Girish Yeotikar joined the department as honorary consultant in the 2003. He has already served as registrar from 1988 1992.Dr. Manoj Dubay joined the department as full time junior consultant in 2004. Milestones The department of orthopedics organized the first state level conference of the hospital. It was 3rd Annual conference of Indian orthopedic association, M.P.chapter. The conference was inaugurated on 10th Feb.1985. The waiting hall in front of Ophthalmology was prepared as conference hall. Prof.A.K.Gupta (Prof. and head, department of orthopaedics, Kanpur medical college was the chief guest and Dr.Prakash Bangani was guest speaker. More than 100 delegates attended the conference. It was a grand success. Mr. Satish Motiani was chief patron and Dr.P.L.Tondon, Dean M.G.M.Medical College, and Dr.R.C.Varma, president I.O.A., M.P.chapter were on dais. This was the time when consultants from Jaslok hospital, Mumbai were frequently visiting Choithram hospital. Prof Gajendra Sinh, a renowned neurosurgeon was a frequent visitor to the department of neurology and orthopaedics. He must be credited to bring the concept of posterior lumbar interbody fusion in cases of disc prolapse and spinal instability. On his

recommendation, hospital purchased a full set of Cloward's instrumentation set for cervical and lumbar inter body fusion. During his visits more than 25 patients were operated and new era in spinal fusion started in Choithram hospital. Prof G. Sinh also gave a lecture and a video demonstration of Cloward's technique of spinal fusion, to the members of Indore orthopaedic association. Dr. Cloward R.B., himself visited our hospital and delivered a lecture showing unbelievable correction and fusion of spondylolysthesis. Dr.R.C.Varma, stimulated by his trip to UK, wanted to start Total Joint Replacement surgery at Choithram Hospital. A note sheet was prepared and sends to the management. After official formalities equipments from M/s Down Brothers, for total hip replacements were purchased. Thanks a lot to far vision of Dr.N.B.Idnani who persuaded the management. Dr.R.C.Varma did the First Total hip replacement at CH&RC in the year 1985. The bone cement used at that time had no Barium Sulphate and therefore it was radiolucent. Dr.S.N.Goyal did next few operations of Hip Replacements in Choithram Hospital. Where there is a will, there is a way, and luck favors prepared minds. This is 128 particularly true as far as joint replacement surgery is concerned. Our interest in the joint replacement surgery was developing. As a destined event, a fatherly figure appeared on the horizon. Dr.C.S.Ranawat, professor of Reconstructive Joint surgery, Cornell University, New York, visited the hospital in the year 1986. He managed to get a gift of nearly 1500 hip replacement “Triad” system from M/s Johnson & Johnson, USA with the help of Dr.Samir Dutta, who was president of Association of Indians in America, Inc. Mr. Leslie Jacobs, group product director, representing Johnson & Johnson Co. U.S.A., played a key role in providing the grant to Choithram Hospital in the year 1987. Only three centers were chosen for this heavenly gift throughout India and Choithram was one of them. A workshop on Total joint replacement was organized in the year 27th Feb.-1st March,1987. Dr. C.S.Ranawat was course Director, and Dr.Lorance Dorr, Dr.Robert Porter were foreign faculty. Dr.K.H.Sancheti and Dr.N.S.Laud were Indian faculty. Live demonstrations and a lecture series on pre-operative planning, X-ray evaluation, and post operative management was discussed. More than 150 delegates from all over the country attended the workshop. It was a three daylong workshop from 27th Feb.1987 1st March 1987. A souvenir was published on this occasion. Mr. Satish Motiani, managing trustee of Choithram hospital spoke on “role of transfer of latest technology from west to east”. This was the beginning of our association with Dr.Ranawat, Dr.K.H.Sancheti and Dr.N.S.Laud. Thereafter, there had been regular annual visits of Dr.Ranawat and

demonstration of operative surgery sessions for junior orthopaedic surgeons for many years. The gift of implants for total hip replacements also brought us “power instruments pneumatic drill and saw”. This was the first test of use of power instrumentations in orthopaedics in our hospital. The year 1988 December was another milestone in the evolution of orthopaedic surgery as well as the upliftment of the overall prestige of the hospital. The event was very dramatic. Dr.Harish Sahni was on leave. Medical superintendent Dr. Asolkar received an urgent telephone call from Chief Minister Shri Arjun Singh's residence. Since it was regarding the treatment of knee joint of Mrs. Singh, the call was diverted to Dr. Naneria. It consisted of only instructions that a phone call from U.S.A. about to come regarding the facilities for arthroscopy at Choithram Hospital. The caller was Dr. Dinesh Patel from Massachusetts General Hospital, Boston, U.S.A., a great name and a top class world renowned arthroscopy surgeon, who has contributed many chapters on arthroscopy of the knee in standard text books of orthopaedics. After satisfying himself, Dr. Dinesh Patel decided that, Mrs. Saroj Singh would be operated in Choithram Hospital. The date of surgery was fixed on 16th Dec. 1988. On the express desire of Mrs. Singh a small workshop on arthroscopy by Dr.Patel was organized. In all 8 arthroscopic surgeries were performed and the same were displayed by audio-visuals. Around 129 50 orthopaedic surgeons from different part of the state, and near by states attended this workshop. This was the beginning of arthroscopic surgery in Choithram hospital. It was followed up further by Dr. Prakash Bangani and later on by Dr.Jinsiwale. A two days Total Knee Workshop was organized on 18th 19th Nov 1989. As the time for organization for a full scale workshop was not enough, there was shortage of patient for operative demonstration. Luckily for us, one of our rheumatoid patient was enrolled for TKR. Dr.J.K.Bakliwal personally went to her home to persuade her for surgery. She was offered free surgery by Dr.Ranawat and free imported implant. To this lucrative offer the lady agreed for surgery. It was a great relief for the organizers. The surgery was performed with state of art “I.B.2 “ from M/s Johnson & Johnson, and was displayed on CCTV for the delegates. The cost of implant provided was 2,200/- Dollars. Dr. Harish Sahni went to Saudi Arabia for a three-month assignment. He made friendship with a fantastic hand surgeon Dr.Devid Haffazee. In the year 1986, Dr. Haffazee Visited Choithram hospital and during his weeklong stay he demonstrated many fine hand surgery. Dr Jinsiwale visited to Sweden the next year and stayed for six weeks to learn the art of Micro vascular surgery and nerve and tendon repair. A new era of hand surgery began. Dr. Naneria visited Kyrgyzstan (a part of former U.S.S.R.) in the year 1992. It was a month long training by observation and discussion on “Ilizarov's technique” deformed bone and difficult fracture management. Dr. S. Kojokmatov and his

junior colleague Dr Bakat visited our hospital in the month of Aug 1992. A workshop and operative demonstration of the technique was organized and Dr.Girish Yeotikar was entrusted as organized secretary. The workshop was held on 22nd 23rd Aug.1992. More than 18 patients were operated by Ilizarov's technique for various conditions like limb lengthening, angulatory deformities of lower limbs, and compound infected non-union of fractures. M/s I.N.O.R. gave a generous grant of instruments for this workshop. March 1992 was a sad month. We lost our beloved donor, Seth shri Thakur das ji Pagarani. A wave of depression swept all over. The first independent Total knee replacement was done in the month of April 1992. This became our independent journey for joint replacement surgery. In August, 1992, Dr. Ranawat gave a complete set of instruments for “Total Knee Replacement, worth 25,000/- Dollars to the hospital as a gift. Most of the initial surgeries were done with the help of this set. The next few years were devoted to the development of “Laser” assisted surgery and use of indigenous Laser for various departments. The role of Laser assisted percuteneous lumbar disc decompression was practiced after its dramatically beneficial effects on patients symptoms demonstrated by Dr.Gupta from Shree 130 Chitra Hospital, Trivendrum. Dr. Choy, from U.S.A., visited our hospital and delived a lecture on the same subject. The project of Per-cuteneous lumbar disk decompression was taken up by Dr. Jinsiwale. Dr.Anant Jinsiwale visited Bangkok for first hand knowledge of Endoscopic Spinal Surgery in the 2002. He attended a hand on workshop on “Endoscopic Spinal surgery” in Thailand, the same year. He visited Germany for PLDD, and recently he visited Australia for a week to study Revision surgery in Joint Replacements, in 2004. Dr. Arjun Wadhwani visited Portugal, in the year 2003 for six week training in paediatric orthopaedic surgery. The Change Many changes in the thinking pattern occurred during the passage of time. From skin shaving to no shaving, “catgut” to “vicryl”, linen to staple, country made plaster of Paris to synthetic resin embedded plasters, from prolong rest to early mobility, long term post operative antibiotics to limited antibiotic therapy, early discharge from hospital, fewer drug prescription, and art of communicating with the patients changed. With this the number of inpatients and surgery from 200/ year went up to more than 800/ year. Lot more revolution took place in the implant surgery. With the addition of power instruments and a complete set of A.O. instrumentations we have entered into the modern era of orthopaedics. The hospital was always first to pick-up the latest. Smith Patterson's nail for hip fixation was discarded by Dynamic hip screws way

back in 1985. Joint Replacement surgery at cheapest possible expanse started in 1987. Operative arthroscopy followed the same way with shaver and video camera in 1988. In the year 1990 hospital purchased Image Intensifier (C-arm) and a radiolucent operating table. With this new equipment we entered in to the era of keyhole surgery. Closed nailing of long bones started in 1991. Ilizarov's technique was adapted in the year 1992. First independent total knee replacement was done in the month April 1992. Then came the concept of laser assisted lumbar disk decompression. The next seven years we were consolidating on new found and acquired knowledge. The anterior and posterior spinal instrumentations, open pelvic fixation and endoscopic vertebral biopsy were added in the next millennium. To enhance the results and prevent un-necessary complications, importance was given to the concept of “Team Approach”. Our surgical colleagues are very co-operative in these endeavors. Establishment of a bone bank for future “Revision” surgeries in joint replacements and Spinal surgeries is in pipe-line. With the availability of Bone bank, we will be able to face many challenges of reconstructive orthopaedic surgery successfully. Bone substitutes are also a must for a well equipped department. Poly-trauma has revolutionized the concept of early intervention with in “Golden hours”. Needless to say we are already practicing this since 1995. 131 Orthopaedics is basically an implant, instruments and equipments dependent surgical specialty. We must stock common implants, a good numbers of instrument trays, and availability of radiolucent orthopaedic table with a high resolution “C-Arm” makes lot of difference in the out come of successful results. The future belongs to computer assisted “Navigation System” for joint replacements & spinal instrumentation. Even robotic joint replacements are reality of today. The cost verses benefit ratio is very high, and hence we can hope to procure these ultra modern facilities in future but not at present. DNB Department of Orthopaedics was bit late in starting DNB course. Although it was originally planned much earlier by Dr. N.B.Idnani and many senior orthopaedic surgeons were kept on panel for DNB recognition. Dr. K.H.Sancheti and Dr.R.C.Verma were on panel for the same reason. The DNB course in orthopaedics finally started in the year 2004 with the first batch joined in Feb 2004. The next batch is due in July 2005. The new millennium The new millennium brought some changes in the staff. Dr. Harish Sahni retired in Jan 2000. Dr. Bakliwal retired in March, 2004. The department was divided into two units. One headed by Dr.Naneria with Dr.Yeotikar and Dr.Wadhwani. Unit two is headed by Dr.Jinsiwale with Dr. Dubay. Where are we heading to?

Our next plans are development of subspecialties in orthopaedics. Pediatric, reconstructive, and poly-trauma surgery will be our priority. Our second priority will be public awareness programme. We have already conducted one such programme on “Backache” in the year 2004. Prof Inglehalikar was the chief speaker and a live demonstration on injection technique was arranged for anaesthetists and orthopaedic surgeon of the town. A booklet was released on “Low Back Pain” in Hindi and English for free distribution as a part public education programme. This was followed by a workshop on “Pelvic fixation course” conducted by Dr. C.J.Thakkar, Dr. Magu and Dr. Ramesh Sen. The city of Indore has never witnessed such programs in the past. The whole month of February 2005, was reserved for Joint replacements at a nominal cost without any operative fee. The next book will be on “all about your knee”, how to manage accidents if you are involved and many such useful programs for public awareness. We are regularly attending camps and operating these poor patients free of cost. 132 rd rd 3 Annual Conference M.P.State, 1985 3 Annu. Conf. MP.State, Feb- 1985 Dr.Ranawat with Dr. Naneria- 1987 Dr.Dinesh Patel with Dr.Naneria - 1988

Dr. R.C.Varma Dr.H.C.Sahni Dr.J.K Bakliwal Dr.A.K. Jinsiwale Dr. M. Dubey th Reunion of old friends on 16 July 2004 Dr. Yeotikar with Dr.Kazakmatov 133 The Orthopaedic Team 2005 Total Knee Replacement Total Hip Replacement

Department of Anaesthesiology By - Dr. Mrs. Meenu Chadha “ The woods are lovely, dark and deep But I have promises to keep And miles to go before I sleep And miles to go before I sleep…….” The OT complex Very few people know that the man behind the scene to establish the department of anaesthesia at CH&RC, was Prof Ahaluwalia, who was then Prof & Head, department of anaesthesia, at M.G.M.Medical College, Indore. All the latest equipments were purchased on his personal recommendations. The flexible and double lumen endotrachial intubation tubes were imported and purchased from M/s Ruggles. The designing of OT was also built up according to his and Prof. B.N.B.Rao's recommendations. The OT complex was a state of art in itself at that time with \"Central Air Conditioning, HEPA filters, Roof mounted air flow and floor level exhaust system, ( for positive air pressure in the OT) copper lining in OT floor ( to prevent accidents from generation of static electricity ) UV light tubes 134 mounted in all theaters (for over night OT air sterilization), CSSD connected with the theater complex by two separate lifts (one for dirty linen and other for instruments transportation), The recovery room was also planned. The wall mounted Nitrous Oxide, Oxygen and central suction lines for the whole hospital was planned from very beginning. In the initial panning the OT complex was designed on ground floor. But on suggestion of Dr.K.L.Bandi, who was in the advisory board, the OT complex was shifted to the first floor. There were three main theaters one minor theater and one septic OT. The minor theater initially was used for minor and endoscopic procedures. Staff The seeds of Anesthesia department were sown 25 years ago in 1979, when anesthesia department started with the simplest drugs and minimum staff but the pace of technological advancement has developed the department into a modern well-equipped department of Central India. Dr. Atul Lokhande a postgraduate from KEM Bombay and an overseas experience joined this institution in April 79; a month later Dr. Vivek Palsule a postgraduate from Gandhi Medical College, Bhopal, and Dr. Devendra Bhargava a postgraduate from Indore. joined him. R. Chouthe and W.P. Thatte joined as honorary consultants. Dr. R. Chouthe continued for about one year, while Dr. W.P. Thatte continued till his demise in 2004. Dr. W.P. Thatte was a man of multifaceted personality. He was a person par excellence and belonged to that era where people determined, dared and did what they hoped for and thus inspired others. Till his

demise he was there at the hospital to help both the students and staff in case of any difficulty. We will always miss the company of this noble magnanimous and beloved personality and will always cherish memories of his association with us. There was no blue print of any future planning for this hospital from the very beginning. There was no plan for expansion of the building also. The hospital was designed to provide the medical facilities to the citizens of Indore and near by area. The hospital was all the time dependent on the trust money to pay the monthly salary to the staff. From 1985, hospital started generating its own money for the payment. But for further development we were still dependent on the trust to finance. This situation continued till 1992, as long as “Baba” was alive. It is only after his death, the situation changed. There was technical difficulty in getting money for expansion. We had to learn independency. It was difficult to begin with, but it worked. This was the time we learned the role of Marketing and Publicity. We approached corporate sectors for entering into a contractual supply of health services to their employees. The un-necessary expenditures were cut down. In between some money did come from the trust. But it was very difficult time for the whole hospital. In spite of this, Free- treatment for needy patients never stopped. The dispensary continued as such, and more facilities were added to it on the top of it. There was a suggestion to start a medical college but Mr. Motiani firmly 135 declined the suggestion on the plea that the hospital was not the money earning business of the trust. The whole idea was to serve the people with “quality care”. There was no need to run for the patients from government sectors. It is a routine for most of hospitals in private sector to get government recognition for reimbursement of medical expenditure of their employs. This gives additional clientages to them. Mr. Motiani believes in providing quality care and by that inflow of the patients automatically. Dr. Lokhande Dr.Palsule Dr.Lalla Dr. P.Doodhya Dr. K.G. Vijayan a postgraduate from CMC Vellore joined the Department in August 1979, as a Consultant and head. Dr. Atul Lokhande and Dr. Vivek Palsule were promoted to the post of Consultant in 1981. Dr. S. Mishra and Dr. M H Quamar joined the department as Registrars in 1983 and 1986 respectively; they were later promoted to the post of Clinical Assistant.

Dr. Meenu Chadha an Indore postgraduate joined the department as a registrar in 1989, and was later on promoted to the post of Consultant in 1992. Quite a number of registrars joined and left the Department during the years. Dr. G.J. Lalla an ex- serviceman, and retired professor Manipal Medical College joined the hospital as the O.T. Superintendent and HOD Anesthesia from 1992-94, it was during that time that Dr. K.G. Vijayan became an Honorary Consultant. Dr. L.C. Soni also an ex-serviceman joined the institution at the post of O.T. Superintendent and HOD after the departure of DR. G.J. Lalla in 1994 and continued for two years. Dr. Sandhya Agarwal a postgraduate from Gandhi Medical College, Bhopal joined the department as a registrar in 1996, and left the institution for abroad after her marriage in 2004. During her tenure she cleared her DNB and was promoted to the post of Consultant. Dr. Prakash Doodhiya joined the Department in May 2000 as a full time Consultant. He had already worked d as a Registrar in the Department for three months in 1996. The Department till date is manned by- Dr. K.G. Vijayan- Honorary Consultant, Dr. V. Palsule- Consultant and Head of Department, Dr. Meenu Chadha- Consultant, Dr. Prakash Doodhiya- Consultant, Dr. Devendra Ghanekar Senior 136 Registrar and five DNB students. Dr. Ahaluwalia Dr. Chouthe Dr. Thatte Mr. Vijayan Milestones- The Department of Anesthesiology along with the Indore City Branch of ISA has been very active in holding various conferences and workshops. The staff has also undergone various training programmes for the upliftment of the Department and is now part of the National Faculty for the National Conferences. Dr. K.G. Vijayan underwent a special training in Open Heart Surgery with emphasis on CABG at CMC Vellore in 1986 for two months. He also spent some time at Apollo Hospital, Madras as an observer before starting Cardiac Anesthesia at Choithram Hospital & RC. and worked as an Honorary Clinical Assistant in Adult Cardio thoracic Anesthesia at London Hospital 1987.

Dr. Vivek Palsule attended the first Moscow Medical Academy for anesthesia in laser surgery in ENT and also took training in Laser Reflexo therapy for pain management. He also took training at M.P. Shah Cancer hospital Ahmedabad towards various pain relief techniques and an acupuncture-training course at Nagpur. He started the pain clinic in the Department in 1988. Dr. Meenu Chadha and Dr. Sandhya Agarwal spent a short time with Dr. N. Mandke at Leelavati Hospital, Mumbai for off pump CABG in 1999. Dr. Meenu Chadha also attended a Study Program at Chicago Illinois, USA in 1996. The 8th Conference of the M.P. State Branch was held at Choithram Hospital on 26/10/1986, where Dr. K.G. Vijayan was the Organizing Secretary. A pain conference and workshop was held by the Dept. of Anesthesia in 1987 with eminent faculties like Dr. MT. Bhatia and Dr. Jatin Vyas from Ahmedabad. The Department in 1997 and 2000 with an International Pain Specialist Dr. Anil Sharma hosted two workshops on pain management. Dr. Sushila Shah and Dr. Gehdoo of Tata Memorial Cancer Hospital, Mumbai took active part in a Workshop on Regional Blocks for Cancer Pain Relief in 1998 held by the department. A CME cum Workshop was organized under the banner of CHRC and Indore City Branch ISA in March 2002, on Pediatric Regional 137 Anesthesia with eminent faculty from Solapur- Dr. Jeurkar and her team. Dr. Meenu Chadha was the Organizing Secretary for the same. Recently we had another CME cum workshop on Nerve Blocks in April 2004, with Faculties from New Delhi- Dr. G.P. Dureja, Dr. Ashok Saxena and Dr. Baljit Singh and Dr. Sandeep Diwan from Miraj. Dr. KG. Vijayan was the Organizing Chairman of the same. Dr.Vijayan - 2004 Dr.Chadha - 2004 Dr.Thatte with Staff Onward journey: Department of Anesthesia at its inception consisted of 4 major operation theatres and a separate septic and gynaec theatre. It has progressed till date to 7 major operation theatres and soon we will be getting an absolutely new ultra modern theatre complex. Anesthesia has progressed from Ether to Sevoflurane till date. In, the early eighties, was the era of Ether and Trilene when the patient would not wake for hours after the surgery and vomiting and anesthesia went hand in hand.

Mid eighties came Halothane, which was considered as a wonder inhalation agent especially for children, but with it also came the cardiovascular depression and bradycardia. Eighties was also the era of the non-depolarizing muscle relaxants, which made long surgeries possible and safer. Nineties however made a rapid progress in anesthesia, making it much safer with early recovery and no postoperative nausea and vomiting. This was because of the inhalational agent like Isoflurane and shorter acting muscle relaxants like- Norcuron and Tracurium. Routine use of hypotensive anaesthesia by continuous epidural catheterization started from 1990 onwards. Initially all joint replacement surgeries were performed under GA and controlled hypotension was induced by the use of Halothane. Today, anesthesia I should say is at its best with Propofol, Fentanyl, Sufentanil and Sevoflurane. The Department of Anesthesia caters to all types of complicated and high-risk anesthesia and also the superspeciality anesthesia- cardiac, neuro, transplant 138 surgeries and joint replacement surgeries. We are also doing procedures like awake craniotomies under local scalp block and conscious sedation, which is performed by very few centers in India till date, and also breast surgeries under local block which is an upcoming thing of the future. DNB The Diplomat National Board recognized the Department for DNB in 1990. We have had three successful candidates till now. The DNB curriculum is carried out regularly in the Department with regular seminars, classes and case presentations by the students and teachers. Present scenario Dr. Vivek Palsule is the President of the Indore City Branch of ISA. Dr. Meenu Chadha is the Editor of the Indore City Branch of ISA since the past two years and is regularly bringing out a quarterly newsletter under the name of NISHCHETANA, which has National Circulation and is also available on the Internet. Dr. Prakash Doodhiya is the executive member of the society. Future plans We would like the Department to be one of the best in Central India. . We wish to pursue more postoperative pain management by using continuous infusions, PCA and epidurals.

Dr. Ravi Kant with Dr. Anil Sharma Pain Management Workshop 139 Dr. B.B. Ohri at M.P. State Conference - 1986 Dr. Ahluwalia with Dr. Idnani

Pain Clinic By: Dr. Vivek Palsule, Professor & Head, Department of Anesthesiology Choithram Hospital and Research Centre has a well functioning pain clinic with myself as the specialist in- charge of pain clinic. Here, precise diagnosis of a pain condition is made and patients treated accordingly by multimodel techniques along with the involvement of multi-specialty team of doctors. Epidural steroid was given for the first time in Indore at CHRC in early 80s in a patient, post laminectomy with severe radicular pain and neurological deficit. From here, the idea of developing a pain clinic originated. I began focusing on this possibility till ultimately the clinic took shape and was full functional in 1998. Various modalities of treatment available at the clinic are: 1. Trans-cutaneous electrical nerve stimulation 2. Diode, He & Ne lasers 3. Various types of nerve blocks 4. Morphine tablets for cancer pain 140 5. Labour analgesia- walking epidural and inhalational analgesia 6. Trigger point injections Various painful conditions being treated at the pain of CHRC, worth mentioning are low backache, cervical spondylosis; osteoarthritis knee; plantar fascitis intercostal neuralgia; post herpetic neuralgia; tension headache and terminal cancer pain re. Neurolytic blocks like coeliac plexus block and gasserian ganglion block are also given when required. Milestones 1. More then 1000 patients have received epidural steroid for low backache and radicular pain. 2. The largest series of patients for various painful conditions have been treated with Diode and He-Ne lasers. 3. This clinic is just one of its own kind in Madhya Pradesh. Conferences & workshops: 1. In the early 80s pain management workshop was held to which Dr M.T.Bhatia and Dr. Jatin from Surat were the guest invites. 2. Workshop on pain management on March 23, 1997, for which Dr Anil Sharma from the US was the guest faculty. 3. Workshop on Regional blocks for cancer pain relief on Aug 29, 1998. 4. Workshop on pain management on Dec 17, 2000. The guest faculty was once again Dr. Anil Sharma. Awards 1. I received the Special Appreciation Fellowship Award for laser work in pain

Laser Programme and Development By: Air Commodore (Dr) N.S.Bhagwanani (Retd) M.S. A.V.S.M. V.S.M , ex. Medical Director CHRC In Oct 1989 Dr. C.S.Chamania consultant CHRC attended an International conference on \"Medical Lasers\" at Tashkent, followed by training at Vishenveski Institute of surgery, Moscow for four weeks. Centre for medical application of laser. Centre was started at CHRC in 1990 under the National Laser Programme with all out support and guidance of centre for Advanced Technology (CAT) Indore. The First CO2 Laser developed in the country by CAT, was handed over by Dr. P.K.Iyenger, Chairman Atomic Energy commission to CHRC on 26th May 1990. Author visited USSR in September 1990, to study the application of different Lasers in various medical fields. The author had the privilege to meet Nobel Laureate Alexander.M.Prokhorov (the man who discovered Laser in 1954) Director G.P.Academy of Sciences. Moscow. We have an ongoing collaboration with USSR under ILT programme through deptt of Science & Technology (DST) Govt. of India. Protocol was planned with First Moscow Med. Academy and Medical Institute Tashkent. Thus started an exchange programme 141 of various consultants between CHRC Indore and USSR in various fields of Laser. Treatment of pulmonary tuberculosis by low level laser therapy (lllt) Author was much impressed with the presentation of large number of Pulmonary Tuberculosis cases successfully treated by intra cavity Nitrogen Laser at Medical Institute Tashkent. He noted down the specification of the Laser used and invited Uzbek team to CHRC Indore. Prof. M.Eshankhanov of Med. Institute Tashkent and Prof. D.Alimov of Uzbek Academy of Science visited CHRC in April 1991. Under their guidance we had first workshop (First such workshop outside USSR) on \"Intra- cavity\" Nitrogen Laser application for treatment of Pulmonary Tuberculosis- an OPD procedure where in quartz fiber carrying N2 Laser(2mw,337nm) is introduced in the lung cavity & irradiated for just 10mts. Results were almost dramatic with an immediate symptomatic relief, Sputum becoming AFB-ve in 2/3 weeks and many cavities closed in 8-12 weeks (Some time second sitting was required) Much before Uzbek team arrived, Dr.D.N.Bhawalkar, Director CAT developed the required N2 Laser for our centre. However Prof. Alimov presented us their N2 Laser unit and also He Neon Laser, which was used intravenously for non specific bio-stimulation in cases of Tuberculosis and may other conditions. Tuberculosis being a serious national problem in our country, this offered a new ray of hope as an adjuvant therapy. Encouraged by the above results we had two more workshops in Aug. 91 and Jan 92, successfully treating many cases. Several papers were presented in National Laser Conferences, Asia Pacific Conf. Oct 92,

Indo-Uzbek conf. April 95. Paper presented at XI World Congress of \"International Society of Laser Surgery & Medicine\" (ISLSM) Oct 95 at Buenos Aires Argentina, was highly appreciated and the same was published by them in Journal of clinical Laser Medicine & surgery Feb 96. Papers were also presented at International workshop on \"Medical Application of Lasers\" Indore Jan 97 and at Association of Surgeons of India conf. (ASICON) 97 at B'lore. Nitrogen laser for non healing. Infected wounds and ulcers/burn cases. We started treating non healing multi drug resistant infected wounds, ulcers, burn cases etc with local application ofN2 laser. We found it very effective in wound sterilization/infection control, relief of pain, better and faster healing. A separate centre (healing Touch) was started under Dr. Shobha Chamania. Surgical consultant CHRC. Special N2 Laser was designed & fabricated by CAT. Apart from National Laser Symposia, papers were presented at National Burn conf. B' lore Oct 94, National Academy Burn Workshop Baroda Jan 95, XI World Congress of ISLSM Oct 95. Buenos Aires Argentina, International workshop on \" Medical Application of Lasers\" Indore Jan 97 and Asicon 97 B'Lore. Dr. Miss N. Oza working with Dr. Shobha Chamania completed her thesis for DNB 142 Surgery on the above subject. Technique of treatment of non-healing /infected wounds and ulcers with nitrogen Laser developed at our centre was well established & acclaimed. By the end of 1998 over 1000 cases were successfully treated. Lab research work to study the effect of low level lasers over microbes & immune system. Successful results of our clinical work with LLI raised many questions of 'How & Why'. Extensive research programme was launched under the guidance of Prof. D.S.Chitnis at CHRC. Special Laser equipment was designed and supplied by CAT. Some of the well documented projects are 3,ve n below: Nitrogen Laser inhibits the growth of wide range of microbes including multi-drug resistant Pseudomonas and Mycobacterium fortuitum in vitro.N2 Laser irradiation activated the polymorph nuclear leucocytes cells (PMN) and increased phogocytosis -killing of intracellular bacteria. Lazy PMN from diabetic patients also showed same effect (thus better healing in diabetic ulcers) Effect of Low level Laser on microphages: - it increases proliferation of human microphages and accentuated their phogocytosis activity. Heavy, multiple Lv doses ofN2 laser in rabbits didn't show any adverse side effects-thus it confirmed the safety of the laser. Only small part of the work has been highlighted above over 30papers were presented/published in various national /international conferences and journals. Three students completed their thesis on effects of LLL on microbial & immune system under guidance of Prof. D.S.Chitnis.

Pain clinic. Special pain clinic was set up under Dr.V.Palsule consultant anaesthesia CHRC Prof. A.N.Nasedkin from Moscow Med. Academy worked with us for two months in 1993 & helped to set up the pain clinic with several semiconductor Diode laser (Ga.Al.As) and Helium, Neon Lasers. This is a popular clinic at CHRC where we have been able to effectively treat many painful conditions, sports injuries, post Herpetic/Trigeminal Neuralgia etc. Dr Palsule presented several papers including a paper at XII congress ISLSM 1997 at Rostock, Germany. Laser in ENT. Prof. D.G. Chfeshkin and Dr. A.N.Nasedkin eminent ENT surgeons from First Moscow Medical Academy visited our centre in Dec 1990 & conducted workshop using our CO2 Laser totally developed at CAT INDORE. Same team conducted second workshop in Jan 1992 when several cases were demonstrated. CO2 Laser is being extensively used in ENT Surgery viz. Oral Sub mucous Fibrosis, Leukoplakia, Laryngeal/Tracheal stenosis, Laser Assisted Uvuloplasty (LA UP) for snoring, vocal nodules, Laser ablation of tonsils in adult with excellent results. National Leaser ENT Workshop was organised in Oct 97. Jointly by CHRC & Indian Association of Laser Surgery & Medicine (IALSM) Two ENT consultants from CHRC went to Moscow for training. At CHRC Laser ENT surgery is very 143 popular more than thousand cases were treated by 1998. Ours is the leading centre in the country in the field. Lasers in Gynaecology CO2 Laser is used for colposcopic guided procedure viz. Vaporisation of CIN, VIN Lesions. Helium Neon Leasers are often used for PID, chronic pelvic pain & etc with good results. Lasers in Ophthalmology Crystal Focused Emerald Nd. Y AG frequency doubled Ophthalmic Laser was procured in July 94 & same is extensively used for Retinal legions viz. Diabetic Retinopathy, detachment of Retina & Eals disease with good results. Nd. Y AG laser Medilas 2, Nd Y AG lOOW (Dornier) procured in May 95 & is used in many surgical fields. Laser Prostatectomy worksl1op held in May 95. Paper on Laser Prostatectomy presented at XI World Congress of ISLSM Argentina 1995 Percuteneous Laser Disc Decompression PLDD, & Lasers in gastroenterology were soon started. Both disciplines. were covered during International workshop on Medical Application of Laser in Jan 97. Special achievements. Nobel Laureate Prof. Alexander.M.Prokhoror, Director G.P.Academy of Sciences Moscow, visited our centre at CHRC on 5th Nov 93. He appreciated our centre &

specially complimented us on our clinical & research work on Nitrogen Laser. By the end of 1995 we had full-fledged laser centre with ten different Laser units. Ten consultants from CHRC visited various Laser institutes in Russia & Tashkent. From our centre more than fifty papers were presented or published in national/international conferences/journals. Audio Visual research centre (A VRC) of DAVV university Indore made Two special Video Films on Laser in ENT & LLLT. There were screened on Doordarshan TV Network under U.G.C Programme. Dr. N.S.Bhagwanani was invited as guest speaker in National Laser Symposium, at Dehradun on 10Feb 1995 & delivered a lecture on 'Medical Laser- an overview'. The same was highly applauded. Dr. A.P.J Abdul Kalam then Chief Scientific Advisor to Govt. of India in his inaugural address complimented CHRC for our work in Lasers. Subsequently author was invited as a guest speaker by Armed Forces Medical College Pune, Anna University Madras, Gauhati University and SCTIMST Trivandrum. Thus the professional image of our centre was well-established and medical application of Lasers well popularised throughout the country. Two Laser Orientation courses were conducted at CHRC in Oct 96 & 97 to 144 familiarise doctors in various medical application of Lasers. International Workshop on Medical Application of Laser, Multidisciplinary & multi-centric workshop, sponsored by National Laser Programme & International centre for Theoretical Physics (ICTP) Italy, was organised jointly by CAT & CHRC from 27th Jan- 8th Feb 97, covering different disciplines viz. PLDD, Lasers in Gastroenterology, Urology, Head & Neck and LLLJ; at CHRC Indore, SCTIMST Trivendrum, Tata Memorial, Bombay Hospital Mumbai and AIIMS Delhi. We invited THE BEST EXPERTS in the field from all over the world. It was a grand success and put CHRC on Laser Map of the world. Dr. Bhagwanani with Dr.Bhavalkar Mr. Motiani with Noble Laureate

Prof. N.Eshankhanav with Dr.Bhatia Prof. N.Eshankhanav with Dr.Bhagwanani 145 Doctors of Choithram Hospital discussing with the Noble Laureate Mr. Prokhorov Nobel Laureate Alexander M. Prokhorov

Promotion of Excellence By - Savita Inambar It had become the talk of the town in the late 1970s, \"A big multidisciplinary hospital is soon going to be set up in the western part of Indore'. Everyone was looking forward to a modern and fully equipped hospital in the private sector, doubtless the need of the day. Many questions kept common people engrossed and inquisitive. Would it be a general hospital or multispecialty? Would it cater to the needs of the common man? Would it be expensive? Many of us, including myself, who had been trained abroad, who were already working in an established institution, were keen to join this hospital from its inception. We had lots of hope of being able to use our practical skills and academic knowledge here. In the early months of 1979 Indore had become aware that soon a hospital named T. Choithram was going to start at the junction of AB road and Manik Bagh road. It was going to be huge and modern. It would be a trust hospital and the chief trustee would be someone from Pagarani's family. At this 146 point of time, we knew that there was an Indian donor and who spent most of his years abroad, Shri Thakurdasji Pagarani. The chief administrator was going to be Dr.S.L.Mangi, one of my teachers in Medical College, a man greatly respected by all. The Department of Paediatrics was established in July 1979. The initial staff included two Consultants Dr.Ashok Porwal and myself and two registrars Dr.Shikhar Jain and Dr.Kamna Jain, all with their basic medical education from M.G. M. Medical College, Indore. Before joining Choithram Hospital, I had been working as an associate professor at M.G.M. Medical College, Indore, Dr. Ashok Porwal was serving the OPD of Choithram Dispensary, and Dr. Shikhar Jain and his wife Dr. Kamna Jain coming from PGI Chandigarh as post-graduate Registrars. The registrars were promoted as consultant within two years of their joining. The original quadruple is still serving the hospital as consultants. The department started with a paediatric OPD and a small inpatient unit. Pediatric wards were on the third floor. The unit was equipped with two incubators and one cardiac monitor, our first out-born nursery. The in-born nursery was near the labor room with an enclosed changing area. The first year kept us occupied with the establishment and planning of the outpatient and inpatient infrastructure. There were some days when we just saw the registers and equipment in the store, but no patients!

Dr. Ashok Porwal Dr.Kamna Jain Dr.Shikhar Jain In the beginning, the total number of cases would be 3 or 4 and everyday the admission would be hardly one. I still remember that special day when there were 4 admissions in a row, and we were an excited because this was a sign of growing popularity of the hospital. We wished the hospital to earn the reputation, since it meant our reputation also going high. It was during these early years that Dr. Shantilal Mehta from Jaslok Hospital visited our hospital and we had dialogue with him. He give some practical tips to all of us for improving our work. He clearly 147 explained to us how involvement and devotion in treating the patient can bring happiness and satisfaction of working. To the management he advised to have faith in the employee. He clearly instructed the management to manage the hospital and never to interfere in the management of the patient. This practical and positive approach of Dr. Mehta was well taken by almost all of us. The management did not have much experience of managing such a big hospital with so many specialties. Many a times we used to be upset as result of unexpended behavior of the management. Once I went to Dr. Jungalwala, Professor & head of the deptt.of Obstetrics and Gynaecology and who was also my teacher and discussed with him about our problems with the management. I told him that the management often doubts about our integrity in working since they feel that we try to change hospital case into a private one. Dr.Jungalwala gave us a beautiful solution to our problem by saying \"Your best guide is your own conscience keep it clear and act accordingly. You don't need to give any explanation to anybody\". Today he is physically not alive, but his saying is still alive and that continue to guide us. Entry of Dr.N.B.Idnani as a Medical Superintendent who was promoted as Medical Director later on changed many things in the hospital Dr. Idnani was a dynamic and pleasant personality who knew administration. He had vision and believed in working with speed. He inspired us to progress, expand, improve and flourish in our own specialty. He did believe that for the growth of the Institution, academic and teaching programs must be started in the hospital. His enthusiasm

inspired us and we started with many academic activities at various levels. He got hospital recognized for house job, and internship. By the year 1983, we were 5 qualified teachers for postgraduates, four were the founder teachers. Dr. M. Harshey who had joined the hospital as a clinical Assistant. It was during these years that I realized the difference between a government Institution and a private one. I would be telling this to many government and non government faculty members who so ever visited our department. The basic difference in the working of the two types of institutions was while the former believed more in written procedure the latter in actual working; hence if one asked for anything from the management the sanction would be a problem in the former and it would be sanctioned instantaneously in the later. Another important thing about Dr. Idnani needs mention here, there used to be constant drift between his army like approach and civilian approach of local consultants. Many a time consultant of Pediatric department had hot discussion with him on many issues but to most of the suggestions he would eventually agree for implementation. We have heard him saving, \"I am with you. I will sink with you if ship sinks.\" We always therefore felt that it is our moral responsibility to see 148 the ship sailing. As the department work load increased, the need for a well organised pediatric unit was strongly felt. Dr. Idnani could convince the managing trustee and a new unit for pediatric was sanctioned in the year 1988. Infect by this time the donor was also well informed about the progress the department of pediatrics was making in those days. Donor Late Shri Thakurdas Pagarani was a great man and unassuming and very simple person whom I could recognize as a donor sometimes in 1987 when he visited the ward and witnessed me working on a serious patient. He stood for a while and silently left the ward. Next day he again came in the ward and asked me about the condition of the same patient He further asked me, \"Who saved that child?\". With gesture I replied, \"The Almighty\". My answer pleased him, as he was a noble & kind hearted person with lot of faith in God. We all respected him. I would like to quote one more incidence here which indicates his style of working. One day I met him in the corridor and I wished him. He asked me if I wanted anything for the hospital. I told him that there is an utter need of a large sized auditorium for organising academic activities. Until then we were organising such events in OPD area which was far from ideal. He smiled and did not say anything. To our pleasant surprise it was in less than one year after this incidence, that the new auditorium was ready to be used. A great gift to us from late Shri Thakurdasji. It was interesting to note that almost all medical directors and medica1 superintendent of the hospital had military background. Probably it was due to the fact that military officer are supposed to have good administrative caliber. We always admired their way of working and efficiency but with a pinch of salt. I felt that whenever a Choithram Hospital employee left the

hospital, either retired or resigned or ousted or died in every such situation he or she was dispatched unceremoniously without any emotion. I always wonders if this attitude was because of harsh temperament of administrators coming from army background? I would not like to include Dr.K.K.Vaidya the present DMS of the hospital in this list as I have special feelings for him since he was my student and of course he is a sensitive person. Gradually, in last 10 years or so, clinicians and specialist started taking interest in administration, name some them are Dr. Norman Sharma, Dr.Shikhar Jain, Dr.Ajay Jain, Dr.Gajaria now for last few years the farewells are relatively dignified. The new pediatric wing of 60 beds was commissioned on 27th Feb. 1988. This was a landmark in developing a departmental concept in Choithram Hospital. The new wing located on the first floor where it still continues, included a fully equipped and updated 20 bedded neonatal unit, 8 bedded Pediatric ICU, 5, Private wards, 2 Semiprivate and 3 general wards. To commensurate the big occasion a neonatal update and national seminar on neonatal monitoring was organised by the department. Eminent Neonatologist of the country including prof. Meherban Singh from AIIMS and Prof. O. N Bhakkoo from PGI Chandigarh were amongst the main speakers. We worked hard for the success of this scientific event. We, the 149 consultants in pediatrics worked with team spirit. All of us wanted to develop the department as we knew that it would mean our own progress. I, being the senior, was respected by all my junior colleagues. I always reciprocated them with love and respect. Every one had freedom to suggest, discuss and progress. Innovative ideas of Dr.Shikhar Jain, organization power of Dr.Kamana Jain, emotional bonding of Dr.Ashok Porwal and frank opinion of Dr.M.Harshey helped me in approaching the management fearlessly for the welfare of the department, for sanction of any project, post or equipment We would first do the homework, discuss and plan the issues amongst ourselves and then approach the management united. Not that we always agreed on every issue but out of 4 at least on 3 occasions, we could build uniform opinion. Contrary to this, the management did not agree with our ideas sometimes total1y and at times partially. Our united and repeated approach and rational demand did help us in developing the department. After Dr. Idnani, Dr. Bhagwanani took the charge as a Director, who was a peace loving, soft spoken and very decent person although not as dynamic as Dr. Idnani. The department grew slowly and steadily. This team approach has been the strength of the department. Dr.Gouri Passi's entry in the department in late 1997 encouraged the DNB students and the academic atmosphere further improved. \"There is only one Pretty child in the world and every mother has it.\" Chinese Proverb

The Consultants of the department have always maintained their academic interests. Soon we realized that teaching helps in promotion of excellence inpatient care. We always participated in all academic activities related to pediatrics at city, state, and national levels. It is because of its academic excellence that the department was recognized for DNB training in 1990. Much earlier, we had already started regular clinical meetings, Journal reviews, perinatal meets, statistical meet and seminar presentation in the department of pediatrics. Hospital organized several academic events including frequent visits of the great teacher Dr. Lele. Although the DNB training had started from 1990, the PG students were not much serious and we the teachers, were also very apprehensive as far as the results were concerned. The first batch which was really serious and was sincere included Dr.Manju Rajguru and Dr.Priyanka Dubey. They worked hard and we also guided them properly. I tried to get involved in DNB examination system, so that we could guide the student better. Soon after Dr. Shikhar Jain fol1owed me and due to his interest in academic activities he was nominated as Dean Academics. The overall result of DNB pediatrics has been quite satisfactory with almost 50 % success rate. These post graduates have been presenting scientific papers in national conferences and some of them have even won prizes and awards, to name some are Dr.Mamta Jaju and Dr.Sfurti Nath. 150 The neonatal unit of the department of pediatrics was accredited as level II care centre by NNF in 1992. The neonatal unit of our hospital has been pioneer in starting ventilatory care, surfactant therapy and parenteral nutrition. This unit is now striving to be accredited as level III care centre. With improvement of neonatal care the survival of neonates have markedly improved in last 10 years and this has contributed in establishing hospital reputation. Nursing is very important for optimum patient care. Nurses interested in child care were identified by us and were requested to continue in this department which has helped in improved patient care. We still have two such nurses working with us namely sister Laxmi and sister Kale who are fully involved in pediatric care. Facilities for Neonatal Transport were started in the year 2000. This is a boon for out-born sick neonates. A project assuming the result of neonatal transportation was also given to a P. G. student. Specialty clinics and specific services have been developed in the department of pediatrics according to the needs. School health services started from the start of the Choithram School. We have been involved with the school health activities right from the inception. In order to improvise the functioning of specialty clinics CME and updates were organized regularly for instance 4 updates on Thalessemia, 2 on development and 2 on neonatal care were organized in the institution in last 15 years. Well baby clinic has also been started from 1980 where besides immunization, dietetic advice is being given. We have

Visit of Dr.Meharban Singh Update in Neonatalogy 1988 Department of Paediatic The Nursing Staff with Dr.Mrs.Inamdar 151 The Team Workshop for Mentally retarded children Dr.Mohini Harshey Dr. Gauri Passi

been modifying the working of these clinics and have tried to march with the time. Thalessemia Day Care centre was started in 90's as we realized that these children needed special care on subsidized rate. More then 200 patients have been registered and a number of academic & social activities have been carried in this unit. Department of pediatrics has always enjoyed cordial relations with other department We always felt that we are very close to the department of Obstetrics & Gynecology right from the time Dr. Jungalwala and Dr.Mrs. Kamal Singh joined the hospital.After Dr.kamal Singh left, Dr. N. Soni promoted as HOD, supported by Dr. Nividita Dashore and Dr. Kamal Gajaria was always willing to work for academic excellence and improved care of mother and child. The admiration & respect has been mutual. As more and more preterm & high risk newborns started surviving, the need for their long term follow-up was felt and this need was the basis of starting developmental clinic. Soon a small centre coith the name of 'Prayas' was started for giving special care to the special babies. Dr.Kamna Jain manages it. Dr. Goun Passi initiated epilepsy clinic. 152 Pediatric surgery started right from the decade of 80. Dr.Shobha Chamania used to look after all the children who needed surgery. It was in 1997 that Dr. Manish Patel joined the department as pediatric Surgeon. Number of neonatal surgeries were preformed by him with very good survival. And now we have another pediatric surgeon- Dr.R.Kutumbale as Dr. Patel's junior colleague. Year 2005 will be remembered as another important year when a fellowship program in pediatric critical care has been started. Dr. Rashmi Shad is the first candidate who has been registered for fellowship. Another important event of this year is Dr. Shikhar Jain's promotion as now HOD of pediatric while Dr. S. Inamdar the farmer HOD has been designated as Prof. Emeritus and visiting Consultant of the department of pediatrics. “Bitter are the tears of a child: Sweeten them. Deep are the thoughts of a child: Quieten them. Sharp is the grief of a child: Take it from him. Soft is the heart of a child: Do not harden it.”

The Neonatology unit Dr. Shikhar Jain The neonatal unit holds a special place in CHRC and in department of pediatrics. It is well acclaimed by patients and by the medical fraternity all over India, accounting for a large proportion of pediatric admissions. From very beginning it had certain imported equipments like incubators, monitors, ventilator and a resuscitation trolley; this was the time when hardly any unit in India had acquired these. This gave an edge and reputation to the unit across the country. The faculty participated in neonatal activities at the national level, which helped it grow in size, facilities and reputation. From a two small room unit with a total of six to eight beds, it has now grown to a 20-bed unit spread over an area of 1000 sq. feet. It is equipped with 20 incubators / warmers, central multi-channel monitoring systems, five ventilators, infusion pumps and other equipment. It was accredited as level II special care neonatal unit by the National Neonatology Forum of India in 1994 and is set to get level III accreditation. 153 Several residents trained here are now working as consultants not only in Indore but also all over India and abroad. The unit has an important role in spreading awareness and training doctors and nurses in neonatal care. National Seminar on Neonatal Monitoring (1987), CME (1984), workshops on low birth weight babies (1992). Perinatal care (2002), NALS, one month training for district pediatricians, was some milestones in educational activities. Most reputed neonatologists of the country have visited the unit at one time or the other. The unit has participated in several multicentric research projects like Neonatal Perinatal Database 1995 and 2000, GMCSF trial.

Department of Medicine By - Dr. G C Bhatia Choithram Hospital and Research Center was initially envisaged as a General Hospital and only later converted into a super specialty tertiary care hospital. Before the hospital started, Choithram Trust was already running a free dispensary at Godha colony Indore. Dr MC Ajmera who was a medical consultant at the dispensary was taken as the first Hon. Consultant in Medicine. Dr. Ajay Dashottar was appointed HOD Medicine. Dr. J.K. Sharma joined as a Nephrologist; Dr K.K. Artwani and Dr. Motiwale, Dr. A Sepaha, Dr. A Puranik and Dr. R. Tharwani joined as Registrars. Dr Dashottar, however, left for the US in April 1980 and around the same time Dr G.C. Bhatia joined as a Junior Consultant in Medicine on probation. He was in Muscat (Oman) working as Medical Specialist in the Ministry of Health. In about a year's time, various specialties of neurology, cardiology and nephrology became functional. Most of the registrars with postgraduate qualifications were 154 promoted as junior consultants. Dr. Tharwani shifted to cardiology and Dr Sepaha to Nephrology. Dr. Artwani continued as consultant in medicine. It was in 1983 that Dr RS Mehta, retired Prof and Head of Medicine MGM Medical College, Indore, joined Choithram Hospital as senior Hon. Consultant. As the whole OPD was free, department of Medicine became one of the most important departments to diagnose patients and channel them to the appropriate super specialty. Dr. S.M. Jain joined some time later. Dr Girish Naik returned to India after having done his American Board in Gastroenterology in 1988. Dr. Ajay Jain also joined at the same time and date as a registrar in Medicine attached to Dr. Naik. The Department of Medicine received accreditation for DNB training in 1990 for one seat. Presently three seats are recognized. Keeping in mind the vision of making Choithram Hospital a super specialty hospital, doctors were sent for training in various fields. For pulmonary Lab. first Dr. D. Mukherjee was sent to Jaslok Hospital Mumbai and then Dr. R. Tharwani was trained but efficient working was somehow not established so Dr Bhatia volunteered and was sent to Jaslok for training in pulmonary Lab. He developed pulmonary function test Lab. Initially we had only Vitalography machine, which was quite inadequate. So on the recommendation of Dr. Bhatia more modem pulmonary function test machines were purchased which could provide Spirometry, Lung volume and diffusion tests. A Treadmill to do V02 max was purchased and installed in the

Respiratory Lab, was moved to the cardiology department. Dr. G.C. Bhatia also developed allergy clinic along with Pulmonary Function Lab. Dr. Norman Sharma was given additional administrative responsibilities in view of his Army background. However, when Dr ldnani wanted to pull him totally into administration side, Dr RS Mehta resisted the move and prevailed upon Dr ldnani and Dr Bhagwanani to let him continue his clinical career. He was subsequently sent to AIIMS in 1991 for training in Endocrinology. Dr. N.S. Bhagwanani (Ex. Medical Director) started the use of lasers in medicine in collaboration with CAT Indore. An exchange program with Russian scientists was started. Doctors who visited and were trained in Russia for the use of various lasers in Medicine are Dr. G.C. Bhatia, Dr. S.K. Bhargava, Dr. Vinit Gupta, Dr. D. Dharkar, Dr. Dinesh Pendharkar, Dr. S.K. Parwani , Dr. C.S. Chamania, Dr. D.S. Chitnis, Dr. Vivek Palsule, and Dr.Girish Naik. The Intensive Care Unit of the Hospital started functioning from the beginning July 16, 1979 under Dr. R. Tharwani. To begin with it was located near the CMO Office and started with four beds and had the facility of bed side ECG Monitor, Central Oxygen supply and suction system. As the ICU was always full six more 155 beds were added and it was shifted to the present Nephrology Department. The ICU continued to function there till 1988 when it was shifted to its present location on the first floor for 18 patients. Dr. (Mrs.) V. Haridas took over in 1985 and continued till 1993 when Dr. N. Bharti became the ICU in-charge till 1999. Dr. Sanjay Geed is currently the in-charge from 1999 onwards. In the meantime, new gadgets were added to the ICU. The Bear series of ventilators arrived in 1986 and so did the central console. Even after increasing the bed strength, ICU always remained full and many times patient had to be turned back for want of beds. From 1994 onwards-new equipments like HP ECG Machine, Nebulizers, Portable Pulse Oximeter, Bear - 3 Bear - 1000, and Hamilton Ventilator were added. The present 17 beds ICU is centrally air-conditioned & has on each bed colored multi-para monitors with ECG. SP02, and NIBP facilities. It has central oxygen supply and introduced suction facility. Further compressed air pipelines for the smooth and silent running of ventilators is provided in ICU. The Vela series of ventilators with noninvasive mode of ventilation arrived in 2002-2003. These ventilators have the facility of graphic display of respiratory waveforms. The ICU has the facility of bedside haemodialysis. Choithram Hospital was the first one in the city to start bedside haemodialysis. The crash cart and the newer fowler's beds have also been added. With the active support of infection control department, cleanliness and waste disposal are followed strictly as per protocol.

Although it may not be possible to mention all who have worked in ICU but the service of the following Nursing Supervisors needs special mention. 1. Mr. Kenneth Calvin (1979 - 2000) 2. Mrs. Usha Subhash (1989 -1996) 3. Mrs. Omna Nair (2000 - 2004) & 4. Mr. Yashwant Sonwane (2004 - till date) Dedicated staff of Resident Doctors, Staff Nurses and Paramedical staff have over the years made it one of the best critical care centre of Central India. Meanwhile Dr.Haridas took up the specialty of Rheumatology and presently sees both general medicine patients as well as Rheumatology. Recently - just this year (2005) Dr. Satyajeet Singh has been appointed as full time Rheumatologist. Department of Skin & VD has always been considered part of Medicine. Dr Subhash Jain was the first consultant in Dermatology. Later Dr Krisnendra Verma joined. Other consultants in Dermatology were Dr Anil Dashore, Dr Dawani and Dr SK Mutha. Dr Anil Dashore is still with us and Dr Surekha Arora 156 has joined us in 2002. Dr RS Mehta retired in 2003 but continues to come and see cases when called. Dr MC Ajmera retired in 2002. Dr GC Bhatia became a Hon Consultant in 2001 and Dr Ashish Jain joined as a full time Pulmonologist in 2004. Department of medicine has played a vital role in the growth of all super specialties and sub specialties and yet has maintained its own distinctiveness. ...., Dr.S. Inamdar, Dr.R.D.Lele, Dr.Bhawanani, Dr.B.Chhaparwal

Dr. N Sharma Dr. K K Artwani Dr. M C Ajmera Dr. V Haridas Dr. A Dashore Dr. S Arora Dr. N Bharti Dr. S Geed 157 Dr. J.W.Sabhaney with Dr. R.S. Mehta Dr.Gandhi, Dr. Mukherjee, Mr.Mitra & Dr. Sepaha Dr. G.C. Sepha with Dr. S.K. Mukherjee

Gastroenterology By - Dr. G. Naik & Dr. Ajay Jain This hospital started in 1979, with well-equipped Department of Gastroenterology. Dr. A.C.S. Jain MRCP Hon. Consultant started GI services in this hospital. Dr. KK Artwani joined him as Registrar and soon became the consultant who helped further in spreading the services of Gastroenterology. The hospital had state of art fibre optic gastroscope and colonoscope, which were acquired before start of the hospital and it became first hospital in the Central India to have colonoscope. Mr. AS. Khan was the first Endoscopy technician, use to, not only assist but also maintain these sophisticated instruments. Dr. C.S. Chamania then a young surgeon who was man Friday for all work was sent to AIIMS for Endoscopy training and he was one of the most active endoscopists from1982 and remained so till 1989. During this time Dr. KK. Artwani Physician, 158 Dr. G.C. Bhatia Physician, Dr. S.K Sharma Surgeon, Dr. Ashok Ladha Surgeon also learned the fibre optic GI Endoscopy and helped in advancement of GI sciences. In 1986 Dr. S. Bafna after his GI training in USA joined this hospital and remained till 1988 before moving to Chennai. The quantum jump came on July1st 1989 when Dr. Girish Naik arrived in Indore after staying for 18 years in USA. Dr. Naik is a Diplomat of the American board of Internal medicine and Gastroenterology. He has been Assistant Professor in Medicine at the State University of New York and chief of medicine at various Hospitals. On the same day Dr. Ajay Jain joined as Registrar in medicine. Dr. Naik started not only GI Clinics, but also brought concept of Hepatology, and Pancreatology as a super specialty. He established the identity of Gastroenterology in the town as a separate super specialty. He also started PG Clinics for residents in CHRC. He introduced the concept of therapeutic Endoscopy and made a dent in the management of UGI and Lower GI Bleed. By this time, the department started getting referrals from all over the M.P. and in next 5 years, Dr. Naik with Dr.Chamania as a team, performed more than 150 Shunt surgeries. Dr. Naik wanted Department of Gastroenterology to become one of the best departments and he persuaded Dr. Ajay Jain to join DM Gastroenterology. Dr. Jain obtained the DM Gastroenterology from the most prestigious department of GE at G.B. Pant Hospital, University of Delhi, and then did his fellowship in

Therapeutic Endoscopy at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA. He was immediately appointed as consultant in the department in 1996. The team of these two saw many new developments in the department. The wide range of advanced therapeutic endoscopies started in 1996, like Endoscopic esophageal dilatation, pyloric dilatation, colonic dilatation, endo- luminal prosthesis placement, laser applications for GI diseases, wide varieties of ulcer haemostasis management. Interventional hepatobilliary and pancreatic procedures were started, in 1996. Today we are tertiary referral Centre for all complex Luminal GI, Hepatobiliary, and Pancreatic diseases. In year 1997, Prof K.D. Bhargava joined this department as visiting Gastroenterologist to enrich with his vast administrative and academic experience. Late Dilip Mishra joined the GI unit as young enthusiastic technician and he proved as asset to the department with hard work and did it till his untimely and sad demise in year 2001. Miss. Rani Mathews joined after few years of Dilip Mishra. Her strict discipline, meticulous patient management and instrument handling is still remembered by all of us. Binimol and Suzan Das followed the footstep. Presently department is supported by Mr. Dilip Parmar as technician, Mrs. Nirmala Singh as Department Secretary and Mahesh Sawle as Helper and 159 present smooth functioning is largely due to their efforts. We have close cohesive working with GI Surgery, which has made possible. All complex clinical problems to be handled here. We are having active interaction with department of Radio- diagnosis and imaging which include USG, Colour Doppler, CT Scan, and MRI. The state of art nuclear medicine with interventional angiography has put us the only centre to deal with patients having obscure GI Bleed. The department of Biochemistry, Microbiology and immunology has helped the department of Gastroenterology towards active research in the field of viral hepatitis. We feel this close co-operative effort between GI Physicians and GI Surgeons, Radiologist, Pathology, Biochemistry and Microbiology has led to better patient care and out come. In last many years we have achieved many milestones. The list is long but to innumerate few we have done approximately 10,000 upper GI Endoscopies and diagnostic and therapeutic(both), 2000 diagnostic & therapeutic Colonoscopies, 1000 Therapeutic ERCPs, 250 Liver Biopsies and many more such procedures in last 8 years. On surgical front we have now done more than 100 pancreatic surgeries, Whipples surgery, liver resections etc. Our long term goal and vision has been to establish a post graduate teaching in the field of Gastroenterology which we are happy to state that we have achieved in January 2005 and department has been recognized for training of 2 PG students every year in this supers specialty. Dr. Shohini Sircar has joined as first PG student in GE after doing her MD Medicine from Calcutta.

Endoscopy under progress Endoscopy under progress 160 Department of Gastroentrology Workshop on Therapeutic Endoscopy - 2004 Dr.A.C.S.Jain

Nephrology and Renal Transplants By - Dr.Achal Sepaha 1974 30 years ago, whole of Central India and Madhya Pradesh especially was lacking in specialized and updated medical facilities. Late Seth Shri Thakurdasji Pagarani planned to start a fully equipped hospital with most modern facilities. It took Him 4 years to realize his dream. At that time I was undertaking training in Jaslok Hospital under renowned nephrologists Dr.M.K.Mani (Known for the treatment of Shri Jai Prakash Narayan) and Dr.Kuruvilla. My father, Prof. G.C.Sepaha was a member of advisory board of Choithram Hospital. He wanted me to comeback to Indore and joins this institution. In June 1979, a month before the hospital was actually commissioned, I joined the institution, on his insistence. At that time there was no Nephrology deptt. in whole of the central India, including part of Maharastra, Rajasthan, U.P. and Madhya Pradesh. My immediate task was to identify and provide IPD / OPD facilities for Nephrology patients. The Hemodialysis unit was planned behind the Orthopaedic OPD and started with the help of Dr.N.B.Idnani. The actual foundation of the Nephrology 161 deptt. with Hemodialysis facility started in 1980. Prof. M.K.Mani formally inaugurated the unit on 27th April 1980 with two Hemodialysis machines. Since then we never looked back, and as on today, I feel proud to have 9 hemodialysis machines, running constantly in three shifts daily. Dr. Pradeep Salgia joined the deptt. in 1984. With his help, we worked together to start \"Renal Transplantation\". At the same time Dr.C.S.Pandit joined the deptt as a house officer and since then he is working in the deptt. He turned out to be a great assess to the department. All most all-clinical procedures like kidney biopsy, femoral, jugular, and subclevian catheterization are done by him with expertise (probably most experienced person in the country for such procedures). He has been promoted to Clinical Assistant post in nephrology. He turned out to be a key person in the renal transplantation unit and was further promoted as main coordinator for the programme. Like many senior visiting doctors from Bombay, Dr. B.N. Colabawala, a senior Urosurgeon from Jaslok hospital, joined the team as visiting honorary urosurgeon to guide and develop all sorts of uro-surgical procedures in this institution. Another key person, Dr.B.C.Bapna, who retired from PGI Chandigarh as Prof. and Head, joined the department of Urology. We had excellent team of urologist and the stage was set for starting of \"Renal Transplantation\". Dr.K.L.Bandi, Dr.R.K.Lahoti, and Dr. Shekhar Chamania formed a very formidable team and were determined to start transplantation. Dr.M.H.Kamat, uro-surgeon and a renal transplant specialist from Jaslok hospital was kind enough to visit Indore on regular basis for the establishment of \"Renal

Transplantation\" unit. First ten renal transplants were done under his guidance. With the establishment of \"transplant unit\" Choithram Hospital became first hospital to have dialysis and transplantation in this part of India. Since then, we, as a team have carried out about 450 renal transplantation (including cadaver transplantation). The Human Organ Transplant Act was passed by Central government in the year 1994. This means, we have to obtained permission from local government for organ transplantation surgery. We at Choithram with the help of Dr. R. K. Lahoti, Dr. K. L. Bandi, Dr. N. S. Bhagwanani and active support of our managing trustee Shri Satish Motiani, were able to arrange meetings with then chief minister Shri Digvijay singh, and Health minister Shri N. Nahata. In 1996, M.P. Government finally adapted the same act. Unfortunately we could not get the proper information in time. As per Act, we were supposed to apply to Director Medical Education(DME) for formal registration. Only a month was left for formal registration, we the news came to us Finally, when we applied for registration for recognition for renal transplant surgery, we were told to stop all transplant activity immediately. No transplant surgery was legal without the state government permission. It was a setback. As per rule, a team of experts appointed by the government had to inspect the hospital for the facilities. For almost three months we could not operate a single 162 patient for transplantation. Repeated meetings with the CM, DHS, and DME with the help of media and patients, we could force the DME to complete the formalities as soon as possible. Once we got the required permission, we were back to the normal tract. Department of Nephrology is most modern and fully equipped with latest technology. With the help of equally modern and state of art departments of Biochemistry, Immunology, Histopathology, Ultra-sonography, Nuclear Medicine and conventional Radiology, and team of dedicated Uro-surgeons we are capable of dealing any / all problems regarding renal diseases. Our department takes active interest to educate the society about renal diseases, Renal transplants, Brain death etc., by arranging live demonstration of renal transplant surgeries for schools children and social organizations. We also arrange interactive sessions for about 2 hours, where the whole team of Nephrologists and Urologists answer their quarries. Land Marks: 1. OPD /IPD 1979 th 2. Peritoneal Dialysis 18 March 1980 th 3. Hemodialysis 27 April 1980 th 4. Renal Transplant 14 Sept.1985 5. Regular Plasma-pheresis 1985 onwards 6. CAPD 1996 onwards 7. Hemofiltration bedside 1990 onwards th 8. Cadaver transplant 24 April 2000 9. Regular Hemodialysis in ICU 2002 onwards.

THE ECSTACY- I: Dream of Renal Transplant By - Dr. Pradeep Salgia One fine morning, while I was doing my fellowship in Nephrology at Manchester th U.K., I received a letter dated 26 June 1984, from then Administrator of Choithram Hospital, Dr. S.L. Mangi. The letter was a sort of invitation to join Choithram Hospital at Indore. Since I had couple of openings at other places too, so I could not make up my mind immediately. I decided to consult my mentor and teacher Dr.M.K.Mani. He advised me to join at Indore. Finally on 1\" Aug. 1984, I joined this Hospital. I had lots of plans in my mind. Starting a “Renal Transplant Unit” was one such dream, I had. Although a Nephrology department with Hemodialysis was working effectively since 1980, my task was not that easy. Four Things were required at this stage: st 1 - the preliminary arrangements at the hospital level for training the staff, arranging the barriers for immuno-compromised patient after transplant, trained nursing staff, organizing the transplant team, and facility for Renal Angiography were primary requisite. I discussed the matter with Dr.Idnani and he managed to arrange every thing as required. nd 2 - I had to search for a Transplant Surgeon with vast experience, who could come to Indore for initial surgeries & guide our team of surgeons. For this I went to 163 Bombay and persuaded Dr.M.H.Kamat to come to Indore. I knew Dr. Kamat from my days at Jaslok Hospital and was confident that he would not turn down my request. 3rd - requirement was to get an immunologist who would do tissue typing and cross match at odd hours. For this I went to Dr. Vrinda Triknnad in Bombay, who agreed to do the tests at her Camps Corner clinic at any time of the day or night. Subsequently Dr. D.S.Chitnis look after the immunological work-up for transplant patients and spared us the trouble. 4th - and most important requirement was getting a patient, who would agree to get his transplant surgery at Indore. Since God's wish was with me, there came a 27 years old school teacher from Shujalpur. Mr. Hemant Gaikwad, he presented to me in renal failure with almost Hyperkalaemic arrest. He survived with dialysis treatment, and on findings him to be in end-stage renal failure, was put on regular haemodialysis. I kept on suggesting the need for kidney transplant and told him that it can be done at Indore, though he would be our first patient. The patient's family had doubts, and went to Jaslok Hospital, Bombay. To my surprise, few weeks later patient's father and brother came to me. They have satisfied themselves about the facilities available with us at Indore. They have decided that Hemant's transplant will be done at Indore, irrespective of the outcome. I disclosed this news to Dr.Bandi, Dr. Lahoti, Dr. Chamania, and Dr.Idnani. They were very enthusiastically looking forward for it. I selected his

younger brother, Satish as donor. He was sent for tissue typing to Bombay along with recipient blood. On finding a suitable match between the two, the D-day was fixed on 14th Sept. 1985. On 13th morning blood was drawn from the recipient and donor and was flown to Bombay with one of their relatives. In the evening Dr. Triknnad informed me that tissue cross match was O.K. I took the patient for Haemodialysis and rang up Dr. Kamat in night, told him that the cross-match was negative. So he can take the morning flight to Indore. Next day when he reached Indore he examined the donor and recipient who were then wheeled to theater. It took four hours for the surgery and the graft started functioning immediately. Dr. Pandit and myself remained awake whole night managing the patient. Next morning when Dr. Kamat returned to Bombay, patient had settled by then. Subsequent story is a history st that on 14 Sept. 1985, Mr. Hemant Gaikwad became 1 Kidney Transplant Recipient, operated in Central India and thereafter the transplant team of Choithram hospital took over the transplant work independently. Since then we have completed more than 450 kidney transplants. Golden Moment - First Renal Transplant Dr. C.S. Chamania 164 It and was 11.45 A.M. in the morning on 14th September 1985, all who were present in O.T. no. 1 of Choithram Hospital & Research Centre Indore cheered jubilantly and ecstatically “ Aa Gayee, Aa Gayee .” It was one of the most cherished moments in the history of the hospital. What it meant by Aa Gayee, Aa gayee, was that the kidney which was implanted in patient Hemant Gaekwad had started pouring urine from its ureter. This message that the first kidney transplant has been successfully performed in the institution was then conveyed to the medical director Dr. N.B. Idnani. He, along with many other well wisher was waiting anxiously in O.T. Lounge. He immediately proceeded to Managing Trustee's room to convey the remarkable feat achieved by the institution. Managing trustee, Mr. Satish Motiani, a charismatic, dynamic and technology friendly person, was equally eager to know the result. He immediately after taking reins of the hospital was instrumental in starting open-heart surgery, percutaneous renal surgery, and hip replacement surgery in the institution. A lot of efforts, perseverance, dedication and hard work could bring this cherished moment. Dr. Achal Sepaha was instrumental in starting hemodialysis facility in the institution way back in year 1980. This was a boon to the patients suffering from chronic renal failure. However renal transplantation was the ultimate treatment for these patients, as it spared them form cumbersome and repetitive hemodialysis. Additionally it assured a better quality of life. Dr. Sepaha and Dr. Salgia could convince and persuade the management to start a renal transplant program. A team of surgeons, anesthetists, immunologist and dedicated full time medical resident was to be identified. It was decided that Dr. K.L.Bandi, Dr.

Rajendra Lahoti and Dr. C.S.Chamania would constitute surgical team, Dr. D.S.Chitnis will take care of immunological aspects of the workup, Dr. Vijayan and his team will give anesthesia, Dr. Karnik will perform Renal Angiography for the potential donor and most importantly Dr. C.S. Pandit was identified as resident physician to take care these patients post operatively. Dr. C.S. Chamania was sent to Bombay for one month to work with transplant team of Jaslok Hospital to get acquainted with intricacies of transplant surgery. Patient, Hemant Gaekwad was a married man of twenty-six years. He was suffering from chronic glomerulonephritis, which attacks individuals silently and insidiously. After the diagnosis, Hemant was put on regular hemodialysis. At the same time discussions were started with his family members about possible live related renal transplantation as a permanent solution for the otherwise fatal disease. After persistent persuasion family got convinced about getting the transplant surgery done at Hospital. To add to his luck Santosh, the younger brother of Hemant, who was of same blood group, agreed to donate his one kidney to his brother. It must have been an emotional and sentimental decision to donate ones own organ to save life of his brother who was dying and helpless. Both the brothers were investigated for fitness and suitability of surgery including HLA typing. One by one all investigations cleared the way for planned surgery. 165 Fourteenth September 1985 was selected as the day for surgery. Dr. Kamat a famous renal transplant surgeon from Bombay was called to supervise and cherish this memorable golden moment. After successful surgery Hemant was wheeled to Renal transplant ICU. On the first day he poured Twenty-one liters of urine, next day he made eleven liters of urine, which is the usual story after successful transplant surgery. His immunosupression was started a day before surgery and continued postoperatively. He would remain on some form of immunosupression for whole life, this a small price on pays for good quality of life. Hemant was discharged after tree weeks form the hospital. After the first successful renal transplant surgery, duo team of Dr. Sepaha and Dr. Salgia have brought this institution to great fame. We have the most successful transplant program of Central India and till date more than 450 transplants have been performed in the institution.

Renal Transplant Surgery Surgical Team working on Donor Surgical team working on Recipient Dr. Chamania, Dr.Bandi, Dr.Goel & Dr. Chadha Dr. Thatte, Dr. Bhatia & Dr. Dudhiya 166 Dr. C.S.Pandit preparing the Kidney for transplant Kidney is getting removed from Donor Kidney is re-implanted in the Recipient

THE ECSTACY- II: Our Dream of a Cadaver Transplant` When the human organ transplant act was passed in Parliament, it had two clear-cut aims. One was to curb down illegal transplant activity and the second was to promote cadaver transplantation. We are thankful to Dr. Lahoti because of his proximity to them C.M., Shri Digvijay Singh, that the organ Transplantation act was adopted readily in our state. Another most important step in starting cadaver transplantation was the public awareness about brain death and organ donation. This work was done extensively by a voluntary organization, M.P. Kidney Foundation, which was helpful in initiating Dr. Pradeep Salgia our cadaver transplant programme. The success story came after two years of active public campaigning. I would narrate here that how I could start the cadaver transplant at Choithram Hospital. On 22nd April 2000 - A 16 years old boy Mayank Mehta met with a severe Road traffic accident and was lying on ventilator at Suyash Hospital. 167 On 23rd April 2000 - His treating Neurosurgeon, Dr. Rakesh Gupta declared him brain dead. His parents Dilip & Sangeeta Mehta were in a stage of shock and refused to accept the situation. At 2.00 pm - When I learned about this, my wife was sitting by my side. She asked about the possibility of organ donations and suggested me to give a try for it. It was very difficult task to talk to the aggrieved parents who would not accept the suggestions. Leaving the organ donation they would not accept his death. Had it been a Western country this task would have been done by the social workers. At 4.00 pm - I decided to inquire the exact situation of the patient and his feasibility for organ donation. I went to Suyash IC.U. where the duty doctor informed me about the confirmed brain death and told me, his kidney were good and pouring lot of urine, he was on respirator and blood pressure support. At 5.00 pm - I started searching for the parents acquaintances and friends, and there came volunteers of Humad Jain Samaj, I explained them that the parents, if can be

agreed for organ donation, the life of couple of people would be saved. Every one felt that it would be difficult to convince father but the mother who was a religious and bold lady could concede to this idea. At 10:00 pm - As soon as, I learnt that the family of Mayank Mehta agreed for organ donation, I rushed to Choithram Hospital. I contacted the Medical Director, Dr.Bandi, Dr.Lahoti, Dr.Chamania, Dr.Thatte, Dr. Goyal, Dr.Pathak, Dr.Chitnis, Dr. Bhatia, and Dr.Pandit and informed them about the possibility of Cadaver Transplant late in the night. At 12.00 mid-night - The dialysis unit was opened. Nursing staff was 24th April called. The phone numbers of matching blood group dialysis patients were retrieved from the record book. At 1.00 am - I started ringing the dialysis patients, when I made the first call and informed about the possibility of cadaver transplant. I was told that it is midnight, and will think 168 about it in the morning. The second call, when I made was a blunt refusal. The third and fourth calls were unanswered as no body picked up the phone. I was getting nervous that nobody would turn up for organ transplant. The fifth call was made to Dewas and patient's father picked it up. The moment he heard about this, he agreed immediately and started asking for instructions. I instructed him to keep the patient fasting and rush immediately to Choithram Hospital. At 3.00 am - Patient Ashok Malu arrived in dialysis unit, his blood sample was drawn for cross match, and other test. His dialysis started without heparin. At 3.30 am - The donor's blood was brought from Suyash Hospital and Dr.Chitnis and his team started cross match. After this, I started searching for the second recipient, so the next call was made to a patient staying close by Choithram Hospital. Her husband agreed immediately. At 4: 30 pm - The second recipient arrives in the Hospital. The atmosphere in Hospital was excited and busy activities were going on , then came a sudden blow As per the organ transplant act the organ retrieval had to be carried out in Choithram only. And for this donor Mayank was to be

shifted from Suyash Hospital, the father of the patient's refused to shift the patient 'in this condition. At 5.00 am - I rushed Suyash Hospital and explained the relation and Mr. Metha about the technical difficulties and could convince them to shift the patient to Choithram Hospital. At 5.30 am - I shifted patient in an ambulance on Ambu bag and dopamine drip along with a duty doctor and rushed to Choithram Hospital. At 6.00 am - Donor reached Choithram Hospital and was wheeled straight to I. C. U., and put on the ventilator and other supports. At 6.30 am - Members of brain death committee Dr.Kathpal, Dr. Haridas and Medical director called to verify the brain death. At 9.30 am - The first recipient Mr. Asbok Malu is ready for the transplant. 169 At 10.00 am - The Mayank's B.P. fell down despite vasopressor, and serum creatinine started rising. This was a again a point of concern if patients Kidney go into renal failure, then the transplant outcome will be poor. At 10.30 am - The tissue cross match is reported negative. At 11.00 am - The brain death committee verify the brain death for the second time as per law. At 11.30 am - Donor was shifted to the operation theater. Kidney transplant team began kidney retrieval Dr.Pathak took the Biopsy for frozen section, Dr. Mrs. Shobha Chamania. and the team started retrieving the skin from the back Dr.Parwani, Dr. Shreya took out the corneal grafts. Meantime Dr. Pathak announced that the tissue architecture in the Biopsy was O.K so second team started to transplant the kidney in to the first recipient Ashok Malu At 12.30.a.m.- after the organ removal ventilator was disconnected Mayank was finally declared dead. The body was handed over for the postmortem. I requested the administration of M.Y.H. to expedite the postmortem formalities. The second recipient while prepared for the transplant

developed high grade fever and therefore, surgery had to be cancelled Dr.Pandit packed up the second kidney in saline and double packed it and buried in the ice. At 3.00.pm - The 1st cadaver transplant was carried out successfully. Patient started making some urine and was shifted to kidney transplant room. Since the second recipient was rejected, I started looking for at list of dialysis patient. Second time the response came again from a patient from Dewas. Yajuvendra Rajput's mother who was a nurse's volunteered immediately to be the second recipient, but expressed her inability for the surgery for the want of money. The only option left with one was to discuss with the management. At 5.00P.M. - I reached Managing Trustee, Shri Motiani's office and told him that we have a Donor Kidney, and a recipient but for want of money it could not be transplanted, hence 170 the donor kidney will go to the dustbin. As usual he asked for the budget and hearing my reply, gave me immediate sanctioning and told me to go ahead with the second transplant without any deposit. At 6.00 p.m. - Dr. Chitnis started second patients tissue cross match and we started dialysis, to make him fit for surgery. At 11: p.m. - Second Cadaver transplant began. At 2:00 a.m.(25th April) - Yajuvendra was shifted to the kidney transplant room, entire surgical team was satisfied with whatever has been done. Dr.Pandit and myself were under great stress because the second recipient did not make any urine, but we were hopeful that sooner or later it would function. At 8: 00 a.m. - I left for home after two days and two nights, without sleep and food, but with great satisfaction that we could make Choithram Hospital, the first one in Central India to start cadaver transplant. Mayank Mehta's name also became immortal in the history of Indore. Five years later On 25th April 2005 - I am sitting at my home and writing the account of the event for the History book of Choithram Hospital. Both recipients Ashok Malu & Yajuvendra Rajput are healthy, happy and enjoying good life up till now.

Dr. Sepaha Dr. Salgia Dr.M.H.Kamat Dr.K.L.Bandi Dr.R.K.Lahoti Dr. M.K.Mani and Dr.Salgia Dr. Bandi felicitating Dr. Kamat 171 Dr.C.Pandit Dr.Chamania Dr. Thatte Dr. Sushil Bhatia Dr.A.Goel Martyrdom of Mayank Mehta Perfect Gift to Mankind

Laboratory Medicine By - Dr. D.Chitnis & Dr. S.P.Joshi Laboratory medicine plays a crucial role in the diagnosis, prognosis and therapeutic monitoring and in view of this a full pledged department was established from the beginning of 1979 at Choithram Hospital & Research Centre to provide quality services for patients not only from the hospital but from outside as well. The department is spread over a large area and has the best of the equipments Past Heads, Laboratory Medicine l Dr. P. Dhand 1979-1980 l Dr. Girish Rindani 1981-1987 l Dr. R. Vijayvargiya 1987- 172 Ex Associates in Lab Medicine: l Dr. Taranath Shetty Ph.D. Biochemist l Dr.D.P. Mukherjee M.D. Clinical Haematologist l Dr. Ashok Dosi M.D. Pathologist l Dr. Dhananjay Dixit M.D. Pathologist l Dr. Anil Sharma Clinical Haematologist l Dr. Solanki M.D. Ex Associates in Lab Medicine: l Head of Department Dr. S.P. Joshi l Division of Pathology HOD Dr. Satish Phatak. l Histopathology & Cytology Dr. Satish phatak M.D l Clicical Haematology: Dr. A. Modi, M.D. Dr. A. Singhvi M.D. Dr. Neetu Thakur M.D. l Blood Bank: Dr. Neetu Thakur M.D. Mr. Prahlad Joshi (JSO) Clinical - Pathology Dr. Neetu Thakur Division of Clinical Biochemistry:

manned by the professional experts. The setup remains unmatched in the entire state. Sample collection facility: Proper collection and labeling of specimen is an important prerequisite for Pathology lab. Central sample collection facility meets the need of the situation. The blood specimen of all admitted cases collected by the team of skilled persons and brought to laboratory while out patients reach the central collection facility. The central collection wing was recently given face up lift for comfortable waiting of the patients. To avoid pre-analytical errors and accidental spillage of samples, the internationally accepted vacuutainer collection system was introduced way back in 1998. The department has also tie-up with some peripheral hospitals to provide services for special investigations. Clinical pathology: Use of multi-sticks was introduced for urine analysis way back in 1980. Close supervision by pathologist & frequent rechecks of abnormal findings helps to render quality services. Haematology: The first semi-automated haematology analyzer in M.P. state, the coulter ZF6 was 173 installed in the lab from the very inception in 1979 & the use of commercial quality control samples to ensure quality remained the practice right from the beginning. With the technological advances the old haematological analyzer was replaced with the new version, T540 & with the growing need additional automated cell counter, 3 part differentional analyzer MS-9 was installed in 2001. An automated co-agulometer offers ease & better precision and hence 'START-4' was installed in haematology in 2002. The disposable Westergrn green tubes for measurement of ESR were introduced to over come the difficulties arising from the washing and reuse of glass tubes. Clicical haematologists had always deep involvement in the working of the Haematology lab & this has added continuous updating & monitoring of the lab. Histopathology & Cytology Lab By - Dr.Satish Phatak The lab is reputed in the State and provides histological and cytological diagnostic help not only for patients from Choithram Hospital but also from many other hospitals. The laboratory undertakes fine needle aspiration cytology study and cytology of various body fluids & smears and histological study over small biopsies to large surgical specimen. The facility of frozen section by “Demon” cryostat existed since inceptions (1979) to offer on the OT table diagnosis of surgical cases. Recently a new cryostat “LEICA CM1510” has been added. The best of the equipments such as tissue processor, microtomes & the disposable knives together with skillful technologists give quality support to the histopathologist. Various special staining procedures are routinely available in the lab & the immuno histo-

chemistry is in the offering to further improve the diagnosis and offer pheno- typing of malignancies and help therapeutic decisions. Blood bank The blood bank at CH & RC has remained a model blood bank in M.P. State “No professional blood donors” was the motto from the day one. The FDA set guidelines are stringently followed. The infectious disease screening for HIV, HBsAg, HCV, RPR and malarial parasites is rigidly followed, with the help of best of the reagents and strict supervision and quality control. Intact screening for HCV was introduced before, it was make mandatory by FDA. For optimal utilization of blood components separation was introduced in 1990 & in the last four years 60% of blood units given are in the form of components. Two dedicated centrifuges suffice the need for components as packed RBCs, fresh frozen plasma, cryoprecipitate, platelet rich plasma and platelet concentrates. To increase the life span of platelets, Terumo platelet agitator was introduced in 2002. With installation of walk-in cooler storage capacity of blood units increased to more than 2000 units and 35oC deep freezer provide space for more than 1000 units of FFP. Blood collection monitors at every donor collection site facilitates easy and proper blood collection. With the component separation facility we are 174 able to cater the need of all thalassaemia patients coming to our hospital at economic cost. Beside, supply of blood units the lab also provides facility of difficult blood groups tests such as Du variants and also provide support service like antibody titer, Coombs tests etc. Clinical biochemistry The division has more than 123 parameters on its list, which includes the routine & special investigation for cardiac, respiratory, liver, renal & full range of metabolic profiles. Besides, it offers therapeutic drug monitoring facility such as for lithium & anti convulsant drugs, electrophoretic analysis for proteins& haemoglobins & has been the first laboratory in the state to startup these special investigations. Addition of newer tests to the armamentarium has been continuous process. Constant efforts are made to expedite the results not only during routine working hours but also during emergency hours so as to help clinicians for speedy management of patients. The automation avoids human errors & offers speed. Hence, was aptly introduced in laboratory medicine. The first of its type, automated discrete type Biochemistry analyzer “Clincon-Corona” was installed in Biochemistry section in 1982. It was the first automated system in the state of Madhya Pradesh. There are large numbers of factors which need to be considered at the time of selection of the equipment and with sincere and honest efforts and spade work of Dr. K.Taranath Shettey the department was equipped with Densitometer, Chromatography, Blood Gas Analyser and Spectrophotomer in 1982.

There is a false notion in the minds of the people that the machine will generate quality results, however the fact remains that it is the man behind the machine who is important to generate quality results. The quotation of John Ruskin “Quality is never an accident. It is the result of good efforts. There has to be a will to produce superior things”. This motivated the department to participate in external quality control programme in clinical Biochemistry organized by Christian Medical College, Vellore since 1985 till to date along with large number of Laboratories all over India. It is a matter of pride that among thousands of laboratories all over India our lab was ranked number one in the CMC quality control programme for the year 1990. With the development in science and technology the discrete analyzer “Clinicon-Corona” was replaced with random access analyzer “Hitachi 704” in August 1989. With the development in Science and Technology the Flame Photometer for measurement of Sodium, Potassium was replaced in 1996 with Ions selective methodology,”Easylyte 2010” marketed by Medica to deliver faster and good results. The Blood gas analyzer “Combi” was replaced by ABL 555 (Radiometer) in year 2000. Hitachi 704 which served for 14 years, was replaced with a similar random access analyzer “Daytona” marketed by Randox Lab. U.K. in November 2003. In order to generate fast and accurate results, specially in emergency services and to broaden the availability of more tests, Photometer and spectrophotometer were replaced by 5010 and 175 spectrophotometer (Thermo) in year 2002 and 2004 respectively. Besides the busy service activities, the staff takes keen interest in academic & research activities. More than 50 papers were presented at National and State Level. In year 1985 and 1990 Dr.S.P. Joshi attended International Training Programme on Clinicon Corona and Hitachi 704 respectively in West Germany. He also attended an International Conference of Association of Clinical Biochemistry of South East Asia held in Kaulalumpur in 1996 and presented a paper. In year 2003 he attended the training programme to update on Daytona held by Randox, U.K. In Belfast, Ireland. The Department of Biochemistry is also recognized for its Ph.D. Programme affiliated to D.A.V.V. since year, 1992. Three students were awarded Ph.D. in Biochemistry in year, 1998 and 1999 respectively. The department has future plans to introduce newer tests in the area of inborn errors of metabolism, especially amino acid metabolism and other storage disorders. Microbiology & immunology Microbiology and Immunology lab has an elaborate setup backed with expert technical force. It has facility for aerobic and anaerobic bacterial culture and drug sensitivity testing. Tuberculosis lab carries out culture, drug sensitivity, antibody tests, TB /Specific antigen challenge with interferon release test and PCR for TB. The Mycology wing caters the need of microscopy and culture of fungi.

The lab also takes up bacteriological analysis of water, food and industrial samples. It also helps the local bodies in the matters of Public Health e.g. our surveillance work on the bacterial analysis of tube well water samples from all over city was an eye opener. The laboratory has often been the first to report over the emergence of cases of infectious diseases in the city. The preparation of auto- vaccines for various allergic conditions, warts, acne and malignancies is our unique facility. The lab has rendered epidemiological services to Indore and adjoining area and notable among them have been cholera, typhoid, tuberculosis, viral hepatitis, leptospira, dengue and malaria. The ICMR-NACO surveillance center for AIDS was established as early as 1987 and is now upgraded as state reference laboratory. The FACS counter facility available exclusively at our lab helps monitoring of anti-retroviral therapy through CD4/CD8 counts for the AIDS cases in this region. The research work carried out at our laboratory in the area of infectious diseases, biological activity of Low Level Lasers, hospital infection control, Bio Medical Waste management and drug resistance has earned national and international reputation. The RIA and Immunology laboratory offers a plethora of tests such as hormone 176 assays, cancer markers, antigen detection tests and Elisa tests for a wide range of infectious diseases , allergic diseases and autoimmune diseases. International reference control and internal controls are run regularly to monitor quality. The Immunology wing also has sophisticated setup of HLA typing facility to cater the needs of transplant Immunology. The lab provides facility of sperm washing and semen banking and has a full pledged tissue culture facility to provide the research back bone and is being extended as genetic lab. The laboratory is geared up with PCR technology to offer ultra modern diagnostic approach. The Microbiology lab forms the backbone of infection control programme and biomedical waste management programme. No wonder, the lab attracts large number of students form MP state for short-term training programme and Ph.D. programme in Microbiology and Immunology. Microbiology and Immunology division has over 100 scientific research papers published in national and international journals and the members have presented over 200 papers, orations and guest lectures in scientific meetings, national and international conferences. Training facility: Over 100 students received short-term training in various sections of Laboratory Medicine and about 15 students had carried out work for their dissertation. The department conducted Post-graduate Diploma course in Medical Laboratory Sciences affiliated to DAVV from 1989 to 2002.

Publications and Presentations: Published over 100 papers in National and International Journals. Presented over 200 papers in National and International conferences. Chaired sessions, delivered guest lectures and orations Future Plan: l HLA typing by molecular biology techniques. l Karyotyping setup for diagnosis of genetic anomalies l Real time PCR for quantification of viruses and genotypes. l Cell sorting and flow cytometric analysis of blood and tissue cells. Ph.D. Thesis from Pathology Department (Biochemistry and Microbiology) In all 12 candidates have been awarded Ph.D. while working in the hospital. They were guided by Dr.D.S.Chitnis and Dr.S.P.Joshi. 177 The Pathology Centralised Sample collection room Dr.S.Phatak Dr.J.Baraniya Dr.S.P.Jaiswal

ABL 555 Blood Gas Analyser Easylyte & Autolab Analyser CDS 200 Densitometer Daytona Biochemistry analyser Hitachi 704 Biochemistry analyzer 178 CD4 / CD8 (FACS) Counter AIA 600 Immuno Analyser MS 9 Haematological Analyser RG 300

Nuclear Medicine By - Dr. M.K.Soni Choithram Hospital & Research Centre, Indore played a vital & pioneer role in the year 1981 by establishing Nuclear medicine department( N.M.D.) in the state of M.P..The installation of CGR GAMMA-TOME T 9000 computarised Gamma camera was state of art, latest technological advancement and was for the first time in the whole country. Dr. Chaitanya R.Divgi, who was at that time working with me at Jaslok hospital,Bombay, under Dr. R.D.Lele, joined the hospital as nuclear physician. He supervise the installation of the Gamma Camera and started the normal functioning of the department. He was supported by time to time visit of Dr. Lele and dr.S.J.Mehta. I joined the department in Feb.1983, when dr.Divgi left the hospital. NMD served not only the people of Indore, but to the whole of the central India including Gujarat, part of Maharastra, Rajisthan and Uttar Pradesh. That the era when Ultra-sonography, Computarised scanning and Magnetic Resonance 179 Imaging were in infancy. Nuclear medicine was the only other method of imaging different part of the body apart from conventional radiology. All the types of scanning like Thyroid, Brain, Lungs, Cardiac, Liver, Spleen, Hepato-billiary system, Renal, Testicular, Skeletal system, and blood-pool for Gastro-intestinal bleeding, were routinely done. Treatment of Thyrotoxicosis by Radioactive Iodine was also routine part of the department. It was a great economical relief to poor patients as it saved them from facing the problems connected with traveling, appointments, and expenditure in going to Metro cities just for this type of investigations. About 8000 scans have been done covering the wide spectrum. Even today, with the availability of MRI, C.T. Scanning and Ultra-sonography, NMD plays a vital role in providing functional as well as structural information. Due to a major brake down, the CGR Gamma Camera became non functional for quite some time. The damage was un-repairable and the department suffered on this account. Due to the keen interest and untiring efforts of our dynamic Managing Trustee Shri. Satish Motiani, the NMD was revived with installation of a new generation of fully computerized, Millennium SPECT Gamma Camera in the mid of year 2003. The ceremony of installation of this new camera was inaugurated by my Guru and mentor, Padmabhushan Dr. R. D. Lele (Director of nuclear medicine department of Lilawati Hospital and Jaslok hospital Mumbai) in July 2003. On this occasion a CME was organized and Dr. Lele and Dr. A. Malhotra HOD, AIIMS, New Delhi delivered lectures on the present day scenario of nuclear medicine. This latest state of art camera is capable of acquiring, and processing the whole

gamut of nuclear medicine procedures. It is also possible to do Cerebral, and Myocardial perfusion scans. Academically, NMD had been very active since beginning. The first paper on SPECT in brain and Liver was presented in National conference of Society of Nuclear Medicine at Jaipur in the year 1983. It was followed by 18 scientific papers, Two chapters in Nuclear medicine book, ( Nuclear Nephrology and Nuclear Cardiology), invited as guest speaker in CME at AIIMS, SPGIMS, Luckhnow and Jawaharlal Nehru Cancer Hospital Bhopal. Ultrasound Department By: Dr. Sudheer Gokhale Dr. Sudheer Gokhale joined as registrar in the department of Radio-diagnosis in the year 1983. But his destiny was different. He got an opportunity to get specialized training in Ultrasonography, Color Doppler, and Digital Subtraction Angiography at University 180 Hospital, Besancon , France. He stayed for more than a year in France and his wife Dr..Mrs. Suneeta Gokhale joined him there with in 2 months . On the return from France, Dr. Gokhale he established the department of Ultrasonography at CHRC, in the year 1985. Choithram Hospital was one of the first few centers in Central India to acquire a Ultrasound Scanner in 1985, when an ATL MK-600 Machine was installed. Dr. Sudheer Gokhale & Dr. Vidyut Jain were instrumental in starting Abdominal & Cardiac Ultrasound in the hospital. Dr. Mrs. Suneeta Gokhale started Obst. & Gynae. Ultrasonography. Dr. H.K. Karmalkar & Dr. M. K. Soni joined the Ultrasound Department in 1987 & 1988 respectively. Dr. Gokhale, however left the service to start private practice, while Dr. Mrs. Gokhale continue to work in the department. In May 1992 the hospital acquired the first Color Doppler Scanner & a new dimension was added to the diagnostic imaging facilities. Dr Sudhir Gokhale went back to University Hospital Besancon, France for a month long hands on training in Color Doppler and rejoined Choithram Hospital to start non-cardiac vascular color doppler scanning. A non-invasive modality was available for the first time to the patients in Central India for diagnosis of vascular diseases. In Oct.1992, the hospital also acquired a small portable system & started providing Bedside Ultrasound examinations to sick patients in ICCU & NICU. The tremendous advances that have occurred in technology of imaging prompted us to go for a modern state of the art Ultrasound scanner.

In 2002 Hospital acquired HDI 5000 Ultrasound Scanner from Philips which was one of the best available scanners in the world at that time. The new scanner with high resolution scanning has given an impetus to Sonography in newer fields especially in the examinations of Vascular problems, Musculoskeletal System, Breast & Eye. Presently Ultrasound Dept has four consultant sonologists: Dr M K Soni, Dr Sudhir Gokhale, Dr Mrs Sunita Gokhale and Dr Mrs Suchita Jain. Amongst them they hold ultrasound experience of more than 10 20 years. Ultrasound deptt is a busy unit performing more than 6-7 hundred scans a month. We are doing bed side abdominal, transvaginal, Transfontanellae HSGS. Along with routine sonographies, high resolution studies are being done also. All peripheral vascular Doppler studies, and Obstetrics dopplers are routinely done. The Department Of CT Scan By Dr. Ashok Tyagi In the year 1986, introduction of CT SCAN in the hospital diagnostic division was a great leap in its 181 history. A whole body CT scanner was imported from Hitach Japan CTW 220.The department was headed by Dr.P.N.Nathani and Dr.Ashok Tyagi. A complete whole body scanning was made possible. The team of efficient Radiologist started CT guided biopsies from various parts of the body. CT guided biopsy from the intracranial lesions was performed with a twist drill hole in the bony skull done by the then head of Neurosurgery Dr.V.G.Dakwale. A case report of 12 cases of CT guided biopsy of intracranial regions was presented by Dr. Ashok Tyagi in the National conference of Radiology and Imaging Association in Nagpur in the year Jan-1987, which was highly appreciated by the scientific community of India. In the same era many lectures were given in the nearby towns for the teaching purposes by our staff. In the year 1998, the department was headed by Dr.P.Shivram and Dr.R.S.Khanuja on the same equipment and state of art work was continue till 1996. In the year 1996 a new Scanner was introduced Sytec 3000i from GE USA which was fasted scanner of its time. Now with the new scanner lmm. slice thickness, 3-D scan, and Laser films were introduced for the first time in the state of M.P. The department is headed by Dr. Ashok Tyagi since 1996 and is performing a complete as well as, patient oriented services of CT scan including HRCT, 3D

scanning CT guided procedures. Mammography was introduced in the year 1997 and more than 600 cases are done so far with positive results. A Streotactic frame from LEKSELL was introduced for the first time in the state of MP whereby it was now possible to evacuate Intracerebral Haematomas from the deep brain under local anaesthesia. Biopsies from deep seated intracranial lesions were made possible with great precision under local anaesthesia. A series of cases of colloid cyst aspiration and their complete resection which is located in the middle of brain is on in the hospital. Two year follow up these cases reveal no recurrence. Recently 1.5 Tesla MRl is introduced in the Hospital from Siemens, with complete coils. Spectroscopy and now MR guided sterotactic procedures like Thalamotomy, epilepsy surgery, Lesion maker and ablation of epileptic focuses of brain is underway. With the introduction of Spectroscopy it is possible to diagnose a benign lesion and differentiate with malignant lesion with absolute accuracy. 182 Department of Radiology By - Dr.Anil Karnik The Department of Radiology started functioning with the beginning of the hospital in July -1979. It had a very large area and was located right in front of Orthopaedic OPD and very close to the Casualty for round the clock working. To start with we had, one “500mA X-ray Machine”, one “200mA with Tomography machine” and a “1000mA ORBIX machines” from Siemens. The ORBIX was the only machine of its kind in the country. It was a dedicated Neuro-Radiology. During those days CT - Scanners were just recently introduced and were available probably at only one or two places in our country. We used to do direct Puncture Carotid angiographies for the evaluation of the patient with head injuries or brain tumors. Dr. Rebello, Dr. P. Shiralkar and Dr. M.M. Ahuja were associated at the beginning of the hospital in Radiology department. Later on Dr. P.K. Shrivastava joined the department who was a very hard and sincere worker. Dr.Anil Karnik joined the department of Radiology in April-1980 & later on took over as Head of the Department from Dr. P.Shiralkar. The Management was very keen to develop new techniques in the department and they always encouraged Dr. Karnik to learn

new things. He was sent for further training in Radiology to Jaslok Hospital, Bombay and also to USA for training in Vascular &. Interventional Radiology in 1984. The senior technician Mr. Paliyani was very helpful during the initial part of development of the Department. Other technicians like Mr. Kamlesh Nephthali, Mr. Arvind Chaphekar and Mr. Shirish Thakurdware have contributed a lot in the day to day running of the department from the day of its inception or early years. Dr. Sudhir Gokhale & Dr. Hemant Karmalkar contributed a lot during the various phases of development of the Radiology department. They started the concept of Sonography in our hospital. Other doctors who contributed at various stages of development of the hospital were Dr. Pradeep Jain, Dr. Sunil Jain Dr. Anil Tyagi and Dr. Ramdas Maheshwari. The Radiology Department of Choithram Hospital became very popular in a very short period of time and was famous for various specialized investigation in Indore as well as in Madhya Pradesh. In addition to very good routine radiological investigations, we used to perform various specialized investigations such as Barium Studies, IVP, Sinograms, Myelographies, and Fistulograms etc. Ours was the only department in M.P. to perform large number of peripheral angiographies. 183 With the changing time, conventional radiology is getting fast replaced by Digital Imaging. Digital Imaging may not be very good but is “demand of time”. We are looking at it as a transient phase in the development. The “Film-less” radiography will be our future, as the computerization of the whole hospital system is going on. Film-less Radiography will be a boon to the treating physician as well as to ICU/Ward personal and for the radiologist too. With the easy availability of CT Scan, MRI and Ultra-sonography, the role of the conventional radiologist is changing fast. We have under taken interventional radiology as our specialty. Embolization of bleeding / feeding tumor vessels making lot of deference in the patients survival. Radiologist these days is no more a silent spectator but forms a active part of team consisting neuro ortho cardiology. Dr. S Gokhale Dr. S Jain

Gamma Tome 9000 - 1981 Millennium SPECT Gamma Camera - 2005 184 Sonography - HDI - 5000 CT Scan - Sytec 3000i GE M.R.I. - 1.5 Tesla Machine

Department of Nursing By - Usha Ukande, Principal and HOD Nursing On July 16, 1979, at around 10 am pooja was performed at the Shiva Temple near the main entrance of the hospital. The first patient, a woman in labour, was wheeled into the ward, a good omen, a new life about to be brought into this world, on the auspicious occasion of establishment of the Choithram Hospital and Research Center. Thirty Nurses headed by Nursing Superintendent Mrs. Shanta Nair, (with an Army background), took the responsibility of nursing care management of the patients at Choithram, which at that time had the bed strength of 130 patients in most of the medical and surgical specialties. Various activities of the Department of Nursing had started nearly six months before the hospital actually began functioning. Mrs. Roy, the first Nursing Superintendent had recruited nurses from all over India and the in-patient units were preparing the necessary equipment required for housing and caring the patients. Induction training of nurses was a routine feature because from the 185 beginning the aim of the Choithram Hospital was to deliver quality care to the people of Central India. Nurses were also required to made accustomed to use the latest medical equipment, which were procured for this, would be superspecialty hospital. The in-service training used to be combined for nurses and doctors. Policies and procedures were developed and finalized for delivery of quality care to the patients with a 'Healing Touch”. A well-furnished nurses' hostel with kitchen and dining facilities was already in existence, with accommodation for 60 nurses. (This has been expanded to accommodate 200 nurses and 250 student nurses by the Silver Jubilee Year). Under the able administration of Nursing Superintendent Mrs. Shanta Nair, the nurses worked with fresh enthusiasm in the rapidly progressing hospital. New departments were added: Mrs. Nair with her military background and administration degree from UK proved a very efficient nursing administrator. During her tenure, in 1985 maximum expansion of the hospital was achieved with the development of medical and surgical superspecialities, such as Cardiac Cath Laboratory, Open Heart Surgery, Hemodialysis and Renal Transplant to name a few. Mr. & Mrs. Rao, Mrs. Achala John, Mr. Kishore Singh, Mr. Lotlikar were sent to Apollo Hospital, Madras for special training in Open heart Surgery and Ms Mildred Moses, Ms Pushpa Singh and Mr. Farooqe Khan were sent to PGI Chandigarh for training in Dialysis. They are the nursing leaders who pioneered and manned the departments of cardio-thoracic surgery and hemodialysis in CHRC.

The other senior nursing officers who joined in the first few months and provided efficient and committed services are, Mrs. S. Jonathan, Mrs. Cicely George, Mrs. Shashi Kanta Nikam, Mr. Kenneth, Mrs. Meena Pansare. They are continuing to give their dedicated services till date. Some, who worked for many years then retired or left for better prospects. I consider it my privilege to place their names in this historical record with gratitude. They are: Mrs. & Mr. Gilbert, Mrs. & Mr. Nath, Mr. Anirudh, Mrs. Shashi David, Mrs. Bensen, Mrs. G. Lawrence, Mrs. Mary Kutty Abraham, Mr. Noel, Mr. Khan, Mr. Chandershekhar, Mr. Paswan and Mrs. Omna Nair. Nursing Administrators Mrs. Roy Nov 1978 - June 1979 Mrs. Shanta Nair June 1979 - April 1985 Mrs. Usha Ukande May 1985 - June 1995 Mrs. Ramola Rao (Officiating Matron) 1993 - 1995 Mrs. Ramola Rao June 1995 - till date School of Nursing/ College of nursing The hospital started progressing rapidly with the addition of new specialties and super specialties. As a result, the bed strength also had to be increased. The need 186 was felt to prepare a cadre of nurses, with a high standard, to serve patients with upfront technical skill and compassionate heart. The aim was to start B.Sc. Nursing course but due to some bureaucratic hurdles we had to be satisfied with obtaining permission to start a General Nursing and Midwifery (GNM Diploma) course of 3½ years duration, which was, started with 20 students in January 1982. Ms. Jyoti Samuel was the first Principal of the School of Nursing. This was hosted in the Choithram School premises for one year though later shifted to the top floor of nurse's hostel building. First batch of 20 students completed their training in 1985. Annamma Samuel topped in the State Council exams. Ever since, we have never looked back, our students always carried the tradition of topping in the state exams and proved they were the best nurses in the country. Four most outstanding students in this list are 1. Annamma Samuel 2. Jainamma Mathew 3. Mary Kutty George and Rachel Mathew. Till 1999, when last batch of GNM passed out we had trained 396 diploma nurses who, after working at our hospital for three-four years, have been working in many reputed hospitals in India and abroad. Feedback from them make us feel proud and fill our hearts with a great sense of satisfaction that Choithram has given, and is continuing giving the world, the best nurses. By 1989, Choithram Hospital had already attained the status of a super specialty tertiary care centre with 350 beds and recognized for DNB in number of specialties

and PhD in Microbiology and Biochemistry under Devi Ahilya Vishwavidyalaya, Indore. Working in a super specialty hospital, our nurses were exposed to the clinical experience that was equal to none less than degree and postgraduate level. So, the thought would come to mind time and again, why not have a B.Sc. nursing program instead of Diploma (GNM)? Dr. N.B. Idnani, Medical Director, a visionary, often talked about raising the standard of nursing education. He passed away in 1988. But his dream was turned into reality in 1996 when the school got upgraded to the Collegiate level with the B.Sc. Nursing degree program of four years duration affiliated to Devi Ahilya Vishwavidalaya Indore. The college has been running B.Sc. Nursing degree program since 1996; 166 students from five batches completed their training. B.Sc. graduates also carried the tradition of bagging top positions in the university exams. Ms. Ragi Susan George won the Dr. Vinayak Pundlic Gold medal for standing first in the University in 2001. B.Sc. nurses serve the institution as staff nurses for two years; thereafter; some of them join the college of nursing as Asstt. Lecturers at a lucrative salary. A number of B.Sc. graduates of our college are opting for the two-year Masters of Hospital administration (MHA) course run by Devi Ahilya Vishwavidyalaya. After 187 completion of this course they are directly absorbed as administrators in reputed corporate hospitals in the country. Choithram Hospital and Research Centre and College of Nursing have been made a study centre for B.Sc. nursing distance education program conducted by Bhoj Open University, Bhopal. For diploma in nursing administration, Indira Gandhi National Open University, New Delhi, has recognized this college as study center. The short-term specialization courses of six months duration for trained nurses in Paediatric and Critical Care Nursing is another milestone that the nursing department has attained. But, we did not stop at the B.Sc. nursing level. Our next step was to start post graduation in nursing. The process started in 1999 and after much struggle, in January 2005, the M.Sc. Nursing in five specialties (Medical Surgical Nursing, Psychiatric Nursing, Community Health, Obstetrics, Maternal and Child Health Nursing) started at Choithram College of Nursing. Today, the nursing fraternity all over India considers this college as the centre of excellence in the field of nursing education. The unique feature of our college is that we have brought to focus the virtues of ancient Indian culture that is “Yoga”, and the most modern information technology of today \"Computer Technology” in nursing. Self-devised courses in these disciplines have been added to all the different trainings run at this college.

Inspection for College of Nursing The students with Mr. Motiani, and H.H.Jhabua, The senior Staff ---2005 Richel Thomas1st 188 Mrs. S.Nair Mrs. U.Ukande Mrs. R.Rao Mrs. Reddy First Batch passing 1985 A.Samual (First)

Our college is the only college in the whole of India where these disciplines have been included in nursing education. Positive benefits of yoga on health and academic performance have been Scientifically proved through a number of studies conducted at our college and presented at national conferences. With starting of M.Sc. Nursing, a special research cell has been opened for promoting evidence-based practice in different areas of nursing education, administration, and practice and community health. This has placed our college among the top-most institutions of the country. All this would not have been possible without the encouragement and wholehearted support of our dynamic managing trustee Shri Satish Motiani. Conferences and Workshop 1998 - State level conference of Student Nurses Association of India. 2000 - Zonal workshop of Nursing Research Society of India. Theme “Nursing Research in New Millennium” 2001 - National Conference of Nursing Research Society of India Theme “Reduction of Maternal Mortality” 2004 - State Student Nurses Association, State Biennial Conference 189 Theme “Preparing tomorrows nursing leaders, changing the Paradigm” Principals of School/ College of Nursing Ms. Jyoti Samuel 1983 - 1985 Mrs. Tara William 1985 - 1987 Ms. Manorama Williams 1987 - 1991 Mr. P.L. Kaul Apr 15, 1992 Oct 14, 1992 Ms. Sarojini Nair 1993 - 1994 Mrs. Sheela Reddy (Officiating Principal) 1994 - 1995 Mrs. Usha Ukande June 6, 1995 to date Many hard working and dedicated nursing leaders, both in nursing service and education contributed in their own ways during the 25 years for bringing this department to the present status. They all are remembered here with a great sense of gratitude for their unique contribution. “Leadership is a potent combination of strategy and character. But if you must be without one, be without the strategy.”

In Fond Memories Some people come into our lives and quickly go. Some stay for a while and leave their footprints on our hearts. They may go far off. Do distances really separate loved ones? The distance may be a mile apart or a life apart, since we remember them, are not they with us? Absent in body, but present in spirit. Death is but one more to-morrow. Silas Weir Mitchell (1829-1914) New Testament We fondly remember..... Seth Shri Thakurdasji Pagarani, Seth Shri Lekhraj ji Pagarani, Dr. S.K.Mukherjee, Dr.BNB Rao, Mr. R.B.Lal, Dr. N.B. Idnani, Dr.P.J.Matwankar, Dr.W.P.Thatte, Dr.E.R.F .Rebello, Dr.G.S.Grewal, Dr.M.M.Ahuja, Dr.B.N.Jangalwala, Dr.G.S.Manudhane, Dr.G.P.Patidar, Dr.S.K.Sharma, Dr.Deepak Choudhary, Dr. S.M.Jain, Dr.R.R.Vijayvargia, Dr.R.P.Dhanda, Dr. M.V.Natu, ……… and many more who started their journey with us but left us in between, to continue on their own eternal voyage. They have passed into another world, but their fragrance will continue to linger on. They were the persons who were instrumental in shaping this institution, and making this world a better place. We salute them from the depth of our heart. 190 Let all my songs gather together their diverse strains into a single current and flow to a sea of silence in one salutation to thee. Ravindra Nath Tagore To console our souls we find solace in the words of wisdom from Lord Krishna - 'You grieve for those who should not be grieved for … Neither for the dead nor those not dead do the wise grieve. Never was there a time when I did not exist; nor you nor these lords of men. Neither will there be a time when we shall not exist; we all exist from now on. As the soul experiences in this body; childhood, youth, and old age, so also it acquires another body; the sage in this is not deluded………. Weapons do not cut this nor does fire burn this, and waters cannot wet this nor can wind dry it. Not pierced this, not burned this, not wetted nor dried, \"'Therefore knowing this you should not mourn. And if you think this is eternally born or eternally dying, even then, you mighty armed, you should not mourn this. Death is certain for the born, and birth is certain for the dead. Therefore you should not mourn over the inevitable. From Bhagwat Geeta Chapter 2 (11 -24)

Down Memory Lane “Line by line, moment by moment, special times are etched into our memories in permanent ink.” Inauguration annual day Dr.Joshi & Dr.Bhagwanani Dr.Dakwale & Bhagwanani 191 Dr.Dholkia & Dr.Sahni Dr.Kalevar & Prof.Chandi Plantation in Campus Capping ceremony Holi - 81 Dr.Rindani,Dr.Vijayan, Dr.Divgi Dr.Vijayan, Dr.Ladha, Dr.Bhagwanani Dr.S.L.Mangi New Year celebration

Chief Minister Arjun Singh 1988 Mr. Motiani with Dr.Kathpal New Directors Mr. Motiani at Anaesthesia Conf.1986 192 Dr.S.K.Mukherjee Dr. Amitabh Goel Mr. Motiani with Dr.Puranik & Dr.Kathpal New year celebrations New year celebrations

VISION 2020 (Col.(Dr.) Kamalakar Vaidya) (Dr. Ajay Jain) Director Medical Services Director Planning & Development Late Shri Thakurdasji Pagarani was a visionary. He realized the pain of common men when they had to rush to metropolitan cities even for common ailment. He conceived the idea of a general Hospital in 1974 in order to provide best medical facilities to the people of Indore. This dream became reality on July 16th 1979 and since then this hospital has progressed leaps & bounds not only in providing medical facilities to common men but also by setting the standard of medical care 193 in last 25 years. There are many achievements which were realized in this hospital for the first time in last quarter century and still many are only possible in this hospital. It will be difficult to name the list of achievements. To quote a few - the first CABG in1985, first THR in 1984, and the first Renal Transplant in 1985. We have completed successfully Twenty Five years so also the expectations of people has also grown by twenty five times. Rules of nature & progress dictate every institution to redefine the priorities. Twenty five years ago our mission was to provide medical facilities to the humanity but now as grown up institution our priorities are not only to provide medical facilities but we are duty bound to create new standards of ethical practice, impart the medical education to young medical graduates & paramedical staff, Nursing education and to create a platform for continuing medical education for the practicing medical fraternity. We also want to create a structure for prevention of various dreaded medical illness by launching preventive medicine by early detection and prompt treat. Choithram Hospital & Research Centre, Indore with its rich experience of past twenty five years has rededicated to grow as an institution par excellence in every field of medical sciences in next decade. We wish to create institutions of excellence like Institute of Renal Sciences, Institute of Cardiac Sciences, Neuro Sciences, and GI & Liver Sciences etc. etc. These institutes will not only provide treatment but will work for post graduate medical education and will create environment for research in various disciplines. Paramedical departments are

backbone of such high profile institutes. Management has decided to provide ultra modern dept. of Radio-diagnosis & imaging with eventually creations of division of Neuro-Radiology, Paed. Radiology etc. etc. we also plan to upgrade our clinical pathology & Histopathology to meet the challenges of new millennium. We wish to create a Centre of Organ Transplantation where people can get various transplants like Kidney, Liver, Pancreas, Heart and Bone Marrow etc. It is also planned to develop a well coordinated trauma centre. It is proposed to provide state of art Radiotherapy to Cancer patients of Central India in near future. This decade belongs to genetics & we aim to start Dept. of Human genetics as soon as possible which will not only diagnose various problems but will help in providing genetic counseling to prevent various diseases. There are many more such new developments which will start in this institute of excellence in near future. Our commitments for community have been witnessed by society in last twenty five years. We want to enhance it further by reaching to most poor section of society by arranging various health camps in remote areas and providing free health facilities to these people who even can not travel to Indore. We also plan to 194 upgrade our Dept. of Physiotherapy to Dept. of Rehabilitation and bringing the disabled masses to main stream especially paediatrics patients. There is a vision to develop Geriatric Medicine in this hospital in future decade. Similarly we have a project in future to establish a Paraplegia centre in the Hospital Campus. Last but not the least we understand that while patients are being treated in this hospital the family members, friends & relatives spent anxious moments watching them. Hospital Management has decided to provide various facilities to them also, so that they can look after their patients with more comfort and provide more support to the treating unit. As we are marching ahead in this millennium, Choithram Hospital & Research Centre will not only be tertiary referral centre for India but it will be an important destination for patients of many other countries as well as for the Doctors of the entire world. We would achieve this goal through medical tourism and various exchange programmes with leading institutions within and out side the country in near future.

The Mission Impossible By - Dr. Kamalakar Vaidya, Director Medical Services A Grateful Acknowledgment When, a DESIRE to have a recorded history of Choithram Hospital, (a journey of 25 years), it was looking like a “Mission Impossible”…. There were many obvious reasons. Hardly anyone who was a decision maker in the beginning of the hospital was either alive or alive yet still working for the hospital. We had to start from scratch, and then build up a story. A team of senior doctors took up the challenge. The senior staff of the hospital also supported them. Many senior colleagues were interviewed, many were contacted through Internet, They were requested to contribute articles, and photographs of various conferences and occasions. The material was collected and compiled. Contributions came from everywhere. People presently attached or not attached, medical and non-medical, all the persons who sometime or the other, in their life had an occasion to be a part of 195 Choithram philosophy, contributed willingly. Outline of a storybook started taking shape. It is really beyond our capacity to enumerate the names of all the contributors. We are especially grateful to the following persons, without whom it was really an “impossible mission”. Ms. Dhanvantari Pagarani, Mr. Murli Pagarani, Dr. R.C.Varma, Mr. Ashvini Varma, Dr. S.L.Mangi, Dr. K.L. Bandi and Dr. N.S.Bhagawanani who gave valuable information. Our own senior colleagues, Dr.Chamania & Mrs. Chamania, Dr.S.C. Jain & Mrs.Jain, and Dr. (Mrs) Chadha, need special mentioning. Dr. Ms. Kalevar, not only contributed departmental history but also did the first proof reading. Mrs. Ukande provided details of nursing as well as, a lucid account of journey from school of nursing to college of nursing. If you are reading this page, you know that the “Mission Impossible” has been accomplished. We gratefully acknowledge the collective efforts of all the contributors and I am really proud to present this book before you. “ They who untiringly make great efforts shall drive through obstacles induced by fate.”

Choithram Hospital, Indore

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