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Dr. K.V.L.N.Raju
Managing Director
 ALUMNI
REUNION
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~ A N U A R Y 1997
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Prof. C.S. Bhas ERSITY OF HEATH SCIENCES
M.D., F.R.C.PATH ANDHRA PRADESH
wada - 520 008 ;,-
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Dear D i Seskg@ri Rao ..$ .
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I am gl&i to learn that the Rangaraya Medical
~tudgnt'o.~ss&iationis cel~bratingits 5tbAlumni
5tb~Ianuary.11997and &out 500 Old Students Q&
i ~ ~ ~ ~ C o4 hm
I! l eall ~ the country and fiv ui
g over
WIK. are'~t@w#i]E)g the func;tion. i.tun Jso gladtb lea&that a
s4-tific
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sessidn'~spme of the.~edical ~robleqbsand on recent
adiaF~s ..... . is being organised during thg celebrdons. 1,.# .i
-.- -. 1 i

ate the Executive Committed for their zeal and

ise the '5th Alumni ~eqkionanwcientific

SUCc.(=SS.
 RANGARAYA ~!L~LI=AI,
COLLEGE

I Dear Dr. K.L.N. Raju

Thank you for inviting us to Reunion of RAMCOSA on

I January 5th 1997. On behalf of RAMCANA, I would like to
convey our Congratulations and best wishes for Grand success
of RAMCOSA Reunion

Yours Sincerely
Indira Mutyala
Vice-President
RAlMCANA
 DR. M.V. SANYASI RAO
Principal, Rangaraya Medical College, Kakinada

, ,
DR.V.V. RAMA RAO
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. Superintendent, Govt. General Hospital, Kakinada
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Ramcosa Executive Committee

 Dr. K.L.N. h j n Dr. P;S.N. Rerddp ( V E ~
President Vice President

Dr. Y.S. Karnalendranath Dr. G. Putla Rao Dr. AS? Krishmm R q j w

Member Building Committee Member Building C O ~ Conveaer, Building
I'
i Conunit&
 Dr. G. Seshagirirao Dr. K.L. Sampath Kumar
Secretary Joint Secretary

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 A Centre of Excellence

Opp : Church, R.R. Road, kakinada. Ph ; 62227

.: ,I' .ir:i Dr.KbSb

Raju
&-'Managing Partner
Dr.S.S.G.Prasad
Consultant Radiologist

Linear Bobe, Micro Convex Cardiac Probe

5 Mhz Probe for superficial Organs
Like breast, Thyroid, etc.
Endo Vaginal probe with Biopsy Attachments
Facilities for U.S. Guided
Interventional Procedures
 RAJENDRA PRASAU
SKIN HOSPITAL I
1 PLASTIC & COSMETIC SIJRGERY I BEAUTY & HEALTH CI,INIC I
( Excision of Scars (* Facial, Waxing, Pedicure
(* Skin Grafting
* Chemical peel (* Ozone Treatment
* Dermabrasion Hair Styling
(* Hair transplantation (* Permanent Perming
Tattooing
(*

(* Liposuction * Bridal make-up, Henna

(* Cryosurgery * Electm Cautery, Electrolysis
(* Rhinoplasty * W A Exposure
Otoplasty
(*

ReconstructiveSurgeryetc.,
* Ion Wophoresis etc.,
 .
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Dr. R.R.C. JOGn RIO. M.B.B.s.,D.c.H.

@!!am!
Dr. Smt. D. ,--=-, -JYA D€Vl M.B.B.s., D.G.O.
 M.D., F.A.C.S., F.R.C.S. (Canada)
Diplomate American Board of Thoracic & Cardio Vascu
 (H)6167?
(R) 61310

M.D. (Gen.) DM, (Neuro)

 Phones : Hospital : 75521
Residence : 63440

Dr. M. Venkatesh,
Dr. M. Sasikala, M.o.,oco.
I
M.B.B.S.,
 ; Dr. K.SIVIIJI
Dr. D. I S 0 6 A RAJU
Dr. D.V.V.I(ESAVA AAJU
DR. KARRI RAMA REDDY
M.B.B.S., M.D., (Psysch), M.A., (Pol. Sci),
M.B.A., M.A., (Litt), M S . (Psych),D.F.E., D.C.E., D.F.M.
 Ph : 431509,432949

HOSPITAL FOR CHILDREN

29- 19-77, DORNAKAL ROAD, SURYARAOPET
VIJAYAWmA - 520 002.

Dr. b.P.WRADHk, D.N.B. (Ped) D.C.H.

ONSULTANT PAEDLATRICLAN & NEONATOLOGIST.
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P- t, Parrctot
1. Ability grows in peace; charecter in the current of affairs. Goethe.
2. Contentment is a pearl of great price and who procures it at an expense of ten
thousand desires makes a wise and ha y purchase. Gohn Balguy.

life grives value,

l'f
3. Disci line of life is more precious than i e itself, for it is out of that discipline
Tiruvalluvar.
4. Every duty is holy; Devotion to duty is the hi hest form of worship to God. Swamy Vivekananda.

no meaning.
1
5. Freedom in the mere sense of independence as no content and therefore
Dr. S. Radhakrishnan.
6. Integrity without knowledge is weak and useless;
Knowledge without integrity is dangerous and dreadful. Samuel Johnson.
7 Life grants no boon to man without much toil. Horace.
8. Morality knows nothing of eographical boundaries and distinction of race.
P
9. Obedience alone gives rig t to command.
10. Purity is the feminine, truth is masculine of honour
Herbert spence.
Emerson.
I.C.& A. W. Hare.
1 1. Studies serve for delight, for ainament and for ability. Francis Becon.
12. Time : That man is always trying to kill, but which ends in killing him. Herbert Spacer.

I 13. Vision is the art of seeing things invisible

14. Wisest habit of all is the habit of care in the formation of good habits
15. Youth is a blunder,manhood a struggle, old age a regret.
Swih.
lynch.

I Dr. D. Ranga Raju, M.B.B.S.,

Contributed by :

I
THE HANDS THAT TETIIz(
Just as a sappling requires protection till
it develops into a tree and iust as a child needs
parental love till it grows into man, an
instituion also requrires protective gaurd and
loving care in its formative period. As one
associated with our institution right from the
beginning I feel it my duty to inform the present
generation o f staff and students the
personalities that contributed their mite to the
healthy growth of our Medical College in the
first twenty years ( 1 958-77).
The seed of Medical College was brought
here by Dr. M.V.Krishna Rao. He placed it in
the noble hands of Col. Dr.D.S.Raju. Together
they planted it in Kakinada in 1958 winning
the cooperation of the elite of this district. The
plant was timely fertilised by Sri Mullapudi
Harischandra Prasad and it was named as
Rangaraya Medical College. It was strongly
fenced by Dr.P.V.N.Raiu and host of dedicated
people.
In that era, political leaders were much
against the concept of Medical College in the
private sector. Dr. Suseela Nayyar, the then
Minister for Health in the Centre openly
expressed her anguish that collecthingdonation
for a seat was against the policy of Socialistic
pattern of Society. Dr.M.V.Krishna Rao a
veteran freedom fighter and Ex. Minister of
Education in composite Madras state struggled
a lot to convince leaders in the centre and the
state the need'of a private Medical College in
this part of our state. He succeeded in getting
permission to start the college in the present
main campus which was once the orphange,
a precious child of Brahamarshi Raghupathi
Venkata Ratnam Naidu. Col Dr. D.S.Raju was
the noblest among noble people. He was the
first President of our Governent Body. Srin
Mullapudi Harischandra Prasad is a great
industialist and i s endowed with a golden
touch. He donated manificiently to meet the
conditions laid by Medical council and state
Sri G.SANKARA BHANU M.sc.,
Head of the bparhnent of Chemisty (Retd.)
Government. Dr.P.V.N.Raju never
compromised with any external pressure.
Dignity of the college was the dearest to him.
Our first Principal was Dr.D.Narayana
Rao. Shy and reserved by nature, he was
dignified and humance ind out-look. He took
great care in developing our laboratories and
encouraged the staff very much in their work.
In the inaugural function of our college, though
it was his prefogative to inaugurate, he
invited me to give the first lecture on 17-9-
1958 before that eager gathering of students,
parents and invitees. Our next principal was
Dr.Basudev Narayana former Vice-Chancellor
of Patna University. He had wide contacts and
that helped our college to recruit staff from
West bengal and bihar when there was scarcity
of eligible candidates in our sate. Our College
acquired recognition at national level in his
tenure. Dr.G.Ramadas, who worked as Head
of the Department of Physiology, Assistant to
Principal and warden of our Hostel did a lot to
the development of physiology, Assistna to
principal and Warden of our Hostel did a lot
to the develoment of his department and
streamlined the administration of college and
Hostels. He had loud voice which kept all alert
in the campus. He was phenomenonly strict in
the coduct of examinations.
Dr.Vissa Ramachandra Rao came next
on deputation as principal and professor of
Anatomy. He was the illustrious son of an
illustrousfather, Sri Vissa Appa Rao an eminent
educationist. Dr. V.R. Rao soon won the heats
of staff and students, memnbers of Governing
Body and the elite of the town. His rich
experience as Vice-Principal in Guntur Medical
College stood in good steadin the development
of healthy traditions in our college. He energised
curricualr and extra curricular activities. In his
regime, all departmens developed and the
college was wellestablished.
Then came Dr.B.Shanmukheswara Rao
3
as Principal. By that time, he was alreaedy a voice to cut ItJhort by Rs. 200/- Faith fully I
renowned Surgeon. Very calm and cool by tried and struggled bui could not do so. b n the
temperament he was a man of few words but day when we were ready to start he called me,
of quick and correct decisions. He knew how gave me more amount than Iasked and advised
to scissor away what was unnecessary and me to be liberal in spending for students.
cut the problem to its correct depthe and close Dr. M.Vallabha Rao, Dr. P.Narasimha
the operation of any file in the shortest time. Rao and Dr. S.Banerjee were very popular
Staff enioyed his administrative acumen. among staff and students. Students and staff
Dr.P .Rama chandra Rao was intimately of that era remember with love and gratitude
involved in the all-round development of our the services of eminent Professors. Like Dr.
college as Professor of Pathology, Vice C.Mallikharjuna Rao, Dr. T.Srinivasan,
Principal and later as Principal. His zeal for Dr.G.Ramakrishna Raju, Dr.K.G.K. Gupta, Dr.
work was unparalleled. He was a pragmatic N.V.S.Naidu, Dr. T.Durga Prasad,
person of determination and dedication Like Dr.P.S.N.Murthy, Dr. Pitchaiahand many more
Dr.V.R.Rao, Dr.P.R.Rao too encouraged extra- of that order.
curricular activities. Not only the, he himselg Preprofessional staff who were the first to
acted in leading roles in several dramas and receive students (Freshers) did their best in
play-lets along with us. those two decades to establish good traditions
Dr.DSundarasiva Rao was th a l of discipline, throughness in the concerned
for the longest perid . prior to that he was subject and healthy relation between staff and
associated with our college as professor of students. Every Principal or Vice Principal
pathology and Viceprincipal. Dry Sundarsiva maintained very cordial relation with
Rao is an eminent pathologist, growing stronger preprofessional staff who functioned as the
. with age. His lessons, particularly in the earlier backbone of the college in administration,
period, created history in our college. He was discipline, conduct of examinations and extra-
uncompromising bur very humane. An incident, . curricular activities, Amongst us Sri S.Jankirama
I quote to indicate his stern exterior and Satry is an accomplished speaker.
affectionate interior. I had to lead a team of Above all, what wonderful batch of
students to the youth festival hosted by A.M.C., students we had Individually a few mighy be
Visakhapatnam. I Prepared a budget and naughty but none were cowardly. All looked to
showed it to him. He asked me in a -steran the Alma Mater with love and regard.

The Maxi Dress is women's attempt to make man curious about what he already knows.
A Hammer sometimes misses its mark - A Bouquet Never.
Philosopher bertrand russel, asked if he was willing to die for his beliefs replied: "Of course not. After
all, I may be wrong. "
w
.Sign in a Newyork store : "Complaint Department on the 45th floor lift out of order, pleaseuse the
stairs. "
A boy asked his father, "Dad, how muchdoes it cost to get married ? I don't know, " replied his father.
''I am still paying".
Farmer us senator Fred harris quoted advice from a friend: " Son don't ever brag about poverty, and
don't be ashamed of it. Just get rid of it as fast as you can."
Classified ad in the statesman: " lady doctor wished to share doctor's chamber for practice. "
The Ultimate test of whether you possess a sense of humour is your reaction when some one tells you
don 't
It is strange but mathematically fact that when a 17 yearold boy borrows the family car, he can,
in one night, subtract five years from the life of the car and add them to the age of his father
mSerious Infections !

'ONT
A

CZPROWIN
 (Amlodopine 5 mg/lOmg)

nmiowr
-
(Amloopine 5 mg + Atenlo150 mg)

IlYTROl am 5
(Enalsrpril2.5 mg + Amlodopine 2.5 mg)

HYTROI am 7.5 -
(Enalapril2.5 mg + Adodopine 5 mg)

AZTEC Committed to Cardiology & Diabetology ,

 G ~ u c oSAFE
(Glibenclamide 2.5 mg15 mg)

5
GLUCORED - + 500
(Glibenclamide 5 mg + Metformin 500 mg)
and
Aztatin
(Lovastatin 10 mg / 20 rng)

AZ TEC Committed to Cardiology & Diabetology

I 21-1-412, Pydavari Street,
Sravani Hospital Opp. Street, Kakinada
 B.A, M.B.B.S., D.O,M.S,

M.B.B.S., D.O.M.S*, M,A.M,SI,

(Vienna)

(The Kakinada Eye infirmary)

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 (PURELY FICTIONAND FANTASY. DEDICATED
TO CLASS MATES OF 1966-WHEREVER YOU ARE
WISHING YOU THE VERY BEST)

* There is no Comparsion between that which is lost by not succeeding and that which is
1 lost by not trying.
* In A British survey. 621, 000 Women Claimed they were engaged or about to be
married,Unhappily for a quarter of them, the survey showed that 476.000 men felt
themselves to be in the same position.
* A Bore is Somebody who talks incessantly about himself when you want to talk about
yourself.
A group of buildings is a Complex. A Psychological fixation is likewise a complex, Thus
an Architect who insists on desiging nothing but industrial complexes can be said to haave
complex complex. Complex also means complicated. So If the Architect's Problem is
Complicated by their factors a s well, he has a Complex Complex Complex.
All if proves. we suppose, that the more complex our civilization becomes, the more
versatile each word mustbe.
* These instructions were left fo a parcel delivery-man: "I am not home, but the dog is.if
I you ring the bell for a few minutes, his barking will set off the next door dog as well. His
master is hard of hearing. but he will come the door. Please leave the parcelwith him.
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DR. K.V.S.PRASAD M.O. PII S Q O Q ~

~ ~ J . J P55.a..0.9.35,
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UG. P.H.C. d 3 g XrE?
SANKAVARAM
 l-rB= Dr. Suvarchala
2+ 4B Dr.D.SaiSatyanarayana
1 3 + 4 =
C+n=
Dr. Sree Rama Raju
Dr. Ratnakaram Seetharama Charyulu
 RAMCOSA
5 t h Alumni Reunion
5 t h January 1997.
PbapaMw,
; p$$ .--
, -
.-
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-
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8.00 AM onwards 1 Break fast

~e~isir6tion
10.00 AM INAUGURAL FUNCTION
INVOCATION - .. : :_ .
Welcome Address ?. . .
a:. . '

Dr. G.Seshagiri Rao, Secretary, Ramcosa

PresidentialAddress
Dr.K.L.N.Raju,President, Ramcosa
Lighting the lamp, handing over the Xerox machine to
-
the library, Address by the chief guest.
Dr.Metla Satyanarayana Rao
Hon'ble Minister for Co-operation, Govt of A.P.
Release of the Souvenir & address.
Dr. K.V.P.R.Viswanatha Raju Ganapavaram
-
,, -:..;,?$:5
.j$.b~,.;~$$ -
Ex.Member Rangaraya Medical education Society
Feliciation of Ex Governing body
Dr.K.L.N.Raju
Felicitation of Ret

Awarding the Rangaraya Medical College Silver

commemoration Medals to the best out standing
Rangarayan ?I.,.i.a9$p@,
.;.>&:,? . .- .. .
r,** -*
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>J.)*->.:~!.:.;::
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-
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Dr. M.V.Sanyasi Rao, M.D !
,
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I L

8
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.
.
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Principal Rangaraya Medical College, Kakinada

Felcitation of promoted Rangarayans by
;; '.'
Dr. V.V.Rama Rao M.D
Superintendent Govt.Gen Hospital kakiniada
Felicitationof Distinguished Rangarayans by
Dr.S.S. Benerjea M.D. ..
' -4
Former Principal & Prof. of pathology RMC
Felicitationof Third Batch Rangarayans
: Reply by the Felicities
u4
*:; .
:* Vote Of Thanks by
. .f:v
-.-T. _ Dr. k.L.Sampath Kumar, Joint Secrtary, Ramcosa
' '\

' : LUNCH courtery :Nagarjuna Agri Tech Md., Hyderabad

I Chairman : Dr.K.V.Rama Raju
1. New Conceptsinthe Managementof Lymphodema

2.
Dr. K.Vishnu Murthy M.S., D.N.B.
Plastic Surgeon, Kakinada
Interaction between H.I.V. & after S.T.D.
Dr. M. Ashok Babu
I

Prof of Venerology AMC Vizag,

-
3. Laproscopic double gall bladder Removal A rare case
Dr.G.Bhaskar Rao M.S.
Swathantra Hospitals Rajahmundry
I
4. 'Study of Salivary Arginase in Hepaticome and
Oral Cancer'
Dr. D.Madhavan M.D. Chittoor
5. -
Spectacles - Contact lenses lntra occcular Lense
by Dr.V.Samba Siva Rao M.S (opth) Vijayawada
: General body meeting

CULTURAL PROGRAMME
: President :
Dr.P.S.N.Reddy. Vice President Rarncosa, Vizag
Destinguished Guests
Dr. T.Durga Prasad
Former Prof & Head of the Department of orhtopaedics
RMC,Retd superntendent R.C.D,Hospital Vizag
Dr. Paruchuri Rajararn
Rangarayan , Guntur
Distribution of Prizes to the Contributors of articles in
the souvenir Dr. P.S.N.Reddy
Induction of oath to the New Executive
: Cultural Events
Prize Distibution to the Winners by
Sri S. Janaki Rarma Sasty
Former head of the Dept. of English, RMC
 CODE OF MEDICAL ETHICS
MEDICAL COUNCIL OF INDIA

{@
1. I solemnly pledge myself to consecrate my life make available to their patients and colleagues the
to the service of humanity2. Even under threat, lwill benefits of their professional attainments. The
not use my medical knowledge contrary, to the laws physician should practise methodsof healingfounded
of humanity. 3.1will maintain the utmost respect for on scientific basis and should not associate
human life form the time of conception. 4.1 will not professionalywithanyonewhoviolatesthis principle.
permit consideration of religion. nationality. race, The honoured ideals of the medical profession imply
party-politicsorsocialstanding to intervene between that the responsibilities of the physician extend not
my duty and my patient. 5. 1 will practise my only to individuals but also to societv.
with cdnscience and dignity. 6. ~ h b
health of my patient will be my first consideration.
3. Advertising :Solicitationof patients directly
or indirectly, by a physician, by groupsof physicians
7. 1 will respect the secrets which are confided in or by institutions or organisations is unethical. A
me. 8: 1 will give to my teachers the respect and
physician shall not make use of or aid or permit
gratitude which is their due, 9. I will maintain by all
others to make use of him (or his name) as subject of
means in my power, the honour and noble traditions .
any form or manner of advertiing or publicity
of medical profession 10. My collegues will be my
through lay channels either alone or in conjuction
brothers. I make these promises solemnly. freely
with others which shall be of such a character as to
- - uoon
and -r
mvI
honour.
invite attention to him or to his professional position,
CODE : GENERAL PRINCIPLES skill, qualification, achievements, attainments,
specialities, appointments, associations, affiliations
1. Character of the
object of the medical profe;sion ir to render slrvice or honours and/or of such character as would
ordinarily result in his self-advertisementnot
. ,shall he
to humanib; rewardof financial aain
I ' " isa subordinate
consideration.Who-so-ever choose this ~rofession. give to any person who-so-ever, whether tor
assumes the obligation to conduct himself in accord compensation or otherwise, any approval,
recommendation, endorsement, certificate report or
ance with its ideals. A phyisician should be an
upright man. istructed in the 'art of healing1'.He statement whith respect of any drug, medicine,
nosterm remedy, surgical or therapeutic article,
must keep himself pure in character and be diligent
in caring for the sick. He should be modest, sober, apparatus or appliance or any commercial product
or article with respect of any property, quality or use
patient, prompt to do his whole duty without anxiety;
thereof or any test, demonstrationor trial thereof, for
~ i o uwithout
s going so far as superstitionconducting
himself with propriety in his professionand in all the use in connection with his name, signature, or
photograph in any form or manner of advertising
actions of his life.
through lay channel nor shall he boast of cases,
2. The Physician's responsibility : The operations, cures or remedies or permit the
principle objective of the medical profession is to publication of report thereof through lay channels.
render service to humanity with full respect for the A medical practitoner is permitted a formal
dignity of man. Physicians should merit the announcement in press regarding the following :-
confidence of patients entrusted to their care,
rendering to each a full mesure of service and (I) On starting practice. (2)On change of type of
devotion. Physicians should try continuously to practice. (31On changingaddress. (41On temporary
im~rovemedical knowledae and skill and should absence from duy. (5)On resumption of practice.
(6) On suceeding to another practice.
4. Payment of professional services: The
ethical physician, engaged in the practice of
medicine limits the sources of his income received
from professional activities to services rendered to
the patient. Remunerations received for such services
should be in the form and amount specifically
announced to the patient at the time the service is
rendered. It is unethicl to enter intoa contract of "no
cure no payment".
5. Patent and copy rights :A pshysician
may patent surgical instruments, appliances and
medicine or copy right publications methods and
procedure. The use of such patents or copy right or
the receipt of remunerationfrom them which retards
or inhibits research or restrict the benefits deriable
therefrom are unethical.
6. Running an open shop (Dispensingof
drugs and appliances by physicians) A - ~h~sicia
physician should not run an open shop for sale of
medicine, for dispensing prescriptions prescribed
by doctors other than himself or for sale of medical
or surgical appliances. It is not unethical for a
physician to prescribe or supply drugs, remedies or
appliances so long as there is no exploitation of the
patient.
7. Rebates and commission :A physician
shall not give, solicit, or receive nor shall be offer
to give, solicit or receive, any gift, gratuity
commission or bonus in considerationof or in return
for the referring, recommending or procuring of
any patient for medical, surgical or other teatment.
A physician shall not directly or by any subterfuge
participate in or by a party to the act of division,
transference, assignment, sub-ordination, rebating
splitting or refunding of any fee for medical, surgical
or other treatment.
The provisions of this paragraph shall apply
with equal force to the referring. recommending or
procuring by a physician or any person, specimen
or material for diagnostic, or other study or work.
Nothing in this section, however, shall prohibit
payment of salaries by a qualified physician to
other duly quallified person rendering medical
care under his supervision.
8. Secret remedies : The prescriptions or
dispensing by a physician of secret medicine or
other secret remedial agents of which he does not
know the composition, or the manufacture or
promotion of their use in unethical.
9. Evasion of legal restrictions : The
physician will observe the laws of the country in
regulating the practice of medicine and will not
assist others to evade such laws. He should be ccl
operative in observance and enforcement of sanitary
laws and regulations in the interest of public health.
A physician should observe the provisions of the
State acts like Drugs Acts, Pharmacy Act, Poisonous
and Dangerous Drugs Act and such other Acts,
Rules, Regulations made by the Central Government/
State Governments or local Administrative Bodies
for protection and promotion of public health.
DUTIES OF PHYSICIANS TO THEIR PATIENTS
10. Obligations to the sick : Though a
is nnot and bound to treat each and every
one asking his services except in emergencies for
the sake of humanity and the noble traditions of the
profession, he should not only be ever ready to
respond to the calls of the sick and the iniured, but
should be mindful of the high character of his
mission and the responsibility he incurs is the
discharge of his professional duties. In his
ministrations, he should never forget that the health
and the lives of those entrusted to his care depend
on his skill and attention. A physician should eneavour
to add to the comfort of the sick by making visits at
the hour indicated to the patients.
11. Patience, delicacyandsecrecy: Patience
and delicacy should characterize the physician.
Confidences concerning individual or domestic life
entrusted by patients to a physician and defects in
the disposition or character of patients observed
during medical attendance should never be revealed
unless their revelation is required by the laws of the
State. Sometimes, however, a physician must
determine whether his duty to society required to
employ knowledge, obtained through confidences
to him as a physician, to protect a healthy person
against a communicable disease to which he is
about to be exposed. In such instance, the physician
should act as he would desire another to act toward
one of his own family in like circumstances.
12. P w i s : The physician should neither
 exaggerate nor minimize the gravity of patient's
condition. He would assure himself that the patient
his relatives or his responsible friends have such
knowledge of the patient's condition as will serve
the best interests of h e patient and the family.
13. The patient must not be neglected: A
physician is free to choose whom he will serve. He
should, however, respond to any request for his
assistance in an emergency orwhenever temperate
public opinion expects the service. One having
undertaken a case, the physician should not nenlect
" TO EACH OTHER :
the patient, nor should bewithdrawn from the case
without giving notice to the patient, his relatives or
his responsible friends sufficiently long in advance
of his withdrawal to allow them to secure another
medicalattendant. No provisionally Or fully
registered medical ~ractitionershall willfully commit
an act of negligence that may deprive his patient or
patients from necessary medical care.
OF THE PHYS'CIAN
To THE
PROFESSION AT LARGE
14. Upholding the honour of the
pfession :a physician is expected to uphold
the dignity and honour of his profession.
15. Mecnbership in medical profession :
For the advancement of his profession, a physician
should affiliate with medical societiesandcontribute
of his time, energyand mean~sothatthesesocieties
may represent the ideals of the profession.
16. Safeguarding t h ppofgsdon ~ : Every
~hysicianshould aid in safeguarding the profession
1 against admission to it of those who are deficient in
moral character or education. Physician should not
employ in connection with his professionalpractice
any attendant who is neither registered nor enlisted
under the Medical Acts in force and should not
permit such persons to attend, treat or perform
operations upon patients in respect of matters
regarding professional discretion or skill as it is
dangerous to publfc health. L.v , , - !
17. ~ x p a s u nof unehical conduit :
~ h ~ i c i should
an expose, without fear or favour,
incomp~entor corrupt, dishonest or unethical
conduct on the part of members of the profession.
Question of such conduct should be considered,
-
first bebre proper medical tribunals in executiw
sessions or by special or duly appointed committees
on ethical relations, provided such a course is
possible and provided, also that the law is not
hampered thereby. If doubt should arise as to the
legality of the physician's conduct, the situation
under investigatioi may be placed before officers of
the law, and the physician investigators may take
the necessary steps to enlist the interest of the proper
authority.
PROFESSIONAL SERVICES OF PHYSICIANS
8. Depsndanceof physicinson each
:~h~~~is no rule that a physician shouldnot charge
another physician br his but a physician
Shouldcheerfully andwithout recornpence give his
professional services to physiciansor his dependants
if they are in his vicinity.
19. Compensationfor expenses :A physician
should consider it as pleasure and privilege to
render gratutious service to all physicians and their
immediate family dependants. When a physician is
called from a distance to attend oc ad&; another
physician or his dependants reimbursement should
however be made for travelling and other incidental
expenses.
DUTIES OF PHYSICIAN IN CONSULTATION
20a Consu~+ation should be encoumged :
illness,especially in doubtfulor
ln case of serious
difficult conditions the physician should request
consultations.
21. Consultation for patients,
benefit : In
evev consultation,the benefitto the patient is of first
importance. All physicians interestedin the case
shouldbe candid with !he patient, a memberof his
familyor responsiblefriend.
22. PuncutalifY in consultation : Utmost
P U ~ C Cshould
~ ~ I be
~ ~observed
Y by J physician in
meeting for ~onsulfafion.
2 3 Conduct in consultation :In consultations,
no insincerity, rivalry or envy should be indulged in.
All due respect should be observed towards the
physician incharge of the case and no statement or
remark be made, which whould impair the
confidence reposed in him For this purpose no
discussion should be carried on in the presence of
the ~atientor his re~resentatives.
24. Statements to patient after
consultation
(a) All statements of the case to the patient or his
reresentativesshould take place in the presence of
all the physicians consulting, except as otherwise
agreed; the announcement of the opinion to the
patient or his relations or friends shall rest with the
medical attendant.
(b) Differences of opinion should not be divulged
unnecessarily but when there is an irreconcilable
difference of opinion the circumstances should be
frankly and impartilly explained to the patient or
his friends. ltwould be open to them to seek further
advice should they so disire.
25. Treatment after consultation : N o
decision should restrain the attending ~ h ~ s i c i a n upon an illness or injury, he should communicate to
from making such subsequent variations in the
treatment as any unexpected change may require,
but at the next consultations reasons for thevariations avoid remarks upon the diangosis or the treatment
should be stated. The same privilege, with its
obligations, belongs to the consultant when sent for
in an emergency during the absence of attending
physician. The attending physicians may prescribe
at any time for patient the consultant only in case of
emergency.
26. Consultant not to take charge of the
case : When a physician has been called as a
consultant, none but the rarest and most exceptional
circumstances would iustify that consultant taking
charge of the case. He must not do so merely on the
solicitation of the patient or friends.
27. Patient referred to specialists :When a
patient is referred to a specialist by the attending
physician a statement of the case should be given
to the specialistwho should communicate his opinion
in writing in a closed cover direct to the attending
physician.
DUTIES OF PHYSICIAN IN CASES OF
INTERFERENCE
28. Appointment of a substitute :Whenever
a physician requests another physician to attend his
patients during his temporary absence from his
practice professional courtesy requires the
acceptance of such appointment inconsistant with
his other duties. The physician acting under such an
appointment should give the utmost consideration
to the interestsandreputationoftheabsent physician.
All such patients should be restored to the care of the
latter upon his return.
29. Visiting another physician's case :A
physician called to visit a patient who has recently
been under the care of another physician in the
same illness, should not takechargeof, nor prescribed
for such patient except in a case of emergencywhen
he should communicate to the former explaining the
circumstnces under which the patient was seen and
treatment given, or when the physician has
relinquished his case, or when the patient has
notified such physician to discontinue his service.
When it becomes the duty of physician
occupying an official position to see and report
the physician in attendance so as to give him an
option of being present. The medical officer should
that has been adopted.
30. Engagement for an obstetric case: If a
physician agrees to attend a woman during her
confinment, he must do so. Inability to doi so on an
excuse of any other engagement is not tenable
except when he is already engaged on a similar or
other serious case. When a physician who has been
engaged to attend an obstetric case is absent and
another is sent for the delivery accomplished the
acting physician in entiled to his professional fees,
but should secure the patient's consent to resign on
the arrival of the-physician engaged.
DUTIES OF PHYSICIAN TO THE PUBLIC
31. Physicians as Citizens : Physicians, as
good citizens, possessed of special training, should
advise concerning the health of the community
wherein they dwell. They should bear their part in
enforcing the lawsofthecommunityand in sustaining
the institutionsthat advance theinterests of humanity.
They should co-operate especially with the proper
authorities in the administrationof sanitary laws and
regulations.
32. Public health :Physicians, especially those
engaged in public health work, should enlighten the
public concerning quarentine regulations and
measures for the prevention of epidemic and
communicable diseases. At all times the physician
should notify the constituted public health aurhotieis
of every case of communicables disease under his
care, in accordance with the laws, rules and
regulations of the health authorities. When an
epidemic prevails a physician must continue his
labours without regard to the risk to his own helth.
33. Pharmacists :Physicians should recognize
and promote the practiceof pharmacy as a rofession
and should recoqnise
., the co-operation of the
pharmacist in education of the concerning
the practice of ethical and scientific medicine.
DISCIPLINARY ACTION
1. The Medical Council of India desires to bring
to the notice of the registered medical practitioners
the following statement upon offences and form of
professional misconduct, which may be brought
before the appropriate medical Council for
disciplinary action in view of the authority conferred
upon the Medical Council of lndia and/or State
Medical Councils as provided under Indian Medical
Council Act, 1956, or State Medical Council Acts
as may be subsequently amended.
2. The appropriate medical Council may c&&b
::1
certain cases bound by law to give, or may from time
such punishment as deemed necessary or may
direct the removal altogether or for a specified
period from the Register the name of any registered
practitioner who has been convicted of any such
offence as implies in the opinion of the Medical
Council of India and/or State medical councils, a
defect or character or who after an enquiryat which
opportunity has been given to such registered
appropriate Medical Council to have been guilty of
serious professional misconduct. The appropriate
Medical Council may also direct that ony name so
removed shall be restored.
3. It must be clearly understood that the instances
of offences and of professional misconduct which
are given do not constitute and are not intended,to
c o n ~ t i t u t e c o m ~ l e t e l i s t o f t h e i n f a m o u s a c t ~ ~ h i ~ h UnderthePublicHealthAct~andfhedrder
may be punished by erasure from the Register, and
that by issuing this notice the Medical Council of
India and/orState Councils are in no way precluded
from considering and dealing with any form of
professional misconduct on the part of a registered
practitioner. Circumstances may and do arise from
time to time in relation to which there may occur
questions of professional misconduct which do not
come within any of these categories. Every care
should be taken that the code is not violated in letter
or spirit. In such instances as in all others, the
Medical Council of lndia and/or State Medical
Councils have to consider and decide upon the facts
brought before the medical Council of lndia and/or
State Medical Councils.
LIST :
*dultery or improperconduct or
association with a patient : Any medical
practitioner, who abuses; his professionb~position
by committing any adultery or improper conduct
with a patient or by maintaining an improper
association with a patient, is liable for disiplinay
action as provided under the Indian medical Council
Act, 1956, and/or State medical Council Actstand
may be subsequently amended.
2. Conviction by Court of Lawfor offences
involving moral turpitude.
pro~ssional repom and
other documents :Registered practitonersare in
be called upon or requested to give certificates,
notification, reportsandotherdocuments,ofkindred
character signed by them in their professional
capacity for subsequent use in the courts of iustice or
for administrative purposes etc. :
(i) Such documents include among other
ce,.+ificates, notifications, reports,
Under the acts relating to birth, death or
disposal of the dead. (6)Under the Ach relating to
[umcy and Mental ~efjciencyand the rules made
there under. (c)Under the VaccinationActs and the
regulations made thereunder. (d) Under the factory
Acts and the made thereunder.
under the ~d~~~~~~~ Acts.
(0
n~adeh e u n d e r (9) Under the W~rkmen's
Com~ensationAct.
(hl Under the ~~t~ and order relating to the
notification of infectious diseases. (i) Under the
Emp/oyeels State bsurance AC~. (iJIn connecjjon
benefit insuranceand friendly
(k) Under the Merchant Shipping ~ ~(11 t For.
(ii) Any registered practitionerwhoshaIIbe shown
to have signed or given under his name and
authorityand such certificate, notification, report or
documenf of a kindred character which is untrue,
misleading or improper whether relating to the
several matters above specified or otherwise, is
liable to have his name erased from the Register.
(iii) A registered medical practitionershall maintain
a Register of Medical certificates giving full details
of the certificates issued. When issuing a medical
certificate always enter the identification marks of
the patient and keep a copy of the certificate. Do not
omit to note down the signature or thumb-mark,
address and identification marks of the patient on
the medical certificates or reports.
4. Contravening the provision of the Drugs Act
and regulations made there under. 5. Selling
Schedule poison to the public under cover of his
(Note :The does nOiapplysoa~tore~hicf
the proper training and instruction of bonafide
students. legitimateemployeesofdocbrs, midwives,
dispensers, surgicalaftendants, or skilledmechanical
ondtechnicalassistants underpersonolsupervisions
8. A physician should not contribute to the lay
press articles and give interviews regarding diseases
and treatments which may have the effect of
advertising himself or soliciting practice; but it is
open to him to write to the lay Press under his Own
name on matters of public health hygienic living or
to deliver public lectures, give talks on the radio
broadcast, for the same Purpose and send
announcement of the same to the lay press.
10. lt is improperfora physician to use an unusually
large signboard and write on it anything other than
his name. qualififcations obtained from a University
or statutory body, titles and name of his speciality.
The name should be the contents of his prescription
paper. It is improper to affix a signboard on a
chemist's shop or in laces where he does not reside
or work.
1 1. Do not disclose the secrets of a patient that
have been learnt in the exercise of your profession.
those may be disclosed only in a Court of Law under
orders of the presiding judge.
,2. on religious grounds aloneto give
assistance in or conduct of sterility, birth control,
craniotomies on living children, and therapeutic
abortions when there is medical indication; unless
the medical practitoner feels himself/herself
and wife is needed.
14. If you are running home and if you
a nursing
employassistance to helf you, the ultimate
responsibility rests on you.
15. N o physician must exhibit publically the scale
of fees. But there is no objection to the same being
put in the physician's consulting or waiting room.
16. NO physician shall use touts or agents for
procuring patients.
17. D~ not claimto be specialist unless you have
put in a good few years of study and experience or
have a special qualification in that branch. Once
you say you are one, do not undertake work outside
your speciality even for your firends.
 HIGH FlEQUENCY VENTILllTION
RWD
ANA€STH€SIR FOR Cg--1T LUlRYNGOSCOW UlND )I- -- --- - - Q.
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By : d r S.V.Lakshminarayana, M.B.B.S,D.A.
. 1 ,.t -'
"
. ; .,
Dept.of Anaesthesiology,

L I :-,!?, ,
8
L

-
i
Govt. General Hospital,
KAKINADA.
Direct Laryngoscopy and Bronchoscopy pose a real challenge to both the surgeon and the
Anaesthetist,as they are commonly done in the extremes of age,i.e. Children (Foreign body,
Papilloma) and Old eople (Neoplasms of the Tracheobronchial tree). Also the procedure poses
P
certain technical dif iculties due to the anatomical variations seen in the above age groups due
to age and pathology, competition between the surgeon and the Anaesthetist for the same
anatomical area presence of secretion~~bleeding due to high vascularity and also the highly
sensitive nature of the area with h e presence of various reflexes.
So before proceeding to Know howthe procedures can be enabled to be carried out, a brief
note on the Nerve supply is in order. The anterior 2/3 rds of the Tongue is supplied by the
HYPOGLOSSAL Nerve. This area cn be easily bloacked by the topical application of 4%
Xtlocaine with a soaked cotton swab.
The posterior 1 /3 rd of the Tongue is supplied by the GLOSSOPHARYNGEAL Nerve with
Pharynx and Superior surface of EPIGLOTT1S.This nerve canbe easily blocked at the Posterior
Tonsillar pillars.
m'
The Superior laryngeal Nerve supplies tnelnter~oraspect of EPIGLOTTIS. Mucous membrane
of the lower part of Pharynx, Vallecula, Vestibule of Larynx, the Aryepiglottic fold and mucous
membrane of Posterior part of Rima glottidis. this Nerve can be blocked at the superior horn of
Hyoid bone.
Please note that the Superior Laryngeal nerve supplies motor fibres to Croicthyriod muscle
which acts as a tensor of the Vocal cords.The rest of the motor innervation is by Reccurent
Laryngeal Nerve which also supplies sensory supply to mucous membrane of Larynx belowvoval
cords, This area can be anaesthetisecl by the TRANSLARYNGEAL BLOCK.
Direct Laryngoscopyand Bronchoscopycan be done under Local of General Anaesthesia,The
selection of the Anaesthetic techniqueis dictated by the age of the patient, technical difficulties,
the prefernece of the scopist of Anaesthetist, indication for the procedure and the type of
instrument used.
First LOCAL ANALGESIA will be considered :
The techinque of Local analgesia for Direct Laryngoscopy is more or less similar to the one
used for Rigid Bronchosopy, except that we may not need analgesia of the area below the Vocal
cords which is achieved by Trans laryngeal block. Rigid Bronchoscopy which is the referred
technique for foreign body removal, though better done under General Anaesthesia, in
experienced hands it canbe comfortably doneunder Local analgesia, Previously analgesia of the
structures cencered was achieved by topical X~locaineover the tongue Xylocaine swabs in the
Pyriform fossae (to bolck Internal Laryngeal nerves)with the help of a Krause forceps and then
spraying of Xylocaine over the Pharynx, Cords, Larynx and Trachea as the scope is advanced,
But better operating conditions canbe achieved by blocking the Superior Laryngeal nerves and
Glossopharyngeal nerves on both sides plus the Translaryngeal block, which I will be describing
next:
A. SUPERIOR LARYNGEAL NERVE BLOCK :,
Patient Lies supine with neck extended. TheHYBID bone is displaced laterally towords the
side to be blocked, I

A 25G, 2.5 cm needle is inserted over the greater cornu of HYOlD towords the tip and
walked off over its caudal edge.
Then it is advanced by 2 to 3 mm,when you can feel it puncturing the Thyrohyoid membrane.
At this Level you should stop and aspirate NO AIR should come, as now the needle Lies Lateral
to Laryngeal mucos.Here 2 to3 ml of 2% Xylocaine is deposited and one more ml as the needle
i s withdrawn.
The procedure is repeated on the opposite side.
CAUTION : Since the airway reflexes may be ablated this block is better avoided in full
stomach cases.
B. GLOSSOPHARYNGEAL NERVE BLOCK :
Patient lies supine with extended Neck and Mouth opened widely. Macintosh Laryngoscope
with appropriate blade is introduced gently until the posterior tonsillar pillars (Palato pharyngeal
folds) are identified.
An angled 22G and 9 cm needle is taken and inserted at the midpoint of the pillar for half
a centimeter.
Aspiration should be NEGATIVE FOR BLOOD.
5 ml of 2% Xylocaine is iniected.
Same procedure is repeated on the opposite side.
CAUTION: The INTERNAL CAROTID ARTERY is nearby, so risk of it's injury and Hematoma
must be kept in mind.
Cotton swab soaked in X~locaineviscousin the mouth prior to the procedure aids
in asmoother technique of block.
C. TRANSLARYNGEAL RLOCK :
Patient is Supine with ekinded neck.
Cricothyroid membrane is identified and punctured in the midline with a 20G, 3 to 5 cm
Catheter over cannula.
Aspiration should be positive for AIR, Needle is removed and 3 to 4 ml of 4% Xylocaine is
quickly depos,ited, This results in a vigorous cough and aids in the spread of the solution with
in Trachea.
CAUTION : Surgical emphysema is aproblem with this technique.
These three blocks given together, can providegood conditions for doing Direct Laryngoscopy
and Bronchoscopy as they cause analgesia of the TONGUE, EPIGLOTTIS, PHARYNX, LARYNX
and most of TRACHEA, However the danger of aspiration must be kept in mind, ans as for any
localy lechmiwe food prernedication and meticulouattention to aseptic technique must be
observed.
The FIBREOPTIC BRONCHOSCOPE revolutionised Bronchoscopy as it can be comfortably
done under local Anaesthesia and also has bete t reach-upto subsegmental bronchi. The
technique of Local analgesia consists of first an aesthetising the nose with 4%Xylo caine soaked
 gauge thenspray 4% Xylocaine directly on the pharynx, this Larynx, Trachea and Bronchi,as the
instrument is advanced.During procedure Anticholinergics like Glycopyrrolate may be used to
control secretions and Oxygen given through nasal prongs or through a Patil-syracuse face mask
which has a diagphram through which the scope can be passed.
Next GENERAL ANAESTEESIA for Rigid Bronchoscopy will be dealt with. This area of
Anaesthesia is receiving constant attention for the Last four decades with the advent of iet
ventilation and High frequency ventilation and, has benefited much from the development in the
field of Bioengineering which enabled r development of sophisticated Monitors and
Ventilators.
In spite of all the technological advances, General anaesthesia to Rigid Bronchoscopy has
certain inherent problems which need thorough understanding and careful and sometimes
prompt handling, failing which there can be catastrophic consequences.

I Certain specific problernswhich are inherent to Bronchoscopy under General Anaesthisia are: 1
I 1 . Thereis competition between the Bronchoscopistand Anaesthetist for control of the airway. 1
2. Sometimes the procedure is done as an emergency. So the patient is unprepared and
inadequately investigated-? impaired C V S and R S.
3. Instrumentation of respiratory tract can cause - BRONCHOSPASAM LARYNGOSPSM -
CARDIAC DYSRHYTHMIAS.
4. Sensitivity to relaxants may be there due to the presence of Myesthenic (Eaton Lambert)
Syndrome. .
5. Excessive secretions if present can make the technique very difficult and pro
longed.
6. Ventilation which mighthave been already impaired, may further be impaired during or after
the procedure if a Lobar bronchus is obstructed by the Bronchoscopeof Haemorrhaeisp caused
by the procedure:
7. Excessive suctioning by the surgeon may lead to Hypoxia and also reduce F RC
8, Excessive use of Oxygen flush, to compensate for leaks around the scope
may dilute the Anaesthetic gases and lighten anaesthesia.
9. Hypercarbia which might occur with some techniques may cause arrhythimas.
10.Barotrauma may occur with some modes bf ventilation if there is no out let for the gases of
ir the scope enters a segment.
REALATIVE CONTRAINDICATIONS TO RIGID BRONCHOSCOPY :
1. Sever acute Hypoxia.
2. Respiratry obstruction.
3. Massive bro~chopleuralfistula.
4. Marked superior vena caval Obstruction.
AIMS OF GENERAL ANAESTHESIA : General anaesthesia must provide the following to
be effective.

II 1. It should provide unconsiousness-usually light planes are used.

2. Sufficient relaxation should be there.
3. Ablation of reflexes in the respiratory tract must be effective. I
4. Adequate gas exchange must be maintained.
5. Rapid recovery at the end of procedure is desirabel.
Before actually explaining the technihue of General ahaesthesia, I would like to emphasise
certain basic precautions which make it more safe and effective.
-Sedatives sholud be used with caution as they might depress the respiration and prolong
recovery.
-Antisialogogues should never be neglected as secretions are a real nuisance.
-Suction Should be used to the minimum possible extent.
-Use of a Cardioscope is always de~irableasarrh~thmisas
are a common occureance.
-If a scope i s passed through an Endotracheal tube is causes a PEEP effect and if the scope
is a tight fitlit may cause barotrauma if you are trying ot ventilate througth it.
General Anaesthesia for Rigid Bronchoscopy can be given by either Spontaneous or
controlled ventilation techniques.
A. GENERAL ANAESTHESIA BY SPONTANEOUS VENTILATION :
This is particularly usefulin children with respiratory obstruction with a rigid scope and also
for flexible Fibreoptic Bronchoscopy. Here deep inhallational anaesthesia with spontaneous
respirations i s given.
The technique involves inducing the patient first and then giving an inahallational anesthetic
(highly blood sutable and potent agent like Methox~fluraneis desirable) with Oxygen through
face mask. The patient is taken to the deepest level possibel with safety. At this stage the mask
is taken out and the patient is handed over to the scopist. The scope is passed and Larynx may
be spraye with 4% X~locaineas the instrument is ~assed.The procedure goes on as the patient
gradually lightens.
At the end of the procedure patient is oxygenated and recovered.
The same technique can be effectively used for Direct Laryngoscopy also.
B GENERAL ANAESTHESIA BY CONTROLLED VENTILATION :
In this method Direct 'Larynogoscopy can be carried out by in tubating the patient after
properinduction, wifh a small sized endotracheal tube and introducing the scope alongside the
tube. cuffaed Endotracheal tubes with small internal diameter but with extra length are.avoilable
presently, these can be passed nasally and the procedure carried out comfortably.
for RIGID BRONCHOSCOPY under general anaesthesia with controlled ventilation four
methods are described:
1 Apnoeic Oxygenation
2 VentilatingBronchoscope.
3 Venturi lniector Device.
4 High Frequency Ventilation-HFPPV & HFJV.
Of these, i will be touching Ventilating Bronchoscope andventuri lniector Device
superficially and will be dealing in depth about Apnoeic Oxygenation and High Frequency
Ventilation, in which along with HFPPV and HFJV I will be dealing in addition about high
Frequency Oscillation for the sake of completion, though it is still in experimental stage and not
relavent here.
I APNOEIC OXYGENTATION :
This technique is based on the observation that satisfactory oxygenation can be maintained
for a fairly long period of time by insufflating 6 Lt/mt of oxygen through a small catheter passed
alongside a bronchoscope into the Trachea of a paralysed apnoeic patient.Though there is no
alveolar ventilation, the patient is oxygenated by diffusion. The gas reahes the alveoli through
mass movement. BUT, the arterial CarbonDioxide tension (Pa C02) rises at the rate of 3 to 5 mm
Hg per minutes. So itis better to Limit the period of apnoea to 5 minutes.So this tehcnique is
unsuitable forprolonged procedures. The technique is as follows: :- -:v*/h -
dr-s&~L<Ypfp,m
+

. .A !el. LLl-

-First the lungs are denitrogenated with 100% Oxygen. >c &J,, I' +* d : $ ~
, +&',
0-

Anaesthesia is induced, say with Methohexitone 1.5 mg/kg. :L,+r.l\h*

-A short acting relaxant like Succinylcholine is given.
-Lungs are Hyperventilated to produce Hypocapnia.
-The Larynx is sprayed and a small gawze catheter is p to carina'and checked visually.
-Oxygen flow of 6 Litrs/minute is connected to the catheter
-Patient is handed over to the surgeon
-Awareness i s a problem with this method. It can be overcome with 1/4th the inducing dose of
Methohexitone given every two minutes or else Propofol induction and infusion can be used.
-If there is no contraindication, use of Opioids is advisable to ecrease the stress response to the
Rigid Bronchoscopy.
11 VENTllATlNG BRONCHOSCOPE :mSidAfil- +;.&$;
, j ;k.
.
3
f p ~ LM.i:t..:ib-

Here the patient is preoxygenated, induced dnd parblysed A

' -
-.. ,.c :.'. ,.;

~-.-
.i .

i the "sual way, but ventilated

. ., , .a , % .. -

through the Bronchoscope.The gases are administered through a sidearm of the scope, the
proximal lumen of which is occuluded with a sliding glass window. The surgeon periodically
removes the window for suction and Biopsy. During these periods the patient cannot be
ventilated and also too much suction may produce Hypoxia. &.;* :{d ! & :+r-l ~ f 7 > 2.; Y%--?IG.T
'. - 4 f;

Here the leaks are very much high, so flows upto 2 0 litres per minute may have to L;;,
- ..- .
employed. . g
Ti 4I. . . . , l ~ ~ .. . ~.K.. c ~..e ~ , , ~ ~ ; . ~ ~ , ~
FreqiJent use of oxygen fI&h to overcome 1eaks'dil"tes gases and lightens anaesthesia,so
instead high initial rateibf Fresh Gas flows areodmisable. he cords ma; also be sprayed with
4% ~ ~ l o c a i to
n eavoid post procedural Bronchospasm.
Ill VENTURI INJECTOR DEVISE :
This was first described by Sanders in
The oxygen from a high pressure source (45 to 60 psi) is injected intermittantly through a
narrow needle palced at the proximal end of a Bronchoscope. This creates a Venturi effect and
entrains atmosphericair, so the lungs are inflated by oxygen enriched airas lunguas the scope
is beyond larynx. a L.i;,
Here the system consists of high pressure oxygen source, low compliance tubing, on-off tap
and needle of suitable size.
A 14G needle if usedwith an Adult Negus Bronchoscope, produces a maximum inflation
pressure of 50cm of water
similarly 17G needle produces maximum inflation pressure of 25cm of water
I A 19G needle used with a child Negus Bronchoscope produces a maximum inflation I
I pressure of 18cm of water.
By this technique we can maintain Pa02 and keep PaC 02 within normal limits.
Intermittant I V anaesthetics wil Ibe needed to control awareness.
CAUTION : Barotrauma can occur if proximal end is obstructed and distal end is tight in Larynx.
IV HlGH FREQUENCY VENTILATION :
This was first described by Oberg and Siostrand in 1967 as a means of ~ r o v i d i positive
n~
presure ventilation free of circulatory effects. Luckenheimer and coworkers constructed the first
High frequency oscillatory ventilator in 1 972.
By definition is 'MECHANICAL VENTILATION USING HIGHER THAN NORMAL FREQUENCIES',
usually more than 1 Hz.
HereTidal volumes less than anatomical deadspace are delivered at friquencies of 60 to 100
breaths per minute (bpm) at a low airway pressure. The inspiratory times are short and I:E ratios
of gases could be de1ivered.h achieves good oxygenation and reasonable C 0 2 elimination.

I Reasons for introduction of HFV in to clinical practice :

- to minimise adverse effects of IPPV on CVS due to raised intrathoracic pressure.

I -

-
to make special procedures like Extracorporeal shock wave Lithotripsy and Bronchoscopy
technically easier.
to achieve better gas exchange where controlled mode of ventilation fails.
I
- to minimise pulmonary barotrauma associated with CMV.
There are two types of High Frequency Ventilation as used for Bronchoscopy. Thery are:
1 . High Frequency Positive Pressure Ventilation.
2. High Frequency Jet Ventilation
3. In addition High Frequency Oscillation will also be discussed here.
1. HlGH FREQUENCY POSITIVE PRESSURE VENTILATION :
Here.small tidal volumes are delivered through an insuflation catheter or Tracheal tube using
highIgas flows through a circuit which has minimum interndl compliance. The effective
respiratory rate is found to be 60 to 100 bpm and the I:E ratio 1 :3
This mode uses a high pressure flow generator coupled to a folw interruptor fluidic
mechanism or a motorised rotating interruptor.
2. HlGH FREQUENCY JET VENTILATION :
1 This was introuduced by Klain and Smith in 1977.
Here a pulse of gas is dilivered at a pressure of 5 to 50 psi from a ventilator which has a
I
rapidly responding valve mechanisoum (usually a Solenoid valve) that acts as a flow inter
uptor.This can be used to adiust respiratory frequency and Inspiratory time. The pulse of gas is
delivered into the lungs through a small cannula. Gas entrainment occurs around the iet and
contributes sig i f i c a n t l to
~ inspiratory folow.To avaidentrainment of exhabed gases a continuous
flow of warm and humidified air oxygen mixture i s provided. Exhaled gases exit from the patient
through the endotracheal airway around the jet cannula into the continuous folw circuitry..
Optimal gas exchange is obtained with rates of 60 to 150 bpm and 30 precent lnspiratory time
:,(I:E-1:3). This technique is ideal for both Laryngoscopy andBronchosocpy. PEEP can also be
 applied if needed. ,qc.;:. W 7.-
. 1 ,, (.'?:
,$;v! :..:. FIG NO. 1
.v

Both HFPPV and HFJV dependon passive recoil of lungs for expiration, This is inefficient at
very high rates as gases ten to get trapped, resulting in poor Carbon Dioxide elimination and
high mean intrathoracic pre
3 HIGH FREQUENCY 0
Here respiratory gases i
oscillated in a to and fro fashio
pump, thereby producing a si
of gas delivery. Consequently there is no net
delivery of inspired volume.
Rates of 1 8 0 to 3 0 0 0 b p
-
volumes of 2to 3ml/Kg.
HFO differs from HFPP
mechanism of expiration. In HFPPV and HFJV at

I high frequencies of ventilation expiratory time becomes insufficient to allow exhallation of the
inspiratory volume. In HFO there is an active withdrawl of inspired volume during expiratory
phase. Hue to these reasons in HFO
and no raise in intrathoracic pressures.
The following is a table comparing the 3 types of
Flow
HFPPV Sq
HFJV Sq
HFO Sine
bpm
wave 60
wave 100-200
,_;
$ ,_L
.:
..;-
-i+''
. .

wave 1 8 0 to 3 0 0 0
-
< ;-/
.-.a
..-d

FCZ:'.'
.+', Froese et. al. suggested that the post fix A or P be used to indicate wether expiration
.b.a

is Active or Passive. Eg: HFJV-P,HFO-A.

Similarly HFV is said to be HFVc, when lnspiratory gas flow is cameclive VT greater
than vD.on HFVnt when Vt is less than vd. CHFV: Combined high frequecny ventilation - this
imposes large tidal volume breths on a bcakground of HF. This is found to be successful.
Many combinationsof HFV and CMV exist.
Mechanism of gas exchange in HFV:
Unlike IPPV where bulk flow of gases occur to alveoli,in HFV, due to tidal volume being
less than dead space volume, some other mechanism must be there, Though there are many

in detail.
I-,
.-p
explanations which werelisted below the firest two arethe most popular and will be explained
' '"'
i#+&&
A. Process of augmented dispersion ?This involves a mixture of turbulent mixing,
convection and enhanced diffusion. This can be explainedas-in the larger proximal airways flow
i s turbulent, so causes some mixing. In The smaller distal airways velocity is low and flow laminar,
and the gas movement follows a parabolic pattern,that is gases at the centre move faster than
those near the wall. This creates a larger interface between fresh gases cnd the gas in the
airways, so more diffusion now takes place.
I Disco lung : In IPPV considerable regional differences in gas flow and hence in gas
:incentrations are common.ln contrast such regional -
mechanism is probably ;Regional PhasicUndulationsl, that is
difference are minirel i.n HFV.The I
different lung regions empty into and fill from each other (Inter
regional gas mixing or Super mixing) without altering the
spatial distribution of pulmonary bl9od
- flow.
C. Directa lveolar.vehtilation can occur with Tidal volumes
greater than 0.8.
FLOW
I
D. Taylordispersion -enhancement of molecular dispersion
by convective flow.
E. Pendelluft-dueto differences in regional time constants.
F. Convective streaming
G. Molecular diffusion
H. Cardiogenic mixing FLOW
I. . Assymetric velocity profiles 0111
Final conclusions:
Points in favour of High Frenquency Ventilation:
1. Because of enhanced inspired ga sdiffusion and interregional mixing, HFV may prove to
be better than IPPV in the presenceof diseased lung.
2. The requirement of lower mean intrathoracic pressure means better CVS satbility and
decreased chance of barotrauma.
3. In some pulmonary pathologies the increase in mean lntrathoracic pressure seen with high
rates of HFPPV and HFJV may act like PEEP and improve oxygenation.
Disadvantages of HFV:
1 . Inadequate humidification-leads to tracheal mucosal damage and thick 'caked' secretions.
2 . Massive barotrauma may occur due to high minute volumes being delivered to the lung,as
in the follwing situations :
- when there is total or partial occlusion of the exit pathway.
- when there is failure of cycling mechanism to terminate inspiratory flow.
- when there is wedging of catheter tip in a small airway.
3. lnadvertant PEEP-when ventilator uses passive mechanism for expiration at frequencies of
more than 1 50bpm.
4. Necrotising tracheobronchitis-probabkydue to injection injury, inadequate humidification
and excessive airway temperature.
5. Airway pressure amplification-animal studies have shown that during HFV pressure swings
xeasured at the airway opening maybe significantly smaller than the swings in alvelolar pressure
SO in humans too the alveolar pressure may be higher than anticipated.

6. Induced bronchospasm severe bronchospasm unresponsive to therapeutic measures has

occured in HFJV. So if it occurs it is dangerous to persist with HFJV.
 Dr. K. Vishnu Mu*
Plastic Surgeon, Kakinada

LYMPHOLOGY is an infant medical science following OMENTUM transposition has not been
neglected in India, for a long time. Filarial Lympho evaluated and reported so far.
dema is endemic in many parts of the World. The In my new Concepts of Lymphoedema
estimated number of cases in different parts of management; the immediate definitive procedure
world according to WHO 1994 are around 104 for the reduction of Limb size following OMENTUM
millions : out of this 48 millions cases are in India.transposition has shown very good results. The
Filarial Elephantiases is a Common Surgical swelling began to reduce fron the very first post
problem in coastal district of Andhra Pradesh. operative day and reaching a maximum in week.
Many surgical procedures that were designed for The gross reduction in sized is noted with
its correction are not entirely satisfactory. f i .t,g
5-OMENTUM, when Compared to N.V.Shunt.The
~ ~hefeasibilityof~ymphaticb
~ ~ skin wrinkled
~ and could be~ picked up like a~fold of ~
-Venus anas~omosis andOMENTUM transposition flap. These 100s Skin can be easily excised and
in by-passing the obstruction. The usefullness of primary sutured OR skin grahed in few places if
immediate reconstructive Surgery in filarial is no Lymphorrheafrom the wound
elephantiasis OR in primary Lymphodema cases #f'nd the healing is excellent.

-. .

Dr. V.Sambasiva Rao,

M.B.B.S.,D.O.M.S.M.N.A.M.S
Viiayawada

Cataract is the must common cause of preventableblindness in india.Previously spectacles

were used after cataract surgery. Later contact lenses have come and now I.O.L. (Intra-occular
Lenses.) Spectacle patients will have 33% magnification and restricted field of vision. Contact
lense patients will have 5.8% magnification and practical problem of daily inserting in the
morning and removing in the evening I.O.L. is superior and is in serted inside the eye
permanantly and will have near normal vision. This paper discusses the merits and demerits
of SPECTACLES Contact lenses and I.O.L. in general practitioners point of view and
advantages of I.O.L. over others.
This paper also high light the HITECH 0.P.Cataract Surgery in the point of General
Practitioner perspective how the guide their patients regarding latest cataract surgery and
I.O.L. etc.,
-
'7
; 9
Rajahmundry -
 1

.-:

. ..

.a

Dr. D. KAMESWARI, MB.B.s.,

i

Dr. D.V. RAMAKRISHNA, Ms.,

Surge~n

-
, I ,

'1
~posul&mt
.:
:~astroint&tinalEn&scopy
<
coqsultant :~aparoscopic.
Surgery
NARASIlUEA RAO NAIDU S
,- SURYARAOPET,
WAYAWADA - $20 002 7 3 43679B,435712
m .

W & k ~ ~

SRINIVASA NURSING HOME

M.D., M.lV4.M.S.. D.G.O., lNEWd-

C O N S U L T m OESlETRlCIAN S GYNAECOLCKU'ST
 Recep :67200

HOSPITAL FOR
& , :Police Out Post
75-6-13, Piakash ~ a ~ Opp
 -f- - -

PHONE : 432512

( Yalamanchi Hospitals & *:I'

.
1 Dr. Yalarnanchi Sadasiva Rao
3:

'

M.B.B.S. ED.(Mad) D.D.Yugoslavia '1

1 .
Beside Hotel Tri~uraInternational. Pithamram

DK
H
.?g * -
K.L. SAMPATH KUMAR, M.B.B.s.,
SUMMARY :a reportofthe firstwell ~ a l n n e d cholecystectomy, using four ~ o r t s . t h e
double gall bladder removal by laparoscopic diagnosisof double gall bladder was con-

reviewed. the incidence of the anomaly and
literature on management are discussed.
KEYWORDS :laparoscopic removal :double
gallbladder anomaly.
INTRODUCTION : laparoscopic
complete duplication of the system with two
cystic ducts opening he~eratelyinto the common
gepatic duct and two cystic afteries. The same
were disscted carefully the arteries and cystic
ducts were s e ~ e r a t e l y clippedand
divided-thetwo gallbladders were dissected

dure compared to open surgery, it is safer but epigastric port. patient had uneventful
technically more demanding the different postoperative period and was discharged after
anomalies of the biliary tract constitute about 24 hours. she is under followup for the last 3
10%of the necropsies Double gall bladder is months and is asymptomatic.
an extremely rare anomaly, very often missed
pathologically, the gall bladder showed
on preoperative if evaluation. ultras~nograph~
evidence of calculi with changes of chronic
and contrast studies can miss the deagnosis
cholecyst it is and mucocoele formation. the
due to intrahepatic position of one of the twins
. other moieiy which did not contain the calculi
or superimposition of the shadows.
but showed mucosal thickening. -
CLINICAL REPORT : a 16 year old lady
DISCUSSION :the frontiers of laparoscopic
presented with recurrent episodes of right
surgery are increasing by leaps and bound
upper abdominal pain of one yera duration.
with a little experience and ingenuity, the
clinical evaluation was unremarkable but for
scopeof laparoscopic surgery can be increased
tenderness right hypochondrium. laboratory
enormously.cholecystectomy by this route is
evaluation showed good general condition
now standardised and i s followed a s a routine
and absence of jaundice. ultrasonography
in several centres. congenital anomalies of the
confirmed gall bladder calculi and the gall-
biliary tract are not uncommon. however,
bladder was fond to be duplicated.
'double gall bladder is a raroiy. there are very
the patiet was taken up for laparoxopic few reports of the dbuble gall bladderremoval
by the laparoscopic rout double gall bladder
recognised following complication of
laparoscopic removal or cases where a second
operation i s needed were described
importance of preoperative cholangiography
i s stressed by some authors in suspected cases
of double gall bladder.
the available literature reveals that this is
the first case of planned removal of double gall
bladder in a completely duplicated biliary
tract. this case shows that it is technically
without much difficulty provided one is familiar
with gall bladder duplication and the surgical
considerations. intraperitoenal fibrous bands
and loculated gall bladder can sometimes
mimick a double gall bladder
an encounter with the double gall bladder
is a challenge for the laparoscopic surgeon.
meticulousdissection at the hepatocystic triangle
is called for in view of the anomalous vessels.this
case draws attention to the rarity of the anomaly
and its management.

nt of Biochemistry
and lab. medicine

Salivary gland is rich in arginase activity and its activity in saliva is 400 times more than
that of Serum. So far the Functional significance such high activity in saliva has not been
studied. (The results of my work on) Some biochmical aspects of Salivary Arginase and its
Level in Hepatic Coma and Oral Cancer are reported in this presentation. The increased not
to bacterial count, because in all patients activity of the salivary Arginase is same after
passing through bactierial filter there by showing the raise of Salivary Arginase activity is
absolute. One of the important biological roles of high Salivary Arginase activity may be
supplying ornithine which is utilized for polyamine synthesis and Amion acid proline and
lutamic acid.

INTRODUCTION :
In my Practice I have come across lot of with the problems of first night failure, prema-
patients complaining sexual problems. To help
them I became a member of ICSEP & IASECT
and equipped my self as a full pledged sex
councillor and started sex counsilling centre in
1990. Since then I have been carrying out this
study. This study includes-historytaking, physi-
cal examination, sex counsilling and therapy.
MATERIAL & METHOD :
So far I have seen about 1 200 pa-
tients. patients are the following groups- 1 .Par-
ents 2. Youth 3. Couples 4. Aged Group.
1. PARENTS :-Parents and grand parents
approach with the fears about their children
regarding small penis, no erection and penis is
not growing in size according to their ages.
Strangely parents requirc counsilling but not
children. I counsil and advise parents to read
my book sex Education which solve thier fears.
I warn parents not to express their fears be fore
children because maiorityof youth sexual p r o b
lems are due to poisinous seeds (negative
feeling of sex) implanted in the minds of chil-
dren by parents and society.
2. YOUTH : -(Students & Unmarried)- They
approach with, the following problems-a) Small
Penis b) Failure in their maiden attempt with a
prostitute (or) girl friend c) doubts about
masturbation and Homo sexual habits d)STD
and AIDS e) Nightejaculation and f) for pre-
marital I Counsilling. I counsill to clear their
doubts and advise them to read my sex educa-
tion book which will make them perfect "man"
for happy married life.
3. COUPLES :-
a) Newly married couplesand b) Middle
aged couples.
DR.YARRA NAGESWARA RAO.
GUNTUR
a) NEWLY MARRIED COUPLES : Come
ture e jaculation, painful sex for women, para-
phimosis, first night bleeding and etc. I prefer
to council both husband and wife to gether to
achieve better results. As you Know sex is two
way traffic not oneway. Hats off to the zeal
and inquisitiveness of modern women. She has
no hesitation to accompanying her hsuband to
my clinic. Common causes are sexual innosence
& ignorence and "fear of failure1' in sex for
males and pain in sex for females. Sex
counsilling and my sex education book solve
their problems.
b) Middle aaed Couples :- Common
problems for men are no sexual desire, no
ercetion, week erection, premature ejaculation
and no orgasm. For women no sexual desire,
dysperunia, vaginismus and no pleasure in
sex. common causes are no foreplay in sex by
partners, diabetis, hyper tention, anxiety and
tensions in day busy life.
I enlighten to couple the causes of their
sexual problems and teach them latest sexual
techniques and skills by showing films and
photos. Sexual problems seems to be more in
modern couples because modern husband is
after materialistic gain in the competitive world
where as the modern house wife is no more
passive in sex. This ultimately results in sexual
problems. I give them a magic-T-formula for
successful married life.'
A) TRUST- Trust each other without suspicions
B) TOUCH -Touching each other (not only in
bed room) while walking and sitting inT.V.
room etc., C) TALK- Free communication at all
levels without reservations and fears. D) TIME-
Spend atleast one hour a day in bedroom
caressing each other.
4. AGED GROUP : - The most common
problems among the aged people are "no
desire and no erection" for males and painful
sex for females. He an't walk without a stick,
but he wants his penis to erect as if he was in
his twenties. I counsil them to accept the facts
of old age yet without pouring cold water upon
their spirits and teach them a few techniques to
enjoy sex even without erect penis.
TREATMENT : - Only sex counselling
and sex education i s sufficient for 85% of the
patients. 10%of the patients require surgical,
medical and HORMONE treatment 5% of the
patients require psychiatrist's or urologyst's
help. Overall, after treatment majority of my
clients O.K.
CONCLUSION : The patients, with
sexual problems, we are seeing is only tip
of an "ICE BERG". Lot of people are suffering
silently without medical aid. Many people are
shy of coming even to their family doctors.
Doctor must be very careful and tactful in
Dr. UDAY SANWR (TIRUPATHI)
The Rangarayan Exemplary
history taking, so that he does not miss patients
with sexual disfunctions. In India; if a person
has a sexual problem there is no qualified sex
counsillor available except in few cities. But lot
of pseudo sex-specialists are present every
where. I.M.A. must paln to start applied sexual
medicine subiect in medical colleges and di-
ploma courses in sex-counselling and therapy.
So that qualified sex therapist can be available
even to common man. At the same time
I.M.A.must bring pressure on Government to
ban quakery and sex clinics. If sex education
starts at college level and good sexeducation
book are made available in market Liberally,
people con enloy "Happy Married Life".
MAN CAN FIGHT WORLD WARS,
CAN SWIM MIGHTY OCEANS, WIN ANY
THING IN THIS WORLD BUT HE CAN'T FACE
A SINGLE SEXUAL FAILUTRE IN HIS BED
ROOM THAT IS MALE'S EGO-CAUSE OF ALL
HIS SEXUAL PROBLEMS.
Dr. P. KOTESWARA RAO
The Rangarayan Unparalled
 I
M.B.B.S., D.O. F.C.C.P., F.I.A.M.S.,

1
DR. (SMT).O. SURYAKUMAlPI
M.B.B.S., D.G.O. g

OBSTETRICIAN & GYNAECOLOGIST

WIT^ BESTC O M ~ ~ ~ M
FROM
ENTS

CITY PHYSIO THERAPY AND ELECTRO THERAPY CENTRE

SpceCaCCty%'y?md@
BONES, JOINTS,POlIO, WEAVE DISEASES
69-5-13,GAIGOLUPADU CENTRE,KAKINADA - 533 005. Phone :75904

THE FIRST AND THE OLDEST PRIVATE

ORTHOPAEDIC HOSPITAL OF KAKINADA

'TOT& ORTHOPAEDIC CARE UNDER ONE ROOF'

Managing Director :
Mrs. FEROZfl BEGUM
 7-4-5, ~ e s h aSai Streel
Ramaraopet, kakinaaa - 533 004
Phones :76913 (H), 72200 (R)

Dr.D,V€NKATARAC
MODo,
(General Medicine)
r).NoBo (Cardiology)
Vijaya Nursing Home Building,
Jowahar Street, Salipeta,
HPHINRDP-533 001
I "PRECAUTION'SFOR HEALTH CARE 1
i
WORKERS IN THE AID'S RR *" 1
DR. M. ASHOK BABU, Professor & Head of the Department,
DR. M. GOPIKRISHNA, Assistant Professor
Department of S.T.D., K.G.H., Visakhapatnam.

In view of present pandemic of Hivin fection following are guidlines for the benefit of medical
b r e - r e s i j m e g v i h l m e forrureckut
~ ad msCpgrd&kersc - - ---- --

paramedical personnel i.e., physicians, surgeons, 1. GENERAL PRINCIPLES OF HYGIENE :

postgraduates, Interness, Nurses, Technicians and
a. Wash hands throughly with soap and water
other paramedical workers, and those who are
before and after handling the blood,
involved in medical emergencies and intensive
care situations exposing themselves to HIV Sero- bodyfluids, veginal fluids, even if the gloves
are worn.
positivecases. Medical and paramedical personnel
may come across patients without knowing their b. Cover, sores, cuts, or rashes on hands with
serolegical status regarding HIV. water proof plasters before wearing gloves.
So there is a risk for medical and paramedical Use Judiciously selected apparel to protect
workers who come in contact with contaminants of from HIV
HIV seropositives. So, it is essential to know how to
It depends upon the task the health worker
protect ourselves from the risk of exposure. The
performs.
Wearing of
Task Disposable/Surgical Gown Mask Protective
gloves eye wear
Measuring B.P. and Temperature No No No No
- - - - -- -- - - - -

Giving Injection - - - - - - - - -- --No- --

Yes - - No --
~

Hemostasis without spurting Yes No No No

Hemostasis with spurting Yes Yes Yes Yes
Blood drawing & Starting IV Line Yes No No No
Emergency child brith Yes Yes Yes Yes
Hadling contaminatedl Yes Yes No No
used instruments
Oral 1 Nasal suction Yes Yes Yes Yes
Endotracheal intubation 1 Oesophagial Yes Yes Yes Yes .
obturator use.
 The surgical gloves can be reused for 3-4
times after proper sterilization each time, then to be
discarded.
"BODY FLUIDS AND PROCEDURES FOR
WHICH DOUBLE GLOVES TO BE WORN"
When ever health care worker comes in
contact with blood, bodyfluids, tracheal intubation,
endoscopy, dental procedure, would irrigation
phlebotomy, puncuture of other cavities (plural,
periteneal), finger and heel punctures arterial
puncture, vascular cathetor placement, tracheostomy
suctioning, rinsing of used instruments, lumbar
puncture, amniocentesis.
"Body fluids not contaminated with blood
and procedures to which hand washing with soap
is recomrnonded :
Urine, stool, vomitus, tears, nasal secretions, oral
secretions, diaper changing.
Preventionofviral transmission in operating theatre:
PROTECTING YOUR SELF : It is by means of
proper use of barriers : to protect skin, eye, foot.
SKIN :Where contactwithblood orbody fluids
is anticipated proper barrier shouldbe
worn. Before entering operating
theatre, each person has to examine
his/her skin for cuts and abrassions
which can be covered by moisture
proof would dressing before scrubling.
Personnel withsignificant skin lesion
better not towork in operation theatre.
Between cases theatre personnel can
wash hands and arms using an efficient
cleansing agent.
EYE :Those who come close to operating
field a protective eye wear should be
worn. Street wear glasses provide some
protectionand are currently accepted.
It there is high pressure lavage or
aerosols a face shield is better. HIV
ma be present in aerosols due to
drilingr sawing bone.
GLOVES :Many centres are new recommendin
double gloving or triple gloving. Ris
of puncture can be avoid by wearing
P percutaneous inoculation or contact with an open
collagen gloves under latex gloves.
Gloves madeup of Vinyl or latex should
be worn.
GOWNS :A gown with water proof frent and
sleeves can be worn.
FOOT WEAR : Water proof shoecover which
completely cover feet reduces the risk
where spill of body fluids is there, for
large quantities of spillage more
rotective knee high rubber boots can
Ee worn.
PROPER HANDLING OF SHARP INSTRUMENTS :
Specific management includes :
a. Removing a needle from suiture before typing a
knot..
b. Correct passage of Sharp instruments.
c. Disposal of hypodermic needles without
recaping, if a needle must be recapped,one
handed recapping technique is used.
d. Use stopcocks for injecting medication or fluids
into IV Fluids.
PROTECTINGASSISTANTS :a. Correct assage
of sharp instruments : Communication eiween 1
team members is essential, when passing a sharp
instruments.
REMOVINGSURGICALGLOVES :Glove should
be removed immediately following the completion
of surgery and for dressing the wound fresh pair of
gloves to be used.
PROPER WASTE HANDUNG : Used linen,
placents and other tissues removed to be disposed
in leak proof baggage or containers and gloves
should beworn while performingthis work. Protective
eye wearmasks, and sometime water proof gowns
or aprons should be worn. Sharp instruments should
be disposed seperately.
WHAT TO DO IF EXPOSED
The C D C defines significant exposure as contact
with blood or body fluids of HIV Patient to which
universal precautions apply :
i.e. blood, semen,veginal secretions, tissue, C.S.F.,
synovial fluids, pleural fluid, peritonial fluid,
pericaridialfluids,saliva from dental patients, through
would, non intact skin or mucosa.
Despite the best precautions, whgn
exposure like above one occurs :
a. Wash the exposed area with water and cleansing
agent. Avoid irritants like alcohol or bleach.
b. Report the incident of possible exposure to HIV
to concerned hospital authorities. (C.D.C.
Recommendation)
HOW TO REPORT :
a. Date and time of exposure :
b. Job activity at the time of exposure,
c. Details of exposure, amount and type of fluid
exposed,
d. Details of washing, and
e. Details about counselling post exposure
management, follow up and out come.
EXPOSURE TO HIV :
Source individual should be informed of the incident
and an attempt made to secure informed consent
for serological testing for the evidence of H.I.V.
Appropriate pretest and ost test counselling should
K
be an integral part of t is serological testing for
both the source and exposed person.
If the source individual is HIV positive or AlDS
patient, schedule recommended for the healthworker
is :
a. Testing the worker as soon possible : for HIV
Status.
b. If the first test is negative repeat the test after 6
months after exposure;
c. During the follow up period the first 6-12 months
after exposure, exposed worker should practice
the following.
i . Refrain from organ, blood, or semen donation.
ii, practice abstinence or safe sex.
The exposed worker should also report and
seek medical evaluation for the acute illness
that occurs during the follow up period.
Patients with AlDS need not be isolated
unless they have other infections for which
isolation is indicated.
INACTIVATION OF HIV AND STERlLlSATlON
METHODS.
1 . Rr,utinely clean all instruments, decontaminate
used instruments by soaking in suitableChemical
disinfectants i.e.,
br soaking in sodium
Hypochlorite (1 0%) so ution for 30 minutes.
2. Clean the instruments in soap and water, during
which cuts and abrasions to be avoided.
3. Heat is best to kill HIV. For sterilisation keep
a
instruments and equipment in boilin water for
atleast 20 minutes with lid on. Artic es must be
submorged in the water through out the boiling.
HIGH LEVEL CHEMICAL DISINFECTANTS :
Linen, Clothing, instruments to be immersed in
suitable chemical disinfectant like 10% hypochlorite
solution for 30 minuts before washing in soap water
A. CHLORINE RELEASING COMPUNDS :
These to be prepared fresh before use, they can
corrode Nickle, chromium and other oxidisable
metals.
1. Sodium Hypochlorite :10% (Hypo, chlorwat,
chloradin, saaf.)
- Liquid concentrate available commercially;
dissolve one part of liquid concentrate with 4
parts of water.
- Bleaching powder : Dissolve 4 table spoons of
powdder in 2 litress. of water.
- Bleach tablets : available as Halazone tablets.
Dissolve one tablet in on litre of water
The above compunds recommended for
contaminated linen, clothing, stainles steel
instruments, table top spills.
B. CETRIMIDE:(SAVLON)Desired concentration
is 1 in 1000 can be prepared from concentrate.
Dilute 10 ml of concentrate in 990 ml. of water
Recommended for equipments, furniture.
C. IODINECOMPOUNDS: (Availableas prvidine
- Betadine effective strength is 1%)
Dilute one part with 125 parts of water.
Recommendedfor instrumentsequipments, and hand
wash, table spills.
D. HYDROGEN PEROXIDE :Effective strength is
6% can be prepared by adding on art of 10 V/V
B
stock solution to four parts of boile water.
E. ETHYL ALCOHOL :Effective strength is 70%
can be prepared by mixing 737 parts of alcohol
with 263 parts of water.
Recommended for instruements, equip
ment,handwash, table spills, rubber tubings.
 Committees for the 5th Alumni Re-Union
f 5th January 1997
Souvenir : Dr. V. Satyadev
Dr. Y. Diwakar
Dr. K.L. Sampath Kumar
Dr. Y.S. Kamalendranath
Dr. Ramakrishna Raju
Dr. D. Raghava Raju
Dr. Ch. Satyanarayana
Dr. B. Rama Mohan Rao
Dr. V. Ravi
Dr. Anand
Finance : Dr. V. Satya Dev
Dr. D. Viajaya Kumar
Dr. Viswanatha Kumar
Dr. D. Ashok Raju
Dr. K. Sivaji
Dr. B. Chandra Sekhar
Dr. I.V. Rao
Dr. A.V. Krishnam Raju
Dr. Nagesh Babu
Dr. G. Pulla Rao
Entertainment : Dr. U.Sudhir.
Dr. Y. Diwakar
Dr. K. Satyanarayana Murthy
Dr. T. Potha Raju
Dr. P. Janaki
Dr. T.V. Balakrish
Dr. Nagabhyru Appa Rao
Transport & Accommodation:
Dr. M.S. Rao
Dr. G. Subba Rao
Dr. N. Nagesh
Dr. M. Venkatesh
Dr. Y. Veeraprakash
Dr. C. Srinivas
Dr. G. Ravi Kumar
Dr. S. Chandra Reddy
Reception Committee : Dr. D.V. Rams Rae
Dr. M. Ramakrishnam Raju
Dr. M.V.V.Satyanarayana Murly
Dr. T.V. Naga dun
Dr. V.V. Krishnam Raju
Dr. P. Butchi Reddy
Dr. C.Rama Rao
Dr. P.Ammana Chowdary
Dr. U. Ramakrishna Rao
Dr. R. Seshavataram
Dr. S.V. Prasad
Dr. D. Dharma Rao
Registration '' *-&, Dt. Y. Suresh
Dr. D.V.S.S. ~rasadaRao
L
U.
Dr. S.V. Laxminarayana
Dr. Rajendra
Dr. V.Lalitha
Dr. N.Rohini.
Dr. N.Jhansi.
Dr. D. Ranga Rao
Dr. N. Bhavani Prasad
,atering : Dr. G. Tagore
Dr. Rao. Rangarao
Dr. B. Sridhar
Dr. G.S. Murthy
Dr. K.S. Raju
Dr. S. Veer Reddy
Dr. A.V. Reddy Naidu
Stage Decoration : Dr.P. Venkatarama Raju
Dr. M.S.P.L.N. Raju
Dr. Premsagar
Dr. N.S. Murthy
Scientif~ : Dr. V.V. Ramana Rao
Dr. M. Chaadramouleswara M d y
Dr. S. Raj Kumar
Dr. K Vishnu Murthy
Dr. D.V. Ramakrishna
Dr. D. Seshagiri Rao
Dr. P. Venkata Rao
Ladies Reception : Dr. D. Kameswari
Dr. M. Sasikala
Dr. T. Uma Devi.
Dr. P. Sudha
Dr. P. Sumathi Laxmi
Dr. J. Krishna Kumari
Dr. J. Sasikala
Dr. P. Rangamyakamma
Dr. R. Mahalaxmi
Stalls Incharge : Dr. D.V.S.S. Prasad Rao
Dr. K.L. Sampath Kumar
Dr. J. Venkateswara Rao
Dr. B. Appa Rao
Lottery : Dr. T.V. Balakrishm
Dr. D.Vijaya Kumar
Press : Dr. S.S.C.Chakra Rao
Dr. P. Nageswara Rao
Dr. G. Kesava Raju
Dr. S.V. Ramana
Dr. K.K.V. Krishna Rao
5 Dr. D.V.K. Mohan Rao
; 4
Dr. P.B.V. Chowdary
.
With Best Compliments From

a. 7
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Gen. Surgeon & Endoscopist

64. M.B.B.S., D.CH

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Sodium Lacwe 2.00% Diclofenac Diethylammonium 1.13% wlw +
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3 HOSPITALS
KAKINADA
Dr. KANTE DURGA,
M.B.B.S., D.G.O.
 Dr. T.V.BALAKRISHNA, M.S.(Gen. s~rg.1
Dr. T. VIJAYANTHI, M.B.B.s.,D.G.o.,

I1 TOWN RAILWAY STATION ROAD

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I
: MAKERS OF :]
 Riingaraya medical College Old Students' Association
(RAMCOSA)
Ex-Officio Advisers : Zonal Representatives :
Principal, R.M.C. Kakinada Dr. T. Gopala Krishna, Vizianagaram
Superintendent, G.G.H. Kakinada Dr. L. Karamchand, Gudiwada
President : Dr. K. Udaya Shankar, Tirupati
Dr. K.L.N. Ra-ju Dr. K. Krishna Swamy, Hyd
Vice-Presidents : Dr. P. Venkateswara Rao, Sec
Dr. P. Butchi Reddy Dr. P. Srinivasulu Reddy, Madras
Dr. P.S.N. Reddy, Vizag N.R.I. Representatives
Dr. N. Apparao, U.K.
Secretary : Dr. K.V. Ramarao, U.A.E.
Dr. G . Seshapiri Rao Dr. S.V.L. Fleming, West Indies
Joint-Secretaries : Dr. S. Suryanarayana Murthy, U.S.A.,
Dr. K.L. Sampath Kumar
Dr. S. Swami Naidu
Building Committee Convener :
Treasurer : Dr. A.V. Krishnam Raju
Dr. V . Satyadev
Past President :
Executive Members Head Quarters : Dr. P. Venkatarama Raju
Dr. P. Viswanadha Kumar
Dr. T.V. Balakrishna Past Secretary :
Dr. M. Sasikala Dr. S.S.C. Chakra Rao
Dr. U. Sudheer Past Treasurer :
Dr. K.S.N. Prasad Dr. D.V.S.S. Prasada Rao
Outside Head Quarters :
Legal Advisor :
Dr. P . Chandra Mouli, Mandapeta
V . Krishna Brahmam
Dr. B. Gangadhara Reddy, Guduru
Dr. P. s e t h i Babu, Hyd - Auditor
Dr. Y. Rajarao, Vijayawada B.V. Kameswara Rao

Convener: Dr.A.V.KrishnamRaju
Advisors : Principal, R.M.C., Kakinada
members : Dr. G. Pulla Rao Dr. Ch. Sornasundara Reddy, Ex MLA
Dr. M.S. Reddy Dr. M. Pedarattayya, MLA
Dr. V. Ravi Dr. K. Srinivas, E. MLC
Dr. Metla Satyanarayana Rao, Minister
Dr. Y .S. Kamalendranath Dr. I.S. Raju, Ex. MLA
Dr.(Mrs.)T.UmaDevi . Dr. K.V. Ramachandra Rao, Ex Member P.C.C.
Dr. K. Viswanadha Raiu, Member,Ex Governing Body, RMC
 RANGARAYA MEDICAL COLLEC 1
SILVER JUBILEE COMMEMORATION AWARD
RECIPIENTS

Dr. Metla Satyanarayana Rao

Hort 'ble Minister of Cooperation
Was born on 4-1-1941 in Koinaragiripatnam of Konaseema in East
Godavari. He joined Rangaraya Medical College in 1960 and took active
part in thestudents Association in his College days. he was one of the
leading Practioners of Amalapuram.
Inspired by the leader of the newly formed Telugu Desam Party he
enteredpolitics and was elected as M. L A . from Amalapuram constituency
in Jan 1983.
Due to his sincerity arzd dedicated work, he was given a berth in the
Hon 'ble N. Chandrababu Gaidu 's cabinet -first as Minister for health &
Family Welfare, later in the recent shuffle as Minister for co-operation.

Dr. K. K Krishna Kumari

Popularly known as "Krishnakka "started her literary career at the age of
".
ten with a playlet "Bhale pelli Her thirty years of literary life made her
receive many laurels awards and titles. To name a few" Or,+~p 8;Icqd
eo&~cloX, S a - 6;I-aC "Sahitya Vidya Siromenai Award" "Durgabai
Deshmukh A wardf' "Indira GandhiAward" "Mahatma GandhiNational
Award" "Smt Madireddy Sulochana award" "Woman of the year" and
"Glory of India International Awurd" She presented many a paper on
Medical and Literary topics at various national and international
conforences. She has written about 50 novels, playlets,cine stories and tele
serials.She runs regularfeatures in various magazines. She wasfelicitated
duringthe Silver Jubilee Celebration of our College in 1984. Presently she
is working as a civil Assistant Surgeon in Hyderabad.
Dr. K. KR R. Vishwanadha Raju
Who was the governing body member of Rangaraya Medical College
From 1959 to 1966 was born in theyear 1936. He took his B.Sc(hons)
degree in 1958 from Andhra University and persecuted his Medical
Studies in Raizgaraya Medical College. He has been a reputed
practctioner at Ganapavarainfor the last 23 years. He was a member,
prcsident Director of various academic bodies, colleges andcompanies.

Dr. RA.Jayakar :
A renowed Microbiologist and a good administrator was born in 1938
at Rajahmurzdry. He had his early education in Bhimanvaram. He
obtained his M. B. B.S degree in 1959. and D. C.H. in 1961form Ahdhra
Medical College Visakhapatnam. He Joined govt. service in 1962 and
worked at variousplaces. He obatined Masters Degree in Microbiology
in 1967. He is promoted as Professor arzdHead of the dept. of
Microbiology in 1975. From 1986 to 90 hte worked as Professor of
Labaratory Medicine at Arab Medical University in Libya. After
woriking in various Capacities in Vijayawada and Kakinada, he was
promoted as Principal and Additonal Director in 1994 and worked at
Kurnool till Feb 95. he worked as Principal of the institution till Dec 95
and then at Andhra Medical College till the day of his retirment in
Marcht96. he was a member of many academic bodies and was an
examinerfor several universities. It is gratifying to note that he had 25
research papers to his credit.

Sri R K. R. M. Sarma
Popularly kizown as N.C.C.Sarma garu in Rangaraya Medical College,
obtained his Master's Degree in applied P h y s w o r m Andhra University
with distinction in 1956. He started his career as Radio Supervisor in
state Broad Casting Department but resigned to take up teaching
profession. He joined as Assistant Lecturer in Rangaraya Medical
College in Julyt59. Later he became Lecturer, waspomoted as the head
of the depratment of physics in 1973 and worked in that capacity till
1984. As the pre professional Cours was been bolished and the college
taken over by the government he was transferred to the education
department andworked as the head of the department of physics at
Tadepalligudem and Rajahmundry. He was promoted as Principal
Degree college Baruva in 1990 and retired from service in Septt94.
Even now to satisfy his he is inner wige still continuing the art of
teaching.
 Dr. U.Ramakrishna Rao
Who retired as tutor in physiology in Nov'96 from Rangaray Medical
College was bron in 1938. He was a 3rd batch Rangarayan and
obtained M.B.B.S. Degree from this institution in 1967.
He started his career as Civil Assistant Surgeon in 1969 at
S.V.Medica1 CollegeTirupathi. He worked till 1979. He obtained his
Diploma in oborhino Lungageology in 1980from RMC and worked as
tutor in various department like pathology, Radiology, Biochemistry
etc., till the date of his retiremet.

Dr. (Mrs)M.Saraswathi
Wife of Dr.M.Ramakrishna Raju the founder President of Ramcosa
was associated with Rangaraya Medical Collegefor over 3 decades as
a teacher. She was born in 1938at Nidubrolu of West Godavari Distirct.
' ' She was a first Bactlt Rangarayan. She obtained her M.B.B.S Degree
1964 and joined the staff of Rangaraya Medical College in 1965 as

i' s
. ,

g
;
biochemistry tuor. (She took her M.D.Degree in bi@chemisttyin I980
from RMC. She was assistant Professor till 1986, Became professorof
Biochemistry in 1986 and worked in that capacity at G.V.Medica1
College and Guntur Medical College. In june'91 She was transferred
to this Institution and worked as Professor of Biochemistry till her
retirement in July'96

Whoretiredas professor of pathology in 1995 was born in 1937. He had

his early education at Madras. He obtained his M.B.B.S.Degree from
Kasturba CollegeManipal in 1962.A good Cricketpdayer,he represented
KarnatakaUniversity. He was a good sports man, played tennis,table
tennis and chess. He has writtert,directed and acted in many dramas
during his of 13 years in this institution. He joined the longtenure
A.P.Medica1 and Health Services and served in this institution in
various capaeitiestill 1967. He obtained his Master's Degree in Pathology
from Andhra Medical College in 1972. He workedas Assistant Professor
of Pathology at Tirupathi and kakinada. In 1977 he was promoted as
professor ofpathology and workedfor 9years in this institution. From
1986 to 1990 he worked as professor of pathology at Vizag and
Tirupathi. In 1994 was transferred to this institution and retired from
this i~zstitutioiz.
 Dr. R Jagga Rao
who retired h f e s s o r of Anasthesis form Rangaraya Medical College
obtained his MBBS degree in 1961from Andhra Medical CeEEege. B e
joined the A. P. medical& health Services in 1962 and workedat various
places. He obtained his Diploma and M.D. Degree In anastheswlogy in
1978 & 79 from Andhra Medical College. he worked as Assistaat
Professor and professor in the some institution. he was transfered k,
Rangaraya medical College in 1993 and worked in this institution till
his retirement in 1995.

.&RlIhPr(7r?@
7
efi
Y k#/
C Z;/
& 9i-B-
Dr. S. Kotewsara-Artld' "

-'
' A\*
was born on lstNov'39atgollaprolu. He wassecond batch Rangarayan.
he was the Drametic secretary during the college days. He wcas B e
secretary, president in various assocations and orgaakations. We
I

joined theAP medical& Health Servicesand workedin wriotas v q d s

IA'f
at severalpracli &dB;kt)bWtthr&v'ftsh1'g8~ZP m..
Pbesently he is tke
District Medical & health Of&er for East Godavari District.

Dr. A. VKrishnarn Raju

Was born on 14th June, 1951. he took his M.B.B.S Degree in 1972
having studied in RMC. he joined the AP Medical a m H e t h Service
in 1976. He obtained D.C.P.in 1978 and M.D. in I967 from
this institution. He worked in capacities in the department sf
7 pathology and now became professor of pathology.He was a good
I I sports man in his student career and now hi is playing a key role in the

1 I Ramcosa activities as building committee convenor.

Dr. B.Anasuya
Presently working as Regional Director of Medical and Health Services
at Rajahmundry. She was born in the year 1941. She joined the
Rangaray Medical College in 1959. Obtained her M.B.B.Degreein
1965. She joined the A.P.Mediea1 and health Services i n 1966
andwerkedas a woman assistant surgeon in variousplaces of Westand
East godavari Districts. She was promoted as deputy civil surgeon in
Oct 90 and Civil surgeon in NQV1995 as Zonal Malaria Offlicer.
Dr. R. KSeshavatharam
Wasborn in 1944. He was a 4th batch rangarayan and utter obtaininig
his M.B.B.S.Degree he joined the Staff of Rangararaya Medical
College and after obtaining his M.B.B.S Degree he joined the Stagof
Rangaray Medical College in 1970 as tutor in Anatomy. He obtained
his Master's Degree in Anatomy in 1979 from Rangaray Medical
College. He was Assistantprofessor ofAnatomyfrom 1979 to 1994 and 1
becameprofessor of Anatomy in 1994. It is a matter ofpleasure that his
son Dr.R.B. V.Sudha was also a student of this institution. 1

Dr.M.Prahakara Rao
Was associated with Rarrgaraya Medical College for two and half
decades. Born in 1942. he took his M.B.B.S.Degree from Kasturba
College Manipal in 1968. Hejoined this instituiton as tutor of Anatomy
in 1970. He obtained M.S.Degree in Anatomy in Aug'80 from this
institution and was Assistant professor of Anatomy from 1980 to 1995
He became professor in Feb'95, He is presently working as professor
and Head of the Department ofAnatomy at Siddartha Medical College,
Vijayawada.

Dr.G. KSubba Rao

Born at Kakinada on 5-7-1949, he obtained his M.B.B.S.Degree in
1972 having studied in Rangaraya Medical College. He took his
Diploma, In Clincal Pathology in 1977. He did his post graduation in
Microbiology in RMC in 1985. He Joined the staff of Rangaraya
Medical College as tutor in 1976. He worked as Asst. Professor of

u Microbiology till 1955 and ivaspromoted as professor of Microbiology

in Janf96 and now working at this instituiton. He had many papers to
hiscredit.

Dr. X Venkateswara Rao

(Professor of Orthopaedicsin Ranagaraya Medical College Kakinada)
was born on 1-5-1950 at Kandikuppa. He took his M.B.B.S Degree in
1975 form this institution. He obtained his Master's Degree in
Orthpeadics from Andhra Medical College in 1979. He Joined
A. P.Medica1 and Health Services and worked as CivilAssistant Surgem
at king GeorgeHospital Visakhapatnamfiom79to 95andgotpromotion
in Dec'95.
I
Was born at Repalle of Guntur District in 1952. He took his
M.B.B.S.Degree in 1974. For a short while he worked at Godavari
Khani, Singareni Colliries.Hejoined the APMedical & Health Service
in 1978. he obtained diploma and Master's Degree in Venereology
from Andhra Medical College in 198511986 respectively. He
Underwent W.H.O.Fellow Training in AIDS. He was assistant
professor till 1995 and became professor of Venereology in Andhra
Medical College Visakhapatnam.

Dr. RRambabu :
Professor of S.T.D. in Siddhartha Medical College Vijayawada was
born orz 16-6-1955. He obtainedhb M.B.B.S.degree in 1978. He didhis
postgraduation in Venereology froin Osmania Medical College in
1984. Starting his career asassistant professor at Siddhatha Medical
College, Vijayawada and got promoted in 1990 as a Civil Surgeon
speciulist.

Dr. ;I:C.Varghese
A good paediatrian Dr. Varghese was born in 1939. His father Sti
Chacko was a famous botainst and former Principal of P.R.Govt.
College, Kakinada. Dr. Vargese had his early Schooling at Kakinadd.
he obtained his M.B.B.S.Degree in1964 and D.CH in 1969 from
Andhra Medical College. He joined the stag of Rangaraya Medical
Collegeas tutor in Pharmacology in 1970. He obtained Masters Degree
in Paediutricsform Rangaraya Medical College in 1980. He rejoined
the S t a f f f this institution and worked in Pharmacology andphysiology
Departments. He became Assistantprofessor of Paediatricsin 1984 and
was promoted as professor of Paediatric in Jan'96. He presented many
papers in various conferences.He isa goodsportsman and he represented
Andhra Medicaly College at the Inter Collegiate Cricker meet and
bagged many prizes.

Dr. S. Venkata Prasad

Was born in the year 1944. He was a 3rd batch Rangarayan and
obtained his M.B.B.S.degree in 1966. He did his post graduation in
general Medicine from Andhra Medical College in 1970. He started his
career as an Assistant Surgeon in 1967. he worked as Assistant
Professor of Medicine in this institution form 72 to 81 and later in the
deartment of cardiologyfrom 82 to 95. He was promoted as professor
of Medicinein 1995 and is working in this institution.
. .
Dr.Madabhushi Chandra Mohan
Born in 1946. Obtained his M.B.B.s Degree from Rangaraya Medical
College in 1974. Took his M.S.Degree Form Guntur Medical College
in 1986. Presently working as professor and Head of the Department
of Anatomy as Shri B.M. Patil Medical College, Bijapur

Dr. D.Sankar Mahadev

Obtained his M.B.B.S Degree in 1980 from the insti4ute.Starting he
career as Assistant Surgeon in the state Government, he worked as
assistantproffessor of Rediotherepy at Hyderebad and Guntur. He was
prometed asproffessor of Nuclear Medicine on'96presently working at
M.N.J. institute of orzcology at Hyderabad.

Dr. A.S.Rama Rao

Was borm in 1939 at punadipdu of Krishna District. He took his
M. B. B.S.Degree in 1971 having studied in R.M. C.After taking up
private practice for 13 tears at Vijayawad,He joined the Staff of
Siddharatha MedicalCollegeVijayawadu in 1986. He provided free
Medical add to thousands of people as a Practetioner.
As a programme coordinator of N.S.S.andas a Satya sai Volunteer
he rendered YeomanServices to the suffering humanity. He was the
receipient of prestigious Dr. B.C.Roy Award in 1994.
Dr. KM. Sukumar
is presently working as professor of Anaesthesiology in Rangaraya
medical College. He was born in theyear 1947. He obhined his MBBS
degree in 1969 having studied in this Institution. He workedfor a short
while as Senior Resident at B.H. U.Varanasi,later he served as medical
of@er at Akiveedu Mksion Hospital. He joined the A..P. Medicine
health service in 1975. He 0btainedD.A. 1977and M.D. Anasthesiology
in 1979from Andhra Medical College Vizag, he worked as Assistant
Professor of anaesthesia at O.M.C. Hyderabad and A.M. C. Viwg and
was promoted as professor ofanaesthesia in 1995.

Dr. Nalluri Raghava Rao

A busy Private Practitioner at Ongole Graduated in Rangaraya
Medical College and obtained his MBBS degree in 1974. Besides
carrying on lucrative pratice, he has been evencing keen interest in
social service. He was the founder director of "Adarsha" Education
Institutes and many more educational centres and health AssocMtions.
He received many awards and citationsfor his yeoman services. It is
gratifjtingthat he was the recepient of National Citizensaward in 1996.

Dr. D. V.K. Mohan Rao

was born on 2-10-1942 at Veeravallipalem. He took his M.B.B.S.,
Degree having-studied in Rangaraya Medical College. He joined the
s w f of Rangaraya medical College in 1976. We obtained M.D., in
Phermacology 1984fiomR.M.C. He was assistantprofessorfrom 1984
to 1996 andbecome professor of pharmacology in Jan, 1997.
 Rangaraya Medical College
Admission made during the year 1960-61
Ananda Kumar. J Murali .V
Anjaneyulu. P.S.R. Mukteswara Rao. Kingarnaneni
Appa Rao. Burugupalli" Mohan Ram. R
Appa Rao. D.V. Mohan Rao K.G
Anantha Subrahmanya Sarma. P.V. Mathews. K.C.
Arumugam. S.P. Nageswara Rao. Ankem
Baburaln Chandramou1i.G Narasimha Rao. Patalakham
Bala Sundaram P. Narasimha Iyengar Nallani Chakravarthula
Bhaskara Rao. S.U Nirmala Atuluri (W)
Bhavani Devi. V.(W) padmavathi. R (W)
Brahmanadam. Bommireddy Philip Jac0b.T
Bhujangeswara Sarma Davuluri Venkata Subrahmanyam. Pitchi Reddy. Devarapalli
Chandra Sekhara Reddy. Anam Prasad Babu. S.L.
Chalapathi Rao. K.V Prasada Rao. M.V.V
Cheria Koya. K Raja Rao. Vemulapalli
Chandra Mouleswara Reddy. Malladi Raja Rao. Gonnabathula
Chandra Moule. P Rajendra Lakshmi Prasad, Boyapati
Chinna Satyanarayanaraju. P Ramachandra Chowdary. Naburi
Dharrna Rao. Darapureddi Ramachandra Rao. Dukkipati.
Dinakara Rao. Damisetti Ramakrishna. Akella
Ganeswara Rao. Garapati Ramakrishna Rao. S
Ganapathi Rao. Ayyagari Ramakrishna Rao. G
George. E.V. Ramakrishna L.N.
Gopala krishna Murthy. Yerramilli Ramamohana Rao. Adusumilli
Jacob Das. P Rama Rao. J.S
Joy chacko Cheriam Sai Babu. P
Joythi Ramalinga Reddy. C Sambasiva Rao. K
Kameswara Rao. C.V.S. Sankara Ramana. M
Kodandaram. Amatum Santha Kumari Pappala (W)
Krishna Rao. M Sarma B.K.
Krishna Ra0.N Satyanarayana Rao M.v.
Krishna Reddy. Marrappareddi Satayanarayana Murthy, Bulusu
Kumaraswamy. Yellamilli Seshagiri Rao. T.V.
Lakshmi Krishna Prasad. Mova Setha Ramacharyulu. Rathankaram
Mallikarjuna Rao. Anne Sitha Ramireddy. Bhirnireddi
Madana Mohana Rao. ~ a l a v v a t h i Singaih G
Mohammad Insaf Siva Prabhakara Reddy. ~ o c h a
Merchiyya. D.J. Srinivasulua Reddy. Venumbaka
 Srivesasa. M.C.
Subba Ra0.G.V
Subbarao.Ch -
Subbara0.K.S.R.N.V.
Subbarao. Chinthaluri
Subba Rao J.V.
Subrahrnanyam Vedaraju
Sudarsana Chetty. Magham
Sunney George
Surendranath Benerjee. Adusumilli
Surya Narayana Murthy. Buddavarapu
Sulyanarayana Murthy. Palanki
Swami Naidu. Sunkara
Syama Sundara Rao. Pisipati
Syama Sundara Rao. Daggobati
Tiruvengaiachary. Tudumbi
Udaya Bhaskara Lakshmi Kantham. Vaitla (W)
Veerabhadra Rao. Medikonda
Venkatapathi Raju Mantena
Venkata Rarnakrishna Sastry. Davvuri
Venkata Ramaraju. K a m .
Venkata Subba Rao. G
Venkata Ratnam, Vallurupalli
Venakta Ndgendranath Babu. Kommireddy
Venkata Sundarasiva Rao. Singaraju
VenkateswaraRao. Pinnamaneni
Vijaya Kumar. George
Vijayapal
Venkata Rao. K.V.
Narayana Rao. G.J.

Rangaraya Medical College

Pre Professional 1960-61
Abraham Varghees Hanu Munishi Md. Omer
Ahobala Rao, Katragadda Hema Prasada Rao. Yedla
Arnrnanna Choudary, Palacharla Hari Prasad. K
Butchi Venkatapathi Raju. B.S. . Jacob. K.C
Babu Rajendra Prasad. K Jagga Rao. K
Bapineedu. K (W) Kamala. Pakalapati
Bapireddy. K Karunakara Rao. B
4
Basivireddy . M Karunakara Rao. Y
Bhaskara Sastry. N Koteswara Rao. A
Bhaskara Rao. K Krishna Murthy Raju. M
Babi. PP (W) Kumari I. Umadevi
Bosubabu. M Lakshmana Rao. N
Chinna Babu . P Lakshrni Ranganadha Babu Prasad Choudary. K
Damodara Rao. M (W) Leela Kumari. R
Durga Raju. P Madhava Varma. G
Durga Das K.V. Madhusudhana Rao. K
Dwarakanadha Reddy. D Madhu. Ayula
George. M.J Md. Khaja Mai
Gopichand. Manney Mohan. S.
Murali. Chilakapaty Seetha Ram. P
Narasimha Raju. K.L Sitharama Raju. G
Nataraju. Yarlagadd Srihari Rao. G .
Padmanabha Rao. P Srinivasa Murthy. G
Panduranga Rao. S Srinivasa Rao. Gorrepati
Pedarattayya. M Stalin. Ch
Praknsa Rao. B.S.R.S. Subba Reddy P.V.
Prasada Rao B Subba Rao. Gatti
Purnachandra Rao Subrahmanyeswara Rao. Pendurty
Purna Prasad. S Subrahmanyam. M
Ranga Rao. R Suryanarayana Reddy. G
Ranga Rao. M (W) Surya Kumari. P
Raghunathan Nair. V Suryanarayana Raju. N
Raghuram. T.C. Uma Maheswara Rao. T
Rajendra Prasad. S Varahalu. Basava
Raja Gopala Raju. A Venkata Durga Rao. P
Rama Gopal. K Venkata Ramakrishna Rao. P
Ramachandra Raju. B Venkata Krishna Murthy. G
Ramakrishna Raju. R Venkata Krishna Sai. Ch
Rama Mohana Rao. N Venkata Prasad. Sistla
Ra~nanaBabu. K.V. Venkat Rao. Y
Ramakrishna Raju. K Venkata Ramaraju. P
Ramachandra Prasad. K Venkata Rao. S
Ratnakara Sastry. J.V. Venkata Satyanarayana. Chilukuri
( W ) Ratnakumari. Moturi Venkata Ram Rao. V
Sanjeeva Rao. V Venkata Ramana Rao. G
( W ) Sarada. K Venkata Rao. Chevakula
Satyanarayana Rao. Venkateswara Rao. G
Satyanarayana. N Venkayya. M
Satyanarayana. D ~enkateswk-aRao. K
Satyanarayana Raju Vinaya Kumari. M
Satyanarayana Raju. Vijaya Rama Raju. D
Satyanarayana. K Virupakasha Reddy. K.N.
Victor Ernrnannel. D
 RAMCOSA BUILDING FUND ACCOUNT 94-95
INCOME Rs. P. EXPENDITURE Rs. P.
By Donations from Rangarayans Towards Laying foundation stone
Interest on S.B. Alc. on 7-1-95 2,611-00
Bank Commission charges for the
out station cheques 40-00

2,651-00
Investment as Fixed Deposit 65,000-00
Balance in the Savings Bank Alc.
on 31-3-95 705-00

- 68,356-00
,s7
. Kakinada SECRETARY TREASURER AUDITOR
' Dt. RAMCOSA RAMCOSA
. :.i

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DETAILS OF FIXED DEPOSITS OF RAMCOSA AS ON 31-4-1 995
......q:,;I. J
!' Rs.
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Co-op. Town Bank Main Branch
,l - -
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'. . 'P (i) FDR. No. 9025 Maturity date 23-11-96 8 13.5%
e
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(ii) FD. Alc No. 10058/95, FDR No. 240948 Maturity date 12-4-96 8 11%
7
-+. :: -
(iii) Vijaya Sree UnitsVSU. 093753 No. 100095194 Maturity date 12-2-96 O 10%
. .<I
+

.-. C. Andhra Bank, Madhavanagar :

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8 . .
iv) FDR. No. 0235671 91 I708 Maturity date 23-11-96 O 13%
.... . - .
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-
v) FDR. No. 416370 901502 Maturity date 29-1-96 O 11%
&:' vi) FDR No. 046805 - 94/l80 Maturity date 5-8-95 O 10%

vii) FDR. No. 308311 - 941498 Maturity date 27-1-96 O 10%

. 4
3: ':,
C' ..!

_ _'I
I
viii) FDR. No. 308447 - 941611 Maturity date 13-5-95 8 8%
. , ix) FDR. No. 478738 - 95/83 Maturity date 5-8-95 8 9%
' -:(, '

8
. . ?
I
.,

Total 3,89,238/-

TREASURER
RAMCOSA
 RAMCOSA INCOME & EXPENDITURE STATEMENT FOR THE YEAR 1994-1995

INCOME RS. P. EXPENDITURE RS. P.

Bank Balance as on 1-4-94 : Towards Lunches and Breakfasts 1,78,580-00

Towards Dinner 68,800-00
a. Co. Op. Town Bank 4,646-03
Towards mementos 97,302-30
b. Vijaya Bank 9,303-83 Towards Printing 50,715-25
c. Andhra Bank 5,668-65 Towards rental Charges for the Shamiyanas, Utencils etc 20,000-00
Cash with Treaurer 400-00 Towards electrical decoration 13,000-00
Towards Photographs and Vedio 12,374-00
Towards Stationery 19,171-00
Life membership Subscription 20,018-51 Towards Stamps, Fax. Courier Services 6,496-00
By Advertisements & Exhibition Stalls 2,14,260.00 Towards Salaries 3,750-00
By donations ,,88,975-00 Towards Transport, Taxi, Petrol etc.
Mescellaneous expenditure (Sundry)
2,963-00
7,404-25
By delegate fee & Spouse delegate fee 19339050-00
Towards Shifting of Transformer 2,600-00
For Hotel accommodation and return Towards Shuttle court repair 3,280-00
Journey Reservations 6,700-00 Towards Artists 8,380-00
V.I.P. & Rangarayan Rly. Reservations 2,424-00
.Donation for distribution of books to Hotel and Guest house accommodations 7,708-00
Silver Medallions 7,000-00
the financially backward students 6,000-00
Stage decoration 1,409-00
Interest paid on the Bank Loan 1,123-00
Interest from the Principal towards the
Towards Orchestra 5,000-00
Silver Jubilee Commemoration Medel. 554-00
Local Rangarans Donation to Shuttle Court Repair 50040 5,23,979-80
Investment as Fixed Deposits 2,00,000-00
Balance in Savings Bank Accounts as on 31-3-95
Interests from the savings accounts a. Co-op. Town Bank 1,406-03
and fixed deposits 15,449-00 b. Vijaya Bank 1,18045
c. Andhra Bank 52,684-83 55,27160
Cash with Treasurer 1,855-20

TOTAL 7,81,106-50 TOTAL 7.81.106-50

Kakinada SECRETARY TREASURER
Dt. RAMCOSA RAMCOSA AUDITOR
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DETAILS OF FIXED DEPOSITS OF RAMCOSA AS ON 1-4-96
.-b >;.
I 1 . + - . 1 1 );i,c'": - ;
Quarterly interest
Principle
, payable to SB A/c
r .t k ,.
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41-: !
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A. THE CO-OPERATIVE TOWN BANK LTD., MAIN BRANCH

1. FDR NO. 9025 LF 10,000-00
Date of deposit 23-11-95
I
Date of Maturity 23-11-96 @ 13.5%

B. VIJAYA BANK G.G.H.EXT. COUNTER

2. FDR No. 074959 FD A/c. 10030196
Date of deposit 12-2-96
Date of Maturity 12-5-98 @ 13%
3. FDR No. 240948 FD AJc No. 10058195
Date of deposit 24-4-95
Date of maturity 24-4-96 @ 11%

C. ANDHRA BANK, MADHAVA NAGAR BRANCH

4. FD No. 0235671 FD Alc 91/708
Date of deposit 23-11-91
Date of maturity 23-11-96 @ 1341 4 #:p
5. FD No. 438813 FD A/c 951250 1,61,479-00
Date of deposit 30-8-95
Date of Maturity 5-8-97 @ 12%
6. FD No. 035258 FD Alc 951691
Date of Deposit 29-1-96
Date of Maturity 29-4-98 @ 13%
7. F.D. No. 035257 FD AJc 951690
Date of deposit 27-1-96
Date of Maturity 27-4-98 @ 13%
8. FD No. 488069 FD AJc 951592
Date of deposit 19-10-95
Date of Maturity 19-4-96 @ 10%
** 9. FDNo. 488070 FD A.c 951593
Date of deposit 19-10-95
Date of Maturity 19-4-96 @ 10%
(**The amount given by NRI Rangarayans
for the purchase of xerox Machine & Books US $5000)

Treasurer
RAMCOSA
 -

ISORIFAZIN-S
ISORIFA-450

*
rC '

rn MALAQUIN (TabslSyp.)
Siko (Chloroquin)
jg;:;*
#' QUINAPRIM (2.5 mg, 7.5mg., 15 mg. Tabs)
-it,: (Premaquin Phosphate)

* METASULFIN (Tabs)
(Sulphadorin + Pyrimetharnine)
i3:.+ 7.: rn
-% * RUBIQUIN (Tabslinj)
(Qunine Sulphate)

The Superior Formulations From D?CE i

 The executive cornmiflee of RAMCOSA extends their hearffvl thanks to the Sponsores for their
generous gesture.
Dr. K.V.L.N.Raju For hosting sumptous lunch
Managing Director
M/s Nagarjuna Agri Tech Ltd.,
Hyderabad
M / s Biological E. Limited For hosting selicious Dinner
Hyderabad
M/s Alembic Chemical Works For providing Tea & Snacks
Varodara
Sri Sarvaraya Sugars Ltd., For providing soft drinks & Dias Decoration
Vemagiri
Doctors Diagnostics For providing compliments to the delegates
Kakinada.
Mr. Repaka Satyanarayana For Providing Bisleri Mineral Water
Managing Partner, M / s Subhateja
Trading Co., Kakinada

W e also extend our thanks to the Pharmaceutical Companies for exhibiting their stalls
and making the show more colourful
1. M/s Uni Sankyo Limited, Hyderabad
2. M / s Cross Lands Research Laboratories Ltd., Bombay
3. M/s Sun Pharmaceuticals
4. M / s Blue Cross
5 . M/s Aristo Pharmaceuticals Ltd., Hyderabad.
6. M/s Biological E.Limited, H ~ d e r a b a d
7. M / s Core health care Ltd., ( Therapy Division) Ahmedbad.
A Special word of thanks to :
Dr.k.Ragini
We earnestly thank
Staff a n d Students of R.M.C., G.G.H
M / s Vinar Paper M a r t \

M/s Sudhita Book Centre

Sri. Y .V.N.Malleswara Rao & his Collegues
Satya Krishna Publishers for printing the souvenir
Our sincere thanks to
the Contributors of the articles
the advertisers
the donors
the well wishers ...
Thank you one and all
-Executive Committee
 I Y .

IN MEMORIUM
Dr.CHUNDZ MASTAN RAO
Dr-nurstan rao, Passed away quite suddenly on 7th Nov'95 at a very
young age of 47.
He was graduated from rangaray Medical College and then
obtained MasterlsDegreein General Medicinefrom Andhra Medical
College. He worked as Assistant Professor of Medicaine at Andhra
Medical College. He resigned the job in 1987 to set up Ph'vate
Practice.
He was founder president of Ramcosa north costal Adhra
Zone and donated Rs.l0,000 towards Ramcosa building fund d
took active part in raising building fund of over 1 luck rupees.
As aman, Dr. Mastan Rao wasfork right andfrank& the same
time those who came close to him greatly appreciated his sense of
loyalty, Fairness andsubtle humour.lt will not be easy toforgeta man
of such nature.

Sri N.Bangarraju - Retd. Prof of Physics

Dr. M.Vallabha Rao - Retd. Prof of SPM
Dr. Ch. Mastan Rao
President Ramcosa North Coastal Andhra Zone, Vizag
Dr. A.VenkataRama Reddy

I Wing commander of recepient of Silver jubilee commemoration Medical as a best out

standing old student of Rangaraya Medical College in 1988.
Dr. Eswara Chandra Vidya Sagar - Tenali
I
Dr.Vijaya kumar - kakinada
Dr.Anne ~iabhakar
Dr. Penchala Reddy
 -
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