OPD services :

Our Medical Gastroenterology OPD functions on all days to render services to patients referred from all over south Tamilnadu. On average we deliver services to 16,500 OPD  cases per year. We deliver outpatient care to variety of Gastrointestinal diseases like Peptic ulcer disease, Gastro-oesophageal Reflux Disease, Dyspepsia, Chronic diarrhoeal illnesses like Irritable Bowel Syndrome and Inflammatory Bowel Disease who directly attend our OP and also those patients referred from other departments for expert opinion. 

Viral hepatitis clinic: 

We have separate Viral Hepatitis Clinic for rendering service to Acute and Chronic viral hepatitis patients under the guidance of National Viral Hepatitis Control Programme. All investigations including viral load testing are available in our Government Rajaji Hospital. Antiviral drugs are being given and follow up of Chronic Hepatitis B and C patients is done with utmost care in our department. We also perform screening for relatives of the viral hepatitis patients to identify the infected persons and treating them also. On an average we get 4000 Viral hepatitis OP cases per year, out of which 150 patients are hepatitis B and 170 patients are hepatitis C. All these patients were given antiviral drugs last year and about 250 hepatitis B and 320 hepatitis C patients are currently on follow up.  

Liver clinic : 

In our Liver clinic we render services to all cirrhosis patients, Extrahepatic portal vein obstruction, Non-Alcoholic Fatty Liver Disease, Alcoholic Liver Disease and Hepato cellular carcinoma patients. Follow up drugs and admission care on need basis is rendered to needy patients. Our average Liver clinic census is around 6000 per year. 

Paediatric transplant clinic: 

Our Department, in association with Rela Institute, Chennai conducts Paediatric liver transplant clinic for the benefit of children with chronic liver diseases. Out of 30 paediatric patients who were worked up for transplant, 6 children underwent liver transplant, free of cost under CMCHIS successfully.

Diagnostic and therapeutic endoscopy services: 

Our department provides diagnostic endoscopic services to following conditions like 

GERD 

Peptic ulcer disease 

Esophageal and Gastric cancers 

Upper Gastrointestinal bleeding 

Oesophageal web/ stricture 

Corrosive poisoning cases 

Dyspepsia 

Chronic diarrheal diseases 

Inflammatory Bowel Disease

Irritable Bowel Syndrome

Colonic cancers

On average we are doing about 3500 diagnostic Upper gastrointestinal endoscopy and 500 colonoscopy per year. 

We also offer a variety of therapeutic upper gastrointestinal endoscopic services to poor people like oesophageal variceal banding, glue injection of fundal varices and endotherapy for ulcer bleeding which are essentially life saving procedures. 

ERCP:

Our Department renders therapeutic services to biliary diseases like Gall stone disease- Common bile duct stones, Post surgical strictures of biliary tree and pancreatic diseases like chronic pancreatitis and pancreatic ascites. On an average, we perform 250 ERCP procedures per year. We render life saving services to patients with cholangitis and pancreatic duct disruptions.

Endoscopic ultrasound (EUS): 

Being a novel addition to endoscopic service, our department caters EUS based services. We not only do diagnostic procedures like Diagnosing Common bile duct stones/ strictures, diagnosing pancreatic lesions like cystic lesions and malignancy but also Biopsy 

( Fine needle aspiration) from the lesions are being done. EUS guided FNA from liver tumors and nodal tumors also been done routinely. Advanced therapeutic procedures like EUS guided Cystogastrostomy for pancreatic pseudocyst are also being done thereby avoiding invasive procedures for the patients,  like open surgery for pseudocyst drainage. Inspite of being a recent technology we perform 212 diagnostic EUS and 60 therapeutic EUS on an average per year. EUS paved way for diagnosis of challenging pancreatic mass lesion like distinguishing inflammatory mass of pancreas from malignant mass lesion. 

In patient services 

Our department inpatient bed strength is about 40. We manage a variety of cases like Cirrhosis of liver related complications, variety of gastrointestinal malignancies like oesophageal, gastric and colonic malignancies - for diagnosis by endoscopic biopsy and palliative care by placing Self Expanding Metallic Stent for nutritional care. 

Intensive care services:

We have a 6 bedded ICU and 5 bedded step down ICU equipped with ventilators, infusion pumps, plasma exchangers, hemodialysers and bedside ultrasonogram, where we provide exclusive intensive care to the patients with advanced complications of liver cirrhosis, liver failure, terminal stages of GI cancers, pancreas related complications like pseudocyts and fistulae. We also provide ventilator care to the patients with respiratory complications of GI related diseases and parenteral nutrition care to the terminally ill.  A novel therapeutic measure, plasma exchange (quite similar to dialysis is also being carried out in our ICU for patients with acute liver failure and acute on chronic liver failure. 

Call over services:

As experts in gastroenterology and hepatology, we provide our expert opinion on call, 24x7, for patients admitted under various departments covering three separate blocks. We attend the call overs, giving the highest priority to OG department, medical ICU, toxicology ICU, surgical ICU and Pediatric ICU which is present in a separate block 700-800 metre away from our superspeciality block without any delay. We also cover two more blocks, one - Trauma care centre, which is 200 mts away and two -our parent superspeciality block. On an average, we get 15 call over for expert opinion per day which accounts for about 5000 calls per year. We not only provide opinion during call overs, we also do therapeutic measures in the respective wards when needed and transfer the patients to our wards who need advanced therapeutic interventions.

Teaching services: 

Being teaching faculty ourselves, we conduct OP and ward classes for MBBS students who are posted on rotational basis. We also conduct theory and practical classes, ward rounds for post graduates students from General Medicine, Biochemistry, Paediatrics, not only from Madurai Medical college but also from Theni Medical College. Interdepartmental classes with SGE, Pathology and Radiology departments are also being conducted on regular basis.  Apart from them, we do conduct theory classes and hands on training sessions for paramedical students including Physician Assistants, Nurses, Lab technicians and Emergency technicians. 

Scientific services:

Apart from treating and teaching, we also strive to contribute to the research field by collecting valuable data on various diseases and also perform interventions in order to develop new treatment modalities which would be most useful, available, affordable, reliable to the general public. 

Income generation: 

Our Department of Medical Gastroenterology annual earning from CMCHIS fund is 

50 -60 lakhs per year. We are procuring our endoscopic accessories and essential requirement without demanding hospital fund.  Additional hands will improve the income generation from CMCHIS fund

Liver transplant programme: 

Our Government Rajaji hospital is successfully running the organ harvesting programme. Being a tertiary care centre we encounter advanced liver disease patients requiring liver transplantation. Since paediatric transplant work up is routinely done and transplantation being done in Rela Institute under CMCHIS. From 2025 onwards we are started performing DDLT in our center for adult patients.

Investigational services like Diagnostic Endoscopy & Colonoscopy  are done daily since the inception of department. 

The Department routinely manages therapeutic endoscopy like Endoscopic Variceal Band Ligation, Sclerotherapy, Polypectomy, Foreign Body removal, Pneumatic dilatation for Achalasia, Dilatation and stenting for malignancy Etc. 

           The department is also doing advanced endoscopic procedures like ERCP ,Endoscopic Ultrasound . Recently the department is having Oesophageal manometry to diagnose Oesophageal motility disorder.

The Professor , the associate professor , the Assistant Professor and Senior Resident of the department are not only engaged in patient care and teaching but also involved in academic activities like case presentations, Seminars, paper presentations in State, National and International conferences. 

Faculties details

Dr.M.Kannan – Prof & HOD

Dr.R.Ramani – Associate Professor

Dr.C.Vijai shankar – Assistant Professor
 

Department Faculties

d

Female ward

Male ward

Department

Manometry

Endoscopy Room

HOD’s of Medical Gastroenterology and their tenure

HOD’s Photo

1. HBV DNA in asymptomatic HBs Ag carrier state – INASL conference Calcutta – 2003.

2. Endoscopic spectrum of HIV infected subjects – ISG Con Chennai – 2003.

3. Prevalence of Hepatitis viruses A to E in sporadic Hepatitis ISGCON    

Chennai – 20

4.  Ascitic fluid cholesterol in malignant as cites ISG Con 2003 – Chennai.

5. Prevalence of HBV and HCV in cirrhosis of liver – IG Chennai 2003.

6.  Prevalence of H pylori in dyspeptic subjects – ISG Con Chennai – 2003

7. Study of Gastric surgery sequalae in asymptomatic patients. 

ISGCON Jaipur – 2004.

8. Study of SAAG as a predictor of oesophageal varices and bleeding

in cirrhosis     liver.  ISG Con – Jaipur – 2004

9. Serum paraoxonase  levels is in chronic liver disease. 

ISGCon – Jaipur 2004.

10. Jaundice in pregnancy evaluation of aetiology maternal and fetal outcome.

ISGCon – Jaipur 2004.

11. Endoscopic findings in Acute UGI Bleed in a leaching hospital –

     ISG Con – Jaipur 2004.

12. Platelet count to Splenic diameter Ratio - a non invasive parameter 

to predict varices. – Asia Pacific Association of the studies of 

liver (APASL) 2004.New Delhi.

13. Analysis of 250 cases of acute UGI Bleed ISG conference Jaipur – 2004

14.  Analysis of Predictors of UGI Bleed – ISG Con  Jaipur -2004.

15.  Liver function abnormalities in HIV infected patients before and  

after ART –  ISG Con  November 2005.

16.  Prevalence of H.Pylori in DM and its relationship to dyspepsia - ISG Con 

November 2005

17.  Cardiac abnormalities in cirrhotics - ISG Con November 2005

18.  Peritoneoscopy using an UGI Endoscope a novel technique for diagnosis

in sick patients - ISG Con November 2005.

19.  Colonoscopy Audit in a peripheral teaching hospital –

ISG Con   November 2005

20.  HBsAg and Anti HCV prevalence in Madurai - ISG  Con November 2005 

21.  Clinical and Biochemical profile of hepatoma – ISG Con November 2005

22.Prevalence of HBs Ag in the family members of asymptomatic 

HBs Ag carriers ISG Con Bombay 2006.

23.Prevalence of hepatopulmonary syndromes in CHR LIVER DISEASE

ISG Con 2007 Bangalore.

24.Clinical and virilogical profile of HCC ISG Con 2007 Bangalore.

25.Auditof ERCP in a tertiary hospital ISG Con 2007 Bangalore .

26.Glutathionesynthetase Gene polymorphisis in HC –

ISG Con Bangalore 2007

27. Analysis of GlutathioneSTransferace M1& T1 Gene Polymorphism 

as   risk factors for HCC. EASL-Prague-Czech Republic-June 2008

28. A case of inflammatory Sclerosing Pseudo Tumour. A rare case report.

Indian Association of surgical gastroenterology conference 

Chennai Oct   2008.

 29. Prevalence of HCV genotypes in HCC .Comparative analysis between   

New Delhi  &Madurai.APASL  Hong Kong Feb 2009.

 30. Association of high viral load & HBV genotype D increases risk 

of HCC .World congress of GE  London UK  NOV 2009. 

(Abstract No:1643)

31. Hepatitis B BCP, Precore/core, X Gene mutations / Genotypes & risk 

of   HCC in India. ISG con Calcutta December 2009

32. Role of Aflaxtoxin b1 in HCC from India ISG con Calcutta 

December 2009

33. Mohamed AsimAbdul  Malik, Manash P. Sharma, Sunil K.Polipalli, 

Nargis  Begum,         LuqmnA.Khan,S.A. Husain, IstagAhamed, Naseem

Akhatar,   L.Thayumanavan, Rajiv        Singla,P.Kar “.Hepatitis B Virus” 

has been accepted  for publication in Journal of Medical Virology 

in January   2010 . Impacted Factor:2.576

34.MohammedAsim, LuqmanA.Khan , S.A Husain, Sajid Husain, Anita 

Sharma,    J.K.Sharma, L.Thayumanavan, P.Kar. “ Geneticpolymorphisum

of Glutathione      S Transferases M1 and T1 in Indian patients with 

Hepatocellular carcinoma” has    Been accepted (under production ) for 

publication in Disease Marker In April 2010 .Impacted Factor:2.3 

35. Study of extra Intestinal manifestations of IBD –ISG con Hyderabad 2010  

36. Gastric Histology in non ulcer dyspepsia   ISG con Hyderabad 2010  

37. Evaluation of UGI endoscopy in dyspepsia in relation to age and 

alarm symptoms. ISG con Hyderabad 2010.

38. Prevalence of Helicobacter Pylori in relation to socio economic status. 

ISG con Hyderabad 2010.

39. UGI Findings and prevalence of H.Pylori in HIV positive patients .

ISG con Hyderabad 2010  

40. Prevalence of H.Pylori in dyspepsia and smokers .ISG con Hyderabad 2010 

41. A Study On Usefulness Of Renal Artery Resistive Index As A Non 

Invasive Predictor Of          Varices & Bleed In Cirrhosis With Portal 

Hypertension INASL Guwahati 2012

  42.LFT Abnormalities In Tb Patients On RNTCP ProgrammeINASL

Guwahati 2012

  43. Doppler of the hepatic veins as a marker of severity of PHT atINASL

Guwahati   2012

OTHER  PUBLICATIONS:

1. Mohamed Asim Abdul  Malik, Manash P. Sharma, Sunil K.Polipalli, Nargis Begum, LuqmnA.Khan S.A. Husain, IstagAhamed, NaseemAkhatar, Thayumanavan, Rajiv Singla,P.Kar “.Hepatitis B Virus” has been accepted (Under production) for publication in Journal of Medical Virology in January 2010 .Impacted Factor:2.576

 2. Mohammed Asim, LuqmanA.Khan , S.A Husain, Sajid Husain, Anita Sharma, J.K.Sharma, L.Thayumanavan, P.Kar. “ Geneticpolymorphisum of Glutathione   S Transferases M1 and T1 in Indian patients with Hepatocellular carcinoma” has   Been accepted  (under production ) for publication in Disease Marker In April  pacted Factor:2.3 

3.MohammedAsim, Manash P. Sharma, , L.Thayumanavan, P.Kar.   Role of  Afotoxin B1 as a risk for primary liver cancer in north Indian  population   has been accepted (Under production) for publication in Clinical Biochemistry Volume 44,Numbers 14-15, October 2011.

A presentation on Transabdominal peritoneoscopy won the best Paper award  in the Indian Society of gastroenterology  National Conference in 2005. 

Another paper on Renal resistive Index in Portal Hypertension got the Best paper Award in the state Conference in 2010.

Publications from the department during the past 3 years:

World Hepatitis Day, observed annually on July 28th, is a global health campaign aimed at raising awareness about viral hepatitis. It's a day to educate the public about the disease, its prevention, and the importance of testing and treatment. The date also commemorates the birthday of Nobel laureate Dr. Baruch Blumberg, who discovered the hepatitis B virus and developed a vaccine. 
Here's why we observe World Hepatitis Day:

•    Raise Awareness:
To increase knowledge about viral hepatitis, its causes, and its impact on liver health. 
•    Promote Prevention:
To emphasize the importance of preventative measures like vaccination (for Hepatitis A and B), safe injection practices, and safe sex. 
•    Encourage Testing and Treatment:
To highlight the need for early diagnosis and access to treatment for hepatitis B and C, which can lead to chronic liver disease and cancer if left untreated. 
•    Advocate for Change:
To urge governments and healthcare organizations to prioritize hepatitis prevention, testing, and treatment services. 
•    Commemorate Dr. Baruch Blumberg:
The day also serves as a tribute to the scientist who made significant contributions to combating hepatitis B. 
CME conducted today on behalf of Department of MGE and Institute of Microbiology on eve of world hepatitis day. Presided over by our respected Dean, our beloved Prof Senthil sir, Vice principal Prof Mallika and Medical Superintendent Prof Kumaravel. Thank all the faculties and students for their enthusiastic participation ?