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159
PLANNING FOR X-RAY SECTION
VA Menon-: NTI Newsletter 1965, 2, 38-41.

Insufficient technical understanding, poor selection and poor planning result in procurement of X-ray equipments that breakdown quickly. Some guidelines are given in this article for planning and procuring x ray equipment for district level hospitals. First of all, it is essential to have an X-ray room and a dark room ready before ordering the equipment. Otherwise, the equipment would lie in the sun and moisture leading to early repairs. The X-ray room should be at least 16 feet 20 feet with a ceiling height of 10 16 feet. It should be painted with light shade of colour. Wooden panel shutters are advisable. Flourescent light is not recommended as it leaves an after glow. Dark room should be adjacent to X-ray room with light tight windows and an exhaust. Powerline also should be ready before equipment is ordered. It is extremely important to check the voltage drop and electrical requirements of the equipment before ordering. It is better to order a machine which can tolerate a higher voltage drop as it will function more reliably under poor line conditions than the one which tolerates only a low voltage drop.

KEY WORDS: X-RAY EQUIPMENTS, PLANNING.

160
PROBLEMS OF MAINTENANCE OF HOSPITAL EQUIPMENT
VA Menon-: J Inst of Engineers 1969, 49, 73-77.

In an investigation carried out at the instance of Government of India, Mr Ernbourg, W.H.O. X-ray Technician, in 1960 61 found that between 40% and 50% X-ray equipment are idle in Government and quasi government medical institutions all over the country. This paper deals with reasons and suggests a remedy for improving the situation because when society creates an institution for delivering health care to the community, it expects the institution to give fair returns on the investment of resources. When facilities made available to such an institution are not put to use, when required, then the community suffers. One of the main reasons for non-utilisation of available facilities is the unserviceable condition of equipments. The main cause for this state of affairs is poor distribution and paucity of maintenance facilities available. These two reasons made servicing of equipment very expensive. Administrative constraints under which the institution delivering health care works, makes the costly service inaccessible to them or creates considerable delay in its availability. Comparing the loss to the community due to idle equipment and cost of creating and running a cheap service organisation for maintenance of equipment, the latter appears profitable. On the basis of experience of X-ray equipment maintenance in NTI during the preceding period, the average cost per maintenance or repair services is worked out. By comparing it with cost of similar service available to an average institution it is shown that to effectively cover institutions over a wide area, a cheap service organization which has units distributed very widely in the country is required.

The estimated loss of Rs. 71 million can be brought down to 11 million with annual expenditure of only 7 million. Thus, a community can gain to the extent of 53 million every year by way of better facilities. For this purpose an investment of 3.5 million is required on capital account for creating a training centre for maintenance personnel and 0.8 million for running it. Such a centre can provide the man power required for running a country wide service organization.

KEY WORDS: HOSPITAL EQUIPMENT, MAINTENANCE.

161
SOME TECHNICAL PROBLEMS CONNECTED WITH EFFECTIVE UTILISATION OF X-RAY EQUIPMENT IN NATIONAL TUBERCULOSIS PROGRAMME
VA Menon-: NTI Newsletter 1970, 8, 88-93.

This paper highlights some of the Technical, Economical and Operational problems encountered in 1955 60 when the National Tuberculosis Programme was being evolved wherein considerable importance was laid on diagnosis of patients using mass miniature radiography. Technological imperfections seen were: 1) High breakdown rates of X-ray units 2) Though power supply was available, the quality of powerline was such that X-ray could not work satisfactorily in 75% of them. Moreover, running cost of X-ray unit when using petrol generator was very high. This can be reduced by connecting the unit to power supply. Reduced sensitivity and specificity of the X-ray is another operational deficiency. The number of suspects diagnosed was 7 times the actual number of cases and probably 60% of cases were being missed also.

In order to solve these problems, the suggestions given were 1) X-ray equipment capable of working from low capacity powerlines without loss in standard of performance is desirable. 2) Flouroscopic image intensifiers using solid state panels which are easy to operate and maintain can probably improve the reliability of flouroscopic examinations without increasing the radiation dose. 3) Electronic contrast enhancement of films are possible and this could improve the diagnostic reliability. Research is needed to improve contrast perceptibility without increase in radiation.

KEY WORDS: X-RAY EQUIPMENT, UTILIZATION, CONTROL PROGRAMME.
 
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