Vaibhav Super Specialty Hospital

Vaibhav Super Specialty Health Care Center Ltd.
VAIBHAV SUPER SPECIALTY HEALTH

CARE CENTER
COMPLETE SOLUTION FOR ORTHOPEDIC, NEUROSURGICAL, PLASTIC SURGERY,
PHYSICAL-OCCUPATIONAL THERAPY AND REHABILITATION NEEDS
Managed by
VAIBHAV SUPER SPECIALTY HEALTH CARE CENTER LTD.
PROJECT REPORT
VAIBHAV SUPER SPECIALTY HEALTH CARE CENTER LTD.

C/o. Mrs. Nutan Kamdar; Western Mumbai, India.
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Dedicated to the sweet memories of Vaibhav,

a soul from heavenly world...
VAIBHAV M. KAMDAR
(18.08.1987-30.08.2008)
“Keep your dreams alive. Understand to achieve anything requires faith and
belief in yourself, vision, hard work, determination, and dedication.
Remember all things are possible for those who believe.”
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Gratitude...
Gratitude...
In sweet memory of our beloved son Vaibhav, we dedicate this “Vaibhav Super Specialty Health Care
Center” to him with great affection and love.
Very well organized, very innocent, highly intellectual, hard working, soft hearted, caring and sharing
by nature and most sincere Vaibhav’s dream to establish “Vaibhav Super Specialty Health Care
Center” one day is coming true now.
As we think back over the past years of our life, we are so very thankful for the gift that God has
entrusted to us ... our son Vaibhav who brought lots of joy, love, happiness along with name, fame and
prosperity in our life. Our hearts cannot fully express the gratitude we feel for how God has provided
for us and for how He has worked through all of us to meet our needs, love and affection...
Although it is not nearly enough, we just want to say "thank you" for giving us support and
encouragement when we were afraid, for sharing our tears and joy when God blessed us with this
precious miracle who lived his life with highest degree of dignity and love, for His generous gift of the
very bravo soldier & pride of parents, and most of all for his constant love and his memories that
continue to give us strength and hope.
May God bless his soul with eternal peace and joy and may He give us the strength to follow his
example of showing Almighty’s love to those around us. As we dedicate our feelings, we also dedicate
ourselves ... to God through healthcare, to people....
Nutan Kamdar (Mother)

Mukund Kamdar(Father)
CEO
….And, when he left this earth, God took him and converted him out in to little
stars, and he has made the face of Heaven so fine that the entire world seems to be in
love with night and pay no worship to the garish sun….
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VAIBHAV KAMDAR
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CARE CENTER
Highlights: our uniqueness

Special Highlights:
• Trauma and critical care
• Orthopedic
• Pediatric Orthopedics
• Neurosciences: Neurology/Neurosurgery,
Spinal Surgery
• Plastic & Reconstructive Surgery
• Physiotherapy and rehabilitation
rehabilitation
• Pool Therapy
• Sports (Athletic ) Medicine
• Complete diagnostic facility
• Medical Education, Research &
Development
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VAIBHAV SUPER SPECIALTY HEALTH CARE CENTER

INDEX
PART - A
Sr. No. Particulars Page No.
1. Mission, vision and objectives 1
2. Brief profile 2
3. Introduction 3
4. Promoters 4
5. Background of the project 7
6. Details 10
7. Vaibhav Super Specialty Health Care Center 13
8. Salient features: Department of orthopedics 16
9. Department of neurosciences 21
10. Department of plastic surgery 24
11. Physiotherapy & rehabilitation services 27
12. Facilities planned at the therapy center 29
13. Center for athletic medicine 38
14. Diagnostics: Radio diagnosis 39
15. Diagnostics: Laboratory medicine 44
16. Pneumatic Air Tube System 45
17. Clinical nutrition 46
18. Clinical research 46
19. Pharmacy services 47
20. Nursing 51
21. Helicopter/air ambulance service 52
22. Organizational chart 55
23. Hospital staff 56
24. Bed allocation to departments 57
25. Area allocation/description for departments 57-58
26. Project team 59
27. Proposed implementation schedule 59
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VAIBHAV SUPER SPECIALTY HEALTH CARE CENTER
PART – B
28. Investment and Financing 61
29. Finance from Private Investors 65
30. Capital introduce by investors, brief investment benefits 67
PART – C
31. Cost of project and means of finance 70
32. Profit and loss account (operating statement) 77-78
33. Balance Sheet 79-80
ANNEXURE
34. Medical Equipment 81
35. Non Medical Equipment 85
36. Physiotherapy Equipment 87
37. Occupational Therapy Equipment 89
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CARE CENTER
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CARE CENTER
Complete solution for orthopedic, neurosurgical,
physical, occupational therapy and rehabilitation needs
Our Mission
“Save the most precious human lives on the earth and provide most natural and
normal life to every individual around the globe to make every moment of human
life worth living”
We deliver health and healing to everyone through trusting relationship
Our vision
“May all be happy and healthy forever”
Vaibhav Super Specialty Hospital builds healthy communities
Our objectives
All patients resume their normal activities as quickly and safely as possible with love
and dignity through excellent combination of hospital services with hospitality.
Creating awareness & providing most advanced healthcare treatment is our top
priority.
To implement updated and latest technologies of the world to meet new challenges
of the modern medical science so that benefit is passed on globally to mankind
Our values
• Integrity. Our actions and decisions consistently reflect the highest ethical standards. We
operate on the basis of openness, to nurture an environment of honesty and trust.
• Respect. We treat each individual with dignity and compassion; encourage creativity and
assist one another to achieve our fullest potential. We believe that each individual is
equally important in a unique way.
• Service. We build our customer commitments upon the philosophy that quality and service
will improve over time using a process of continuous quality improvement. We measure our
performance against customers’ standards and strive to exceed their expectations.
• Teamwork. We combine our efforts with the efforts of others to achieve the greatest
success. Collaboration and open communication are essential to our relationships.
• Safety. Safety of patients and staff is our top priority. We continue to integrate new learning
in quality improvement and safety.
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BRIEF PROFILE
1. Name of the Institution Vaibhav Super Specialty Health Care Center Ltd.
Reg. Office C/o.: D-202, Shantinagar Society, Dutt Mandir Road,
Malad (East), Mumbai-400 097.
2. Constitution Registered Under Companies Act, 1956(No1 of 1956).

Certificate No. :
Incorporation Date : ____________________
3. Sector Corporate
4. Location of Center Western Mumbai, India.
5. Group Mrs. Nutan Kamdar (CEO-Chair Person and

Chief Managing Director (CMD))
Mr. Mukund Kamdar (CEO-Managing Director)
6. Date of Incorporation Incorporation Date: ___________________
7. Product World-class Super Specialty include Orthopaedics,

Neurosurgical and Advance Rehabilitation Center with
Trauma care Facilities
8. Industry Healthcare
9. Location of Controlling c/o Mrs. Nutan Kamdar

Office 89, Theresa Court, Galloway, New Jersey–08205, USA
Tele- Fax: (609)404-7999
Cell Phone: (609) 705-5435.
E-mail: mmk1711@yahoo.com
10. Governing Board Mrs. Nutan Kamdar CEO/CMD

Chair Person & Chief Managing Director
Mr. Mukund Kamdar CEO & Managing Director
11. Project Cost INR 13046.63 Lakhs (130 Crores Approx.)
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Introduction:
Vaibhav Super Specialty Health Care Center would be a Super Specialty institution and the
first of its kind in India where renowned doctors and highly qualified support staff will be
available to start a unique corporate set up.
Located in the heart of Mumbai between Andheri and Mahim, the institute proposes to bring
world-class medical facility, super specialties viz., orthopedics and neurosciences, trauma
care, plastic and reconstructive surgery plus physiotherapy, pool therapy and rehabilitation
work with due care of every international standard. It would serve as an institution providing
facility for sophisticated super specialty healthcare to all sections of the society and also create
awareness among the people about related ailments and preventive care.
The center will have excellent therapy set up with state-of-the-art ultramodern and Sophisticated
Operation Theaters. All invasive and non-invasive neurological/orthopedic plastic and trauma
care surgical procedures will be performed by expert doctors who will be supported by the latest
diagnostic and advance therapeutic care facilities including world class most modern
Physiotherapy and rehabilitation Center with Tele-rehabilitation facility and an ultramodern
pharmacy.
Neurology programs would encompass all super specialty procedures including treatment of all
types of neuro trauma cases.
The institute will place special emphasis on early diagnosis and prevention of cardiac,
pulmonary, brain and /spinal problems. It proposes to have an excellent facility for public health
education and medical education programs for medical practitioners as well as the lay people.
Rehabilitation would receive priority attention so that the patients can recover faster and resume
their normal duties early.
The hospital also proposes to mobilize a highly sophisticated Mobile ICU facility for speedy
transportation of the trauma care patients. This Ambulance would be equipped with modern
critical care/cardiac resuscitation facility and manned by specialist staff from the institute. It is
also planned to have an excellent team for HEM services along with well equipped, state of the
art facility to air lift the patients by Helicopter Services.
In addition, the institute will plan a Patient Support facility, separate accommodation for
relatives of the patients coming from outside the city and Country.
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The hospital will have the benefit of the expertise of highly experienced, world-renowned super
specialist surgeons and physicians plus leading super specialists of India. Services of specialists
like Intensivists, physicians; plastic and orthopedic and neurosurgeons for poly trauma cases;
pediatricians, radiologists, pathologists, nephrologists, urologists will also be available under the
same roof.
Best part and additional attraction will be excellent and well trained support team well equipped
with all the modalities of indigenous system of medicine too.
Powered by the most renowned, highly experienced, expert & dynamic Surgeons and therapists
of the nation, it will be one of the finest Super Specialty and Rehabilitation Centers of the
Country with ultramodern infrastructure with NABH approval (afterwards JCAH).
Promoters:
In the sweet memory of their beloved great late son Vaibhav Kamdar (21 years young);
Mrs. Nutan Kamdar and Mr. Mukund Kamdar (Parents) wish to start whole hearted
dedicated to him; a “Model Super Specialty Health Care Center with Therapy &
Rehabilitation Center” of the Country which will be first in row of most modern and
sophisticated Super Specialties in the country and number one on its own category. Their goal is
to help maximum people of the country to remove physical and mental deformities, restrictions
and provide them with positive mental and physical fitness with highest quality of treatment and
facilities. It will be Complete Center for Orthopedic, Neurology, Physical & Occupational
Therapy plus a center with holistic approach for the treatment of trauma care patients.
Mr. Mukund Kamdar & Mrs. Nutan Kamdar are very dynamic, most talented, creative and
had been a well known and the most successful God gifted technocrat and historical
revolutionary reputed and respected business persons of our country. They are hardworking,
confident, self motivated, well disciplined and highly initiative with strong ethics and clear
vision. They are settled in USA at present. However, to make the people of our country well
aware about the latest developments of the world and keep them abreast with the latest treatment
and therapy modalities, the Kamdar family took up this noble cause for the benefit of our people.
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CEO: Mr. Mukund Kamdar
Profile
• An accomplished entrepreneur and business professional with over 28+ years of
comprehensive experience in manufacturing technology.
• Strong background in managing entire operations of large corporate business
establishments. Adept in mobilizing resources and judicious deployment thereof to
achieve maximum productivity. The masterminded personality with new and innovative
ideas to improve designing, processes, quality and productivity to yield the best results
ever produced by anyone in the industrial sector.
• Holds the credential of being involved at all levels in Telecommunication
manufacturing, manufacturing of Plant and Structural Engineering. His team-building
skill and leadership capability are unparallel
• Coordinated the activities of 8 industries simultaneously at state, national and
international levels & bagging honors for the same.
• Confident, self-motivated and an efficient problem solver, with perseverance to succeed
and immense zeal and zest to achieve results
• His efforts for Products Range development: 1670 Products (over 56000 components)
indigenously developed and manufactured in India without any help and support of foreign
technology, technical transfer and collaboration. 100% indigenous products. 85% approx.
of total products range replacing foreign products (Foreign Substitutes) and saved
Government precious foreign exchange.
Brief of some of his strategic skills is appended here below:
Industrial Management Administrative skills Total Quality Management
General Administration: Expert in Project management:

Fiscal Discipline
Multi task operation skill excellent planner and organizer
Coordination/ Liaising/Global
Turnaround Management Award winning professional
marketing
Training & Development Fund Management Budgeting
Strong Interpersonal Skills:

Team Management Cogent Communication
excellent PRO
Well versed with latest trends Inventory Management Up dated in CQI process
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HIGHLIGHTS
• Community Representative and Private Consultant Services: Galloway, New Jersey,

USA since 2 years. Prior to this, he had also achieved ‘WOW’ Certificates four times and
prices for exclusive customer services.
• Chief Executive Officer (CEO): for M. K. Group of Industries an ISO 9001-2000 and
TEC certified unit, Mumbai, India for 23 yrs. Looked after the Factory Production, Office
Executions & Business Promotion:
Chief Managing Director: Mrs. Nutan Kamdar
Profile:
• Over two decades of experience in diverse Industrial atmosphere and office working
environments
• Result oriented with proven track record as a top sales performer & excellent marketing
skills at national and global level
• Effective team builder, excellent problem solver
• Great leadership and organization skills
• Most efficient strategic planner
• Exceptionally well organized with strong work ethics to achieve employer objectives
• Extraordinary skills of communication: business as well as technical
• Self starter with a can do attitude
• Highly skilled in areas of material management with multi task operation skill
• Outstanding skills of event management at all levels: regional, national and international
• Expertise across administration and full range of manufacturing functions
• HR planner and manager; Selecting, developing and inspiring teams of managers and
operators towards common goals
• Innovation: Can add Value through challenging established practices and delivering
creative solutions to complex business problems
• Can manage growth and organizational changes in a professional and entrepreneurial
manner
• Adaptable and flexible to assimilate new concepts, technologies, industries and cultures
HIGHLIGHTS
o Had been the Chief Managing Director (C. M. D.) for more than 23 years, The M. K.
Group of Industries an ISO 9001-2000 & TEC certified unit, Mumbai, India.
o Looked after own business group of industries
o Received prestigious Six National Awards by the Government of India
o Excellency in Telecommunication Manufacturing and Manufacturing in Structural
Engineering
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Background of the project

Healthcare Sector Structure / Market Size (India)
Healthcare, which is a US$ 35 billion industry in India, is expected to reach over US$ 75 billion
by 2012 and US$ 150 billion by 20171.
The sector offers immense potential to healthcare players as the country witnesses a rise in the
incidence of lifestyle-related and other diseases. A growing elderly population and rise in
awareness and income levels are also pushing for better facilities in the country.
To meet this growing demand, India needs to add 3.1 million beds by 2018 to the existing 1.1
million, and requires immediate investments of US$ 82 billion1
India needs an investment of US$ 14.4 billion in the healthcare sector by 2025, to increase its bed
density to at least two per thousand populations2.
Driven by strong local demand, Indian healthcare market is expected to continue growing close
to previously projected rates of 10 to 12 percent. With average household consumption expected
to increase by more than seven percent per annum, the annual healthcare expenditure is projected
to grow at 10 percent and also the number of insured is likely to jump from 100 million to 220
million3.
India's healthcare industry registered 42.44 percent growth in net profit during April-June 20094.
In the healthcare sector, the leading 10 companies posted a growth of 23.94 per cent in total
income and 21.37 percent in total expenditure during the quarter.
Health Insurance
Currently only 10 per cent of the Indian population has health insurance, which means that there
is tremendous scope for growth in this area. The Indian health insurance business is growing at
50 percent. The sector is projected to grow to US$ 5.75 billion by 20105.
Investments in Healthcare
The sector has been attracting huge investments from domestic players as well as financial
investors and private equity (PE) firms. Funds such as ICICI Ventures, IFC, Ashmore and Apax
Partners invested about US$ 450 million in the first six months of 2008-09 compared with US$
125 million in the same period a year ago. PE funds are expected to invest at least US$ 1 billion
in the healthcare sector in the next five years6.
In February 2009, India Venture invested almost US$ 18 million in Tamilnadu-based Kavery
Medical while in June IFC invested US$ 30 million in Max India.
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‘India Healthcare Trends 2008’, Technopak Advisors
2
FICCI-Ernst and Young report
3
McKinsey
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Associated Chambers of Commerce and Industry (ASSOCHAM)
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PHD Chamber of Commerce and Industry
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Feedback Ventures
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Piramal Life Sciences, the research and development (R&D) arm of Piramal Group is investing
US$ 41.17 million in the next two years’ period to discover and develop new chemical entities
and novel drug delivery systems.
The Hinduja Group will invest up to US$ 72 million in increasing capacity of its hospital in
Mumbai by 350 beds in the next four years through expansion of existing facility and setting up
of a new unit.
As part of its ‘Healthy imagination’ initiative, GE will spend US$ 3 billion over the next six
years on research and development, provide US$ 2 billion of financing over the next six years to
drive healthcare information technology and health in rural and underserved areas, and invest
US$ 1 billion in partnerships, content and services.
The government, along with participation from the private sector, is planning to invest US$ 1
billion to US$ 2 billion in an effort to make India one of the top five global pharmaceutical
innovation hubs by 2020.
The Ajay Piramal Group-owned private equity (PE) firm, India Venture Advisors, will launch its
second US$ 150 million healthcare fund next year.
Medical Tourism
In 2007, India treated 450,000 foreign patients ranking it second in medical tourism.
Medical tourism in India could become a US$ 2 billion industry by 2012 (from US$ 350 million
in 2006)7. Medical tourism is expected to be growing at between 25-30 percent annually.
The key selling points of the medical tourism industry are its cost effectiveness and its
combination with the attractions of tourism. Treatment cost is lowest in India - 20 percent of the
average cost incurred in the US, Singapore, Thailand and South Africa.
Besides world class medical facilities, India is also trying to promote its traditional medicine
such as ayurveda.
Areas of Opportunity
The fast growth in the Indian healthcare sector has created various pockets of opportunities for
investors. A recent survey8 highlights several such areas within the healthcare sector.
• Medical infrastructure forms the largest portion of the healthcare pie. Beds in excess of one
million need to be added to reach a ratio of 1.85 per thousand at an investment of US$ 77.9
billion.
• The medical equipment industry is around US$ 2.17 billion and is growing at 15 percent per
year. It is estimated to reach US$ 4.97 billion by 2012.
• The medical textiles industry is projected to double to reach US$ 753 million by 2012.
• Clinical trials have the potential to become a US$ 1 billion industry by 2010 and the health
services outsourcing sector has the potential to grow to US$ 7.4 billion by 2012, from US$
3.7 billion in 2006.
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McKinsey and the CII
8
FICCI-Ernst and Young report
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Notwithstanding the current economic slowdown, the US$ 2.26 billion Indian wellness services
market is expected to grow at about 30-35 per cent for the next five years on the back of rising
consumerism, globalization and changing lifestyles8.
Wellness industry is classified into seven core segments of allopathy, alternative therapies,
beauty, counseling, fitness/slimming, nutrition and rejuvenation. While rejuvenation services
such as spas, alternative therapies, ayurveda treatments and beauty services are expected to grow
by as much as 30 percent, fitness comprising gyms and slimming centers are expected to grow by
more than 25 per cent.
Government Initiative
The government has announced a US$ 63.2 million initiative to promote domestic manufacture
of medical devices such as stents, catheters, heart valves and orthopaedic implants that will lead
to lower prices of this critical equipment.
The Government launched the National Rural Health Mission (NRHM) in 2005. It aims to
provide quality healthcare for all and increase the expenditure on healthcare from 0.9 percent of
GDP to 2-3 percent of GDP by 2012.
During the 2009 interim budget, the government allocated US$ 2.42 billion for NRHM.
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DETAILS
Geographic’s:
ECONOMY AND INDUSTRY PROFILE:
Mumbai the commercial capital of India has a vast array of different industries Today, Mumbai
accounts for 20% of India’s total employment in Industries and 11% of India’s employment in
totality. Mumbai is shouldering 30% of India’s export and imports. Being India’s economical
capital it contributes 40% to income tax, 60% to the collection of custom duty, 20% to the central
excise collection and 40% to the foreign trade of Indian economy.
Today Mumbai has included industries like pharmaceutical, telecommunication, construction,

engineering, metal, silk, glassware, automobiles and film, plastic, printing and petroleum.
Industries like IT, medical research, computers and electronic equipment of all varieties,
renewable energy and power are located in Mumbai. Almost all of India’s petroleum is marketed
in Mumbai. Today, headquarters of the major financial institutions like the Bombay Stock
Exchange, the Mint, the National Stock Exchange and the Reserve Bank of India are located in
Mumbai along with corporate offices of numerous Indian industrial giants like Tata Group,
Reliance, Bombay Dyeing, Vedanta Resources, etc. In the area of south Mumbai many foreign
MNCs also have their branches. Most of India’s television and satellite networks are located in
Mumbai. Bollywood, the Hindi movie industry is also located in Mumbai, along with the big film
studios and production houses. Vast skilled human resources are located in Mumbai.
World’s most famous Bhabha Atomic Research Centre deep rooted with state-of-the-art
infrastructure is situated here.
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Mumbai’s unique lunch dispatchers known as Dabbawallas, hardly aware of management school
studies, yet catering the corporate citizen with the organizational skill of six-sigma has compelled
the world’s top management schools to conduct a research on India’s very native management
skill.
List of major Mumbai based industries:
1. Telecommunication
2. Industrial Engineering
3. Modern Technology
4. Textile mills
5. Pencils
6. Tractors
7. Pharmaceuticals
8. Biscuits
9. Clothing
10. Utensils
11. Film industry
12. Film equipment
13. Automotive parts
List of some major Mumbai based companies
1. ICICI Bank
2. Maharashtra Chamber of Commerce, Industry & Agriculture (MACCIA)
3. Standard Chartered Bank
4. Life Insurance Corporation
5. HDFC Bank
6. JP Morgan Chase
7. Accenture India Limited
8. Blue star Limited
9. Lehman Brothers
10. Tata Group
11. Godrej
12. Bajaj Group
13. Hindustan Lever Limited
14. Reliance Industries Limited
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Mumbai has about 40,000+ hospital beds distributed in about 1000 health care centers. Of
these about 17 are municipal hospitals which can be afforded by the urban poor who make up
50% of the population.
The private sector, as per CEHAT database records, consists of 1,082 private hospitals/nursing
homes in Mumbai city run by individuals, co-operatives, corporate bodies, companies, religious
bodies, trusts and NGOs. Apart from this, there is a large segment consisting of private practitioners,
polyclinics and dispensaries.
Alongside the shortfalls in hospital beds, there is also a shortage of healthcare professionals,
equipment and infrastructure needed at various levels in the healthcare delivery supply chain.
Healthcare delivery in Mumbai faces other important challenges. Mumbai does have traditionally
reputed and well known general and specialty hospitals but new healthcare infrastructure
development in Mumbai has been constrained because of high cost of real estate.
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CARE CENTER
Introduction:
Ready to be named among the "Best Hospitals in India", Vaibhav Super Specialty Health Care
Center is poised to be the result of tremendous efforts of a visionary business entrepreneur to
combine resources, research, and administrative acumen with his unparallel skills and expertise
to reach the new heights of success in the field of healthcare for the greater benefit of our patients
and the community at large. Taking excellence and expertise in patient care, education and
research to an odyssey of the highest talents in healthcare, designing accessible service systems
that are flexible, culturally competent and responsive to family-identified needs; are the steering
factors to aspire for this dream project
Our philosophy
Healthcare combined with hospitality and technical excellence at Vaibhav Super Specialty
Health Care Center of Mumbai will endeavor with earnestness to respect each family's values,
needs, cultures, resources and strengths. We strive to provide the highest quality of care by
successfully blending patient care, education and research. The following beliefs serve as the
foundation of our care and partnership with families.
1. We are committed to providing care and services that are guided by the needs of families
and are perceived as flexible, accessible, responsive and sensitive. Therefore, we will
develop systems that enable staff to respond to family preferences and priorities in a timely
and creative manner.
2. We recognize that families provide a constant source of support in the child's life. While we,
as caring professionals, play an important role, families maintain the central role.
3. We turn to families to define their members, understanding that each family has different
values and unique ways of functioning.
4. We value the importance of the family's role in educating staff and future health care
providers.
5. We welcome families' participation in the planning and evaluation of new and existing
programs and policies of the institution.
6. We believe that care should be provided by an identifiable health care team that includes
families as an integral part of developing a plan and caring for adult and their children. The
family-professional partnership is based on mutual respect for the understanding that each
brings to the situation.
7. We strive to provide coordinated care and linkages between our services and the family's
community, including schools, local physicians, services and agencies.
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8. Approaches to care will be built on the family's strengths. We value exploration of what
they can and cannot do. Accepting and understanding their strengths and needs, we will
recognize that the stresses families face can influence their ability to cope. We strive to
promote family competence through knowledge and skills. In all cases, we believe that
competence is enhanced by sharing complete information.
9. We are committed to creating a healing, supportive environment that respects privacy. We

believe that all oral and written communication must respect the family's right to
confidentiality.
10. We recognize that care is a human undertaking. When there are differences of opinion, we
will try to seek quick and respectful resolution among ourselves and with families.
Quality and Performance

At “The Vaibhav Super Specialty Health Care Center”, our priority will be delivering the
safest and highest quality patient care. Measuring our performance is fundamental to achieving
this goal. Consistent services and providing excellent patient care, we will continually measure
and improve our systems to enhance the patient and family experiences and the outcomes of the
care we deliver.
Care at Vaibhav:
The Vaibhav Super Specialty Health Care Center’s orthopedics program is expected to be ranked
number one among the World Class Best Hospitals-with specialization in bone, joint, spine
and muscle care. Whether the patients need a joint replacement or have a sports-related injury,
our specialists will deliver the highest quality care through rehabilitation.
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Department of orthopedics
Department of neurosciences
Department of plastic surgery
Physiotherapy & rehabilitation services
Pool Therapy
Treatments, evaluations and other
programs
Center for athletic medicine
Diagnostics
Radio diagnosis
Laboratory medicine
Clinical nutrition
Clinical research
Pharmacy services
Nursing
Helicopter/air ambulance service
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Department of Orthopedics
A team approach to Orthopedics
To continue to provide top-quality care for our patients, it becomes progressively important that
we update our services to better manage the changes in health-care law and reimbursement, to
keep up with the investment needed in technology, and to retain and attract top orthopedic
surgeons.
Our practice model will encourage our stakeholders to invest jointly in three areas: improved
technology, expanding our practice sites and, most importantly, the recruitment and retention of
expert Orthopedic Surgeons, Neurosurgeons, Neurophysicians, Trauma Care Surgeons,
Intensivists, Therapists and Technical Staff for our medical center. While our consultants will
intimately be involved with the management and policy decisions and with the efficiencies in our
medical center, our hospital will equally be engaged in the best personnel arrangements and in
the success of our consultants’ practices. Obviously, in a successful partnership, all partners are
protected by carefully designed contractual arrangements that provide for fair participation and
compensation of all involved.
In view of the constantly changing health care compliance issues as well as third-party
compensation initiatives, our panel of experienced surgeons and administrators will provide their
views regarding the impact of these issues on their practice in the future.
Our services
This will be a Tertiary Level Referral Centre providing a comprehensive range of orthopedic
services in the areas of:
• Adult Reconstructive Surgery

• Spinal Surgery
• Orthopedic Trauma
• Sports Medicine
• Pediatric Orthopedics
Patient Care
Care of patients undergoing treatment with the Department of Orthopedic Surgery, will involve a
dedicated team of professionals. This will include consultant surgeons, house staff, nurses,
physiotherapists, occupational therapists, social workers, pharmacists and other paramedical
professionals.
• Inpatient Services
• Outpatient Services
• Allied Service
- Bone and Tissue Bank: supplying bone and soft tissue allograft
- Therapeutic Tissue Engineering Laboratory
- Orthopedic Diagnostic Center
• Bone Densitometry Laboratory: Equipped with latest models using fan beam
technology, bone densitometer and two pencil beam densitometers dedicated for research
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• Following are the various conditions which our surgeons will manage and the procedures
which they will perform;
1. Advanced Cartilage Surgery

2. Arthroscopic Surgery
3. Artificial Disc Replacement
4. Autologous Chondrocyte Implantation
5. Benign Tumors in Children
6. Bone and Soft Tissue Tumors
7. Cervical Spine Surgery
8. Cryotherapy for Bone Tumors
9. Joint Replacement Surgery: All joint replacement and spine cases will be performed in
operating theatres with laminar flow technology. In addition, joint replacement surgeons
will be equipped with body exhaust suits while operating and this will further minimize
the chance of infection. There will also be an integrated computer assisted surgery
platform with a ceiling-mounted camera that tracks instrumentation and connects to
Communications platform9 for viewing a variety of software applications for spinal, joint
replacement and trauma use.
10. Limb Abnormalities in Children
11. Neck Pain
12. Returning to Court Sports
13. Returning to Running
14. Safety in Spinal Surgery
15. Scoliosis
16. Sports Tips for Young and Old Athletes: Knee Injuries, Back Injuries, Shoulder Injuries,
Elbow, Wrist and Hand Injuries, Head Injuries, Heat Injuries
17. Stem Cells in Orthopedic Surgery
• Centre for Reconstructive Orthopedics using the Ilizarov Techniques10.
All aspects of Ilizarov Techniques with Ilizarov Apparatus: such as Limb Lengthening,
Deformity Correction, Treatment of Problem fractures, Nonunion, Bone gaps,
Poliomyelitis, Foot Deformities, Hip Reconstructions, Vascular Disease and Arthritis of
the Knee have been extensively practiced. We will have most advanced set up for
Extensive Limb lengthening for increase of height in Dwarfs. Technique will be useful in;
9
e.g. Platform provided by one of the MNCs leading the worldwide orthopedic market and from amongst world’s largest
medical device companies. They deliver results through a wide range of capabilities including joint replacements, trauma, spine
and micro implant systems, orthobiologics, powered surgical instruments, surgical navigation systems, endoscopic products as
well as patient handling and emergency medical equipment.
10
The Ilizarov Method uses Ilizarov's Principle of DISTRACTION OSTEOGENESIS (osteo=bone, genesis=formation). This
refers to the induction of new bone between bone surfaces that are pulled apart in a gradual, controlled manner. The distraction
initially gives rise to NEOVASCULARISATION (Neo=new, vascular=relating to blood), which is what actually stimulates new
bone formation. In addition, there is simultaneous histogenesis (histo=tissue) of muscles, nerves and skin; in bone diseases
(osteomyelitis, fibrous dysplasia, pseudo-arthrosis) this new bone replaces pathological bone with normal bone. This is a
revolutionary concept; diseases for which earlier there was no treatments, are now successfully treated using the Ilizarov Method.
17
Height Increase (for dwarfs)

Bone infections
Poliomyelitis Sequelae (limb lengthening and correction of deformities)
Correction of deformities, both congenital & acquired, of the limbs
Badly comminuted fractures (multiple fragments) in the limbs, even with skin loss.
Treatment of non-unions and malunited fractures
Lengthening of foot stumps, limb stumps and fingers (Amputation/foot formation) 11
• Motion and Gait Analysis Laboratory: Equipped with a six-camera analysis system
integrated with two force plates, EMG system and reference digital video. This
comprehensive and sophisticated system allows us to perform objective assessments of
human gait and attain other important biomechanical data
• Cartilage and Cell Culture Facilities: harvest, culture and re-implant patient's own
cartilage or stem cells for therapeutic purposes like cartilage or bone regeneration.
Patient's own cartilage or stem cells will be cultured in world-class laboratories for
procedures like Autologous Chondrocyte Implantation (ACI) or stem cell-augmented
therapies
Pediatric Orthopedics:
Some common orthopedic conditions
Congenital deformities of the limbs

Dysplastic and dislocated hips in children
Fractures and dislocations in children
Spine deformities (e.g. scoliosis) in children
Neuromuscular conditions (e.g. cerebral palsy, spina bifida, muscular
dystrophy)
The range of pediatric orthopedic services will include:
Pediatric Orthopedics and Trauma

Pediatric Rehab/Seating (1st Thursday afternoon of each month)
Combined Spina Bifida Clinic (1st Saturday morning of each month)
Combined Pediatric Rheumatology Clinic (quarterly during school
holidays)
Combined Bone Clinic (quarterly)
Bone Mineral Density Scanning for Osteoporosis
Gait and Motion Analysis Laboratory
Prosthetics and Orthotics Laboratory
11
Advantages of Ilizarov Techniques are;
No skin incision is made as in a conventional operation. Incidents of hemorrhage, tissue trauma and infection are much fewer.
The whole procedure is minimally invasive as only wires fix the bones to the rings and there is very little soft tissue damage.
The Ilizarov fixator is very versatile; the cylindrical shape of the fixator allows deformities to be corrected simultaneously in 3
dimensions.
The patient remains mobile throughout the course of the treatment. Intensive physiotherapy is instituted early; as a consequence,
problems of joint stiffness and contractures are rare. Further, the patient's stay in the hospital is considerably reduced.
18
Research
Ours will be a University and/or National Examination Board-affiliated Orthopedic Surgery
Department. Our surgeons will be at the cutting edge of research and surgical techniques. All of
our orthopedic surgical consultants will be well-published in the national and international
medical journals and each of them will devote a portion of their time to both clinical and basic
science research. Our emphasis will be on translational research where we aim to bring our
findings from the laboratory bench to the patient's bedside in the form of novel and useful
therapies. This is achieved through collaborations with many agencies and departments both
nationally and internationally.
Orthopedic Medical Devices: Emerging technologies and trends

Research is looking beyond using implants, screws, metallic cages, to incorporating biologic
bone substitutes with regenerative potential to address orthopedic conditions12
A biologic substitute can be any material that dynamically alters and affects the surrounding
environment to proceed in an active biological manner, which manifests as cellular activity,
growth, and differentiation. For instance, orthopedic surgery required surgeons to use
biocompatible specifically designed metal implants to structurally support a fractured bone or in
some cases to fuse bones in spinal conditions. Now surgeons are looking towards a biologic
component incorporated with the metal implant so that the latter serves to regenerate living bone
tissue while the metal implant functions in a structural manner. Definitely, the next stages of
technology development would reduce the amount of metal in implants and use biodegradable
scaffolds for the structural function.
An ideal biologic bone substitute is required to have either or all of the following--osteogenic,
osteoconductive, and osteoinductive properties. Steady progress in biologic material sciences
assures that the future treatment of injury and tissue loss will be altered with more biologically
accuracy.
The objective of our research service will be to analyze and contribute towards new and
emerging orthopedic biologic substitutes; advances in research and development (R&D) and
product development in the orthopedic field. The research service plans to identify key players
(with contact information who are in the forefront of technology development and
commercialization pertinent to this market and end-user information.
A technology primer of the different kind of biologic substitutes--allografts, demineralized

bone matrix (DBM), synthetics, factors and stem cells will also be utilized or we will try to
make these modalities available for our worthy clients. A heads-up of the trends in the
orthopedics industry and important clinical trials will be included under relevant departments.
12
For example, Medtronic Sofamor Danek of Memphis licensed the growth factor rhBMP-2 developed by Wyeth and this
powerful bone stimulant has been coupled with their LT-CAGE Lumbar Tapered Fusion Device.
19
Education
Our department will be at the forefront of advanced surgical techniques and we will have the
facilities for thoracoscopic "keyhole" scoliosis surgery, hip surface replacement, advanced
cartilage repair using autologous cartilage implantation or mesenchymal stem cells, and artificial
spinal disc replacement. This is an attraction for regional and international doctors who seek
super specialty training in their respective areas of interest to train with us e.g. in Spine, Joint
Replacements, Pediatric Orthopedics, Trauma and Sports, musculoskeletal oncology.
We will frequently conduct workshops and courses to impart advanced surgical techniques to
both local and international surgeons.
The department will also impart continuing medical education (CME) to our Family Physician
friends with guest lectures and updates for them.
There will also be frequent public symposiums on various topics related to bones and joints to
empower our community with the knowledge to lead an active and healthy life.
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Department of Neurosciences
Neurology:
Major Activities planned: Routine work in check up of Infections, stroke, clinical

neurophysiology, neuromuscular disorders, Exotoxins and free radicals in neurodegenerative
disorders, Dementia, hereditary ataxia, Infection.
Laboratory facilities: Tests planned to be carried out routinely in the neurophysiology

laboratory,
Electroencephalography (EEG)
Electromyography (EMG)
Nerve conduction velocity
Brainstem auditory evoked potentials
Visual evoked potentials
Somato sensory evoked potentials
Motor evoked potentials
Sympathetic skin response
Cognitive evoked potentials
Repetitive Stimulation ,F – Wave, H – Reflex, Blink Reflexes Needle EMG,

MUAP analyzer
Neurochemistry laboratory for conducting experimental stereotactic surgery
and evaluation of biochemical markers, viz. neurotransmitters, exotoxins, etc.,
facilities for estimation of serum levels of different drugs for patient care.
Facilities required include EEG machine, nerve conduction velocity measurement machine,
well established laboratory facility for routine blood, biochemistry, microbiological and
neurochemistry investigations, facility for spinal fluid aspiration, ICU etc.
Staff includes qualified Neurophysician, EEG technician, physician assistants, trained

nursing staff, lab staff, and other support staff.
21
Neurosurgery:
Surgery remains the best modality, either by itself or in combination with adjuvant treatments
in solid tumors. The Department of Surgery requires the best diagnostic acumen coupled with
the state-of-art surgical expertise. Development of super specialty services in Head and Neck,
Breast, Reconstructive surgery, Thoracic, Gastro-intestinal, urology/gynecology and bone/soft
tissue oncology has further improved the technical excellence in each specialty over the last
15 years.
Judicious use of Laser, micro-vascular techniques and multi-modal therapy has increased
organ preservation leading to a remarkable improvement in the quality of life without
compromising on cure rates.
Purpose of the Neurosurgery department is not only to save life, but also to preserve all
functions, cosmesis and reduce pain, shorter hospital stay, avoiding discomfort.
The use of the surgical microscope, bipolar Cautery, the availability of the ultrasonic
surgical aspirator, neuro-anesthesia, neurosurgical intensive care and neuro-imaging
technology , stereotactic and minimally invasive neurosurgery, Trans-sphenoidal
surgery for pituitary tumor, spinal fusions for congenital and traumatic (CT scan &
MRI for locating the target for functional neurosurgery) and intra-operative monitoring
for different kinds of surgeries have revolutionized this super specialty.
Following will be the available facilities in this department;
1. Neurosurgical and Neuro Anesthesia Team, Neurosurgical Intensive Care Unit , intra-
operative electro physiological monitoring for spinal surgery
2. Diagnostics with Computerized Tomography (CT), Magnetic Resonance Imaging
(MRI) and Angiography. All routine X-rays and ultrasound investigations
3. Operating Rooms with preferably laminar air flow system and equipped with the
ceiling mounted microscope with in-built still photography and video recording
facilities compatible with the Optical Tracking System (OTS). OTS allows the
monitoring of the progress of surgery in real time and residual tumors, hemorrhage
etc can be seen.
4. Intensive Care Unit equipped with the latest Modular Invasive Monitoring System
and Advanced Life Support equipment capable of managing complicated
neurosurgical and neurological patients effectively. The nursing ratio is one to one.
All associated specialists like Respiratory Physicians, Nephrologists and
Endocrinologists will be available round the clock.
22
1. Specialized Equipments:
X-Knife; X-knife (Gamma knife) has the added advantage of being used for fractioned
treatment (Stereotactic Radiotherapy-SRT) for benign and malignant tumors not
suitable for SRS.
Computer Assisted Neurosurgery, operating computer with an accuracy of 1mm in
which images of the patient's brain can be directly transferred from the MRI or CT Scan
to the Operating Theatres at the Operating Table. The surgeon can join the probe to
different parts of the brain and retrieve the images previously taken. This is of great help
not only in locating difficult tumors, but also in avoiding critical structures and ensuring
completeness of excision. Surgery for abnormal movements, epilepsy and small deep
malformation can be done.
Frame Based Stereotaxy; Radionics CRW System complete with full range of
accessories to include the ability to carry out Frame Based Stereotactic Surgery
including Craniotomies. Equipment to generate RF lesions for functional neurosurgery
procedures like Pallidotomy and Thalamotomy for treatment of movement disorders and
Parkinson’s disease. Image Guided Frameless Stereotaxy allows safe surgery in
eloquent areas.
Interventional Neuro Radiology. A separate Department and a separate machine shall
be available for this crucial area. This machine with biplane rotational angio facilities is
utilized for embolization of arteriovenous malformation, treatment of giant aneurysms
by proximal occlusion and endovascular packing using GDC system, Thrombolysis by
injection of Urokinase directly into thrombus into the specific artery in the treatment of
brain attack, Angioplasty and stenting to prevent stroke, treatment for Vascular lesions
such as Dural AV malformations, carotid-cavernous fistula hemangiomas of the head
and neck, vascular tumors .
Microsurgical Instruments.
Neuroendoscopy. Equipment for minimally invasive endoscopic removal of certain
tumors (e.g. intraventricular and pituitary tumors), third ventriculostomy in the
treatment of hydrocephalus, drainage of brain abscesses and cysts.
Spinal Instrumentation: A complete range of spinal instrumentation shall be available
for stabilizing the spine using metal implants. These are used in cases of spinal
instability from spinal injuries, Tuberculosis & tumors. This allows early ambulation,
facilitates rehabilitation and early discharge from hospital.
Staff: Super specialist Neurosurgeon as the team leader, qualified Neurology
anesthetist, physician assistants, radiologist, technicians for radiology and operating
rooms, nursing staff in 1:1 ratio for ICU, pathologist and support staff.
23
Department of Plastic Surgery

Plastic surgery department will be developed with the goal of restoring function and form to
the body. Unlike most surgical specialties, it is not confined to one organ system or body part.
Instead, plastic surgery repairs, reconstructs and replaces physical defects involving:
• Skin and soft tissue

• Head and neck
• Facial structures
• Trunk and extremities
• Hand
• Breast
• Peripheral nerves
There are two types of plastic surgery: reconstructive and cosmetic.
Reconstructive surgery is performed on abnormal structures of the body caused by

congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is
generally performed to improve function, but may also be done to approximate a normal
appearance.
Cosmetic surgery is performed to reshape normal structures of the body in order to improve
the patient's appearance and self-esteem.
Well equipped operating room with trained nurses and O.T. staff for plastic surgery
procedures under the plastic surgeon, anesthetist and many times dermatologist during
cosmetic surgery are primary needs of the department. The main facilities covering
equipments and prosthetics/implants will be:
Naso-endoscope and Videographic recording facility

Liposuction machine
Electric saw, dermabrader, Roto-Osteotome and drill.
Operating Microscope
Cold light fountain small 150 watt
Pneumatic Tourniquet 13
Foetal Monitor/Doppler
Nerve stimulator
Skin graft mesher
13
e.g., deluxe model 851 BIOMET
L & T Minimon 7133 A/2 with accessories
KM 1215 - Kilburn MITA 1215 Copier with 2KV Servo Stabilizer
24
Tissue Expanders
Titanium Maxillo-Cranio Facial Modular System, Titanium Fracture Reconstructive
Mandibular Distractions, , Smooth & Textured Mammary Implants, Anatomic
Textured Mammary Implants, Aspirators All Kinds of Cannula , Microinjection ,
Epiderm Gel, Sheeting Areola Circles/Mammary Sheets , Xeragel Silicon Ointment,
Microsurgical instruments and equipments, Electronic Surgical Motor, Hand pieces
for Small bone Surgery and Micro-Bone Surgery,
Complete anesthesia and monitoring systems, headlights, light sources , video
cameras and portable halogen light ,cryosurgery and electrosurgical equipments,
laser supplies and wound care products,
Transonic Laser Doppler Perfusion Monitor used for post-operative flap
monitoring,
Laser Doppler monitoring systems for blood flow monitoring on tissue transfers,
Complete facility for Bariatric surgery
Treatment of skin diseases, cancer, trauma:
• Malignant and benign lesions of the skin (basal cell, squamous cell)
• Melanoma
• Malignant and benign lesions of the soft tissue (sarcoma, lipoma)
• Birthmarks
• Reconstructive flaps and grafts
• Scar revisions
Complex wound and burn treatment:
• Acute burn management (thermal, chemical, electrical)

• Reconstructive burn treatment
• Difficult wound care (infections, bites, foreign bodies, chronic open wounds)
• End-stage hidradenitis suppurativa
Surgery of the breast:
• Post-mastectomy breast reconstruction

• Breast reduction
• Congenital and developmental breast deformities
• Gynecomastia
Treatment of facial deformity, disease, trauma:
• Facial fractures (mandible, zygoma, orbits, nose)

• Tumors of the lips, mouth, tongue, salivary glands
• Congenital tumors and vascular malformations
• Wound and laceration treatment
• Nasal deformity, ear deformity
• Cleft lip and palate
25
Surgery of the hand:
• Hand and forearm wounds

• Tendon injuries and lacerations
• Nerve injuries
• Fractures of the hand
• Vascular injuries of the hand
• Carpal tunnel syndrome
• Dupuytren's contracture
• Trigger finger
• Congenital anomalies (extra digits, webbed fingers, etc.)
Surgery of the trunk and extremities:
• Chest and abdominal wall reconstruction

• Perineal reconstruction
• Lower extremity coverage
• Flaps, grafts, free tissue transfer, expanders
Cosmetic surgery:
• Facelift (brow lift, neck-lift)

• Blepharoplasty (eyelid surgery)
• Cosmetic rhinoplasty
• Cosmetic otoplasty
• Liposuction
• Collagen injections
• Abdominoplasty
26
Physiotherapy & Rehabilitation Services

Very essential part of comprehensive medical care comprises of physio and occupational
therapy. Physiotherapists assess and evaluate the disability; it's resultant functional and
psychosocial impact. The primary focus is on performance of personal care activity and then
extends it to social and vocational activity. The patient and rehabilitation professionals share
responsibility in setting goals that allow them to work together toward maximum
independence.
Our Activities:
Ventilatory muscle endurance training to improve pre and postoperative
pulmonary functions. Here, treatment is aimed towards improved oxygen transport
and tissue metabolism along with maintenance of cardio-pulmonary hemodynamics
and preservation of overall functional status (neurological and musculo-skeletal).
This helps to facilitate an early discharge of patients from the I.C.U. and reduce
morbidity.
Recovery following mastectomy. To restore pain free movements at the shoulder

joint by appropriate exercises. Prevent edema by exercise in Elevation, pressure
garments and by a state of art equipment called the lymphapress. Restoration of self-
esteem and well being is achieved by providing breast prosthesis.
Rehabilitation following head and neck surgery. Areas of major concern are
deglutition, self-care consideration and minimizing functional and cosmetic
deformity. Activity includes, maintaining clear airways, post-operative active
exercise for neck and shoulder joint and strengthening of shoulder girdle muscles to
improve scapular stability. Electrical stimulation to prevent atrophy of facial
muscles. Infrared and Transcutaneous nerve stimulator are used for relief of pain.
Combination therapy of ultrasound and jaw stretching exercise for Trismus following
radiation and surgery of alveolo-buccal complex and due to submucous fibrosis.
Rehabilitation following bone and soft tissue malignancy. re-education and

strengthening of partially resected muscles as well as atrophied muscles, general
exercises, sitting and standing balance, gait training, stair climbing exercises and
other activities of daily living. At a later stage non weight bearing or partial weight
bearing ambulation are given with the help of braces or crutches.
27
Rehabilitation for the patients receiving chemotherapy and radiotherapy.

Suitable isometric and isotonic exercises with weight cuffs are used for strengthening
limbs. Specially designed spinal braces, splints, aids and supportive orthotics help in
functional restoration, mobility, pain relief and comfortable posture and assist in
independent living. In Pediatric conditions especially leukemia and Hodgkin's
disease, remedial interventions are given to overcome neuro-psychological
differences, learning problems and handle incidental psychological stress.
Relief of pain.
Palliative care: To enable the patient to sit, walk, and sleep in a comfortable
position, appropriate supportive braces and aids are given.
Personal care activity and group activities are employed for physical and
psychological benefits. Energy conservation and relaxation techniques, yoga and
therapeutic recreational activities help debility.
Support services.
Rehabilitation research
28
Facilities planned at the Super Specialty Health Care and therapy center
# Facility Description
I. Physical Therapy A complete healing center with most modern and

sophisticated facilities which will be attended by well trained
and expert therapists in the following areas;
• Orthopedics
• Neurology: diseases of brain and spinal cord
• Trauma care
• Disabilities and rehabilitation
• Musculoskeletal disorders
• Biomechanics and ergonomics: clinical gait analysis,
ergoweb, stretching and flexibility etc.
• Cardiology and cardiothoracic surgery
• Pulmonology
• Obstetrics and gynecology
• Pediatrics
• Burns and plastic surgery
• Obesity and bariatric surgery
• Psychiatric disorders
• Speech therapy
Geriatric care
II. Hydrotherapy for Hydrotherapy for Anthrax, Anxiety Disorders, Arthritis,
healing Back Pain, Chronic Fatigue Syndrome, Diabetes , Infertility
diseases/conditions - women, Infertility - men, Insomnia, Shingles, Stress
Management, Varicose Veins
Hot & Cold Water Therapy:
• Warm water Pool Therapy
• Cold rubbings
• Douches
• Sauna and Steam Baths
• Full and partial immersion baths
• Wraps
• Packs
• Herbal baths
• Drinking water therapy
III. Laser Therapy I. Laser Integrated Physical Therapy for;
• Patellar tracking
• IT Band Syndrome
• Tennis elbow
• Sciatica
• Volleyball shoulder
• Shoulder impingement
• Neck injuries
• Bursitis
• Muscular strains
• Sprains
• Tendonitis
LLLT/Low level laser therapy (photobiomodulation, cold

29
laser therapy and laser biostimulation) Musculoskeletal,

pain relief, low back conditions, carpal tunnel syndrome etc.
IV. Pool Therapy • For all injuries and rheumatological conditions,
including osteo arthritis, rheumatoid arthritis, ankle
and leg sprains and fractures, presurgical and
postsurgical hips, knees, and backs, muscle strains,
frozen shoulders, painful necks and backs,
fibromyalgia, achilles and patellar tendonitis
Aquatic therapy, water exercises; Pre-op and Post-
op Rehab, Planning or Recovering From Surgery,
inpool cervical and lumbar traction
V. Occupational Mental Health Occupational Therapy:
Therapy
I. Mental health inpatient units
• Adolescent, adult and older people's acute mental

health ward
• Adult and older people's rehabilitation ward
• Specialist unit for Eating Disorders, Learning
disabilities
• Forensic psychiatry(in later phase)
• Psychiatric intensive care unit (in later phase)
II. Community based mental health teams
• Child and adolescent mental health team

• Adult and older people's community mental health
team
• Rehabilitation and recovery and Assertive Outreach
community team
• Home treatment teams
• Team for early intervention in psychosis
• Specialist; learning disability, eating disorder
community services
• Day service
• Vocational Service
• Dementia & Alzheimer Care
III. Workshop for For Ankle, Back, Calf, Cold Therapy, Elbow, Foot, Groin
Advanced Braces & Wraps/Straps, Knee, Maternity, Night Splints, Shoulder,
Splints SupportHose, Thigh, Wrist, Thumb and Finger
e.g. Cramer supports and braces, procare braces, Corepillows,

bioskin, bodysport equipment
IV. Common orthopedic I. Conditions Related to Aging
conditions
• Arthritis – typical among elderly; however anyone can
be affected at any age. The condition is an
inflammatory condition seen in joints. This may result
from age, trauma or infection.
30
• Osteoporosis – due to loss of non-collagenous proteins

and minerals from bones, leading to excessive bone
fragility. Treatment and management is important as
symptoms can include an unexpected bone fracture.
II. Back Problems
• Back pain
• Sciatica – irritation of the sciatic nerve. Symptoms can

include pain or tingling running down the inside of the
leg.
• Lumbar and Cervical Disk Disease (CDD) –

deterioration of the spongy disks in the spine. Symptoms
can include pain, limited movement, numbness, tingling,
or weakness.
• Slipped disc (prolapsus disci intervertebralis) – a tear of

the most outer component of the intervertebral disc
allowing of the medial component to ‘slip’ towards to
outside. The disc protrusion can occur in any area of the
spine.
a
• Spondylosis/Spondylolysis – arthritic or osteoporotic
degeneration of the spinal vertebrae of the spine. If
progressive, it can cause severe pain and/or paralysis due
to compression on the nerve roots. Typically occurring
in the lower vertebrae
III. Hand and Arm Conditions
• Carpal tunnel syndrome (CTS) – compression of the

median nerve at the wrist. Symptoms can include
numbness, tingling, and pain in the fingers.
• Frozen shoulder (Adhesive capsulitis) – tightening and
thickening of the connective tissues which support the
structures of the shoulder. If not treated and managed
through exercise and physiotherapy the smallest of
activities can become painful, leading to chronicity and
decreased function is inevitable.
• Rotator Cuff Injuries - Typically seen by patients

who have painful arc. The result of inflammation and
tearing of the cuffs decrease the space (subacromial)
for which they can pass beneath. The end results
typically seen are increasing pain, weakness, loss of
work, painful, waking sleeps and decrease function.
31
IV. Lower Body Conditions
• Knee ACL/MCL/LCL/PCL sprains and tears – it is

important to restore to health of these cruciate ligaments;
as many will go without therapy and exercise. These
tendons assist the strength, function and congruency of
the knee.
• Ankle Sprains and Strains
• Patello-Femoral Syndrome (PFS) – an abnormality

kneecap movements, causing scraping of the femur and
consequent pain. Symptoms can include pain in the front
of the knee, behind the kneecap, or behind the knee, as
well as difficulty using stairs.
• Plantar Fasciitis – irritation and swelling of the tissue

on the bottom of the foot. Faulty foot biomechanics can
be the cause of this condition. Orthotic fitting and
therapy will help to resolves the pain and discomfort.
Symptoms can include pain or aching in the bottom of
the heel.
V. Sports Injuries
• Sprains – over stretching of a tendon beyond normal

length. Results will vary however most can expect
swelling, decrease function and use and pain.
• Strains – over stretching of a muscle, typically

accompanied by swelling, bruising and pain.
• Tennis Elbow (lateral epicondylitis) – an

inflammation to the outside of the elbow. The
condition is usually companied by pain, loss of range
of movement and increased tenderness. Many
sufferers note decreasing ability to grasp and hold on
to objects, such as coffee cups and pens
• Golfer’s Elbow/Pitcher’s Elbow (medial

epdicondylitis) – an inflammation around the tendons
of the medial elbow. Treatment is crucial in order to
avoid increased damage to the ulnar nerve; which
slides between bony processes
32
VI. Other Conditions
• Neck pain/whiplash – WAD are seen as a result of

sudden impact injuries, leaving the neck in a vulnerable
position. The result of such scenarios leaves patients
with over-stretched and/or tearing in the neck. The
condition is not always apparent at the time of injury
and symptoms may present days even weeks later.
Localized pains, as well referred pain are typical
complaints. Pins & needles and paralysis are also seen
depending of the severity of the incident.
• Nerve impingement – abnormal pressure on a nerve.

Symptoms can include tingling, pins & needles,
numbness, burning, referred pain and/or shooting
sensations.
• Post-surgical rehabilitation
• Repetitive strain/overuse injuries (tendonitis/

tendonosis) – this is a result of inflammation to the
tendon. There are many areas affected could be the
Achilles, Patella, etc.
• Fibromyalgia – a medical condition whereby patients

experience heightened pain sensitivity to both strong
and light touch. Allodynia is commonly referred to as
over sensitization. The syndrome is renowned for
having acute flare-ups and remission periods. This is
often frustrating and painful to the patients. Research
indicates a genetic predisposition to the condition, but
through physiotherapy it can be managed.
V. Telerehabilitation • Telerehabilitation: Assessing acquired neurogenic

communication disorders online
• Telephysiotherapy: Accuracy and Reliability of

Medial Longitudinal Arch measurement in Children;
Determination of the accuracy and reliability of
observation gait assessment for children and adults;
• Speech Pathology: Telehealth assessment and

treatment of disordered voice in Parkinson's disease.
• Internet assessment of ADL and hand function in

Parkison's disease
• Occupational therapy : limb range of motion in people

who have had a stroke,
33
VI. Panchakarma • Taap Swedan,

• Vashap Swedan,
• Dravaya Swedan,
• Snehan Karma,
• Pradhan Karma,
• General Treatment
VII. Equipment • Laser Therapy unit with deep mitochondrial

stimulation,
• laser therapy IR unit single channel,
• Shortwave Diathermy 500W digital models along with
pulse operation, disc electrodes, mechanical timer,
• Interferential Therapy,
• Cervical & Lumber Traction with Solid state circuitry,
Patient safety switch, Audio visual alarm, static
intermittent switch, digital treatment timer.
• Muscle Stimulator (Dignostic & Semi-Digital) for
muscle dystrophy, functional paralysis resulting from
traumatic neurosis, Hysteria or Neuroproxia, Flacid
paralysis, Spastic paralysis, Cardiovascular disorders,
Muscle strains, etc
• Stimulation of denervated muscle ion transfer.
maximum output 75 MA
• for diagnosis and the extent of Muscle lesion
• Continuous Passive Motion (CPM) therapy
immediately after surgery
• 4 Channel Digital & Semi-Digital LCD Model (IFT +
MS + TENS) Programmable
34
TREATMENTS, EVALUATIONS AND OTHER PROGRAMS

At Physiotherapy Active Rehab, institute will offer a variety of treatments and programs to get
the patients into the best pain-free condition possible.
First patient will be assessed to determine current condition and symptoms; then, a customized
treatment program to improve their health. Will be given which may be as under;
Advanced Manual Therapy (Physiotherapy)
Techniques/Skills
Massage Therapy: Gliding, kneading, pressing, tapping or vibrating the soft tissues of the body
to improve health.
Acupuncture: Inserting fine, medical-grade needles into the skin at various points of the body to
relieve pain and for other health benefits.
Mulligan: is an outstanding new physiotherapy treatment used by individually trained

physiotherapists assisting in passive physiological patterns and movements of the patient.
Mulligan mobilizations are used everywhere including ankle, knee, back and shoulder. Amazing
results are seen Day 1. Gliding the patients restricted joints from a stiff and immobile position
to a functional and pain free range.
Myofascial Release: is a used by specifically qualified and educated therapists assisting in

sustained pressures/tensions into the associated areas where patients suffer pain and discomfort.
The therapist assists in stretching out and maintaining the fascia (fascia is the connective tissue of
the body which covers and penetrates the vascular system, nervous system and muscular system
of the body) of the patient. During this treatment the fascia is mobilized from its restricted areas,
decreasing tension and restoring normal movements and ranges.
Exercise Programs: Various types of exercise to strengthen or limber up muscles, soft tissue,
joints, and ligaments.
Traction: the focus of this treatment technique is to decreasing joint stiffness, decrease muscle
spasms, modulate pain levels and reduce nerve impingement.
Manual and machine traction will be available for Cervical, Thoracic and Lumbar spine.
Customized Orthotics (Shoes and Inserts): Custom-fit footwear to reduce foot, knee, hip and
back pain, while optimizing biomechanics and posture.
Splints, Braces, and Other Devices: Medical devices to immobilize parts of the body (such as
the knee or the elbow) to reduce pain and promote healing. hysical Therapy
Ultrasound: The purpose of this modality is to modulate pain, improve the connective tissue
extensibility, minimize and eliminate inflammation, decrease healing time, avoid muscle spasms
and decrease joint restrictions.
35
TENS: The TENS unit assists in the management of pain. Current evidence specifies central
inhibition of neurotransmission through the Pain Gate Theory, the end result felt by the patient is
decreased pain and improved quality of life.
The TENS units are ideal for both acute and chronic conditions.
Interfential Current Therapy: IFC therapy focuses on muscle stimulation pads which gear
towards decreasing pain levels by diminishing the rate of neurotransmission, as well as reducing
the rate of available receptors. Moreover, the IFC therapy helps to improve range of motion and
strength. Premodualted Interferential currents will be used.
Paraffin Wax: With increased thermal effects and circulation, wax baths are an excellent
treatment modality to assist those suffering from arthritis, carpal tunnel, fibromyalgia, muscle
and joint pain +/- stiffness.
Cold/Heat: Administering the thermal effects to optimize metabolic rate, capillary permeability,
muscle strength and decrease muscle spasms, assisting in pain levels, joint stiffness, muscle
spasms and comfort.
Laser: Recent research establishes laser therapy to be effective in treating many conditions such
as pressure sores, plantar fasciitis and surgical wounds by relieving pain and promoting quicker
healing.
Functional Ability Evaluations:

If patient is injured in the line of work, or if making a disability claim for other reasons, our
institute experts will objectively assess physical abilities and limitations.
The end result will be a formal report for insurance provider that will tell them exactly what
patient can and cannot do from a physical perspective.
Other Specialized Programs:
Injury-specific exercises (including Return to Sports): Exercises that focus on the injured
body part to gently return it to optimal health and function.
Personal Training: Assistance and education about physical fitness, including regular workouts.
Work Hardening/Conditioning Programs: Exercise programs designed to improve ability to

do manual labor or other physically-intensive tasks.
Motor Vehicle Accident Rehabilitation: Therapy to help recover from injuries sustained in a
motor vehicle accident (such as whiplash).
36
WSIB (Workplace Safety & Insurance Board) Education/Injury Prevention/Return to

Work: Education on workplace safety and how to avoid accidents and injuries. For those injured
on the job, exercises and physical therapies designed to return to full function and return to
everyday living.
1. Team of highly qualified professionals from physiotherapists to massage therapists,

acupuncture specialists and kinesiologists.
2. Skilled and trained medical professionals graduated from the best universities of our
country equipped with the very latest knowledge in their fields.
3. Wide range of services and treatments will be offered: no matter whatever condition or
health situation, treatments to assist all patients. If recovering from an accident or surgery,
help to return to peak condition. Work-hardening programs to strengthen body plus
personal training and education on how to avoid work accidents.
4. Every treatment will be customized for individual need.
5. 7/24 hours access to services.
37
Center for Athletic Medicine

Following services will be particularly included;
1. Cardiology and Exercise Physiology: FITNESS PROGRAM

a. Exercise physiology applied to an athlete. Aspects of fitness, aerobic and strength
training, and other exercises, works out with exercise physiologists and trainers.
b. Body fat analysis, heart rate, cholesterol, and other elements will be evaluated. A
nutritionist will cover basics in sports nutrition.
2. Medical Issues in Sports: We will focus on such diseases as exercise-induced asthma,
diabetes, osteoarthritis, cardiovascular disease, hypertension, cancer, heat illness, cold
illness, altitude illness, dermatologic issues and pregnancy.
3. Musculoskeletal Imaging: MRI, ultrasound, and CT scan of the extremities and spine
4. Orthopedic Surgery: surgical repair of sports injuries, surgical post-operative care,
surgical rehabilitation for various procedures.
5. Pediatric Sports Medicine: athletic screening, proper diagnosis of heart murmurs, and
recommendations for sport participation. Orthopedic surgery will emphasize scoliosis
screening, early gait abnormalities, and management of acute orthopedic injuries in the
pediatric population.
6. Physical Therapy and Injury Rehabilitation: All available modern therapeutic modalities
7. Primary Care Sports Medicine:
8. Spine Management: injuries, vertebral disc disease and radiculopathy, and invasive
management of back pain, integrative medicine approach to the patient with back
problems, i.e. acupuncture, neuron-muscular massage, chiropractic care, and movement
re-education.
9. Sports Psychology and Nutrition, counseling patients on proper nutritional concepts.
10. Sports Trauma Management: management of concussion and severe brain injury
following trauma, integration with neuropsychology.
11. Hand / Foot & Ankle.
38
Diagnostics
RADIO DIAGNOSIS
Our department of Radio-diagnosis will cater to the needs of several departments including the
surgical, medical and radiation oncology departments.
The large variety and depth of information can be provided by radiological investigations like
several imaging modalities such as, CT scan, Magnetic Resonance Imaging, Colour Doppler,
digital Imaging and Digital Subtraction Angiography and Digital Spot Mammography with
stereotactic breast biopsy in a modern Radio-diagnosis Department, all of which are
complementary to each other.
Activities planned:
o Imaging facilities for clinical work

o Interventional and therapeutic work
o Functional MR studies
o Quality control and radiation monitoring
o Teaching activities
Conventional Radiology:
Conventional Radiology is the backbone of the department of Radio-diagnosis. The majority of
patients entering the department are referred for plain radiographs of the chest, abdomen and
bones.
There will be a digital x-ray machine and Mass Miniature Radiography (MMR) unit. X-ray unit
shall be equipped with Image Intensifier-TV systems on which fluoroscopy guided
investigations will be carried out. A large number of specialized contrast procedures such as
Barium studies, intravenous Urography, Angiograms, Myelograms etc will be performed on
these x-ray machines. The image intensifier TV systems used for performing these procedures
enable more accurate diagnosis and significant reduction in radiation dose to patients.
Digital Radiography and Fluoroscopy:

1000 mA x-ray unit14 : a high power, digital radiography/fluoroscopy system which acquires x-
ray images in a digital format. It will be employed for specialized contrast procedures such as
barium swallow, barium meal, myelograms and for Digital subtraction Angiography (DSA). The
digital format allows manipulation and magnification of the images to improve contrast and
make the lesions look more conspicuous. The improved quality of images will almost eliminate
the need for repeat radiographs. The DSA facility will permit accurate visualization of blood
vessels after injection of contrast medium and allow lower dose of contrast as compared to
conventional angiography. It is of great value in studying diseases of blood vessels, blood supply
of tumors and mapping vascular anatomy in various parts of the body.
14
e.g., Advantx Legacy 1000 mA x-ray unit
39
Ultrasonography and Colour Doppler:
The department shall have colored ultrasound scanners15 and colour doppler16 scanners to be
used for initial screening to investigate suspected tumors and other disorders in various parts of
the body. All these will be equipped with a variety of multifrequency sectors, linear and convex
probes. These scanners will allow examination of the abdomen, pelvis and other organs such as
the breast, scrotum, thyroid and eye with a high degree of sensitivity. They will provide useful
information regarding the size and extent of tumors, lymph node enlargement and metastatic
deposits in the liver and other organs. Special Endorectal and Endovaginal probes will be used to
obtain better visualization of the pelvic organs and prostate gland.
The Colour Doppler scanners enable colour flow studies to be added to the ultrasound
examinations to evaluate blood flow and velocity and assess tumor vascularity. Narrowing and
thrombosis of blood vessels can be diagnosed with this technique. The other features are Tissue
Harmonic Imaging, Coded excitation and 3-D imaging.
Bedside sonography using Portable Ultrasound Scanners17 will also be arranged. These scanners
will also be employed for intraoperative sonography, especially for evaluation of the liver, gall
bladder and pancreas, using a specialized high frequency intraoperative probe.
Endovascular Ultrasound unit 18 for detailed assessment of blood vessels using a special
intravascular probe will be useful for endovascular brachytherapy
Computerized Tomography (CT)

CT scanning of the whole body with spiral and sequential techniques will be performed on the
Spiral CT Scanner19. The Spiral scanning techniques employed for the chest and abdomen will
enable an entire volume or region of the body to be scanned in one or two breath-holds, thus
eliminating motion and misregistration artefacts. Tiny nodules in the lungs and liver will be
detected with greater accuracy. Dual/Triple phase contrast enhanced scans will also be performed
with the spiral scanning techniques, to evaluate and characterize tumours in the liver, pancreas,
kidneys etc by scanning during the arterial and venous phases following contrast injection. In
short Diagnostic CT scan of head/body including CT cisternography CT Angiography for
abdominal, cranial and peripheral regions
Newer applications like CT Angiography, 3D-CT studies for cranio-vertebral junction and other
body parts, Biopsy and drainage procedures under CT guidance and Bone Mineral Densitometry
will also be performed on the spiral CT Scanner.
Magnetic Resonance Imaging (MRI)

Echo speed MRI System20 with attached Advantage Workstation. MR imaging is of great value
for the brain and spine, with excellent differentiation of grey and white matter, normal and
abnormal tissues. It has also proved to be of value in the head and neck regions and for
evaluation of the musculo-skeletal system and joints. It depicts changes in bone marrow with
great clarity. MR imaging of abdominal and pelvic organs can also provide useful information
regarding characterization, staging and operability of tumors in selected cases.
15
- the RT 3200 ans Sterling units
16
- the Logiq 500 and Logiq 700 units
17
- the Capasee and SDR 1200units
18
-CMF-800 Endovascular Ultrasound unit
19
e.g., Somatom Plus 4 Spiral CT Scanner
20
e.g.,1.5 tesla Signa Echospeed MRI System
40
In addition to routine imaging, the facilities with Echo speed MRI system will be:
Diagnostic head and spine studies, Diagnostic musculoskeletal studies, MR

angiography, Functional imaging and studies
Ultrafast imaging sequences, to reduce scan time and motion artefacts. Single breath-
hold imaging, useful for abdominal scanning.
MR Angiography, a non-invasive method of visualizing arteries and /or veins in the
head, neck, trunk and extremities.
MR Cholangiopancreatography, a non-invasive method for depicting the biliary tree,
pancreatic duct and gall bladder. It is most helpful in cases of obstructive jaundice
Diffusion imaging, helpful for detecting early brain infarcts.
Functional imaging, useful for presurgical mapping of brain centres e.g., motor, visual,
and speech centers.
MR Spectroscopy (Hydrogen and Phosphorus). This is a non-invasive method of
measuring the levels of certain metabolites in body tissues and organs, which helps in
diagnosis of tumors, and differentiation from other conditions like infarcts, infective and
degenerative lesions.
Functional MR Studies
Proton and phosphorus MR spectroscopy, Magnetization transfer, MR imaging, Phase imaging,

Perfusion imaging limited to renal perfusion, other techniques like diffusion imaging, fiber
tracking, perfusion imaging, MRCP, MR Urography and functional brain mapping.
Digital subtraction angiography
Diagnostic head, spine, abdominal/thoracic and peripheral arteriography and

venography with subtraction
Neuro- and other vascular interventional therapeutic procedures
Interventional and Therapeutic Procedures
A number of interventional procedures such as Percutaneous Nephrostomy, Stenting,

Percutaneous transhepatic biliary drainage, tumor embolization and celiac plexus blocks are
carried out to assist the management of cancer patients, and for relief of pain and other
symptoms.
Fine needle biopsies and aspirations are performed from deep seated tumors under ultrasound,
CT or fluoroscopic guidance to provide material for cytological or histopathological
diagnosis.
41
Neurological interventions
• Guglielmi detachable coil (GDC) embolization treatment for intracranial aneurysms

• Carotid angioplasty and carotid stent placement
• Intracranial arteriovenous malformation treatment
• Vein of Galen aneurysm treatment
• Carotid cavernous fistula treatment
• Skull base tumor embolization i.e. meningioma, nasopharyngeal angiofibroma, glomus
tumors, etc.
• Cranial vessel thrombolysis
• Therapeutic and diagnostic carotid occlusion
• Intracranial vessel angioplasty / papaverine infusion for treatment of spasm
• Petrosal sinus sampling.
• Scalp arterio-venous malformation embolization
• Facial arterio-venous malformation and venous anomalies treatment
• Spinal arterio-venous malformation embolization
• Spinal vascular tumor embolization
• Vertebroplasty for osteoporosis, metastasis, multiple myeloma or hemangioma
• Spinal biopsy procedures
• Facet joint steroid injection
Vascular Interventions
• Balloon angioplasty or stent placement in steno-occlusive lesions i.e. peripheral vascular

disease, renal artery lesions and aorta
• Embolization procedures in routine and emergency in renal lesions, gastrointestinal
lesions, lung lesions and peripheral malformations
• Stent grafts
• Aneurysms / pseudo aneurysms
• Arteriovenous fistula
Non-Vascular Interventional Radiology
• Image guided aspiration cytology, biopsy

• Interventional uroradiology
• Percutaneous nephrostomy
• Antegrade ureteral stent deployment (Drainage of peri-nephric collections, Transrectal
prostatic biopsies, Urethral strictures – dilatation and stents)
• Interventional therapy of infertility (Fallopian tube recanalization)
• Biliary tract interventions (Percutaneous biliary drainage, Complex hilar reconstruction
with metallic stents, Percutaneous management of postsurgical strictures, Percutaneous
drainage of postoperative bilomas, Gall Bladder intervention, Cholecystostomy,
Gallbladder ablation)
• Gastrointestinal interventions (Gastroenteric feeding, Gastrostomy, Enteral feeding,
Esophageal intervention, Metallic stents, Colonic interventions – cecostomy and stents)
• Drainage of abdominal abscesses
42
• Interventional procedures in thorax (Empyema drainage, Broncho-pleuro-cutaneous

fistulae, Bronchial stents)
• Hepatic Interventions (Percutaneous ablation of liver tumors, Arterial embolization of
liver tumors, Portal vein embolization, Percutaneous ablation and drainage of hydatid
cysts)
• Interventional therapy for Budd-Chiari syndrome (Inferior vena cava recanalization,
hepatic vein recanalization - using metallic stents, TIPSS)
NETWORKING/PACS
A Radiology Information System (RIS) with networking and PACS shall be established. In
the first phase, the digital imaging modalities i.e. CT, MRI, Colour Doppler, and digital
Radiography (DSA) units will be networked for intra-departmental transfer and storage of
images in digital format. Conversion of conventional radiographs to the digital format, with
log on term archiving of images will be done through a PACS system employing Magneto-
Optical discs and jukeboxes. The RIS will also be integrated with the Hospital information
System, enabling images and reports to be transmitted to sites throughout the Hospital, where
they can be viewed by the referring clinicians at different sites.
Quality Control and Radiation Monitoring:
Imaging quality control using sensitometry and densitometry, Radiation monitoring diagnostic
and Interventional procedures using thermo luminescent dosimetry.
43
Laboratory Medicine
Research in any disease has to be translated into improvement in patient care. The Department
of Laboratory Medicine will act as an interface between research and treatment. Equipped with
the most modern fully automized machines and facilities, our laboratory will undertake
sophisticated tests like hormone receptor analysis in breast cancer, tumor marker in blood to
detect hairline fractures, minute residual cancers, genetic and immunologic markers in breast
and hematological cancers, and many others that are helpful in making treatment decisions
Department of Pathology:
Major Facilities
Histopathology, Cytopathology, Electron Microscopy, Haemato-pathology, and Clinical

Chemistry, Endocrine Pathology, Gastrointestinal and Hepatic Pathology including
endoscopic biopsy pathology and Renal Pathology including transplant pathology,
Ultramodern Blood Bank will carry out regular screening of blood for hepatitis, B & C,
AIDS and ensure supply of safe blood to the needy patients. It will be equipped with
modern equipments like Cryoprecipitate bath for preparing cryoprecipitate preparation
and Platelet agitator for storing platelet concentrates Whole blood and blood components
will be provided to the patients as per their needs on the advice of the clinicians
concerned.
Special equipments in addition to routine equipments:
Histokinette,
Platelet aggregometer,
Precision Rotary Microtome,
Fluorescent Microscope
Deep Freezer,
Microtome Rotary HM 320,
Elisa Reader,
Floor mount video Projector,
Blood Cell counter
Cell counter Challenger
Platelet Agitator
Refrigerator Centrifuge
Cell washer,
Automatic Tissue Processor,
Cryostat,
Immuno histo chemistry.
ABG analyzer
44
PNEUMATIC AIR TUBE SYSTEM

This will be unique system in our hospital for speedy transport of laboratory specimens,
pharmacy prescriptions, certain items of drugs and other suitably sized mail to and from
clinical areas, main reception, laboratories, pharmacy and radiology. The system conveys
these items in carriers quickly and timely, secured and directly between stations, freeing ward
and portering staff for other duties. It enables laboratory specimens and pharmacy prescriptions
to arrive more evenly throughout the working day, reducing bottlenecks in their initial
processing. The system is capable of operating 24 hours a day, 7 days a week. THE
PNEUMATIC AIR TUBE IS A SIGNIFICANT TIME AND LABOUR SAVING PLUS
ERRORLESS SYSTEM.
Each Ward/Department will have an allocation of labeled and colour-coded carriers for which
they are responsible. Carriers are colour-banded in Blue or Green and will only be used for the
items relating to that colour.
Laboratory Medicine Blue carrier
Pharmacy Green carrier
Each individual carrier has a "Home Station" and is labeled with a "Return to
Station" number and the ward / department to which it belongs.
Carriers will be returned to the home station as quickly as possible with original
packaging.
All emergency samples are sent via this system. Other items are; Fluids of less than 30ml
from normally sterile sites, Tissue samples for microbiology investigations, High risk
samples, double bagged and labeled as per "Safe working , and the prevention of infection
in the Laboratory," and transported singly in a carrier after the relevant Laboratory
Discipline has been notified, Glass ampoules - suitably packaged, level 3 pathogens,
medicines and prescription charts, Cytotoxic drugs , Blood Culture bottles placed in special
carriers and Posts
45
Clinical Nutrition
This department will cover a variety of services for patients and doctors. Patient-oriented
services including endoscopy, nutrition therapy, cancer chemotherapy, cancer surveillance and
screening and cancer education will be offered either on a day-care basis or by distance
consultation.
All types of therapeutic and diagnostic endoscopy for palliation of cancer such as
upper endoscopies, endoscopic gastronomy, sigmoidoscopies and colonoscopies,
dilatation of strictures, esophageal prosthesis (plastic and metal), polypectomy,
endoscopic laser therapy, ERCP, sphincterectomy and biliary endoprosthesis
placement.
Adjuvant and palliative chemotherapy for patients with digestive cancers.
For enteral nutrition therapy, nasogastric/duodenal tube placements and PEG
Total parenteral nutrition therapy consultations
TPN formulations as per the clinical requirements for in-patients and out-patients.
Screening of high-risk individuals such as those with Barrett's esophagus, gastric
intestinal metaplasia and hereditary colorectal cancers
A comprehensive clinical nutrition team comprising of gastroenterologists, endoscopist,
nutrition nurse and dietician should be available on all working days.
CLINICAL RESEARCH
With clinical research, wide range of services is obtained from collection, maintenance,
quality control and analysis of data to design and execute prospective trials of importance. The
primary aim is;
To generate easily testable hypothesis from focused retrospective analysis or

laboratory studies,
To test novel avenues with survival or quality of life end points in observational
studies or randomized trials,
To support mega-trials from multiple centers (spread all over the nation),
To rethink on more technology in patient care and prevention through
epidemiological studies as well as to collate published evidence by meta-analysis to
define the state-of-the-art treatment.
46
Pharmacy Services
DEPARTMENTAL GOAL
The Pharmacy Team will determine the short and long term departmental goals, which will be
consistent with and focus on fulfillment of the departments and institution's mission and vision.
24 HOURS PHARMACY SERVICES:
A unique aspect of Vaibhav's Pharmacy will be medicine stacking and inventory management
system. It will be amongst those Pharmacies in India where medicines will not be visible at all
but arranged in protective cabinets
Ergonomic placement of cabinets ensures that there is minimum fatigue and that cleanliness and
asepsis is easier to maintain. Our system will ensure that expired medicines never reach the
patient by mistake. All medicines will be stored in the correct environmental conditions so that
the efficacy and potency of the drugs do not deteriorate
Pharmacy Service resources and expertise will ensure the highest quality of pharmacy services
with coordinated and organized program including the development of defined, measurable goals
and objectives. These processes will involve assessment, strategy development, and
implementation programs
• Services
o Staffing Support
o Purchasing Management Services
o Management Support
o Regulatory Compliance & Survey Report
o Quality Initiatives
o Clinical Protocol Development
o Operational Process Re-engineering & Audits
o Medication Safety Planning and Tracking
o Network of Pharmacy Chief and Clinicians
o Drug Information Center
o Staff Education and Competency Program
o Hospital Staff in-Services
o Benchmarking Programs
o Corporate Newsletters
o Pharmacy Residency
Programs and systems:
• Pharmacy Financial and Operational Management.

• Inventory Management.
• Process and Work Flow Redesign.
• Productivity Enhancement.
• Pharmaceutical Care Program Development - coordinate the clinical and distributional
functions for patient focused care.
• Clinical Services Development and Support - maximize and improve the provision of
clinical pharmacy services needs.
47
• Automation Development, Integration, and Support - capitalize on computer

applications and supporting systems.
• Accreditation Preparedness.
• Pharmacist Intervention and Outcomes Management Program Development -
optimizing documentation of interventions and improving patient outcomes.
Operational Excellence
Institute will provide a full range of pharmacy services, with management and operational
expertise providing the foundation as the core service set.
Comprehensive Solution
• Management Support
• Staffing Support
• Purchasing Management Systems
• Industry-Leading 340B Initiatives & Support
• Regulatory Compliance and Survey Support
• CPS Quality Initiatives
• Clinical Protocol Development
• Operational Process Re-Engineering and Audits
• Medication Safety Planning and Tracking
• National Network of Pharmacy Professionals
• Drug Information Center
• Comprehensive Staff Education and Competency Program
• Hospital Staff in-services
• Benchmarking Programs
Financial Performance
In most hospital settings, Pharmacy expense ranks within the top 3 or 4 expense line items of the
facility. Our comprehensive Pharmacy Services will develop proprietary programs and processes
that will empower our client facilities to measurably decrease drug expenditures, while at the
same time improving quality of patient care and service
Guarantee performance - we will not meet our financial objectives until our client facility
meets their financial objectives for the department.
Quality Patient Care
Pharmacy Services' goal is leading the pharmacy services in every measurable indicator. The
first and foremost includes the quality of care we will provide to our patients. We firmly believe
that intense focus on this priority will result in all other success factors following closely
behind. Therefore, we dedicate our efforts to six cornerstones of pharmacy services
48
Services and Competencies
• Quality of Care - considering the quality of patient care as the primary driver to all
projects and management relationships.
• Associate Development - Improving staff competencies, morale and productivity is key
to effectively preparing the department for exemplary performance and customer
satisfaction.
• Department Operations - employ the best resources to lead and support the Pharmacy.
• Clinical Improvements - Clinical program development and expansion to improve
patient care and deliver measurable savings.
• Regulatory Performance - consistently advancing our operations from regulatory and
quality of service focused strategies.
• Purchasing Effectiveness - proprietary programs and partnerships with our Distributor
and Group Purchasing Organizations (GPO) to insure the accuracy and compliance of
contract purchases, including participation in the drug purchase program.
Transparent Structure
• Independence
• Flexibility/Innovation
• Transparency
SCOPE OF SERVICES
Overview
The Department of Pharmacy will provide systems-based services including drug and disease
state information, drug preparation and distribution, and dosage monitoring services for all
patients. All physician orders/prescriptions for medications will be reviewed by a clinical
pharmacist for appropriateness of therapy and entered into a pharmacy database. This database
will provide clinical screening, drug preparation lists, drug production reports, and other drug use
information.
• Anticoagulation Clinic
• Central Pharmacy
• Cancer Center Pharmacy
• IV Pharmacy
• Investigational Drug Service Pharmacy
• Operating Room Pharmacy
• Shock Trauma Pharmacy
• Outpatient Pharmacy
• Women and Children's Pharmacy
• Respiratory Compounding Pharmacy
• Internet / Mail Order Pharmacy with facility of electronic transfer of prescriptions and
• Pneumatic air system for speedy transfer of medicines
• Closed System Pharmacy
49
Clinical pharmacy specialists and clinical pharmacists will provide direct patient care throughout
the institution. They will be active, integral members of medical service teams and assist the
team by providing services including:
• Drug selection
• Pharmacokinetic assessment and drug dosing
• Drug information
• Patient medication counseling and education
• Other patient-focused services to optimize drug therapy outcomes
All pharmacists will provide patient and health care provider education; participate in Adverse
Drug Reaction (ADR) and Medication Error programs; and participate in investigational drug
research, drug and therapeutic policy development and implementation, and other cost and
quality enhancement programs and projects. Pharmacists' interventions will be recorded and if
necessary documented in the medical record.
Pharmacy work areas will be staffed by:
• Clinical pharmacists/specialists
• Pharmacy operation managers
• Technicians
• Inventory control specialists
RECOGNIZED STANDARDS
Department compliant with the Hospital Policy Manual and all state, and regulatory standards
Other standards of care will be:
• Therapeutic Guidelines for Medication Use developed and approved by the our drug
Committee
• IV Push Guidelines Manual
• IV Infusion Manual
• Medication Protocols or Algorithms
• Critical Pathways
• Investigational Drug Protocols approved by the Institutional Drug Committee
50
Nursing
Areas of specialized nursing facilities will be as follows:
Surgical Nursing
Orthopedic Nursing
Trauma care Nursing
Neurology Nursing
Critical Care Nursing
Emergency care/Casualty Nursing
Medical Oncology Nursing
Bone Marrow Transplant (BMT) Nursing
Palliative Care Nursing
Radiation Nursing
Preventive Oncology Nursing
Aviation Nursing
Specialized areas where the nurses will contribute a great deal;
Protocol Nurses
BMT
Central Venous Catheter Clinic
Breast Care Services
Palliative Care
Stoma Care
Infection Control
ICU
Nursing Administration
Educational Courses related to oncology: Diploma in ICU/Critical care Nursing, Oncology

Nursing, trauma care nursing, Enterostomal Therapy training programme, Central Venous
Access Device (CVAD) Programme, Training programme in Palliative Care. (Certificate
courses ranging from 1 month to 12 months duration).
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Helicopter/Air Ambulance service

(To be planned in second phase of the project)
Service 24 hours a day, 7 days a week with services of highly trained group of qualified doctors
and paramedics for emergency transfer of patients by commercial airline, chartered planes or
helicopters throughout the world. Our services will extend from medical escorts to commercial
airline stretcher services to evacuation of critically ill patients on ventilators by chartered flights
to any destination in India and abroad.
3 levels of medical air transportation will be made available:
• Basic Life Support (BLS): BLS is the simplest of air ambulance transports. BLS patients
need minimal external life support, but are in need of monitoring or potential care during
the air ambulance transport
• Advanced Life Support (ALS): Patients needing ALS transport care are typically
suffering from trauma, burns or cardiac failure, but may suffer from a variety of other
conditions. Patients on ALS transports may require the equipment and medical flight care
to handle BLS functions as well as cardiac defibrillation, ability to control and monitor
dysarrythmia, administer drugs, and establish and maintain respiratory airways
• Critical Care: Critical Care is the highest level of care, typically necessary for patients
who are severely ill or injured. To provide the best care, the medical flight crew on a
Critical Care air medical transport may include a physician or other specialty staff. Patients
requiring a Critical Care air ambulance transport must utilize the Private Air Ambulance
service
• Our doctors will be available 24 hours a day on our medical HOTLINE to respond to
patients’ request and propose the most suitable and economical solution for their transport.
Medical Escorts
Medical Escort Services will prove to be good and economical for patients who have recovered
from a serious illness and are stable and do not require critical care management on flights. A
qualified doctor and a trained nurse or a paramedic will accompany the patient. Patient’s basic
monitoring of vital parameters, bathroom and travel assistance and administration of medications
will be taken care of e.g., booking of tickets for patient and relatives; priority boarding and
seating of the patient; ground transportation at origin and final destination and all documentation
procedures.
52
Commercial Airline Stretcher services

Air stretcher service: for patients who are stable for transportation in Commercial Airline and
eligible for economical Air stretcher services
This will include obtaining clearance from airline medical department; coordinating ground
transportation at the origin and the final destination; arranging for lifesaving medication, oxygen
and emergency lifesaving equipments which include cardiac monitors, pulse Oxymeter,
pacemakers, nebulizers and ventilators. The patient will be accompanied by an intensive care
doctor and trained nurse and necessary medical management done throughout the transport
process.
Helicopter ambulance and Air Medical Charters
Helicopter ambulance and Air charter services for transportation of critical patients who do not
qualify for the above services, to any destination in India and abroad.
The equipments includes all lifesaving apparatus including cardiac monitor, pulse Oxymeter,
multi parameter monitors, pacemakers, ventilators, nebulizers, defibrillators / monitors, suction
machines which are suitable for air transport.
Primary Medical Equipment and Supplies On-board:
• Multi-function monitor
o Cardiogram
o Blood Pressure
o Pulse oximetry
o End tidal CO2
o 2 invasive pressure lines
• Pediatric and adult intubation and advanced airway equipment
• Defibrillators with external pacing capability
• Latest transport ventilators
• Long distance 2000 psi oxygen tanks
• 3-channel infusion pump
• ALS/ACLS drugs and supplies
• Chest decompression kit
• Electrical inverter
• BiPap machine
• Suction units
• Aortic balloon pumps and infant isolettes (on special request)
53
The doctors will be qualified and experienced to carry out air evacuation operation and selected
carefully depending on the requirement of the patients. The doctors will be intensive care and
emergency physicians, anesthesiologists, pediatricians, cardiologists, neurologists, registered
nurses who have good experience in the field of emergency medicine plus capable of carrying
out all lifesaving emergency medical procedures and international in flight repatriation.
The doctors will have their working experience in hospitals of India and/or developed countries
and well tuned to the working of the hospital procedures and management of patients in their
medical system. They will also have their visa status eligible to transport patients in most of
countries of the world including Asian, African, European, American, Australian countries.
VIP Medical Escorts
This will be an exclusive medical security service for prominent guests and VIPs traveling
anywhere in India and abroad; essential from the view of fatigue, stress associated with travel,
jetlag, and business stress, individual medical problem both acute and chronic. More important
during travel in countries with poor medical infrastructure
Medical Staff
We believe that every mission is unique and each patient requires special considerations. The
medical staff with patient will be assigned according to the patient’s specific needs. The medical
crew will consist of a combination of Flight Paramedics, Flights Nurses, and Physicians &
Respiratory Therapists. Each medical staff member undergoes countless hours of aero medical
and flight physiology training. Once the patient’s medical report has been reviewed the team will
be structured accordingly.
N.B.: Critical care ambulance service with similar facilities of trained staff and all modern
equipments and instruments (ICU on wheels) will also be made available for the benefit of
local population
54
ORGANIZATIONAL CHART:
Mrs. Nutan Kamdar (Chair Person and Chief Managing

Director (CMD))
Mr. Mukund Kamdar
(CEO & Managing Director)
Chief Medical Director
Pharmacy
-Director, Education, R & D Chief Administrative
-Director, Orthopedics Officer/ Hospital
-Director, Neurosciences
administrator
-Director, Trauma care/ ICU
-Director, Plastic surgery
-Director, Oncology
-Director, Physiotherapy & Nursing
Rehabilitation MANPOWER & HR: supervisor
-Director,
-FRONTOFFICE
Diagnostic services -ADMINISTRATION
Laboratory & Radiology -ACCOUNTANCY In charge nurses
-P.R.O./Marketing
Officer
Staff nurses:
super
1. IT & COMPUTERS specialty
2. ENGINEERING: nurses
Consultants/super MAINTENANCE
specialists ELECTRICAL
3. BIOMEDICAL
ENGG &
workshops for Nursing
Ortho /Neuro aids
appliances
Physiotherapists
4. AMBULANCE
SERVICES:
critical care, HEM
Medical officers 5. SECURITY
6. HOUSEKEEPING
6. CSSD
7. CANTEEN
8. LAUNDRY
55
Hospital Staff
# Designation No. required
1. Intensivists/Physicians 2
2. Neurosurgeons 2
3. Orthopedic surgeons 2
4. Plastic surgeon 1
5. Anesthetist 1
6. Physiotherapists 4
7. Naturopathy/Indigenous therapy experts 2
8. Radiologists 2
9. Pathologist 1
10. Medical Officers 10
11. Hospital Administrator 2
12. IT managers: specialists 2
13. Biomedical engineer 1
14. Accountant 1
15. Computer operator 2
16. Clerical Staff 3
17. Chief Pharmacist 1
18. Jr. Pharmacist (3 Jr.) 3
19. Nursing Supervisor 1
20. Senior Nurses 3
21. Nurses: qualified GNM staff 12
22. Nursing Aids 12
23. Front Office Staff 5

reception/inquiry/telephone
operating/cash collection/registration of
pts
24. House Keeping Supervisor 1
25. Ward Boys, Ayahs, 15

Sweepers/Housekeepers
56
26. Security Staff 6
27. Technicians: CT and MRI scan 4
28. Technicians: lab 2
29. Electricians 4
30. Laundry Staff 4
31. Marketing Executive 1
32. Store Keeper 1
33. Peons/office boys 2
34. Drivers 2
TOTAL 117 staff
BED ALLOCATION FOR 45 BEDDED SET UP
No. Department Allotted beds
1. Orthopedics, Neurosurgery, Plastic 32

surgery, Trauma care, and General
Surgery
2. ICU 08
3. Casualty 05
Total 45
THE DETAILED AREA AND DESCRIPTION STATEMENT OF THE

BUILDING SHALL BE AS UNDER:
Sr. No. Type / Floor No. Area Sq. ft.
A. Basement/Cellar: Parking Space, lift well 8000

with lift cabin, stair cabin, lift landing of lift
well and Underground septic tank & water
tank, Generator, Central gas station/suction
unit, electricity room, small workshop for
biomedical engineer, central stores and
records, laundry, etc.
Super Structure
B. Ground Floor 8000
57
1st Floor 8000
2nd Floor 8000
3rd floor 6000
TOTAL AREA as per FSI 30000
(20000 sq. ft plot area)
Approximate space allocation to different departments:
No. Particulars Area required Total area in sq. ft.
i. Suite rooms 10 rooms 4000
ii. Deluxe rooms 20 rooms 6000
iii. Special rooms 7 rooms 1400
iv. ICU 8 beds 1800 sq. ft 1800
v. Emergency room 5 beds 1000 sq. ft 1000
vi. Operation Theatre 3000 sq. ft. 3000

complex
vi. OPD clinics 8 rooms 2000 sq. ft. 2000
vii. Front office: reception, 1200 sq. ft. 1200

registration, patients’
waiting area
viii. Laboratory 1000 sq. ft. 1000
ix. Radiology 1500 sq. ft. 1500
x. Physiotherapy center 1000 sq. ft. 1000
xi. Pool & hydrotherapy 1000 sq. ft. 1000
xii.. Director’s office, admin 1000 sq. ft. 1000

and board room
xiii. Seminar room + library 1000 sq. ft 1000
xiv. VIP guest rooms 800 sq. ft. 800
xv. Staff room, doctors’ 500 sq. ft. 500

duty room
xvi. Relatives’ wing 1800 sq. ft. 1800
Total 30000 sq. ft.
58
PROJECT TEAM:
# Designation Name
1. Chairperson/Chief Managing Director Mrs. Nutan Kamdar
2. Managing Director Mr. Mukund Kamdar
3. Lead persons for Project Management Dr Devvrat Sukhwal

& Co-ordination
4. HR & Administration
5. Training and Development
6. Legal Advisor
7. Architect
8. Structural Engineer
9. Electrical consultant
10. HVAC consultant
11. CA
PROPOSED IMPLEMENTATION SCHEDULE :

# Activity Estimated/targeted Completion Dates
i. Completion of Structural work 30th November, 2010
ii. Civil Finishing 31st December, 2010
Electrification
Plumbing & Fire-fighting
iii. Interiors 30th April, 2011
iv. Air-conditioning 30th April, 2011
v. Procurement of Equipment 15th May, 2011
vi. Installation of Equipment 31st May, 2011
vii. Testing & Soft Opening 31st May, 2011
Commercial Operation: 18th August, 2011

Full Commercial Operation: Inauguration date
59

CARE CENTER
60
Investment and Financing
Background
The Indian healthcare sector is on a high-growth trajectory propelled by unparalleled domestic

growth, increasing public awareness and growing global interest in India's delivery capabilities.
The focus of government on making healthcare a priority sector, increasing penetration of health
insurance, rising per capita income and increased incidence of lifestyle related diseases is
resulting in exponential rise of patient base21.
Half of India is below 25 years of age and two-thirds are below 35, it is easy to ignore the fact
that India is also home to a very large number of aged in absolute terms and that by 2027, it will
have over 170 million people above 60 years of age, almost double of what we have today.
According to industry estimates, over next 6 years about US$ 78 billion worth of investment
would be required in the Indian healthcare sector. However, the government spending in the
healthcare sector still lags behind other developing nations. According to WHO, government
spending on healthcare in 2004 amounted to 24.8% of the total health expenditure in India, as
compared to 45.3% in Brazil and 49.4% in South Korea. Against a world average of 3.96 hospital
beds per 1,000 populations, Russia has 9.7, Brazil has 2.6, China has 2.2, and India languishes at
just over 0.7. The deficiency is appalling on a similar scale when one compares the norms versus
the actual for doctors and nurses
As a result, private sector participation in this sector is crucial to meet the shortage of quality
healthcare facilities. It is expected that OUT of this US$ 78 billion investment, up to US$ 70
billion may come from the private sector.
Historically, participation of private sector players has been extensive in the primary and
secondary healthcare segment. Corporate hospitals were set up in the late 1980s, but the
emergence of chains (other than Apollo to some extent) was not forthcoming. The focus at the
time was on availability of medical care rather than providing comprehensive quality healthcare.
However, the last 5-7 years have witnessed the emergence of organized healthcare with a number
of players such as Fortis, Apollo, Wockhardt, Max Healthcare etc. setting up multiple hospitals
and creating a comprehensive healthcare delivery platform. In addition, even players like Apollo
Tyres and Reliance, who have traditionally concentrated on other industrial segments, are making
a foray into this sector. Due to such private sector participation, revenues from private sector
hospitals are estimated to reach around US$ 35.9 billion by 2012-13
Why to invest in healthcare in India
• Capital Intensive: The hospital business is extremely capital intensive and involves long
gestation periods. The initial costs per bed are in the range of INR 5-10 million for
tertiary care hospitals in large cities.
• Manpower: It is estimated that by 2012, there will be job opportunities for 4.5 lakh
doctors and 12 lakh nurses plus around 1 million other vacancies in hospital sector.
21
The healthcare sector of India is currently estimated at about US$ 30 billion and is expected to grow at a CAGR of 12-15% out
for the next 10-15 years.
61
• Brand Building: Long term success of a hospital is dependent on the brand image it
enjoys in the market. Building a brand requires significant commitment of time and
resources which are our magnificent assets.
• Obsolescence Costs: The healthcare industry is characterized by frequent product
innovations and evolving technology. This leads to redundancy of expensive medical
equipments every 5-7 years, thus requiring regular reinvestment in the facility. Our
frequent updating plans will definitely be our advantage recognizing our geographical
presence as well as profitability
• Greenfield Expansions: In our Greenfield set up, we will complete the construction of
the facility and all other operations costs including equipment planning, staff, liability
insurance, maintenance supplies and capital expenditures. Such a set up can cost
anywhere between INR 2.5 to 10 million per bed, depending on factors such as hospital
specialty, location of the facility, target consumer segment etc. Some of the recent
hospital projects announced and the associated cost per bed are as under.
Sr no. Facility Location Specialty Cap.exp. in No of beds Cost/bed in

name INR Million INR Million
1. Fortis Jaipur Cardiac sciences, 200 320 0.60
Escorts Neuro sciences, Renal
car, GI disorders
2. Fortis Gurgaon Oncology flagship, 3500 350 10
Medicity pediatrics, trauma
specialization
3. Fortis West Delhi Multispecialty 2000 250 8
hospital
Shalimar
Baugh
4. Fortis New Delhi Orthopedic, 1200 350 3.4
hospital Neurology
Noida
5. Apollo Chennai Orthopedics 1100 200 5.5
6. Apollo Mumbai Multi specialty 2500 400 6.3
7. Vedanta Chhattisgarh Specialty cancer 1000 100 10

group hospital and research
Raipur center
Our arrangements will not require tremendous capital expenditure and have a much shorter
gestation period of about 6 months. Our arrangements shall be structured as a revenue & profit
share or as fixed lease contracts of varying durations with leading consultants of the nation
and/subcontinent. (Dependent mostly on the level of investment being made by the new entrant)
Moreover our tertiary care hospital will be the hub where as the primary and secondary
healthcare facilities, diagnostic centers and pathology labs will act as spokes. This 'hub and
spoke' model will allow us to further expand our reach, build our brand and effectively utilize the
available resources.
Performance Evaluation
Key financial milestones for a tertiary hospital in India are presented in the below table:
Year end Milestone achieved

1 -ve EBITDA
2/3 Cash break even
4/5 Profits
6 Peak margins reached
8 Majority debts paid off
62
Like leading healthcare players we will leverage our hospital size, experience and capabilities to
shorten this time line and achieve higher profitability and financial viability. Even though the
Indian healthcare sector is still in its infancy, private healthcare players in India are faring better
than their overseas counterparts with respect to various key financial parameters.
Some of the critical financial parameters of a hospital's profitability and financial efficiency are
as under:
• EBITDA Margin - The Indian healthcare industry's average EBITDA margin of 17.7%
compares favorably to its US counterpart (15.7 %). The EBITDA margin depends on
various factors including location, target market, price sensitivity and hospital
specialty.
• Return on Capital Employed (ROCE) - Even in this performance measure, the Indian
healthcare sector's leading players have an average ROCE of about 13% which is
significantly higher compared to their US counterpart's average of 7.3%.
As the Indian Industry matures and improves its operating efficiency (in terms of ALOS, BOR
etc), these financial performance measures are expected to improve further.
Even though the above parameters are average performance measure of the players in Indian
healthcare industry, it is important to note that there exists significant variation in their individual
performance depending on different factors including hospital specialty, size etc. An Ernst &
Young Healthcare Survey conducted in October 2007 made some interesting observations:
• Multi-specialty hospitals tend to show the maximum average EBITDA margins (20.7%),
followed by single-specialty (14%)
• Super specialty hospitals generate the maximum revenue per occupied bed per day (INR
13,413) followed by single-specialty hospitals (INR 11,141) and multi-specialty hospitals
(INR 10,620)
Also, the Multi-specialty show maximum profitability per occupied bed per day (INR 2200 per
occupied bed per day)
Financing Options:
Significant variations exist in the financial and operating parameters among different players.
Lenders and investors pay significant attention to these parameters in their evaluation.
Equity investors are attracted by proposals to invest in hospitals that are a part of a larger
business model or several such stand-alone hospital projects are being financed through a
holding company format.
Such a strategy leads to value accretion at the holding company level and risk mitigation across
the hospital projects. The promoter's track record of establishing such projects is another
key factor in the evaluation process. Hospital configuration of tertiary/multi-specialty format is
important in determining the commercial viability based on the hospital's location, other
competitors, characteristics of the target market etc. Kamdars have a definite edge over the other
players in this case as they have proven track record of handling national & international projects
of different sizes at various places in Asia and Africa.
63
For Greenfield hospitals, the debt to equity ratio of 1:1 is considered optimum.
Despite the above mentioned stringent criterions being used by investors for evaluating project
financing, there is an increased tendency amongst the private equity players to invest in the
healthcare sector.
Some of the marquee transactions in the healthcare delivery space include Apax Partners' US$
104 million fund infusion in Apollo Hospitals, Warburg Pincus' investment of US$ 32 million in
Max Healthcare and Trinity Capital's funding of US$ 31.4 million to Fortis. ICICI Ventures has
launched a US$ 250 million fund for acquiring hospitals and investing in the healthcare sector.
On the debt side, hospital projects need access to long term funds. Multilateral institutions such
as IFC, World Bank, Asian Development Bank etc have lent to this sector. Indian banks and
financial Institutions are also increasing their exposure to this sector. The recent budget
announcements would also improve the viability of new Greenfield hospitals being set up in Tier
II & III cities, thereby encouraging debt and equity investments in this sector.
Given the urgent need for developing quality healthcare infrastructure in India, the Government
may also consider according Infrastructure status to this sector, thereby, enabling a better fund
allocation and longer tenure to this important industry.
Lastly our investment in this project will be channelized as under;
# Particulars Approximate figures in %
1 Equity Share Capital 40-50% of total investment will be raised from

equity shares in the company
2 Unsecured loans/promoters 15-20% will be the promoters’ share and

unsecured loans
3 Bank loan 35-40% of total investment will be raised from

long term bank finances
64
Investment and Distributions

Finance from Private Investors
Investors are invited to consider Investment Opportunity in this Hospital Project. Investment in
Healthcare Sector in India is highly profitable due to lack of adequate and quality infrastructure
to cater to the requirements of the growing healthcare needs of over 110 Crores population of the
Indian republic which has less than 150 Medical Colleges to produce quality doctors to cater to
healthcare needs of over 110 Crores of Population.
Investment in this super specialty hospital is an excellent investment opportunity to reap

excellent returns.
Today’s knowledge-based economy combined with healthcare industry is fertile ground for
entrepreneurs in India. The success stories of businesses built on great ideas executed by
talented team leaders like Mr. Mukund Kamdar and Mrs. Nutan Kamdar have great
appeal in India, where access to capital is scarce and regulation has often created barriers
to success. And many young Indians have a dream: to be the next Kamdars of
India. Estimates indicate that several thousand “new economy” businesses were launched during
past years in India. This is not just a “big-town” phenomenon.
India has an extraordinary talent pool with virtually limitless potential especially when healthcare
sector is booming and every type of good opportunity is lying ahead, we must commit ourselves
to creating the right environment to develop successful healthcare enterprises of international
standard. To do this, we focus on four areas.
1. Create the right environment for success: a professional, multifunctional management

team would drive the healthcare business; and partnerships would be explored early on to
scale up the business.
World class hospital: Critical support services, professional managers, legal firms,
venture capitalists, potential investors, and placement agencies with excellent
infrastructure – connectivity, communication, and enough space.
Create areas of excellence: Mumbai is the breeding ground where ideas grow into
healthcare activities but it needs strengthening with the best education and training
activities to be India's ultimate “healthcare destination.” Our tie up with educational
institutions of Medical Sciences and Universities will be our top priority to create areas of
excellence in medical field.
2. We will ensure that we have access to the right skills: Healthcare sector in India needs
two types of skills; entrepreneurial (how to manage business risks, build a team, identify
and get funding) and functional (product development know-how, marketing skills,
etc.). Kamdars have these inherent skills and they have a vast experience of
successfully leading eight industries at a time with extraordinary skills of
development and management.
Our focus at Vaibhav will be on today's changing healthcare business landscape,

particularly in emerging markets, and to build “centre of excellence” in healthcare sector
that will prove to be a milestone in the history of medical science.
With an environment of intellectual vibrancy, our staff and doctors will have great
clinical skills, strategy to develop the work and insight towards impact of technology on
healthcare. They will have spent time developing their own methodologies to work, while
65
utilizing state-of-the-art technology, communications technology and skills to interact

with members of industry and experts worldwide.
We will help our staff become successful technocrats by offering a diverse set of
programmes, activities and facilities such as residency programme, field projects, and
every chance to get updated in their respective fields of expertise.
3. We look forward to join hands with VCs for capital as well as critical knowledge and
access to potential partners, suppliers, and clients across the globe. This is a challenge
before us: creating a global support network of 'investors' willing to support our
endeavors.
4. Enable networking and exchange of ideas: Entrepreneurs learn from experience - theirs
and that of others. Much of the success depends upon the experience, sharing and support
from excellent clinicians, worthy patients/clients and well wishers. We would benefit
from creating a strong network of medical professionals from tertiary healthcare and
managers that we could draw on for advice and support.
The rapid pace of globalization and the fast growth of our economies present tremendous
opportunities and challenges in healthcare as well. Through planning and focus, we aspire to
create the pool of extraordinary workforce which can be the country’s – and the world's – leaders
of tomorrow.
It is the hope in wider sense which has inspired Kamdars to build some of the country's
excellent modern enterprises. Kamdars’ undertaking powered by hard work, initiative, self-
belief and tremendous capacity to put in any amount of efforts are going to be the landmark in
the healthcare industry.
66
Capital introduce by investors, brief investment benefits

Indian healthcare sector:
Private equity investment supports the growth of new and specialized sectors of the healthcare
industry. This includes the greater development of geriatric services for the nation’s aging
population. Private equity investments, future medical research, expansion of private operations
guarantee long-term demand for professional services sufficient to assure an adequate return for
investors.
Demand for quality healthcare is unlikely to slow anytime soon. The health of a population tends
to improve with the improvement of economic circumstances, but this improvement in overall
health does not decrease the demand for healthcare. In fact, the opposite is the case. Several
factors increase the likelihood of even greater public demands upon the nation’s healthcare
system. For example, the overall economic growth in India is growing in the nation’s middle
class. In 1996, India’s middle class amounted to an estimated 35 million families; in 2006, 80
million. Growing middle class has increased demands for adequate healthcare and, equally
important, they have the resources to pay for that care. “Higher expectations for good
healthcare accompany higher incomes.” Improved economic circumstances of individual
increase their search for healthcare services.
India’s healthcare system provides an optimal environment for private equity investment. The
healthcare industry is poised for future growth as demand increases, consonant with the
continuing increase of the middle class’ overall prosperity.
The advantages garnered through private equity in the healthcare industry of India promise
significant returns for investors. Private equity investment into India’s healthcare industry will
support not only the expansion of the country’s healthcare system to local patients, but also
bolster the nation’s growing medical tourism industry. Indeed, the relationship may be self-
reinforcing: expansion of one will likely spur concomitant growth in the other. Additional
industries, including India’s real estate market, will also benefit from investment in this sector.
Indian healthcare system is a sound investment target for private equity firms and likewise
may become a paramount factor in private equity investment in India for years to come.
SIZE
• The Indian Healthcare market is estimated at about US$34 billion (FY 2006)
• The industry is expected to grow at 15% p.a., to reach US$79 billion by FY 2012
• The large domestic market complemented by the inflow of medical tourists
• Medical tourists have increased almost 20-fold from 10,000 in 2000 to about 1,80,000–
2,00,000 in 2006
STRUCTURE
• The industry is fragmented with a large number of independent, privately run hospital and
healthcare centers
• Private sector corporate entities like the Apollo Hospitals, Wockhardt Hospitals and
Fortis Healthcare have aggressive expansion plans
• Indian hospitals are gaining reputation globally as “quality” service providers
• Many Indian hospitals have secured accreditation from the British Standards Institute and
Joint Commission on Accreditation of Healthcare Organizations
• NHS, UK has indicated India to be a preferred destination for surgery
67
POLICY
• 100% FDI is permitted for all health-related services under the automatic route.
• Infrastructure status has been accorded to hospitals.
• Lower tariffs and higher depreciation on medical equipment.
• Income tax exemption for 5 years to hospitals in rural areas, Tier II and Tier III cities.
OUTLOOK
• The industry is expected to grow to US$79 billion by 2012.

• Medical tourism is expected to become a US$2.2 billion industry by 2012.
POTENTIAL
• High-growth in the domestic market arising from:

Increasing health awareness: share in total private consumption expected to increase by
10%.
Increasing penetration of health insurance.
Rapid growth in private sector companies owning and managing hospitals.
High-growth in medical tourism.
• Cost of comparable treatment is on average 1/8th to 1/5th of those in western countries.
• Opportunities exist in multiple segments along the value chain.
• Service providers: curative and preventive in primary, secondary and tertiary care.
• Diagnostics services: imaging and pathology labs.
• Infrastructure: hospitals, diagnostic centers.
• Health insurance: less than 10% of the population is covered by health insurance. The
medical insurance premium income is expected to grow to US$3.8 billion by 2012.
• 44% growth in health insurance during 2006-2007.
• Healthcare BPO: medical billing, disease coding, forms processing and claims
adjudication.
• Training: large opportunity for training doctors, managers, nurses and technicians.
• Investment opportunity of over US$25 billion by 2010.
68

CARE CENTER
69
FINANCIAL ANALYSIS
COST OF PROJECT
# Particulars Amount in INR
lakhs
1. Acquisition of land/site for hospital 6000.00
2. Construction cost for 30000 sq ft area @ Rs 2500/sq. ft for therapy 750.00

center
3. Interior work: Interior work includes: interior designing/decoration 900.00

(@ Rs.2500/sq. ft), HVA/C and ducting for the same, all fittings,
fixtures, beds and non medical furniture & equipment, generators,
lifts etc
4. Development work: Developmental work includes: internal 1012.50

pathways/roads, drainage system, site development expenses
(assumed @ 8 to 10%), water supply and piped services, electricity,
Payment to statutory bodies, advertisement and promotional
activities
5. Technical, legal, architect etc 127.50
6. Professional services fees 875.00
7. Diagnostic and therapeutic equipment, class 100/10000/100000 OT 1750.00

equipment & instruments, CSSD/surgical microscope etc,
8. Computers with LAN & WAN, central server, hardware, software 80.00
specially designed for the institute, web-designing and library for
students
9. Preliminary (survey/feasibility study) and pre operative expenses 337.50
10. Contingency expenses 675.00
11. Working capital 201.63
12. Miscellaneous expenses 337.50
Total 13046.63
M.O.F
Funds will be raised as under;
1 Equity Share Capital 5530.00
2 Unsecured loans/promoters 3316.63
3 Bank loan 4200.00
Total 13046.63
70
EQUIPMENTS:
Medical equipment and instruments including computers 1830.00
Total (amount in Rs. Lacs) 1830.00
INCOME ESTIMATES:
A). PROJECTED ANNUAL INCOME FROM HOSPITAL
Projections of daily income from 45 bedded super specialty hospital at 100% capacity:
Room Revenue
No. Department Allotted beds Per bed per day Total amount per
charge day Rs.
vii. Suite rooms 10 5000.00 50000.00
viii. Deluxe rooms 20 4000.00 80000.00
ix. Special rooms 7 2500.00 17500.00
x. ICU 8 5000.00 40000.00
xi. Emergency room 5 5000.00 25000.00
Total 45 212500.00
Annual income = Rs. 69062500.00 i.e. Rs. 690.63 Lakh
B). PROJECTED ANNUAL INCOME FROM DEPARTMENTS AND DIAGNOSTIC

MODALITIES
Assumptions:
• Number of beds: 45
• Available beds in a year: 14625
• Occupancy: 100%
• Average length of stay: 4.5 days
• Number of admissions: 3250
• Total number of days – Indoor: 325
• Total number of days – OPD: 300
• Daily patients in OPD: 200/day
71
No. Department Productivity Average rate Income Total

per year per case income
IPD OPD IPD OPD IPD OPD
i. X ray 3250 3000 200 200 650000 600000 1250000
ii. USG 3250 1500 500 500 1625000 750000 2375000
iii. ECG 2500 1500 200 200 500000 300000 800000
iv. 2 D Echo with 1500 600 700 700 1050000 420000 1470000
Color Doppler
v. Pathology lab 14625 60000 500 250 7312500 15000000 22312500
vi. CT scan 2000 900 1000 1000 2000000 900000 2900000
vii. MRI 1500 600 3000 3000 4500000 1500000 6000000
viii. OPD @200 pts/day - 60000 - 500 - 30000000 30000000
ix. Admission: 3250 - 100 - 325000 - 325000

registration
x. Use of Ventilators 850 - 4000 - 3400000 - 3400000
xi. O2 use 1500 - 500 - 750000 750000
xii. Surgeries@ 10/day 3250 - 50000 - 162500000 - 162500000
xiii. Health check - 1500 - 2000 - 3000000 3000000
xiv. Physiotherapy 3250 15000 200 100 650000 1500000 2150000
xv. Pharmacy (daily 14625 60000 1000 200 14625000 12000000 26625000
consumption of
medicines by
indoor & out
patients)
Total 265857500
Annual income in Lakhs 2658.58

lakhs
72
C). MISCELLANEOUS INCOME:
Income head Revenue per Number of days Total income

day
Canteen: F & B 5000 325 1625000
Certificates & other documents 1000 325 325000
Ambulance: critical care 16000 325 5200000

(ICU on wheels) @ 2000/hour for
8 hours a day
Total i.e. 71.50 Lakhs 7150000
Total income A + B + C = 3420.71 Lakhs.
73
EXPENSE ESTIMATES:
A. SALARIES AND WAGES:
# Designation No. required Salary Total Total

structure expense per expense per
month year
1. Intensivists/Physicians 2 50000 100000 1200000
2. Neurosurgeons 2 2 to 250000 500000 6000000
3. Orthopedic surgeons 2 1 to 150000 300000 3600000
4. Plastic surgeon 1 2 to 250000 250000 3000000
5. Anesthetist 1 75k to 100k 100000 1200000
6. Physiotherapists 4 50000 200000 2400000
7. Naturopathy/Indigenous 2 30000 60000 720000

therapy experts
8. Radiologists 2 100000 200000 2400000
9. Pathologist 1 75000 75000 900000
10. Medical Officers 10 25000 250000 3000000
11. Hospital Administrator 2 45000 90000 1080000
12. IT managers: specialists 2 25000 50000 600000
13. Biomedical engineer 1 25000 25000 300000
14. Accountant 1 10000 10000 120000
15. Computer operator 2 15000 30000 360000
16. Clerical Staff 3 10000 30000 360000
17. Chief Pharmacist 1 20000 20000 240000
18. Jr. Pharmacist (3 Jr.) 3 7000 21000 252000
19. Nursing Supervisor 1 18000 18000 216000
20. Senior Nurses 3 15000 45000 540000
21. Nurses: qualified GNM 12 12000 144000 1728000

staff
22. Nursing Aids 12 6000 72000 864000
23. Front Office Staff 5 5000 25000 300000

reception/inquiry/telepho
ne operating/cash
collection/registration of
74
pts
24. House Keeping 1 10000 10000 120000

Supervisor
25. Ward Boys, Ayahs, 15 4000 60000 720000

Sweepers/Housekeepers
26. Security Staff 6 4500 27000 324000
27. Technicians: CT and 4 15000 60000 720000

MRI scan
28. Technicians: lab 2 10000 20000 240000
29. Electricians 4 7500 30000 360000
30. Laundry Staff 4 4000 16000 192000
31. Marketing Executive 1 30000 30000 360000
32. Store Keeper 1 10000 10000 120000
33. Peons/office boys 2 4000 8000 96000
34. Drivers 2 5000 10000 120000
TOTAL 34752000
347.52 lakh
B. DEPARTMENTAL EXPENSES:
# Department Income Expense as % Expense per

of income annum
1. X ray 1250000 30 375000
2. USG 2375000 8 190000
3. ECG 800000 10 80000
4. 2 D Echo with Color Doppler 1470000 10 147000
5. Pathology lab 22312500 40 8925000
6. CT scan 2900000 30 870000
7. MRI 6000000 30 1800000
8. OPD 30000000 5 1500000
9. Admission: registration 325000 5 16250
75
10. Use of Ventilators 3400000 10 340000
11. O2 use 750000 10 75000
12. Surgeries 162500000 10 16250000
13. Health check 3000000 10 300000
14. Physiotherapy 2150000 5 107500
15. Pharmacy 26625000 10 2662500
TOTAL Rs. 336.38 lakh 33638250
C. OTHER EXPENSES
# Particulars Bed days per Cost per bed/day Cost per

annum annum
1. Food and beverages 14625 25 365625
2. Housekeeping 14625 10 146250
3. Laundry 14625 5 73125
4. Linen 14625 4 58500
5. CSSD 14625 4.25 62156
705656
Total 7.06 lakh
D. WATER, POWER AND UTILITIES
# Particulars Annual expense

1. Medical gases 300000
2. Cooking gases 60000
3. Electricity @ Rs.6/- per unit approx. 1800000

No. of units per month: 25000
Cost per month: 150000
Total 2160000 i.e. 21.60 lakh
Total expenses; A + B + C + D = 712.56 lakh at 100% capacity
76
STATEMENT SHOWING PROFITABILITY AND NET CASH ACCRUALS (Rupees in Lacs)
Particulars 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 2018-19 2019-20 2020-21
Revenue / Income / Realization
Gross Domestic Sales 1710.35 1881.39 2223.46 2736.56 3335.18 3335.18 3335.18 3335.18 3335.18 3335.18
Realization
Less : Excise Duty /
Levies
Net Domestic Sales 1710.35 1881.39 2223.46 2736.56 3335.18 3335.18 3335.18 3335.18 3335.18 3335.18
Realization
Total Revenue / 1710.35 1881.39 2223.46 2736.56 3335.18 3335.18 3335.18 3335.18 3335.18 3335.18
Income / Realization
Expenses/Cost of Products/Services/Items
Main Material Cost
Trade Item
Purchases 242.94 194.36 246.68 280.31 313.95 302.74 302.74 302.74 302.74 302.74
Opening stocks 74.75 67.28 78.49 89.70 100.91 100.91 100.91 100.91 100.91
Closing stocks 74.75 67.28 78.49 89.70 100.91 100.91 100.91 100.91 100.91 100.91
Nett 168.19 201.83 235.47 269.10 302.74 302.74 302.74 302.74 302.74 302.74
Consumption/Usage
Total Nett 168.19 201.83 235.47 269.10 302.74 302.74 302.74 302.74 302.74 302.74
Consumption/Usage
Sub Total of Net 168.19 201.83 235.47 269.10 302.74 302.74 302.74 302.74 302.74 302.74
Consumption/Usage
Employees Expenses 173.76 191.14 210.25 231.27 254.40 279.84 279.84 279.84 279.84 279.84
Power/Electricity 22.41 23.49 24.57 25.65 26.73 27.81 28.89 29.97 31.05 32.13
Expenses
Repairs & Maintenance 130.50 174.00 174.00 174.00 174.00 174.00 174.00 174.00 174.00 174.00
Depreciation 644.25 514.21 413.56 335.29 274.08 225.90 187.75 157.29 132.80 112.95
Cost of Output of 1139.11 1104.67 1057.85 1035.31 1031.95 1010.29 973.22 943.84 920.43 901.66
77
Good/Services Sold
Gross Profit 571.24 776.72 1165.61 1701.25 2303.23 2324.89 2361.96 2391.34 2414.75 2433.52
Administration 9.00 12.00 12.00 12.00 12.00 12.00 12.00 12.00 12.00 12.00
Expenses
P. & P. Exp. W/Off 25.31 33.75 33.75 33.75 33.75 33.75 33.75 33.75 33.75 33.75
Technical Know-how, 9.56 12.75 12.75 12.75 12.75 12.75 12.75 12.75 12.75 12.75
legal, architect etc Fees
Professional fees 65.63 87.50 87.50 87.50 87.50 87.50 87.50 87.50 87.50 87.50
Financial Charges
Long/Medium Term 399.00 319.20 239.40 159.60 79.80
Borrowings
On Working Capital 9.53 8.84 10.24 12.30 14.61 14.69 14.69 14.69 14.69 14.69
Borrowings
Total Financial 408.53 328.04 249.64 171.90 94.41 14.69 14.69 14.69 14.69 14.69
Charges
Total Cost of Sales 1657.14 1578.71 1453.49 1353.21 1272.36 1170.98 1133.91 1104.53 1081.12 1062.35
Net Profit Before 53.21 302.68 769.97 1383.35 2062.82 2164.20 2201.27 2230.65 2254.06 2272.80
Taxes
Tax on Profit 19.55 111.23 282.96 508.38 758.09 795.34 808.97 819.76 828.37 835.27
Net Profit After Taxes 33.66 191.45 487.01 874.97 1304.73 1368.86 1392.30 1410.89 1425.69 1437.56
Less : Dividend Tax 55.30 55.30 55.30 55.30 55.30 55.30
Depreciation Added 644.25 514.21 413.56 335.29 274.08 225.90 187.75 157.29 132.80 112.95
Back
P. & P. Exp. W/Off 25.31 33.75 33.75 33.75 33.75 33.75 33.75 33.75 33.75 33.75
Added Back
Technical Know-how, 9.56 12.75 12.75 12.75 12.75 12.75 12.75 12.75 12.75 12.75
legal, architect etc Fees
Professional fees 65.63 87.50 87.50 87.50 87.50 87.50 87.50 87.50 87.50 87.50
Net Cash Accruals 778.41 839.66 1034.57 1288.96 1657.51 1673.46 1658.75 1646.88 1637.19 1629.21
78
STATEMENT SHOWING PROJECTED BALANCE SHEETS (Rupees in Lacs)
Liabilities 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 2018-19 2019-20 2020-21
Equity Share 5530.00 5530.00 5530.00 5530.00 5530.00 5530.00 5530.00 5530.00 5530.00 5530.00
Capital
Surplus of 33.66 225.11 712.12 978.79 1675.22 2435.78 3219.78 4022.37 4839.76
Previous Year
Add : Net Profit 33.66 191.45 487.01 874.97 1304.73 1368.86 1392.30 1410.89 1425.69 1437.56
After Taxes
Less : Dividend / 553.00 553.00 553.00 553.00 553.00 553.00 553.00 553.00
Drawings
Less : Dividend 55.30 55.30 55.30 55.30 55.30 55.30 55.30 55.30
TAx
Surplus at the 33.66 225.11 712.12 978.79 1675.22 2435.78 3219.78 4022.37 4839.76 5669.02
End of the Year
Long/Medium Term Borrowings
Proposed-BANK 3360.00 2520.00 1680.00 840.00
FINANCE
Unsecured Loans/Deposits
Proposed- 3316.63 3316.63 3316.63 3316.63 3316.63 3316.63 3316.63 3316.63 3316.63 3316.63
unsecured loan
Bank Borrowing 100.33 93.05 107.79 129.43 153.75 154.68 154.68 154.68 154.68 154.68
for Working
Capital
Current Liabilities
Sundry Creditors 26.99 16.20 20.56 23.36 26.16 25.23 25.23 25.23 25.23 25.23
Other Current -
Liabilities
Total Current 26.99 16.20 20.56 23.36 26.16 25.23 25.23 25.23 25.23 25.23
Liabilities
Total of 12367.61 11700.99 11367.10 10818.21 10701.76 11462.32 12246.32 13048.91 13866.30 14695.56
Liabilities
ASSETS
Fixed Assets
79
Gross Block 10830.00 10830.00 10830.00 10830.00 10830.00 10830.00 10830.00 10830.00 10830.00 10830.00
Less : 644.25 1158.46 1572.02 1907.31 2181.39 2407.29 2595.04 2752.33 2885.13 2998.08
Depreciation to
Date
Net Block 10185.75 9671.54 9257.98 8922.69 8648.61 8422.71 8234.96 8077.67 7944.87 7831.92
Current Assets
Stocks on Hand 74.75 67.28 78.49 89.70 100.91 100.91 100.91 100.91 100.91 100.91
Receivable 95.02 78.39 92.64 114.02 138.97 138.97 138.97 138.97 138.97 138.97
Other Current 159.18 43.39 45.08 46.91 48.92 41.14 41.23 41.32 41.41 41.50
Assets
Cash and Bank -61.59 59.89 246.41 132.39 385.85 1514.09 2619.75 3713.54 4797.64 5873.76
Balances
Total Current 267.36 248.95 462.62 383.02 674.65 1795.11 2900.86 3994.74 5078.93 6155.14
Assets
P & P Exp. 1239.50 1105.50 971.50 837.50 703.50 569.50 435.50 301.50 167.50 33.50
and/or Other
Dvp.Exp(To The
Extent Not
W/Off)
Other Non 675.00 675.00 675.00 675.00 675.00 675.00 675.00 675.00 675.00 675.00
Current Assets
Total of Assets 12367.61 11700.99 11367.10 10818.21 10701.76 11462.32 12246.32 13048.91 13866.30 14695.56
80
Annexure 1:
MEDICAL EQUIPMENTS:
Anesthesiology and Critical Care Medicine: -
1. Anesthesia Trolley with Anesthesia Ventilators 1
2. Ventilators for ICU/ICCU 5
3. Multipara Monitors for ICU/ICCU: invasive 3
4. Multipara Monitors : 8
non-invasive
5. Central station 1
6. Infusion pumps 8
7. External pacemaker 1
8. Respirator 1
9. Emergency Trolleys 3
10. Nebulizers 3
11. Defibrillators 2
12. ECG machine 1
13. Suction machines 6
14. ETCO2 monitor 1
15. Hemodialysis machine 1
16. RO water plant for dialysis 1
17. Refrigerator 1
18. ICU beds 8
Operation Theaters:-
19. Operating table (multipurpose; electro hydraulic) 1
20. Operating table (general) 1
21. Orthopedic operating table 1
22. Ceiling mounted lights: shadow less) 3
23. Anesthesia apparatus & trolley 3
24. Surgical instruments: minor 2 sets
25. Surgical instruments: general 2 sets
26. Surgical instruments: orthopedic 1 set
27. Gastroscope 1
28. Bronchoscope 1
29. Hepa filters, central suction unit, central oxygen,
nitrous oxide, air compressor etc.
Neurosurgery: -
30. Operating microscope 1
31. Neuro surgical Instruments 1 set
32. Bipolar Cautery 1
33. Neurosurgical Operating table with all attachments 1
34. Shadow less Lights 1
35. Surgical Instruments for minor surgeries 1 set
36. Surgical Instruments for major surgeries 1 set
37. Spinal endoscope 1
81
Emergency: -
38. Operating table 1
39. Boyle’s apparatus (anesthesia trolley) 1
40. Ceiling mounted shadow less light 1
41. Surgical instruments set 1
42. ECG machine 1
43. Pulse Oxymeter 1
44. Defibrillator 1
45. Simple bedside monitor 1
46. Crash cart, procedure trays, drums etc. As required
47. Suction machine, Oxygen cylinders etc.
Pharmacy:
48. Pneumatic Air Tube System with green colored 1 set/system
carriers for transfer of medicines from pharmacy
area to clinical areas.
In addition;
• Drug Mixing and Delivery Device
• Medicament container and transfer devices
49. Refrigerators 2
Laboratory:
50. Pneumatic Air Tube System with blue & Green 1
colored carriers for transfer of samples for tests from
clinical areas to laboratory area
51. Elisa Reader & Washer 1
52. Automatic Hematology analyzer 1
53. Automatic clinical/biochemistry analyzer 1
54. ABG analyzer 1
55. Digital Spectrophotometer 1
56. Auto Karl Fischer Titrimeter 1
57. Centrifuges 3
58. • Donor Chair

• Blood Collection Monitor
• Die-electric Tube Sealer
• Tube Stripper
• Needle Burner
• Blood Bank Refrigerators
• Refrigerated Centrifuge
• Plasma Thawing Bath
• Laminar Flow Bench
• Balance
• Plasma Deep Freezer minus 40 Degrees
• Plasma Deep Freezer minus 80 Degrees
• Hemoglobin Determination
• Oven
• Water Bath
• Rotary Shaker
82
• Rh-Viewing Box
• Incubator
• Cross-matching
• Plasma Low/Hb for checking Hemolysis
• Blood Cell Separator
59. • Confocal Microscope

• Cryostat
• Electron Microscope
• Fluorometer
• Gas Liquid Chromatograph
• Glycohemoglobin Analyzer
• HPLC
• Immunoassay Analyzer
• Laboratory Hood
Laboratory Hood, Ductless
• Laboratory Incubator, Thermocycling
• Laboratory Information System
Laboratory Scale
• Laser Microdissector
• Micro centrifuge
• Microplate Washer
• Microscopy Sample Preparation System
• Microtome
• Paraffin Bath
Pathology Work center
• Slide Stainers,
• Histology
• Tissue Homogenizer
Tissue Processor
Ultra miller
• Video Conferencing Equipment
Voice Recorder
60. Laminar Air Flow Cabinets (Horizontal & Vertical),

Flame Photo Meters, Lab System Analyzer, Digital
Photo Colorimeters Filter Photo Colorimeters,
Turbidity Meter, Digital pH Meters, Temperature
Indicator Digital Telethermometer, Digital Colony
Counter, Digital Potentiometer, Digital pH
Conductivity cum Temperature Meter
61. Autoclave 1
62. Lab Refrigerators 2
83
Radiology:-
63. 1000 mA digital X ray machine with PACS/CRS 1
system
64. Portable X ray machine 60mA 1
65. Spiral CT scan 1
66. MRI scan 1
67. USG machine with color doppler 1
68. X Ray Viewer 8 film panel 5
Cardiology and Pulmonology:

69. 2-D Echocardiography with color Doppler 1
70. Cardiac stress test system with Spirometry 1
71. ECG machine: 12 channel computerized 1
72. Pulse Oxymeter 2
CSSD: -
73. Horizontal autoclave 1
74. ETO sterilizer 1
75. 3 Tank Ultrasonic cleaner 1
Nurse call system:

76. Ward and iCU 35
77. OPD 10
78. OT 5
Morgue:
79. 2 drawer cold room 1
80. Morgue table and accessories
84
NONMEDICAL EQUIPMENT
EDP :
1. Computers and LAN plus software expenses
(High End Server & nodes with networking
Software & application for Integrated Hospital
Database Management System
General:
2. Generator and substation
3. Air conditioning and A/C ducting, false ceiling etc.
4. Medical record and library
5. Photocopy machine 1
6. Lifts
Medical gas pipeline:

7. Oxygen 35 outlets 1
8. Nitrous oxide 5 outlets 1
9. Central suction 35 outlets 1
10. Compressed air pumps 1
Laundry:
11. Sluice wash machine 1
12. Side loading washing machine 1
13. Hydro extractor: 10-15 kg 1
14. Drying tumbler 1
15. Sorting trolleys: wet and dry 2
16. Flat work iron tables 2
17. Hand iron table 1
18. Linen storage racks 2
19. Steel cabinet 1
Automobiles:
20. Critical care ambulance with all equipment 1
21. Cars 2
22. Delivery van 1
23. Motor cycle 2
Furniture:
24. Stretcher on trolley 5
25. Examination tables 10
26. Bedside tables 45
27. Hospital beds 37
28. ICU beds 8
29. Wheel chairs 5
30. Dressing trolleys 5
31. Instrument trolleys 5
32. Bedside screens 10
33. Soiled linen trolley 5
34. Crash carts 4
35. Chairs, waste receptacles, cupboards etc
85
Engg & maintenance:

36. Repairs tool bench 1
37. Welding machine 1
38. Heavy repairs tools 1
39. Ampere meter 2
40. Voltage stabilizers 5
41. Tool kit 1
86
Annexure 2.
PHYSIOTHERAPY EQUIPMENTS
Hydro Therapy Equipment

- Hydrotherapy Tank (tank shape)
- Accessories for Hydrotherapy Tank

- Whirlpool Bath (for Arm, Foot & Lower Leg)
- Whirlpool Bath (large Size)
- High Chair (for use with Whirlpool Bath)
Electro Therapy
- Shortwave Medical Diathermy-500w.
- Muscle Stimulator
- Interferential Therapy Unit
- Ultrasound Therapy Unit (digital,pre programmed)
- Ultrasound Therapy Unit (1mhz,3mhz with dual head)
- Autosound, Hand-Free Ultrasound
- Transcutaneous Nerve Stimulator (tens digital)
Heat & Cold Therapy Equipment

- Paraffin Wax Bath (arm, hand & foot)
- Paraffin Wax Bath (arm & hand)
- Physio-Wax
- Moist Heat Therapy Unit (table model)
- Moist Heat Therapy Unit (junior, mobile)
- Moist Heat Therapy Unit (senior, mobile)
- Steam / Hot Packs
- IMICO Cold Therapy Unit (with Fan)
- Contrast Bath (hot & cold therapy unit)
Physiotherapy Treatment Equipment

- Examination Couch (wooden)
- High-Low Treatment Table (electrical)
- Hi-Low Mat Platform (floor)
- Tilt Table (manual)
- Tilt Table (electric operated)
- Activity Mattress
- Continuous Passive Motion Unit (L/E)
- Continuous Passive Motion Unit (U/E)
Physiotherapy Exercise Equipment

- Complex Exercising Unit
- Exercise Chair
- Multi Exercise Therapy Unit
87
Shoulder, Arm & Hand

- Shoulder Wheel (with 360 deg. scale)
- Shoulder cum Elbow Cycle
- Axial Shoulder Exercise
- Shoulder Pulley Set (tee bracket)
- Shoulder Pulley Kit
- Shoulder Spring Exerciser
- Shoulder Abduction Ladder (wall mounting)
- Arm Exerciser (pulley apparatus)
- Rowing Machine cum Sliding Seat
- Wall Bar (wall mounting)
- Hand Exercise Table
- Hand Gymkit Board
- Hand Exerciser
- Rotary Wrist Machine (wall mounting)
- Wrist Roll (wall mounting)
- Wrist Circumductor
- Grip Ball Set
- Grip Exerciser (with base)

- Weight Cuff Set
- Dumbells Iron (with cart)
- Ball Medicine (set of 5, leather)
- Ball Medicine Set of 3 (PVC)
- Ball Medicine with Cabinet (set of 5, leather)
- Smooth Exercise Board
- Smooth Exercise Table
- Therapy Putty (imported, 2.25 Kg)
- Exercise Putty Board (plasticine)
Physiotherapy Suspension Aids

- Suspension Frame (with suspension gear)
- Couch for Suspension Activities
Physiotherapy Traction Aids

- Hi-Trac Unit (computerised, with bed)
- Hi-Trac Unit (deluxe package)
- Nice-Trac Traction Unit
- Traction Table (fixed height)
- High-Low Traction Table (electrical)
- Traction Set Cervical (wall mounting)
- Traction Set Cervical (over door model)
- Traction Set Pelvic (manual, portable)
88
OCCUPATIONAL THERAPY EQUIPMENTS

Positioning Equipment
- Relaxation Chair (with adjustable incline & activity tray)
- Floor Sitter (corner chair)
- Stand-In-Frame (adult)
- Stand-In-Frame (child)
- Stand-In-Table (one place)
- Stand-In-Table (two place)
- Standing Positioner (Three-in-One)
- Vestibular Board (large)
- Wedge Boards
- Vestibulator / Swing System
- Bean Bag (Body Positioner)
Evaluation Systems
- Steadiness Tester-Hole Type (Electrical)
- Linear Motion Steadiness Test Apparatus (Electrical)
- Pencil Maze Test Board
- Tremor Quantifier (Talking Pen)
- Pinch Guage Electronic (Table Model)
- Hand Dynamometer (25 Kg. Capacity Portable)
- Hand Dynamometer (Electronic)
- Strength Evaluation System (Electronic)
- Finger Goniometer (Stainless Steel)
- Goniometer (180ø) Stainless Steel
- Goniometer (360ø) (Aluminium)
- Tweezer Dexterity Test (For Eye-Hand Coordination)
- Key Hole Test Board
- Counting And Colour Sorting Beads Set
- Colour Matching Plate Box Set
- Puzzles Programme Set
- Body-Parts Puzzle Kit
- Finger Prehension Device
- Sound Discrimation Set
A.D.L.Training Units
- Door-Latch Frame Set
- Electro Equipment Frame Set
- Dressing Frame Set (consist of four frames)
- Eating Aids with Utensils (set of four)
- Reacher (Pistol Grip)
89
Exercise Units
- Sanding Unit for Reciprocal Exercise (with Adjustable Incline)
- Sanding Unit Semicircular (with wall mounting)
- Sanding Unit Semicircular (table model)
- Sanding Unit Vertical (with wall mounting)
- Sanding Unit Overhead (with stand)
- Horizontal Sanding Table
- Quadriceps Exercise Chair (children)
- Sand & Water Table
- Wax Tray (Electric with Carving Tools)

- Multi Purpose Wheel (Children)
- Supinator & Pronator (Rainbow Type)
- Supinator & Pronator (Zig-Zag Type)
- Basic Balance Beam
- Inclined Tapered Balance Beam
- Slanted Walking Board
- Foot Placement Ladder
- Inclined Mat (medium size 180x90x40cm)
- Inclined Mat (large size 185x120x40cm)
- Rolls (Bolster Set of 5)
- Physio-Gymnic-Ball (Therapy Ball)
- Physio Roll (Imported, Inflatable)
- Equilibrium Board (Rectangular)
- Prone Crawling Board (with wheels)
- Vestibular Board (large size)
- Vestibulator / Swing System (with attachments)
- Trampoline (Jummper)
Sensory Motor
- Multi-Activities work station (Upper Extremities)
- Mushroom Board (10 Pegs & 10 Tops)
- Pegs & Shapes (4 Pegs & 4 Shapes)
- Five Peg Board (25 Pegs)
- Ten Peg Board (100 Pegs)
- Pinch Tree Board
- Square Peg Board (20 Pegs)
- Graded Square Peg Board (25 Pegs)
- Multi Shaped Peg Board (5 round & 5 square)
- Peg Board Wall Mounting (10 round & 10 square)
- Magnetic Peg Board (25 Pegs)
- Magnetic Peg Board (Magic Square with 9 Pegs)
- Depth Perception Peg Board Set
- Size Perception Round Board Set
- Size Perception Square Board Set
- Geometric Shape Form Board Set
- Pyramid Round
- Pyramid Square
90
REHABILITATION AIDS
Walking Sticks / Canes

- Walking Cane / Walking Stick (Aluminium, Fixed).
- Walking Cane / Walking Stick (Aluminium, Adjustable)
- Walking Cane / Walking Stick (Four legged)
- Tips for Walking Cane / Crutch (19 mm, 22 mm, 25 mm diameter
Walkers / Rollator
- Walker Invalid's
- Walker Infant's
- Prone Crawler
- Walker Scissors Gait Preventive
- Walker Rollator
- Walker Paraplegia (Adult)
- Walking Aid (Aluminium, Fixed Frame & Height)
- Walking Aid Folding & Adjustable Height
Wheelchairs
- Wheel Chair Folding (Adult, Painted)
- Wheel Chair Folding (Adult Deluxe Model)
- Wheel Chair Folding (With Commode)
Crutches
- Crutches Underarm (Wooden, Adjustable)
- Crutches Underarm (Aluminium, Adjustable)
- Crutches Elbow / Forearm
- Tips for Walking Cane / Crutch (19 mm, 22 mm, 25 mm diameter)
Panchakarma (Ayurvedic) Products
Taap Swedan Yantra

- deluxe sauna cabin (for Two Persons)
- Vidyut (I.R) bath cabinet
- Infra-Red Lamp (Floor)
- Ultraviolet Lamp (Floor)
- Shortwave Medical Diathermy-500w. (with Fan)
Vashap Swedan Yantra

- Steam Cabinet (for 1 person with steam generator)
- Steam Room
- Sarvang Vashpa Swedan Yantra (Trolley Type)
- Sarvang Vashpa Swedan Yantra (Box Type)
- Nadi Sawedan Yantra
- Aarsh Vashapa Swedan Yantra (Electrical)
- Moist Heat Therapy Unit (Junior, Mobile)
91
Dravaya Swedan Yantra

- Leg Bath (Hot Bath, Electrical)
- Full- Body Water/Oil Bath
- Hydrotherapy Tank (Table Shape)
- Whirlpool Bath (Large Size)
Snehan Karma
- Massage Cum Sirodhara Table
- Full- Body Water/Oil Bath (Tank with Pump)
- Massage Table (Oil Bath, Ordinary)
- Massage Table With Sirodhara Yantra (Electrical)
- Ultrasound Therapy Unit (Solid State)
- Compression Therapy Unit (Medomer)
Pradhan Karma
- Vaman Peeth (Chair And Table)
- Nasya Peeth
- Veerachan Chair
General Treatment Equipments

- Examination Couch (Wooden)
- High-Low Treatment Table (Electrical)
- Tilt Table (Manual)
- Varun Continuous Passive Motion Unit (Large, Electrical)
- Pankaj Continuous Passive Motion Unit (U/E)
- Vibrator / Massager (Electrical)
92
93

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Vaibhav Super Specialty Health Care Center Ltd.

VAIBHAV SUPER SPECIALTY HEALTH

VAIBHAV SUPER SPECIALTY HEALTH CARE CENTER LTD.

Dedicated to the sweet memories of Vaibhav,

Nutan Kamdar (Mother)

VAIBHAV SUPER SPECIALTY HEALTH

Highlights: our uniqueness

VAIBHAV SUPER SPECIALTY HEALTH CARE CENTER

1. Mission, vision and objectives 1

5. Background of the project 7

7. Vaibhav Super Specialty Health Care Center 13

8. Salient features: Department of orthopedics 16

10. Department of plastic surgery 24

11. Physiotherapy & rehabilitation services 27

12. Facilities planned at the therapy center 29

13. Center for athletic medicine 38

14. Diagnostics: Radio diagnosis 39

15. Diagnostics: Laboratory medicine 44

16. Pneumatic Air Tube System 45

17. Clinical nutrition 46

18. Clinical research 46

19. Pharmacy services 47

21. Helicopter/air ambulance service 52

22. Organizational chart 55

23. Hospital staff 56

24. Bed allocation to departments 57

25. Area allocation/description for departments 57-58

26. Project team 59

27. Proposed implementation schedule 59

VAIBHAV SUPER SPECIALTY HEALTH CARE CENTER

28. Investment and Financing 61

29. Finance from Private Investors 65

30. Capital introduce by investors, brief investment benefits 67

31. Cost of project and means of finance 70

32. Profit and loss account (operating statement) 77-78

33. Balance Sheet 79-80

34. Medical Equipment 81

35. Non Medical Equipment 85

36. Physiotherapy Equipment 87

37. Occupational Therapy Equipment 89

VAIBHAV SUPER SPECIALTY HEALTH

VAIBHAV SUPER SPECIALTY HEALTH

We deliver health and healing to everyone through trusting relationship

“May all be happy and healthy forever”

Vaibhav Super Specialty Hospital builds healthy communities

Reg. Office C/o.: D-202, Shantinagar Society, Dutt Mandir Road,

Malad (East), Mumbai-400 097.

2. Constitution Registered Under Companies Act, 1956(No1 of 1956).

4. Location of Center Western Mumbai, India.

5. Group Mrs. Nutan Kamdar (CEO-Chair Person and

6. Date of Incorporation Incorporation Date: ___________________

7. Product World-class Super Specialty include Orthopaedics,

9. Location of Controlling c/o Mrs. Nutan Kamdar

10. Governing Board Mrs. Nutan Kamdar CEO/CMD

11. Project Cost INR 13046.63 Lakhs (130 Crores Approx.)

CEO: Mr. Mukund Kamdar

Brief of some of his strategic skills is appended here below:

Industrial Management Administrative skills Total Quality Management

General Administration: Expert in Project management: