FORMNME: 2.66 (C089 Signati STANDARD ASSESSMENT FORM FOR PGCOUR’ SUBJECT - COMMUNITY MEDICINE: SORS AND AS INSTRUCTIONS FOR DEANS/PRINCIPALS tease read the Standard Assessment Form (SAF) carefully before filling, You will NOT be Please Tena any changes in the Data after i has been submitted Do NOT leave any seotion of the SAF of part thereof unanswered Incomplete filled up Forms pene sunmanty rejected ssithout any intimation tothe callege/institaion, Do NOT edit or modify any part of the SAF. Tampering with the format of these forms will render your submission invalid Do NOT attach Annexures or enclosures. All the information furnished should be in the appropriate sections of the SAF. Annexures and Enclosures will NOT be considered. Do NOT attach experience certificates with SAF. It is mandatory fo submit Experience eo oa taaund by the competent authority from place/s of work (from. Whe office of the DGAEMS in case of personnel of the Indian armed forces) along with the Faculty declaration aaa iting which information about work experience will nt be considered. In case of faculty/residents with DNB qualification, full Name of the hospital/insinsion where DNB taining was obtained and year of passing should clearly be mentioned fa\ing which they BRI NOT be considered. Merely mentioning National Board of Examinations, New Delhi, shall not suffice. “The Dean/Principal is responsible for filling up the entire form and signing at appropriate places. If promotions are after the cut-off dates (21/07/2013 for Professors; 21/07/2014 for Associate Professors) and benefit of publications has been given in promotion before the cut-off dates, list the publications immediately below the name of faculty in the format: Title of Paper. Authors Citation of Journal, details of Indexing in the faculty table. Photocopies of published articles Should be attached with the Faculty declaration forms failing which they will not be considered, Please provide details of full/original articles ONLY. Case reports, review articles and abstracts shall NOT be considered. Do NOT use abbreviations for names of Medical Colleges in the SAF and Declaration Forms. INSTRUCTIONS FOR ASSESSORS. Please follow all instructions carefully. Instructions marked NOTE: are repeated in various sections of the SAF to ensure compliance for the sake of consistency and uniformity Only Faculty members and Resident doctors who sign the attendance sheet by 11:00 A.M. present themselves for subsequent verfcation and are found eligible must be considered, In eae OineetAsTarc| Ga NMAC fered | eure WorTon| NMC Coun (es fereT is be aaaieveied Please ensure that signatures of faculty members and resident doctors are ctyained in the Faculty table. » So a ( - 52 éot Eee es oe nature of Assessor wed pur Gon NE Cr OA Dish V-YORMENME. 2.66 (COMMUNITY MEDICINE -¥. 2020 12. OPD attendance up to 2:00 P.M, and Bed occupancy till 10:00 A.M. must be considered, without any exceptions, Please adhere to instructions regarding time very strictly. Data for Radiodiagnosis investigations, Central Clinical Laboratories, Blood Bank etc., centered in the SAF must be verified with physical records/registers. 14, Assessors may write confidential remarks not shown in the assessment report on the page marked “Remarks of Assessor. Do NOT send/attach separate confidential letter/s. a Age Stott : aie acre Signature of AssessorPORMNME: 206 (COMMUNITY STANDARD we WANE) -V 2020 MENT FORM FOR POSTGRADUATE COURS (COMMUNTTY MEDICINE) 1, Name of Institution: Govt, Medical College & Hospital Nagpur NMC Ri 2. Particulars of the Assessor: ‘Name Dr. Dipesh V. Parmar | Designation: Professor and Head | Specialty: Community Medicine Name & Address of Institute/College: M. P. Shah | Government Medical College, Medical Campus, Pin- 361008 l | Jamnagar (Gujrat) 3. Institutional Information: A, Particulars of the Instit nee No.: Nme Confidential Letter Via Email Date 28/8/2022 Date of Assessment 29/08/2022 Residential Address (with Pin Codey 301, Saket Ri idency, Plot no. 11, Valkeshwarinagari, Phase 2, Jamnagar- 361008 | Phone No. (Off) 0288-2551707 (Res) 0288- 2555143 (Fax) 0288-2540036 Mobile No: 9825639992 | : Chairman! Directo) | Medical — Institution/College Health Secretary Dean/ Principal | _ Superintendent | Govt. Medical | Shri. Shaurabh Vijay Dr. Sudhir Gupta | Dr. Sharad | College, Kuchewar | Name | Nagpur | Hanuman Dept. of Medical Education | Govt. Medical Govi. Medical ‘Address | Nagar , Nagpur | & Drugs, Mantralaya College & Hospital, | College & | ‘Mumbai Near Hanuman | Hospital, Near | Nagar, Nagpur | Hanuman Nagar, | Nagpur | Maharashtra ~ [Maharashtra | Maharashtra”) | | 400032 440003 440003 joe _t Phone | 0712 | Nos. | 22701642 Office Residen | |x angmedie 022-22028614 psce,mededumabarashtra jzou.in 0712- 22701042 9422824729 de }om ewumaile Signature of Assessor 241? | 0712- 2744671 9373215775, a co 2@gmail, — spt pitORMENME: 2.96 (COMMUNITY MEDICINE) -V. 2020 BParticulars of Affiliating University { University | Maharashtra University of | Health Sciences, Nashik (MS) | Vice Chancellor LA. Gen Madhuri Kanitkar Registrar | Dr. Kalidas D, Chavan | Name | ~) Vani Dindori Road, Mhasrul, | Vani—Dindori Road, | Vani-Dindori Road, | Address | Nashik - 422004 Mbhasrul, Nashik - 422004 | Mhasrul, Nashik - 422004 | | | (Maharashtra) (Maharashtra) (Maharashtra) | Maharashtra - Maharashtra Maharashtra State [Pin Code | 422004 422004 422004 Phone Nos. | 0253- 2539292 (0253- 2539128 (0253- 2539294 | Office 0253- 2539295 0253- 2539113 0253- 2539295, Residence | Fax Mobile No. 7770086644 7720036370 E-mail: | wwwmuhsacin veoffice@muhs.ac.in registrar@muhs.ac in Ap { , if Daal Signature of AssessorFORMENMC- 2.06 (COMMUNITY MEDICINE) ¥_2020, 5 SUMMARY Date of Assessment: 29/08 _/_ 2022 Name of Assessor:Dr. Dipesh Parmar pes re — | Name of Institution Director / Dean / Principal | (Gow (Whosoever is Head of the Institution) | | Government Name Dr. Sudhir Gupta _| | Medical College, [> —|———_____— | Nagpur |Age & Date of Binh | (62 yeas) 01/02/1960 | | ‘Teaching experience 32 years 8 months || | PG Degree (Recognized/Non- | MD, DM (Recognized) | | R | L Discipline/Subject Gastroenterology | l | Department ‘Community Medicine inspected | Pe | | Community ‘Name Dr. Uday Narlawar Medici (ea eee ‘Age & Date of Birth 60 years, 30.06.1962 | | Teaching experience 36 years 6 months | | PG Degree (Recognized/Non- | MD (Recognized) | R) al @ Recognized Permitted First LOP date when Number of UG seats | (Year: 1964) (Year: 1947) MBBS course was first | | permitted | | 250 (50 increased | 250 August 1947 | | since 2019) | | 3b) UG -17" September | PG 8" August 2018 | | Date of last 2018 : | | assessment for Purpose: Routine Purpose: Increase PG | | seat | 7 | a ____} yt Ss —ryth ies Signature of AssessorFORMENMC: 2.6 (COMMUNITY MEDICINE). 2020 6 Total Teachers available in the Department: . } | Designation Number Name Total teaching | Benefit of publications | \ experience in promotion | Professor 1 Dr. Uday Narlawar | 36 years YES 2 Dr.Subhash B Thakre | 29 years YES | | Assoc Professor |g Dr. Sonali Patil 20 years Dr. Sarita Sharma. | 28 years | YES Dr. Avinash Gawande | 22 years YES Dr. Shilpa Lanjewar | 22 years YES | Dr. Sandeep Bhelkar | 18 years YES | Dr. Sameer Golawar | 22 years YES | Dr. Ujwala Ukey | 14 years YES | DrManjusha Dhoble | 17 years YES Asst Professor 6 Mr. S. M. More 29 years NO Dr. Pawan Meshram | 11 years YES Dr. Abhay Chavan | 7 years YES | Dr. Rushali Lilare | 5 years. YES | Dr. Mahesh Jajulwar | 5 years YES. | Senior Resident Dr.Bhagyashree 7 months : | Gawande Joined on DrMurari Hemalatha | 22/08/22 [Tuor Dr Ruchita Chavre = | Dr Chetan Wanjari | . Joined on Dr Sameer Kedar 10/06/2022 Dr Bhushan Gawande Dr Rajat Kharve Note: Only those who are physically present to be considered, Signatyec%! College & NAGPURFORM-NMC- 2.96 (COMMUNITY MEDICINE) -V_ 2020, 4. Clinical workload of the Institution: Entire Hospital Particulars — \ a On Day of Assessment Avgof3 Days Random | OPD attendance upto 2:00P.M. 2082 1832 Total number of new admissions 152 131 Total Beds occupied at 10:00A.M. Noo 1098 Total no. of Required Beds 1430 1536 Bed Occupancy at 82 8 (0. of Major Operations 58 8 No. of Minor Operations 34 1 No. of Day Care Operations 61 3S | Total no. of Deliveries 18 16 Total no. of Caesarean Sections 16 9 | Total no. of Deaths 5 4 Casualty attendance 161 216 Note: . i, OPD attendance to be considered only up to 2:00 P.M. and Bed occupancy till 10:00 A.M. ee Clinical Laboratory and Blood Bank. 5. Investigative Workload of entire hospital. Particle Data to be verified with physical records/registers for Radiodiagnosis, Central Ente Hospi ‘On ay ol aicomet {vgot random dae | Ratings Ma ° Gi 16 is Us6 256 Pan Kempe WPrBarum Mannopacy sa I - (Cpe EAC st wade AC Cpopatotny icry (COM 19 tne) Commaity Mie [ns of tond comme Signati ee one ae 1 NAGPUR med ignature of Assessor, analFORMENMC-2.06 (COMMUNITY MEDICINE) -¥.2020 8 64. Details of Field Services provided by the department of Community Medicine. cS | | UHTC | . [Now | Particulars purre | MANEWADA | a (NEW) : 1 - - 4 y_| Manewada, | \ 1 | Location (Name of Place) Saoner | Shahu Nagar) Ajni a = _ Nagpur [2 Distance from th the in tution 14 km 4akm 2km le ‘Ownership (whether fully Pwned by Adoption YES | >> | institution) No) YES | 1 Aaminstrtive& financial J control with Dean * | or not il = | Department "Department ‘Department | 5 Bas available or not me | vehicle | vehicle 5 ; Non- ‘Non Ls | Residential or non Residential Residential | residential | Residential | 7. | Hostel for interns available or not Yes No | NA, Tg. | Number of Indoor beds 20 2 | _o | Tiffin | Not available 9, | Mess faculty available or not system Lo available |__No [_ 10 ‘Available medical Staff (Give Number) | u | ‘Available Paramedical staff (Give Names) | 12| Average Daily OPD attendance 173] OPD attendance on the day of Assessment T_T | 141 Average daily Bed Occupancy Js I 15, Bed Occupane oe sn the day ofnspecton | | 16) Average Monthly Deliveries a= | 17) Any Deliveries on inspection day Fo | Arrange for immunization (Daily oF | otherwise) 1 | | storage of vaccines: Onsite or transported | 19) from institution + IN college & Hogpftal NAGPUR ii 2sa0_| _ 0 | 0 twesdny, | Tuesday § Thursday | iday | On site Onsite | ary | _ | Available Available py yy Signature of Assessor vil —_FORM.NMC-2.PG (COMMUNITY MEDICINE) 2020 7. Publications from the department during the past 3 years: (Only original articles published in indexed journals are to be accepted, Case reports, abstracts and review articles are not to be included), 1) NarlawarU etal, Knowledge, attitude and Practice regarding sickle cell disease in adult sufferers and carriers in a rural area, I]CMPH, 2021: 1075-1080. 2) Narlawar U etal. Sero prevalence of sars-cov-2 in general population of nagpur district. LICMPH, 2021: 3952. 3) Kulkarni etal. Independent association of meteorological characteristics with initial spread of covid-19 in india. SCIENCE OF THETOTAL ENVIORMENT, 2020 Ukey U etal. Snapshot of stress and anxiety related to covid-19 among health care professionals of central india, ICMPH, 2020 Gavande A etal, Impact of anti-tubercular treatment on weight and symptoms of category | tuberculosis patients in an urban city of central india, . IJCMPH, 2020: 491 Gawande Aet al. Psychological Effects Of Covid-19 Lockdown On Working From Home Information Technology (It) Professionals By Using Dass?1 Scale:A Cross Sectional Web Based Study, ISR, 2020 : 27 Sukanya Kamble etal. Perceived stress and behaviour change during covid-19 pandemic in Beneral population;a cross sectional web based survey in india, 2020; 10(8: 27. 8) Uvala Ukey etal. Snapshot OF Stress And Anxiety Related To Covid-19 Among Health Care Professionals Of Central India, IJCMPH, 2020: 7(9:-- 9) Uiwala Ukey etal Emotional Intelligence Of Medical Undergraduates: A Cross Sectional Study, IRMS, 2019: 6/12 10) Ujwala Ukey , Serta Wadhva Barriers For Utilization Of Urban Public Health Services A Community Based Cross Sectional Study, IIBMR, 2022 : 93-96, 11) Sarita Wadhva et al. Covid-19 And Subsequent Lockdown: Adverse Effects On Psychological Health Of Indian Women, JFMPC, 2021 : 4102-09, '2) Patil Sonali et al. Covid-19: Awareness And Attitude Of Healthcare Professionals At A ‘Tertiary Care Centre In Central India UCM and PR, 2021: 547-76. 15) Sorta Sharma ct al, “HIV/AIDS Awareness Among Hospital Employees" OCM, 2021: 106-8 '4) M.S Chahande et al. Study Of Some Epidemiological Factors In Teenage Presnancy « Hospital Based Comparison Study, IJOCM, 2021 15) Pati! Sonali tal. Exam Anxiety And Factors Contributing To It Amongst Medical Interns OFA Tertiary Care Centre, JOSR, 2021 16) Pati Sonal et al. Maternal knowledge and practices regarding diarrhoea in under fives,, WOSR, 2021: 8177-8179 4) s) ® n 17) Waghmare P et al. Cross Sectional Study Of Depression, Anxiety And Stress DueTo Covid-19 Pandemic Among Undergraduate Medical Students From Maharashtra, LCMPH, 2021: 95-98. 18) Tolani P, Wadhva S. Prevalence And Pattern Of Tobacco Consumption In Urban Community :A Cross Sectional Study In Adults Of Central India, IICMPH, 2021:3976- | 3980. 419) Sharma s etal Sero Prevalence Of Sars-Cov-2 In General Population Of Nagpur District, UCMPH ,2021: 3952-3957, 20)Sharma 5 otal Mental Health Issues Dus To Covid 19 Pandemie And Possible Solutions, ae wie i e se vosst Signature of Assessor Signptaye Be? ignature of Assessor NAGPUR BeYORMNMC. 2.76 (COMMUNITY MEDICINE) 2020 10 [ Vhe Antiseptic, 2021; 22-26. 8.Blood bank, | License valid ‘Yes(31/12/2022) | | Blood component facili Yes | | Number of units stored on the day of Asses n | | Average number of units consumed daily (entire 30-35 | hospital) Specialized services provided by the department: Sex und Marriage Counselling OPD 9. Specialized equipment available in the department: Adequate 10. Space (Offices, Teaching areas) Adequate AL. Library: - - _ > \ Particulars | Centrat Departmental _| | Number of Books pertaining to Comm. Med | is 1026 [Number of Joumals 33 235 | —e eee — | Latest journals available up to 2x 021 2021 \ 12, Emergeney/Casualty: Number of Beds: 50 Available equipment: Adequate 13. Common facilities: 1. Central supply of Oxygen / Suction: Available 2. Central Sterile Supply Department Adequate 3. Laundry services: Mechanical 4, Dietary services Hospital supply 5. Bio-Medical Waste disposal Outsourced 6. Generator facility Available 7. Medical Record Section: Computerized 8. ICDX classification Used 15, Total number of OPD, IPD & Deaths in the Institution and department over the last Lyears — | - a Community Medicine Paramete Entire hospit —— | Parameter Entire hospi | RUC | UNC AJNL HUNTTC MANEWADA 1 1.0PD Attendance 6,01,006 4 30242 - | IPD (Total no. of Pts. admitted) | $2,788 184 . ~ Deat ) 0 0 | 3.Deaths 2 | 1893 — ad beat ; p? aay al Signatu A Signature of AssessorWw [FORMENME: 2:06 (COMMUNITY MEDICINE) -¥_ 2020 live birth-7493 16. Number of Births in the Hospital during the Inst one yom Note: ee ro be verified with Birth/Death registration forms sent by the college/hospital to the Registrar of Births & Deaths si. Calendar year: P* January 10 39" December 17. Accommodation for staff: Available 18. Hostel accommodation: Interns a Boys | Girls 300 | 330 | 90 vs [130 [25 (25 we fale | Permitted seats | Date of permission | Date of rrecognitio =| 2302119 | —_ 20. Year wise PG students admitted (in the department inspected) during the preceding 5 years lable number of PG teachers > ‘Year | Number of PGs adi ‘mber and Names of PG Teachers available eS Se | 7 Narlawar , Dr. Thakre, Dr Patil, Dr Wadhva, Dr) \ 2021-22 | uN Lanjewar, Dr Gawande ,Dr.Bhelkar, Dr Golawar, | | Dr Ukey, Dr. Dhobale, Dr Rathod, Dr. Chavan ie a Dr Narlawar , Dr Patil, Dr Wadhva, Dr Lanjewar, Dr | \ 2020-21. | 11 Gawande ,Dr-Bhelkar, Dr Golawar, Dr. Ukey. Deeg | Rathod__ _ Dr Narlawar Dr Patil, Dr Wadhva, Dr Lanjewar, Dr | Gawande Dr Bhetkar, Dr Golawar. De. Uke} | Dr Gawande , Dr Golawar , Dr Lanjewar Dr | Rathod, Dr Patil, Dr Chaudhary Signat ow® ‘Signature of AssessorFORMNME: 206 (COMMUNITY MEDICINE aon 12 21. Other PG courses run by the Institution | Course Name | No, of seats Departmentis DNB Ni MSc. | NIL MPH(Nutrition) [20 Community Medicine Others(Ph.D.) | 4 Community Medicine 22. Stipend paid to the PG students, year as per Government rates shown above. 23. List of ieved after the last Assessment: | | Names of faculty members Designation Number [eae Relea Professor 2 Dr.Subhash B Thakre Dr.Prashant Bagdey, Associate Prof. Dr Sandeep Bhelkar, Dr NIL Manjusha Dhoble | Assistant Prof. 14 Dr. Komal More Dr Pragati Rathod Dr. Arshiya Sheikh Dr. Tushar Tathe Dr. Tushar Tathe Dr. Kawinkumar Dr. Kawinkumar Dr. Komal More | Dr sophie Simon Dr. Arshiya Sheikh | Dr Shruti Shukla Dr. Rajan Bamnwal Dr Ajay Sahu Dr sophie Simon | Dr Shruti Shukla i} Dr Ajay Sahu | Dr Sandeep Zurmure | | Dr Ujwal Sauray SRTutor/Demonstrators, | 7 Dr. Bhagyashree NIL | Gawande[SR] Dr.Murari Hemalatha Nair {sR} | Dr Chetan Wanjari, [1] | | Dr Ruchita Chavare, [T] | | Dr Rajat Karve, (1) | , : Byes Signaturect FORM-NMC= 2.96 (COMMUNITY MEDICINE) -¥_ 2020, 24, Faculty deficiency, if any: 13 Designation _| Numbers available | Numbers required | Deficiency, ifany f 2 1 NIL (+1) Associate Professors 1 8 3 i NILGS) : | 2 6 \NIL(COMPENSATED | | BY ADDITIONAL | ASSOCIATE, | | PROFESSOR) | Senior Residents z NIL(+2) Junior Residents 2 NIL | Tutors Demonstrators 5 | NIL(COMPENSATED BY ADDITIONAL SR) | Any 1 1 J nil Others(Statstician | cum Assistant Professor) * Faculty Attendance Sheet duly signed by concerned faculty must be handed over to the Assessors. 25. REMARKS OF ASSESSOR ‘The department is having adequate staff, clinical material & infrastructure. Please DO NOT repeat information already provided elsewhere in this form. Please DO NOT make any recommendation regarding grant of permission recognition | Please PROVIDE DETAILS of irregularities that you have noticed’ come across, during the assessment, like fake/dummy faculty, fake/ dummy patients, fabrication falsification of data of material etc. if any. C wf? PR ee, pros — mies Signatureotd RAO pur , a» Ce at Signature of Assessor CO, D5Petl Ve Gore)Ps FORMENMC: 2.06 (COMMUNITY MEDICINE) -V_ 2020 PART-1 1. Particulars of Director / Dean / Principal: the Head of the Institution) (Whosoever Name: Dr. Sudhir Gupta {PG Degree | (INSTITUTIONAL INFORMATION) Ins Age: 62 years (Date of Birth) 01 1021960. Subject | Year | — Univer | Resosnized | Gastroenterology 1 aint Mee ses Banaras Hindu 14 University Teaching Experience (Designation —_| Institution From To | Total experience | Assistant Professor | Mahatma Gandhi Institute of 26.06.1993 | 26.11.1993 | $ months | Medical Sciences, Sewagram | | Associate Mahatma Gandhi Institute of 27.11.1993 | 30.03.1999 | 5 years 4 months | Professor/Reader _| Medical Sciences, Sewagram | | | Professor Mahatma Gandhi Institute of (01.04.1999 | 30.08.1999 | 4months | Medical Sciences, Sewagram 31.08.1999 | 22.02.2021 | 21 years 8 months | Super Speciality Hospital, Nagpur | Dean Govt Medical College 72.02.2021 | Till date | 1 year 6 months | &Hospital Nagpur | Any Other Grand Total | 32 years 11 | | months 2. Central Library a) Total number of Books in library: 38877 ) Books pertaining to Community Medicine: 11 ©) Purchase of latest editions of books in last 3 years: Total:194 Community Medicine books: 12 ) Journals: ‘¢) Year / Month up to which latest Indian Journals available: ) Year / Month up to which latest Foreign Journals available: 2 g) Internet: hy) Library opening times: 10 am t ‘Total number ‘Available i) Reading facility out of routine library hours: A (Obtain alist of buoks & journals related 9 Community G NAGPUR 15 Community | Medicine t) | ge to 10 pm (12 Hts) vailable Medicine duly signed by Dean)FORML-NMC: PG (COMMUNETY MEDICINE) 2020 15 3. Casualty/ Emergeney Department / Parti a ‘articulars Numbers / relevant details | ioe s Medicine 30 Surgery 20 | Jo. of cases © daily d No. of cases (Average daily OPD and 250 (OPD).40-50(1PD) | _Bmergeney Lab in Casualty (Found the clock): | Available | Emergency OT and Dressing Room =| YES - | | Suit (MeicarParedies ‘EMO present 24 hours, Resident ofall ~| departments on call, Lecturers of all departments | on call, Consultants of all departments on call Interns 15 eta time (posted for 15 days), Staff | nurse 3 at atime +3 sister in charge Equipment available “All essential equipments are present in casualty | like ECG machine, Oxygen Cylinder, Emergency | Kit, Fully equipped disaster trolleys, refrigerator | for medicines | | | | | 4. Blood Bank (i)_| Valid License Yes Verified | (31/12/2022) Gi | Blood component facility available Yes Verified | Gi | All Units tested for Hepatitis C,B, HIV Yes Verified [Gv | Nature of Storage facilities (as per specifications) | Yes Verified ). | Number of Units available on Assessment day n "| Weriied (¥)_ [Number of Units availble oo 7 f , = ite) Paw) ccalene® VD iron ¥ Signatu NAGPUR Signature cp kaoae