Essentials of Hospital Infection Control Apurba S Sastry, Deepashree R
Page numbers followed by f refer to figure and t refer to table.
ABC Calc 507
Accelerate Pheno system 483
Active MDRO surveillance 375
Active surveillance 70
Adult ventilator associated event algorithm 90
Aerosol-generating procedures 232
particle counter 361
surveillance 356
Airborne precautions 159
Alcohol 263
Alkaline hydrolysis 412
American Society of Anesthesiologists score of patient physical status 55
Antibiotic cycling 497
Antimicrobial lock therapy 34
Antimicrobial resistance
in India 514
outcome indicator 507
surveillance 511
research network 512
Antimicrobial skin sealants 62
Antimicrobial stewardship 476
Antimicrobial-coated sutures 66
Aprons 152
fistula 173
graft 173
Automated blood culture systems 479
Automated cart washers 310
Automated endoscope reprocessors 276
Automated healthcare-associated infection surveillance 119
Automated washers 309
Awareness on infection control 6
Baclink 513
Bacterial endotoxin test 349
Baseline period of stability 92
Biological indicator 327
Biomedical waste 399
Biomethanation 420
Biosafety levels 207
Burn center 218
Burnout syndrome 457
Capacity tests 296
Carbapenem-resistant enterobacteriaceae 379
Care bundle
approach 24
for central line 39
for urinary catheter 24
Carrier tests 297
asymptomatic bacteriuria 15
urinary tract infection 15
surveillance 80
Catheter-related bloodstream infection 26
CDC NHSN common terminologies 74
Central line 26, 83
venous catheter 26
Central sterile supply department 301
Central venous catheter 26
Centrifugal sampler impactor 360
Chemical disinfectants 257
Chemical indicator 326
Chemical spill
kit 424
management 424
Chemical sterilant 259
Chennai declaration—roadmap to tackle challenge of AMR 515
Chick-martin test 296
Chlorhexidine 266
Chlorine 264
Cleanroom standards 362
Cold water jet guns 305f
Common source outbreaks 462
Composting 419
Computer physician order entry 493
Computerized decision support systems 493
Contact precautions 155
Contaminated linen 382
Continuous common source outbreak 463
Cumulative antibiograms 507
Cytotoxic drug waste management 415
Daily minimum PEEP 92
Date of event 75
Days of therapy 507
Decontamination sinks 305f
Deep burial 410
Defined daily dose 505
criteria 77
reinsertion criteria 78
utilization ratio 115
Differential coliform count 340
Dirty linen 382
Disinfectant testing 295
Disinfection policy 256
Disinfectors 309
Doffing sequence 153
Donning sequence 153
Double gloves 145
Droplet precautions 157
Dumb waiter 305f
Effluent treatment plant 420
Eijkman test 340
Electronic waste management 417
Embalming 252
Encapsulation 411
Endoscopy reprocessing 272
Endotoxin detection 349
Enhanced antibiograms 508
Envelope wrapping method 316
surface surveillance 364
surveillance 329
Enzymatic cleaners 307
Epidemic curve 461
Epidemiological chain of healthcare-associated infection 2
Eskape pathogens 4
Ethidium bromide disposal 427
Ethylene oxide 321
E-waste disposal 418
Exposed person 432
Facemasks 146
checking 150
testing 151
Formaldehyde 262
Formulary restriction with preauthorization 496
Fraction of inspired oxygen 91
Framing antimicrobial policy 494
Glassware management 414
Glo germ 135
Global action plan on antimicrobial resistance 515
Global antimicrobial resistance surveillance system 511
Gloves 144
Glutaraldehyde 260
Gowns 152
Guidewire exchange 38
Hand hygiene 121, 123
adherence rate 136
measurement methods 131
methods 123
partial adherence rate 136
products 124
Hazard analysis and critical control point system 397
Healthcare-associated infection 1, 75
surveillance cycle 115
Hemodialysis equipment 174
High-level disinfectants 259
Hospital antibiogram 507
Hospital infection control
committee 9
team 10
Hospital information system 492
Hospital-wide healthcare-associated infection surveillance 72
Housekeeping policy 281
Hydrogen peroxide 263
Hygiene preparation in funeral parlor 252
Hypochlorite 264
ICD-10-PCS category mapping 113
Ideal disinfectant 259
Immediate use system 321
Improvement of PEEP 92
Index of microbial air 357
Indian Public Health Standards 525
Indicators used for monitoring the sterilization 326
Indwelling catheter 17
Indwelling urinary catheter 81
Inertization 411
Infection control
during bioterrorism attack 242
for influenza 230
for legionellosis 234
for prion contaminated items 237
for tuberculosis 219
for viral hemorrhagic fever 244
in blood bank 212
in burns unit 216
in C. difficile infection 224
in dialysis units 172
in ICU 195
in kitchen and food safety 390
in laboratory 206
in laundry 382
in operation theater 199
in outpatient setting 203
in transplant units 183
nurse 12
officer 11
policy for after death 250
requirements for accreditation 520
Infection present at time of surgery 103
Infection window period 75
Intermittent common source outbreak 463
International patient safety goal 525
Iodophors 264
Jaipur declaration on antimicrobial resistance 515
Joint Commission International 525
Kayakalp Swachta guidelines 525
Kelsey-Sykes test 296
Kerala Accreditation Standards for Hospitals 526
Laboratory confirmed bloodstream infection 85
Laboratory stewardship 478
surveillance 72
ward liaison surveillance 72
ward surveillance 72
Landfilling 420
Laqshya 525
Line listing of cases 470
Liquid waste management 420
Location of attribution 78
Low-temperature steam formaldehyde 324
Luminometer 134
Maintenance care bundle for mechanical ventilator 53t
Mechanical bowel preparation 60
Mechanical ventilation 161
Medical care devices 256
Medicines with the red line 517
Medicolegal aspects of healthcare-associated infection 13
Membrane filtration method 340
Mercury spill kit 425
Mercury spillage management 425
Metal sharp management 414
Methicillin-resistant Staphylococcus aureus
surveillance 375
tagging 376
Microwaving 410
Mode of transmission of healthcare-associated pathogens. 5
Monitoring the efficacy of sterilization 325
Mucosal barrier injury laboratory confirmed bloodstream infection 88
Multiple-tube method 336
N95 respirator 150
National accreditation board for hospitals 520
National action plan on antimicrobial resistance 515
National healthcare safety network 73
National Program for Containment of Antimicrobial Resistance 511
Needle stick injury management 432
Needleless intravascular catheter systems 39
Nosocomial legionellosis 234
Occupational exposure 432
Ortho-phthalaldehyde 261
Outbreak control team 467
Outbreak investigation 461
Outcome surveillance 71
Parcel fold wrapping method 315
Pareto charts 507
Passive surveillance 70
PED VAE surveillance 98
Pelletization 420
Peracetic acid 262
Personal protective equipment 143
Phenolics 266
Physical or mechanical indicator 326
Physiochemical analysis of water 355
Pioneers in infection prevention and control 7
PK-PD monitoring of antimicrobials 487
pyrolysis 411
sterilization 323
PNEU/VAP surveillance 99
Point prevalence survey 73
Point source outbreak 462
Population-based surveillance 70
Positive end-expiratory pressure 92
Practical tests 298
Present on admission 75
Presumptive coliform 333
Procalcitonin 484
Process challenge device 327
Process surveillance 71
Promession 412
Propagated outbreak 464
Prophylactic negative pressure wound therapy 65
Prospective audit and feedback 498
Prospective incidence surveys 73
Protective isolation 165
Proteolytic cleaners 307
Qualifying antimicrobial days 94
Quality indicators in infection control 521
Quaternary ammonium compound 267
Radioactive waste management 417
Red line 517f
Repeat infection timeframe 75
Resident flora 122
Respirators 147
Respiratory protection equipment 220
Reverse isolation 165
Screening for multidrug-resistant organisms 371
Secondary blood stream infection 87
attribution period 75
Selective digestive decontamination 52, 61
Selective or cascade reporting 479
Selective oropharyngeal decontamination 51
Semirecumbent position 50
Sentinel event-based surveillance 70
Sharp pit 411
Shredder 410
Sieve impactor 358
Single-use devices 277
Skin reactions related to hand hygiene product 129
Slit-to-agar impactor 359
Sodium dichloroisocyanurate 265
Soiled linen 382
Solid general waste management 419
Source person 432
Sources of infection 3
Spaulding's classification of medical devices 257
Spill kit 424
Spillage management 422
Sputum collection booth 221
SSI bundle (adapted from WHO) 67
Staff clinic 450
Standard precautions 121
Standardized infection ratio 115
Steam sterilizer (autoclaves) 319
Subtraction antibiogram 508
Superoxide water 265
Surface disinfection test 298
Surgical antimicrobial prophylaxis 59
Surgical hand preparation 62
Surgical site infection 53
surveillance 103
Surveillance of healthcare-associated infections 70
Targeted healthcare-associated infection surveillance 72
Test of Kelsey and Maurer 298
Theatre sterile service unit 301
Thermotolerant coliform 334
Three bucket trolleys 288
Transfer rule 78
Transient flora 122
Transmission-based precautions 155
Trolley washer 310
Turn-around time 490
Ultrasonic cleaner 308, 309f
Ultraviolet germicidal irradiation 162
Urinary catheter insertion technique 21
Vancomycin-resistant enterococci 377
events and pneumonia surveillance 90
events window period 94
pneumonia 40
Vermicomposting 420
Ward liaison surveillance 72
Washer 309
management in healthcare facility 399
receptacle 404
segregation 401
Water surveillance 330
Waterborne pathogens 330
WHO priority pathogens 510
WHO's proposed core components for infection prevention and control 5
Work restriction 450
for healthcare worker 453
Workflow of blood culture laboratory 488
class type 54
protector devices 64
Chapter Notes

Save Clear

Apurba S Sastry MD DNB MNAMS PDCR Hospital Infection Control Officer Officer in-Charge HICC Antimicrobial Stewardship Lead Associate Professor Department of Microbiology Jawaharlal Institut e of Postgraduate Medical Education and Research (JIPMER) Puducherry, India Deepashree R MD (Gold medal) DNB MNAMS Senior Resident Hospital Infection Control Committee Division Department of Microbiology Jawaha rlal Institute of Postgraduate Medical Education and Resea rch (JIPMER) Puducherry, India Foreword Nizam Damani Senior Consultant at Infection Control Unit of WHO, Geneva Author of the internationally renowned book ‘Manual of Infection Prevention and Control’
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Essentials of Hospital Infection Control
First Edition: 2019
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According to the World Health Organization (WHO), it has been estimated that at any time, over 1.4 million patients worldwide are suffering from infections acquired in healthcare facilities. This is an underestimate due to the lack of surveillance in most healthcare facilities. Based on the reported data, it has been estimated that the incidence of healthcare-associated infections (HAIs) in high-income countries is between 5% and 10%; while in low- and middle-income countries, it can exceed 25%.
HAIs not only drain valuable health service resources in terms of additional costs but also have the impact of extra length of stay in hospital as well as additional nursing and medical time. They can also cause adverse hospital publicity which may result in loss of confidence from patients in the delivery of medical care. In addition, especially in low- and middle-income countries, the cost and impact of HAIs on the individuals and their families can be devastating due to loss of income, indirect cost and burden to family members in terms of time lost from work in caring for the affected individual. As a result, worldwide, prevention and control of HAIs are now a major priority and its control is a part of the patient's safety and delivery of quality service by all healthcare facilities.
Unfortunately, due to various reasons, implementation of even basic infection prevention and control (IPC) practices can be challenging, especially in low- and middle-income countries. Increasing awareness through surveillance to assess the burden of HAIs supplemented by education and training, and behavior change is necessary to achieve this important objective.
Essentials of Hospital Infection Control by Dr Apurba S Sastry and Dr Deepashree R is an important publication to provide basic information to all healthcare workers involved in prevention and control of HAIs in the healthcare facilities. It is commendable that authors have written this book, especially for hospitals in India and cited relevant publications and references to inform readers about local policies, procedures, and guidelines. This is important because, for an effective implementation of any IPC programme, local adaptation of guidelines is essential which should be based on local need and resources without compromising the application of basic IPC principles and the authors should be congratulated for their efforts with an aim to achieve this objective.
I really appreciate the efforts made by the authors for this commendable work and I am sure that this book will be widely read by infection control practitioners including clinicians, microbiologists, postgraduates, and other infection control specialists.
Best wishes in your future endeavours!!!
Nizam Damani
Consultant at the World Health Organization (WHO)
Consultant at Southern Health and Social Care Trust, Portadown, Northern Ireland, UK
We are greatly privileged to announce the release of most-awaited book on infection control ‘Essentials of Hospital Infection Control’. This is probably the first book in India which gives an in-detail explanation of various aspects of hospital infection control.
  • Chapter-1: Introduction to Healthcare-associated Infections —Enfolds the definition, burden, epidemiological chain and various modes of transmission of HAI. It also covers overview of WHO core components for infection prevention and control including preventive strategies.
  • Chapter-2: Structural Organization of an Infection Control Program —Deals with the composition of HIC team and function of key stakeholders such as infection control officer and infection control nurse.
  • Chapter-3: Major Healthcare-associated Infection Types —Covers various major HAI types such as CAUTI, CRBSI, VAP and SSI; with respect to their pathogenesis, laboratory diagnosis, treatment and preventive measures; with inclusion of the concept of care bundle for prevention of device-associated infection. Various standard references such as IDSA guidelines, Mandell's Principles and Practice of Infectious Diseases, Harrison's Principles of Internal Medicine, NCDC and ICMR guidelines were followed.
  • Chapter-4: Surveillance of Healthcare-associated Infections —Content of it is exceptional in its way, covering the most challenging concept ‘HAI surveillance’ according to the latest CDC NHSN guidelines. This chapter is furnished with numerous illustrations to make the concept crystal clear. Topics included are CDC NHSN Common terminologies, CAUTI surveillance, CLABSI surveillance, VAE surveillance and SSI surveillance. To aid readers on practical application, data collection and analysis of HAI has also been described.
  • Chapters-5–7 elaborate on various preventive measures such as standard precaution components like hand hygiene, personal protective equipment and also, transmission-based precautions components including contact, droplet and airborne precautions. These chapters also describe measurement of hand hygiene compliance along with an illustration of case scenario, which will guide the readers to conduct hand hygiene audits in their respective hospital sectors.
  • Chapter-8: Infection Control in Special Situations —Serves as a landmark chapter of this book, which discusses in detail about infection control measures to be taken for various locations such as dialysis units, transplant units, intensive care units, operation theater, outpatient setting, laboratory, blood bank, burns unit; and for various infections such as tuberculosis, C. difficile infection, influenza, legionellosis, prion-contaminated items. This chapter also portrays IPC measures during gray circumstances like a bioterrorism attack, outbreak of viral hemorrhagic fever and after-death situations.
  • Chapters-9 and 10 comprehend disinfection policy and infection control in central sterile supply department. These encompass the fundamental concepts of disinfection and sterilization, guidelines for reprocessing of endoscopes, policy for reuse of single-use devices, housekeeping policy and disinfectant testing methods. The workflow of CSSD from dirty area to packaging, sterilization and sterile area have been described in detail following standard references such as WHO and CDC guidelines.
  • Chapter-11: Environmental Surveillance —Elaborates basic concepts of water, air and surface surveillance; the indication for conducting environmental surveillance, recommended methods of testing, and also a special note on endotoxin detection methods has been described.
  • Chapter-12: Screening for Multidrug-resistant Organisms —Gives a bird's-eye view of policy for screening of staff and patients for various MDROs such as Methicillin-resistant S. aureus (MRSA), Vancomycin-resistant Enterococci (VRE), and Carbapenem-resistant Enterobacteriaceae (CRE); covering various aspects such as the indication of screening, method of detection, management (decolonization) and control measures.
  • Chapters-13 and 14 comprise of infection control policy in peripheral ancillary areas such as laundry, kitchen and food safety.
  • Chapter-15— Covers various Waste Management in Healthcare Facility in detail, adapted from 2016 BMWM rule with 2018 amendment. The gray areas and challenges in implementing BMWM 2016 have been discussed. Waste management in intricate circumstances like discarding a sharp waste, cytotoxic drug, radioactive waste, solid municipal waste, liquid waste (effluent treatment plant) and ethidium bromide waste, etc. have been discussed in detail. Spill management including chemical and mercury spill have also been covered at the end.
  • Chapter-16: Staff Health Issues-I: Needle Stick Injury Management —Encompasses the prevention and management of needle stick injury, including a detail discussion on postexposure prophylaxis of hepatitis B (according to CDC guidelines) and HIV (according to NACO guidelines). Guidelines on Management of HBV-infected HCWs have been described at the end.
  • Chapter-17: Staff Health Issues-II: Work Restriction and Vaccination —Covers in detail about the pre-exposure prophylaxis (vaccination) of healthcare workers (HCWs), work restriction policy following exposure of HCWs to infectious diseases in healthcare facility and postexposure management to various infectious diseases other than hepatitis B and HIV.
  • Chapter-18: Outbreak Investigation —Constitutes with the CDC recommended sequential steps of outbreak investigation. Also, Nipah outbreak, Kerala 2018 has been briefed at the end.
  • Chapter-19: Antimicrobial Stewardship —An exceptional focus topic which describes various components of Antimicrobial Stewardship Program (AMSP) such as definition, goals of AMSP, steps of implementation of AMSP, monitoring compliance to the AMSP. Also, upgrading of conventional microbiology reporting to laboratory stewardship reporting has been discussed in a crisp. The current situation of AMR and AMSP in India has been discussed at the finish.
  • Chapter-20: Infection Control Requirements for the Purpose of NABH Accreditation —This chapter enlists various infection control requirements for the purpose of NABH accreditation at various levels such as entry level award, progressive level award and full accreditation award.
As you know, human errors are inevitable; and no book is immune from it. We would request all the readers to provide any errata found and also valuable suggestions and updates via e-mail.
We are confident and hoping that readers will fall in love with the book and will extensively use this book while implementing infection control practices at their institutes across India.
Deepashree R
Apurba S Sastry
The release of Essentials of Hospital Infection Control would not have been possible without our close association with many people. We take this opportunity to extend our sincere gratitude and appreciation to all those who made this book possible.
Hearty acknowledgments to our teachers, departmental staff, family members and others for their blessings and support
  1. We would like to sincerely thank Dr Nizam Damani, author of Manual of Infection Prevention and Control and Consultant at the World Health Organization (WHO), Consultant at Southern Health and Social Care Trust, Portadown, Northern Ireland, for his willingness to write an encouraging foreword.
  2. We express heart-felt gratitude to Dr S Sujatha Sistla, Professor and Head, Department of Microbiology, JIPMER, for her guidance during manuscript preparation.
  3. We are extremely thankful to Dr Rakesh Aggarwal, Director, JIPMER, and also the previous Directors, Dr Vishnu Bhat and Dr Vivekanandan for giving the permission to write this textbook.
  4. We are grateful to Dr Ashok Bade, Medical Superintendent of JIPMER and the previous Medical Superintendent of JIPMER Dr J Balachander for their help during manuscript preparation and also giving permission to reproduce various HICC data collection forms of JIPMER.
  5. Other Faculty Members of Department of Microbiology, JIPMER— Dr Jharna Mandal (Additional Professor), Dr Rakesh Singh (Additional Professor), Dr Rahul Dhodapkar (Additional Professor), Dr Noyal M Joseph (Associate Professor), Dr Rakhi Biswas (Associate Professor), Dr Nonika Rajkumari (Associate Professor) for their kind support during manuscript preparation.
  6. Residents, JIPMER— Dr Vanathy, Dr Mugundan, Dr Sindhu, Dr Gopichand, Dr Ramya, Dr Suman, Dr Prasanna, Dr Kavita, Dr Sunil, Dr Radha, Dr Rachana, Dr Sushmita, Dr Sneha, Dr Akshatha, Dr Sruthi, Dr Subhashree, Dr Dhanalakshmi, Dr Sarumathi, Dr Anitha, Dr Kalpana, Dr Monica, Dr Lakshmi and Dr Tintu.
  7. HICC, JIPMER— Infection control nurses (Ms Rani Thamizharasan, Ms Ruth Lilly, Ms Djiva Azhwar, Ms Rajalakshmi B, Ms Radjalatchoumy Gobinath, Ms Mohanakumari, Ms Devapriya SD, Mr Thirumavarasu G, Ms Lathika Gladson, Ms Vijitha), infection control technicians (Mr Sulfihar Ali, Mr Rajasekar) and other office staff (Ms Ilaveni, Ms Ramya and Mr Venkatachalapathy).
  8. Faculty, JSS Medical College, Mysuru, Karnataka— Dr Tejashree, Dr Madhuri, Dr Sumana and others.
  9. JIPMER HICC Workshop: We would like to acknowledge all the participants and guest speakers of first, and second national workshops on Hospital Infection Control at JIPMER for sharing their knowledge and experience.
  10. Our friends—
    • Dr Apurba: Dr Godfred, Dr Sadia, Dr Srinivas Acharya, Dr Chaya, Dr Manisha, Dr Ira, Dr Wajid and others.
    • Dr Deepashree: Dr Bewin, Dr Usha, Dr Shilpa, Dr Rajeshwari and also, dearest juniors and seniors.
  11. Family— Parents, brother, sister and other family members, maternal and paternal cousins and all other well-wishers.
Sincere acknowledgments for helping in manuscript preparation and providing photographs
  1. Dr Sanjay Bhattacharya, Consultant Microbiologist, Tata Medical Center, Kolkata
  2. Dr Malini R Capoor, Professor of Microbiology, Vardhman Mahaveer Medical College and Safdarjung Hospital, New Delhi
  3. Dr J Jayalakshmi, Professor, Department of Microbiology, PSG Institute of Medical Sciences, Coimbatore
  4. Dr Ratna Rao, Consultant Microbiologist and Infection Control Practitioner, Apollo Hospitals, Hyderabad
  5. Dr Umasekar, Professor, Department of Microbiology, Sri Ramachandra Medical College, Chennai
  6. Ms Nandini Krishnamurthi, CSSD Manager, Fortis Hospital, Mumbai
  7. Dr G Arunkumar, Professor and Head, Manipal Centre for Virus Research (MCVR), Manipal
  8. Dr Smita Kayal, Associate Professor, Department of Medical Oncology, JIPMER
  9. Dr Priyamvada PS, Additional Professor, Department of Nephrology, JIPMER
  10. Dr Vivekanand, Professor, Department of Medicine, JIPMER
  11. Dr Nishad Plakkal, Associate Professor, Department of Neonatology, JIPMER
  12. For resource materials: We are thankful to Centres for Disease Control and Prevention (CDC), Kayakalp (India), National AIDS Control Organization (India), National Accreditation Board for Hospitals (India), Indian Council of Medical Research (ICMR), National Centre for Disease Control (NCDC)
  13. For HAI Surveillance: We are thankful to CDC's National Healthcare Safety Network for giving permission to use Patient Safety Component manual as a reference for HAI surveillance chapter
  14. World Health Organization: For giving permission for representing topics on ‘Decontamination and Reprocessing of Medical Devices for Health-care Facilities’ along with reproducing figures on prepared tray with surgical instruments ready for transportation to the SSD, parcel fold wrapping method and also envelope wrapping method.
  15. Manufacturers Forum for Infection Control Products: We are thankful to the resource persons from various manufacturers for providing specifications, principles and detail description about infection control products— BioMérieux India (Mr Sandeep, Mr Liju V argese, Mr Haribabu, Ms Kiran), Metro Scientific (Mr Raghuram, Mr Manoj), Ms Kavitha Kulkarni and Mr Aravind (3M), Mr Naresh (TSI), Raman and Weil (Mr Rajesh, Mr Yuvaraj, Mr Shiva and Mr Praveen)
  16. For providing photographs— We are extremely thankful to all people/institutes/companies who have agreed to provide valuable photographs
  17. A special acknowledgment to Dr Anitha for her help during the manuscript preparation
Special acknowledgments to my publishers
Jaypee Brothers Medical Publishers (P) Ltd.
  • Shri Jitendar P Vij (Group Chairman)
  • Mr Ankit Vij (Managing Director)
  • Mr MS Mani (Group President)
  • Dr Madhu Choudhary, Head-Publishing (Education): She is extremely sweet, and dynamic. She has been the backbone behind publishing of this book.
  • Ms Pooja Bhandari (Production Head)
  • Ms Seema Dogra (Cover Visualizer)
  • Dr Astha Sawhney (Development Editor)- humble, dynamic, and talented
  • The Development Team: Mr Deepak Saxena, Mr Nitesh Jain, Mr Binay Kumar. These guys are simply outstanding in their work. A special mention for Mr Deepak, we must say that he is the best operator of India in medical publishing. The way Nitesh does the designing of photographs is extraordinary. It's a treat for me to work with all of you. You guys are extremely workaholic and have a very good team spirit. We salute them for their professionalism.
  • Staff from other branch office: Mr Venugopal, Mr Palani A and Mr Venkatesh E (Bengaluru Branch), Mr Parimal, Mr Sharma and Mr Rajesh Malothu (Hyderabad Branch), Mr Senthil Kumar, Mr TM Bhaskar, Mr Dharani Kumar P and Mr RK Dharani (Chennai Branch), Mr Muralidharan (Puducherry Branch), Mr CS Gawde (Mumbai Branch), Mr Sandip Gupta and Mr Sanjoy Chakraborty (Kolkata Branch), Mr Vasudev H (Mangaluru Branch), Mr Arun Kumar (SSPO Thiruvananthapuram Branch), Mr Sujeesh (Kochi Branch) and Mr Dinesh Waghade (Ahmedabad Branch).
Lastly, we would like to keep in record that without the support of Adarsh (Son of Dr Apurba) and Dr Sandhya (Wife of Dr Apurba), Mr Rajashekar and Ms Usha (Parents of Dr Deepashree) and other family members, it would have been impossible to continue the spirit on, during the journey of the manuscript. We deeply apologize to you, as we could not give enough time and care to you during the manuscript preparation.
Apurba S Sastry
Deepashree R