situational analysis report vol-i

7/28/2019 Situational Analysis Report Vol-I

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Development of Standard Specification of Medical Equipment, Drug/ Medicines and

General Goods for the Provincial and Special Areas Health Department Situational Analysis Report

1

Development of Standard Specification

of Medical Equipment, Drug/ Medicines

and General Goods for the Provincial and

Special Areas Health Departments

Volume-I: Situational Analysis Report

Acknowledgements


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The consultants are grateful for the assistance of TRF, officials of provincial health

departments and special area in this research. Their constant support for the consultants in

this research helped in formulation of this report. Provincial coordinators of TRF and their

staff provided unrelenting support in achieving this task, their dedication and hard work

made this possible.

Authors Disclaimer

This report has been prepared by Dr. Shehzad Nazir Leghari, Biomedical Engineer & Team

Leader and Dr. Amer Umer Nagi, Pharmacist, in response to a Terms of Reference provided

by the Technical Resource Facility, Pakistan. The analysis is based on the information

provided by the Provincial Health Departments. The authenticity and accuracy of

information is not the responsibility of the Consultants. However, the analysis based on this

and the recommendations deriving from the analysis are the sole responsibility of the

authors and do not represent the view(s) of the TRF.

Group Disclaimer

This document has been prepared for the titled project or named part thereof and should not

be relied upon or used for any other project without an independent check being carried out

as to its suitability and prior written authority of HLSP being obtained. HLSP accepts noresponsibility or liability for the consequences of this document being used for a purpose

other than the purposes for which it was commissioned. Any person using or relying on the

document for such other purpose agrees, and will by such use or reliance be taken to

confirm his agreement, to indemnify HLSP for all loss or damage resulting there from. HLSP

accepts no responsibility or liability for this document to any party other than the person by

whom it was commissioned.

Dr. Shehzad Nazir LeghariBiomedical Engineer & Team Leader

[email protected]

Dr. Amer Umer [email protected]
mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]


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Contents

1. Introduction and Background ..................................................................................... 52. Objective ....................................................................................................................... 53. Methodology and Strategy .......................................................................................... 64 Visit Assessment .......................................................................................................... 8

4.1 Sindh ........................................................................................................................ 84.1.1 Outcome of the Discussions ............................................................................... 8

4.2 Baluchistan ............................................................................................................. 104.2.1 Outcome of the Discussions ............................................................................. 10

4.3 PUNJAB ................................................................................................................. 114.3.1 Outcome of the Discussions ............................................................................. 11

4.4 AZAD JAMMU AND KASHMIR ............................................................................... 134.4.1 Outcome of the Discussions ............................................................................. 13

4.5 Federally Administered Tribal Area ......................................................................... 144.5.1 Outcome of the discussions ............................................................................. 14

4.6 Khyber Pakhtoonkhwa ............................................................................................ 144.6.1 Outcome of the discussions ............................................................................. 14

4.7 Gilgit-Baltistan ........................................................................................................ 155 Analysis ....................................................................................................................... 156 Issues and Risks ......................................................................................................... 187 Recommendations ...................................................................................................... 20Annexure I ......................................................................................................................... 22

Annexure II ........................................................................................................................ 43


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General Goods for the Provincial and Special Areas Health Department Situational Analysis

Report

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Abbreviations

ADB Asian Development Bank

ADP Annual Development Program

AusAID, Australian Agency for International

Development

BHU Basic Health Unit

DFID Department for International Development

DG Director General

DHQ District Headquarter

DTL Drug Testing Laboratory

DUHS Dow University of Health Sciences

FATA Federally Administered Tribal Area

FDA Food and Drug Administration

KPK Khyber Pakhtunkhwa

LRH Lady Reading Hospital

MCC Medicine Coordination Cell

MSD Medical Store Depot

OBGY Obstetrics and Gynaecology

RHC Rural Health Centre

SEML State Essential Medicine List

THQ Tehsil Headquarter

TOR Terms of Reference

TRF Technical Resource Facility

UNICEF United Nations Children's Fund

UPS Uninterruptible Power Supply


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1. Introduction and Background

The provincial and Special Areas (Gilgit-Baltistan, AJK and FATA) Health

Departments are committed to improve the health status of the people of their

respective provinces, with focus on systems strengthening and staff

performance to ensure quality and transparency.

The recent devolution of functions from federal to the provincial governments

includes procurement of goods and services. Procurement of medical

equipment, drugs/medicines, hospital supplies and general goods (like

Information Technology (IT) equipment, furniture and electronic items) is

crucial for the Health Department to ensure delivery of quality services to the

general public. Timely availability and quality assurance of the goods are

highly important factors, which need to be addressed during the procurement

process. Supply and acceptance of inferior quality goods will not only affect

the performance of Health Department, but may also lead to audit

observations. One of the most significant steps to ensure the quality of

goods to be purchased consists in the development of clear and well-

defined specifications.

Development of standard specifications in the procurement process is

one of the critical requirements explained under rules framed by the

federal as well as provincial governments. During the process of need

identification and meetings of the Executive Committees, all the provincial and

Special Areas health departments requested the Technical Resource Facility

(TRF) for detailed, generic and standard specifications for all the items

listed in the approved lists available with the departments.

2. Objective

The objectives of the situational analysis were as follows:

The main objective of this assignment is to develop Provincial

and Special Area wise detailed generic/standard specifications of

medical equipment, drugs/medicines, hospital supplies and general


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goods listed in the approved lists of Health Departments, which will be

used for all procurements within the provinces.

To visit the provincial/regional offices to gather information on

prevailing system of and specifications.

Review the specifications already prepared by the respective health

departments.

To get the viewpoint of procurement personnel and other stake holders

on existing list of supplies and their level of satisfaction.

To identify and understand the issues and risks in the field in regard to

existing specifications that affect on the implementation of transparent

procurement.

Based on the feedback from the visits, develop situational assessment

report indicating detailed analysis of the existing situation, issues and

risks and recommendations for mitigation. This report will be followed

by detailed generic /standard specifications of agreed list of medical

equipment, drugs / medicines and goods.

3. Methodology and Strategy

The methodology is based on the following:

Assessment of the data collected from the Provincial Health

Departments.

Meetings and interviews with and information gathering from the

provincial health departments management and technical s taff

including Procurement officials, MSD officials, Pharmacists, Biomedical

Engineers, Drug Testing Laboratory officials, health service providers

and committee members of various notified procurement committees.

Consultative Interviews with Donor Agencies.

Study of PPRA and Provincial procurement guidelines.

Study of standard procurement specification of various governments

According to the scope of assignment following geographical areas were

covered;


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Health Department at Provincial capital of KPK

Secretary Coordination Office of FATA

Health Department at Provincial capital of Punjab

Health Department at Provincial capital of Sindh

Health Department at Provincial capital of Baluchistan

Health Department at capital of State of Azad Jammu and Kashmir

To the date of this report and submitted work plan, GB was not covered due to

unavailability of concerned staff and unfavourable law and order situation.

Following persons were interviewed during filed visits

Khyber Pakhtunkhwa

Secretary Health, KPK

DG Health, KPK

Professor Masood Rehman Head of Department Medicine, LRH,

Peshawar

Dr Seemi Fayyaz Associate Professor. OBGY.- LRH Dr Gohar Ali Associate Professor Anaesthesia LRH

Dr Zia ul Hussain - Deputy Director Public Health

Dr M. Hussain Assistant Professor Paediatrics LRH

Dr M. Irshad Senior Registrar Paediatrics LRH

Mr M. Yasin Head of Electro medical Engineering KPK

Mr Saif ur Rehman Electro-medical Engineer

Mr M. Shoaib Electro-medical Engineer

Mr Aurangzeb Khan Pharmacist, MCC

Dr M. Khalid Senior Government Analyst, DTL, KPK

Baluchistan

Dr Tariq Jaffer Deputy Director, Director General Health Department,

Ministry of Health , Baluchistan.

Dr Masood Nosherwani, D. G. Health, Baluchistan

Mr Saif ur Rehman, Pharmacist, MSD, Baluchistan


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Azad Jammu and Kashmir

Dr Abid Shah

Dr Manzoor

Mr Abdul Rasheed Office Superintendent

Punjab

Mr Shahbaz Yasin, Pharmacist, PSO-I, Punjab Health Department.

Mr Abdul Razzaq PSO-III (ME)

Mr. Suhail Hassan

Sindh

Dr Abdul Haq Memon, DG Health, Sindh, Hyderabad.

Mr Shafqat Hussain, Procurement Officer Dow University Hospital

Karachi.

Dr Insaf Magsi, Deputy Secretary Procurement

Dr Abdul Jabbar Memon,(DDD) Deputy Director Development

Professor Masood Hameed, member purchase committee

Federally Administrated Tribal Area

Dr. Nauman Mujahid

4 Visit Assessment

4.1 Sindh

4.1.1 Outcome of the Discussions

Central purchase and Drugs formulary were abolished in 2004 after devolution

of powers to District governments. After devolution, only tender to tender

purchases are done, no prequalification process is in place. Standard


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specifications of Medical Equipment and drugs/medicines are not maintained.

Only Dow University of Health Sciences is formally developing specifications

for its allied healthcare facilities.

Before devolution MSD Sindh used to issue three kinds of tenders for

drugs/medicines

Proprietary Tender Only Multinational Products for Teaching

Hospitals(for10 -15 products)

Limited Tender Competition between multinational companies.

Open Tender All Companies for OPD Medicines

There is a central biomedical Lab. in Hyderabad, this facility is inadequately

staffed and equipped and has no role in procurement exercise and

specification development. The technical staff is neither qualified nor properly

trained to service Medical Equipment at different levels. The Specifications

are made on ad-hoc basis as need arises and no organized record was

available. The specifications from DUHS were collected and analysed but they

are mostly for the tertiary care and research needs with some useful

specifications for items falling in the sphere of Primary and Secondary level

health facilities. Equipment and General Items specifications for DUHS will be

consulted in development of standard specifications of medical equipment and

furniture

On mutual discussion with health department personals met the general

consensus was that budgeted amount for required specification of Medical

Equipment for any PC-I does not meet the requirements, leading tocompromises on quality and functionality hence the healthcare needs are not

met appropriately.

Due to procedural delays, Budget release for any purchase is generally by the

4th Quarter. This eventually leads to compromises and errors in purchase, and

delayed payments to suppliers, resultantly quality manufacturers abstain from

competition.


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Recently, in the month of February 2012, MoH Sindh has issued a notification;

again reinstating central purchase system. Health Department has started

structuring policies for the new central purchase system which was abolished

and does not exist.

4.2 Baluchistan


Health Department is maintaining centralized purchase system and system in

Baluchistan was never devolved. Medical Store Depot is a functioning body.

Additional Secretary Health is in charge of MSD but at the time of visit D.G.

Health was in charge of MSD. D.G Health is also chairman of MSD and

Secretary Health is the Principal Purchase officer.

Pre-qualification of Companies and Medicine Renewal is on yearly basis. Pre-

qualifications were not done in last 3 years. Old medicine list is being

continued with charges on need basis. MSD Drugs List is not regularly

revised.

Tertiary care institutions are not autonomous in Baluchistan and they submit

their requirements for medicines. These institutions include Bolan Medical

Complex, Sundemon Provincial Hospital, Helpers Eye Hospital, Fatima Jinnah

General and Chest Hospital and Sheikh Khalifa Bin Zayed Medical Complex.

Sheikh Khalifa Bin Zayed Medical Complex is recently transferred on

devolution under 18th amendment to Provincial Government and is being

equipped by the UAE Government. There has been no purchase of equipment

in the recent years and we were told that the last purchase of equipment was

done some 8 years ago. The list of last year demand of Medical Equipment

amounting to Rs. 3.0 Billion from the province and tertiary care hospitals were

under review for procurement but no structured specifications were available

for tendering. DHO has the powers to purchase drugs/medicines for District

Hospitals, according to the approved list, issued by MSD.


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MSD gives preference to Quality over price, although lowest price is

considered but this is not a preferred parameter of selection. High End and

latest generation drugs/medicines are purchased from Multinational

Companies and Low End general use medicines are purchased from Local

Manufacturers. One Company is selected for one Generic Medicine.

MSD store acts as a Quarantine Area for the purchased stocks, for Quality

Assurance Sampling is done at MSD store before releasing the stocks to

Hospitals, by area Drug Inspector. Batch numbers are used to track

distribution of stocks to the Hospitals. MSD is not aware of storage facilities at

district level and below. MSD desires support from TRF regarding evaluation

of storage facilities at District level and below. Expiry of stocks is minimal/rare.

Local Hospital Management is responsible for dispensing drugs to the patients

and control expiries.

HD and MSD have a desire for Inventory Control System, linking HD, MSD to

Districts. Currently conventional system of report generation is being used.

Computers are available at all levels, but not linked to provide comprehensive,

real time MIS reports. There is no Indent scrutiny system, and a strong need

is felt at HD and MSD.

4.3 PUNJAB


There was a prequalification process for suppliers of Medical Equipment in

place but after adoption of PPRA rules the tenders are floated on open

competition basis. The PV List existed some 4 years ago but has not been

updated since and is now redundant. The procurement in the last two years

has not followed a defined pattern and is mostly carried out by Health

Department Purchase wing. Punjab Health Department has nominated

officers mostly working is the tertiary care facilities as biomedical engineers

who act as technical resource for specification generation and technical

evaluation. The only set of recent specifications developed and available with


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health department are for Rawalpindi Institute of Cardiology which were

developed by Punjab Institute of Cardiology clinical and technical staff. These

specifications only serve the specific needs of Rawalpindi Institute of

Cardiology and can not be used for primary and secondary care facilities.

In case of Drugs and Medicines, health department has a list of

pharmaceutical products for drugs/medicines for District level and below and

EDOs follow this list for purchases. EDOs purchase drugs/medicines

according to this list but have financial independence. Tertiary Care

Hospitals/Teaching Hospitals have 100% Autonomy on purchase of

medicines.

Medicines directly purchased by HD on annul basis, for DHQ, THQ, and

below are for vertical programs like Hepatitis, T.B and EPI.

Validation of Specifications and Suppliers profile is difficult due to lack of

expertise and redundant data at hand.

There is acute shortage of Trained Biomedical Engineers for EM service and

maintenance after expiry of warranty period. For capital equipment, service

contract is always done but general equipment repair and maintenance has

no defined protocol except utilisation from meagre repair and maintenance

budget, which always falls short. HD is maintaining Biomedical Equipment

Repair Workshop at Lahore and Multan but this infrastructure is insufficient toprovide ME service for the whole province leading to frequent interruption in

service.

Infrastructure and HR evaluation before establishing a Specialty Centre, like

Dialysis Centres in Punjab needs to be looked into as some centres like

Pakpatan, were established without addressing the afore mentioned

mandatory requirement.


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Equipment enlisted in any PC-1 does not correlate with the healthcare facility

in quantity and budgetary allocation for equipment is not realistic so the

equipment procurement is delayed due to revision of PC-1 costs or equipment

procured is substandard and inadequate when budgetary allocation is

followed.

4.4 AZAD JAMMU AND KASHMIR


DG Health has a Central Rate Contract system is in place for the procurement

of Medical Equipment and drug/medicines. Prequalification of suppliers is

mandatory for participation in tenders issued by HD. Renewal of Company

registrations is after 2 years. Medicines are purchased through an Open

Tender, as policy only registered companies can participate.

Central Purchase Committee approves prices for the Medicines.

End users make specifications for the Medical Equipment and existing

Purchase Manual and State Essential Medicine List are followed for

procurement. DHQ, RHC purchases are made by the DHO, THQ by MS.

Autonomous Institutions like AIMS have their own Medical Equipment and

drug/medicines specifications and are not bound to comply with the SEML.

In case of emergency, delayed supplies or on supply of substandard

Medicines, medicines are purchased on the basis of second lowest approved

rates of previous years. HD has adequate and well-equipped storage facilities

at all levels for drugs/medicines.

HD Budget is used for purchase of General Medicines, Reimbursements;

Local Purchase is used for Insulin, Hepatitis, Anti Cancer Medicines, Dialysis,

Antirabies Vaccines and Anti-snake venom.


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EPI Programs are being managed at the state level. Directorate for

Communicable Diseases AJK is performing its duties. AIDS Control Program,

funded by World Bank is stopped.

4.5 Federally Administered Tribal Area

4.5.1 Outcome of the discussions

Despite efforts the concerned person from FATA was not available for the

interview and this portion would be covered during the course of assignment.

4.6 Khyber Pakhtunkhwa

4.6.1 Outcome of the discussions

There is keen interest on part of the HD to improve on the existing system of

procurement. To this, standardized specifications of Medical Equipment and

drugs/medicines are required to maintain an optimum level of health service.

This would facilitate the health providers in performing their duties, resulting in

prompt, quality treatment to the patients.

There is prequalification of companies with MoH for drugs/medicines. Medical

Equipment and drugs/medicines are purchased through a central contract

through MCC. EDOs are bound to follow this approved list of drugs/medicines

for their districts, Tertiary Care Institutions have some autonomy.

Since KPK had not adopted PPRA rules to date, the prequalification of

medical equipment suppliers is still undertaken and on review of list of

suppliers and their prequalification it was noted that the companies pre

qualified for various equipment had no market standing relevant to their

prequalification.

The Medical Equipment is currently purchased after seeking the expert

opinion of the end users. The Biomedical Equipment Workshop staff has a

vast data of specifications that was shared with the consultants. The end


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users and clinical staff from tertiary care hospitals are consulted and notified

for specification development of each purchase on need basis. Data base is

not structured and lately used specifications are consulted for each tendered

and modified where required. In many instances the specifications are not

updated according to the technology advancement e.g. Anaesthesia

machines procured are not efficient, compared to the new generation of

Anaesthesia machines, having inbuilt ventilators and monitoring. Similarly,

surgical instruments have out lived their effective life, but are still being used

due to non-availability of standardized specifications for new instrument sets.

There is clear understanding that qualified staff is not at the disposal of MoH,

and Doctors/End Users are purchasing Medical Equipment and Medicines to

their liking. At EDO level, there is limited control of MoH, in procurements,

issuing of indents and limited inventory controls and consumption, especially

for drugs/medicines. There is also no control on NGOs donations in the form

of Drugs, Medical Equipment and supplies at the DHQ level. Purchase is done

on quarterly and yearly basis, based on availability of funds. There is a

concern of Budget lapse, due to lack of performance.

4.7 Gilgit-Baltistan

Visit to GB was planned but due to repeated unrest, law & order situation the

visit is still pending, the required information would be gathered during the

course of assignment.

5 Analysis

Related Health department executives from all the areas except Gilgit-

Baltistan were interviewed during the visits. Except for some specific issues

the problems are common which are enlisted as follows. The data also

provided in-depth analysis of specification and mistakes thereof

Mostly Members of procurement and related committees including

pharmacists, biomedical engineers and health service providers are


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involved in designing/developing standard specifications of medicines,

medical equipment and general items who are not skilled in the

specification development. The end result is either proprietary

specification based on the experience of one end user on one specified

make and model or very basic specification which do not address the

needs of service provider due to errors in specifications.

Majority of interviewees were not fully satisfied with the existing

specifications and felt the need for continuing support in renewal of

standard specifications due to introduction of new medicines and

medical equipment. Based on their practical experience, most of the

service providers suggested additions in the list and improvement in

the specifications.

Indent scrutiny is the key element missing in the supply chain, leading

to imbalances in supply and demand at different levels of health

services.

At the time of PC-1 preparation the cost of equipment is not taken

seriously and budgetary cuts are applied to the revenue portion of the

PC-1. This although ensures the infrastructure development but once

complete the facility lacks quality equipment due to

o Nomenclature being wrong in PC-1 and equipment procured is

not what is required

o The BOQ development in PC-1 does not correlate with the

facility built as the it is a general practice that each stakeholder

is requested to produce their demand for inclusion in PC-1 andthe resultant demand is not shared with the architect / designer

of facility hence there is a mismatch of facility and

equipment/furniture

o There is no structured data available in with any health

department where the budgeting of equipment can be

rationalised in revenue portion of PC-1

o

The demand raised by end stakeholders is based on their wishlist and not requirement both in case of PC-1 development and


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general raising of indent. There is no document available where

prices can be rationalised and demand justified.

The specifications are almost always developed on ad hoc basis in line

with existing demand. The end result is mostly either proprietary

specifications or much generalised specifications preventing quality

purchase.

The health administrators have no reference document to neither

consult in correcting error nor have qualified staff to develop

specification themselves.

Drugs/medicines storage and inventory controls are manual and

inconsistent with modern needs, leading to shortage or expiries.

Officials of the HD showed concern about the existing specifications of

drugs/medicines lists and stressed on improvement and designing of

detailed standard specifications for ensuring supply of quality products.

Some Executives were generally satisfied with the existing

specifications but they couldnt justify as to why they were satisfied.

The additional drugs list would be reviewed technically with WHO

essential drug list and national essential drugs list.

Involvement of service providers in development of technical and

standard specifications has been minimal.

There is no Inventory control at District level and below for Drugs and

Medical supplies.

Lack of standard specifications leads to duplication, irrelevance to the

current needs of end users.

Donations from NGOs at District Hospital Level in the form of Drugs,

Medical Equipment and supplies leads to duplication.

There is a lack of concept regarding environmental control particularly

with reference to basic factors like heat, humidity and light controls

which may result in chemical and physical degradation of drugs at drugstorage facilities of primary and secondary care levels.


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Though majority of drugs required were common in all provinces, there

were some specific requirements, which vary from area to area

depending on disease prevalence pattern.

In the result of Information gathered during interviews from the HD officials,

health service providers and review of available service requirements,

rationalised lists of Medical equipment and Furniture (Annexure I) and

Drugs/Medicines (Annexure II) is prepared which addresses the

comprehensive needs of primary and secondary health care facilities at

provincial level. This list should be shared with all stakeholders for inclusionand deletion. The specification will be based on the final list received from

stakeholders.

6 Issues and Risks

Due to out-dated lists, lack of standard specifications in all of the provinces,

cumbersome renewal procedures, mismatch of budget and facility

requirement, lack of trained manpower there is an acute shortage of essentialdrugs, medical supplies and equipment. There is acute mismatch of facility

and resource. Where equipment is available the trained staff is inadequate

and where staff is available resources are deficient and not fulfilling the

demand of health facilities.

There is a large gap in budget allocation and release, which delays the

process of procurement.

There is a justified concern of budget laps every year due to non existing

standard specification and very late releases, and when release actually

comes the time is too short to complete the process of tendering and hasty

tender document specifications leave demand /supply gap at the health

facilities.

Pre-qualification of companies supplying ME and drugs/medicines does notprovide level playing field for healthy competition.


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Lack of automated Inventory control system at District level for Drugs

and Medical supplies which results in the following;

o Flying Invoices from MS, EDO offices,

o Late or Partial Delivery

o Expiry of Stocks due to Excess Purchase, Irrelevant Purchase,

Short Expiry Purchase

o No Inventory Control, consequently no system of verification of

raised Indents/Demands for supplies.

o Irrelevant purchase of drugs/medicines.

The HD policy in KPK dictates that for Sub-standard medicines supply,

the same manufacturer will re-supply till the required standard is met.

This leads to shortage of medicine and compromised treatment to the

patient.

Lack of proper patient record system could lead to the misappropriation

of funds.

Due to unavailability of detailed specifications and guidelines for use of

specifications, various items, which were procured by the health departments,

are out of service at different health facilities without being used. The reasons

being that the items were selected without proper information about field

requirement and lack of familiarity of service providers about the usage of

equipment.

The actual end user and service providers were not involved in any exercise

related to development of generic specifications of drugs and equipment and

most of them had limited knowledge of generic specifications of goods where

as most of the concerned staff involved in the development of standard

specifications of ME and drugs/medicine does not have ready reference to the

available nomenclature of equipment in general and very few knew about the

generic names of drugs, their strength / formulation / packaging details and

technical parameters. This necessitates development of generic standardspecifications in order to procure quality items.


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The drugs/medicines being supplied lack proper storage facilities at health

units and results in loss of efficacy during storage.

7 Recommendations

Standard Specifications in isolation will not address the issue of

transparent procurement. A complete revamping of purchase process

should be done simultaneously.

Audit of existing Medical Equipment should be done, at Primary,

Secondary and Tertiary Care. This will assist in proper allocation of

resources at facilities according to the infrastructure and trained human

resource availability.

NGOs should also coordinate with the relevant health department for

donations in the form of drugs/medicines and ME at District Hospital

Level.

Instead of selecting the first lowest for purchase of ME and medicines,

preference should be given to the companies first qualifying in technical

bid and then competing on financial bid.

Specifications and Bid document should be standardized.

The suppliers including China should provide Certifications like CE,

MDD, FDA with the submission of tender documents.

Once developed, the specifications require revision on continuing

basis.

PPRA rules are more suitable, as they address more on Technical

Evaluation of the Bid than the financial evaluation.

Medical Record of patients should be maintained to avoid

misappropriation of drugs/medicines along with inventory control

system.

Less expensive, quality products should be selected to provide quality

service to the masses like Oral Medicines for OPD patients, Injections

for Indoor patients and Surgical and Medical Disposables for Hospitals.


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Local Purchase (LP) should only be allowed for proprietary products

within prescribed financial limits.

Cold Chain should be maintained for Biotech Products for Teaching

Hospitals and District Hospitals.

The Specifications should also give the budgetary prices of items as it

will assist is proper revenue allocation for any new facility while

preparing PC-1

Maintenance of Medical Equipment should be catered for otherwise the

equipment is likely to go out of service soon for want of minor service

needs.

Care will be taken to keep the specification simple so that the user can

prevent faults by routine maintenance and fix minor problems in-house

with minimal application training.


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Annexure I

ANAESTHESIA

Cylinder oxygen F

Cylinder oxygen E

Cylinder oxygen D

Cylinder nitrous oxide size D

Flowmeter O2 cylinder fitting

Flowmeter O2 outlet fitting

Infuser pressure

LaryngoscopeLaryngoscope c/w neonate blade

Nebuliser ultrasonic

Nebuliser heavy-duty

Warmer blood dry heat type

Airway guedal size 0




Connector set international



Resuscitation bag adult

Resuscitation bag child

Resuscitation bag infant

Resuscitation bag

Anaesthetic unit with ventilator 2 vaporiser

Anaesthesia unit induction O2/N2O/1 vaporiser

Analgesia unit 2 gas

Suction unit p/line high vac

Medical gas pipeline system

Suction unit p/line low vacuum

Ventilator intensive care

CPAP continuous flow system

Ventilator portable

Ventilator compact ICU air/O2 power

Clock battery operated wall mounted

FURNITURE GENERAL

Bench sample sorting and collecting

Bench wooden 2 seater

Bench wooden 4 seater


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Bin sanitary towel disposal

Bin waste paper plastic

Bin waste pedal op/plastic insertBin waste waiting areas

Blinds horizontal

Blinds vertical

Bookcase large

Bookcase small

Buffer rail

Cabinet filing 4 draw metal

Cabinet filing 3 draw metal

Cabinet tall 2 door / 5 shelf

Cabinet tall 2 door / 4 shelfCabinet tall 2 glass door / 5 shelf

Chair desk class 2

Chair desk class 3

Chair desk class 4

Chair desk class 1

Chair dining cafeteria

Chair lounge

Chair patient relaxing

Chair patient waiting 1unit

Chair patient waiting 2 unitChair patient waiting 4 unit

Chair reception/computer

Chair visitor class 1




Chair wood with arm

Control desk medical equipment

Curtain and track cubical

Curtain and track showerDental work station

Desk class 1

Desk class 2

Desk class 3

Desk class 4

Desk computer

Holder bin/sac fire retardant large

Holder clinical waste 70 litre

Lamp reading

Lamp table/bedsideSide rack class 1


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Side rack class 2

Sofa 1 seat fully upholstered

Sofa 1seat wood frame upholstered cushionSofa 2 seat fully upholstered

Sofa 2 seat wood frame upholstered cushion

Sofa 3 seat fully upholstered

Sofa 3 seat wood frame upholstered cushions

Sofa cum bed

Stool epoxy frame vinyl seat

Stool laboratory height adjustable vinyl seat/back

Table coffee class 1

Table coffee class 2

Table conference 4 seatTable conference 10 seat

Table conference 16 seat

Table corner class 1

Table corner class 2

Table dining 4 persons

Table dining 8 persons

Table photocopier

Table printer

Trolley waste double

Truck clinical waste 1100 litresTV stand

TV stand wall mounted

Video player

Wardrobe with shelf

STERILIZATION EQUIPMENT

Autoclave class B 16 - 30 litres

Autoclave class B vacuum 16 - 30 litres

Autoclave portable 9 - 12 litres

Autoclave 40 - 60 litresAutoclave 80 - 100 litres

Autoclave 200 - 300 litres

Autoclave 400 - 600 litres

Sterilizer hot air

Tray system pre-set type

Dispenser paper packing reel

Gun water with nozzles

Lamp magnifying

Dispenser tape two roll

Washer adjustable pressure for trolleys washingGloves needle resistant


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Goggles safety

Face shield

Gloves heat resistantGloves rubber general purpose

Trolley paper dispenser/4 levels

Table mobile pack preparation

Work/pack table CSSD low/high shelf

Work/pack table CSSD with part boxes

Trolley S/S 2 shelf 122x61cm

Cabinet drying floor standing

Heat sealer

Trolley/cupboard CSSD storage

Trolley CSSD returns constant levelRack mobile 3 shelf cooling/transport

Trolley CSSD delivery constant level

Ultrasonic washer / irrigation system

Washer disinfector dryer 50 - 60 litres



Hatch door pass through

Sink unit 2 sinks u/shelf 240x65 cms

ETO / Formaldehyde sterilizer

DENTAL EQUIPMENT

Stool dental assistant height adjustable

Stool dentist's height adjustable

Amalgamator

Scalar ultrasonic

Instrument set dental surgery

Light curing unit dental surgery

Glass bead steriliser

Electric pulp tester

Prophi unitCasting unit

Porcelain furnace

Dental engine

High speed turbine

Low speed air motor

Polisher

Vacuum

Dental unit for procedures

Dental unit for diagnostics

Cabinet multi drawerCabinet with sink & waste bin


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ENDOSCOPY

Basin soaking urology

Disinfector endoscopePaediatric rigid bronchoscope

Cystoscope flexible set

Rhino laryngoscope

Tester leakage

Cystoscope paediatric

Laparoscope set 7mm with accessories

Nephroscope percutaneous

Resectoscope set

Laparascope system

Arthroscope systemRhinomanometer

Flexible nasopharyngoscope

Video gastroscope for adult

Video colonofiberscope for adult

Video sigmoido scope adult/paediatric

Cysto urethroscope

Flexible fibre nephroscope

Tuboscopy set

Vaginoscope set

MediastiniscopeEsophagoscope

Resectosope 24fr continuous flow

Urethrotome 22fr 0O

Video gastroscope paediatric

Video system centre

Cupboard endoscopes storage

FURNITURE MEDICAL

Cradle bed folding

Bed intensive care hydraulicBed intensive care electric

Bed fixed height adjustable back

Bed fixed height fowler position

Bed adjustable height fowler position

Bed labour / delivery

Dialysis chair

Chair venepuncture with arm rest

Couch examination

Couch examination gynaecology

Couch ultrasonographyPatient stool


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Locker bedside

Table over bed cantilever auto rise

Bassinet with trolley cupboard mattressBed child fixed height with mattress

Bassinet with trolley folding

Mattress nappy change

Trolley patient recovery

Stool examination physiotherapy

Cabinet drug floor standing glass door / shelves

Cabinet instrument glass door / shelves

Cupboard controlled drug

Rack bedpan & bottle

Trolley instrument 3 tierTrolley instrument 2 tier

EQUIPMENT MEDICAL GENERAL

Ambulance for transport

Ambulance cardiac

Cabinet urine testing

Crash trolley with defibrillator

Defibrillator

Defibrillator with pacemaker

Diagnostic set paediatricDiagnostic set adult

Fork tuning

Haemodialysis machine

Lamp examination ceiling mounted

Lamp examination mobile

Lamp examination wall mounted

Plaster removal set

Poles stretcher

Pump breast electric

Pump breast manualPump syringe

Pump volumetric infusion

Ripple mattress with motor

Saw plaster with dust extractor

Scales baby digital / electronic

Scales baby mechanical

Scales domestic type stand on

Scales patient with height measurement

Sphygmomanometer aneroid wall type

Sphygmomanometer mercurial desk typeSphygmomanometer mercurial mobile


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Sphygmomanometer mercurial wall mounted

Spirometer

Stand iv antistatic castors S/SStethoscope litman type

Stethoscope litman type paediatric

Suction unit 1 x 2 litre jar mobile



Tens unit

Thermometer clinical

Thermometer electronic

Thermometer tympanic

Trolley cylinder f sizeTrolley medicine ward lockable

Trolley patient accident and emergency

Trolley patient notes

Trolley stretcher

Trolley plaster

Trolley soiled linen

Video colposcope

Washer / disinfector bedpan / urinal

Wheelchair children

Wheelchair folding adultWheelchair non folding adult

HOUSEKEEPING

Scrubber floor with suction

Electric flying insect controller small

Electric flying insect controller medium

Electric flying insect controller large

Trolley cleaners small

Trolley cleaners large

Vacuum wet / dry S/SVacuum dry S/S

INSTRUMENTS

Dermatome with mesh graft

Drill air surgical orthopaedic

Drill motor ENT

Instrument for removal of fingernail

Change of bandage

Splinter removing set

IncisionSounding set


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Kirschner wire extension

Dressing set for hand

Small instrument set bonesBiopsy excision

Dressing set small

Dressing set large

Bone wiring set

Tracheostomy set

Outpatient dept. Instruments

Paracentesis puncture tympanic

Tympanic drainage

Aural polyp set

AbscessBellcoq-tamponade

Epistaxis (small)

Sinus examination

Exploratory excision larynx

Examination nose

Examination ear

Phimosis - set

Individual instrument for exam

Intra-uterine-pessar-set

Biopsy vaginalPlacenta set

Supplement set specula for children

Cut down set

Basic set traumatology large

Basic set traumatology small

Bone instruments set

Bas instrument set bone screw & bone

Set of bone screws

Set bone plates with glide holes

Plate benderSmall frag & mini instrument set

Small fragment & mini implant set

Broken screw removal set

Hand surgery set

Bone set for hand surgery

Suppl. Set hand-tendon

Hand extras

Micro instruments for nerves

Instrument set for kuentscher

Guide pins kuentscher intramedExtraction instruments kuentscher


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Nail extract for kuentscher

Kuentscher implants

Hallux setInstruments for hip arthoplasty

Cement removal

Dynamic hip screw system

Implants dynamic hip screw meniscus

Meniscus set

Knee ligament replacement

Bone nails & bone clamps

Fixator-extern with fixing elements

Amputation set

Metal removalInstruments for stems w/container

Prosthesis stem only12/14mm

Centraliser

Prosthesis head only 28mm

Prosthesis head only 32mm

Prosthesis head only 22.2mm

Instruments for acetabular cup

Chirulen hip cup only 28mm

Chirulen hip cup only 32mm

Chirulen hip cup only 22.2mmMajor basic set

Laparotomy set

Supplement set for gallbladder

Suturing apparatus petz

Rectum set (sacral)

Supplement set for rectum

Hernia appendix for adults

Supplement set for kid with special instrument for ablation

Supplement set for kid with special instrument for ligation

Chest instruments setEmergency thoracotomy

Abdominal punction set

Lumbar punction set

Buelau punction set

Puncture set

Thorax puncture

Saphena set

Kirschner frame

Supplement set for lung op

TrepanationMicro instrument set


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A-V shunt set

Antrotomy set

Tympanoplasty & stapedectomyNasal septum plasty (cottle)

Tonsillectomy / adenotomy

Biopsy of the larynx

Extras

Suture and wound care set

Nasal polypectomy set

Nasal fracture set

Nasal septum surgery (killian)

Bladder set

Kidney setSupplement set for gastrointestinal operation

Abdominal retractor

Supplement set for vessels

Thorax supplement set

Anal retractor

Urethra set

Supplement set urethral

Supplement set thoracotomy

Set for orchidectomy testicle

Labour roomInstrument set for preparation

Instruments & other needs delivery

Delivery room curettage set

Supplement for embryotomy

Suturing set

Umbilical vein set

Large suturing set

Amnioscopy

Obstetric set perineal protection

Cerclage for initial incisionAbdominal basic set

Caesarean section set

Vaginal basic set

Supplement set for vaginal total operation

Set for mamma ablation operation

Supplement micro tuboplasty set

Supplement set hysteroscopy

Supplement set for mamma vessels operation

Supplement set for vulvectomy

Set for tubal ligatureConisation


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Cerclage (shirodkar)

Abort-curettage set

Basic instrument for laparoscopySet for biopsy cervix & vagina

Mamma biopsy set

Fimbriectomy set

Abdominal & vaginal set children

Vaginal fistula set

Preparation set

Set for salpingography

Basic eye set

Phacoemulsiffication set

Astigmatic keratotomy setRadial keratotomy set

Glaucoma set

Lid set

Muscle set

Lacrimal set

Sinus surgery set

Removal of impacted wisdom teeth

Wiring of mandible utilizing teeth

PHARMACYCounter tablet automatic

Box pharmacy distribution

Pharmacy miscellaneous items

Bench pharmacy preparation

KITCHEN

Conveyor turbo toaster

4 slot bread toaster

2 slot bread toaster

Gas range with oven 5 burnerGas range with oven 3 burner

Gas range without oven 3 burner

Tandoor

Juice extractor

Mobile refuse bin

Heavy duty food blender

Wooden chopping block

Washer dish cabinet & hood type

Scales platform 100 kg cap

Visual display merchanderHeavy duty mincer


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Ice cuber

Bread/cutlery/glass & tray dispenser

Kettle electric autoIngredient bins

Filter coffee brewer

Exhaust hood canopy

Reach in refrigerator 2 door

Reach in freezer 2 door

S/S dust bin sink with drain boards

Exhaust hood for tandoor

Food trolley

Food service heated trolley

Basket trolleyHot water & steam dispenser

Water cooler

Table prep w/1 drawer S/S 1800x700

Self service counter

S/S ambient storage cabinet

S/S work table w/splash back

S/S continuous work top

S/S wall cabinet 1500mm

S/S wall cabinet

Self service counterS/S work table

S/S hand wash basin/sink

S/S work table with sink

S/S pot and pan sink

Sorting table

Pre-wash/soak sink

Wire shelving unit

S/S wall mounted shelf

LABORATORYBath paraffin section mounting

Bath water unstirred 16 L ambiant 9Oc

Analyser biochemistry random access

Analyser biochemistry random access

Analyser blood gas

Analyser biochemistry semi-automatic

Flamephotometer

Analyser electrolyte

Bilirubinometer

Meter pHSpectrophotometer


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Elisa system

Centrifuge bench top multiuse

Centrifuge cell preparationCentrifuge microhaematocrit & reader

Centrifuge refrigerated floor/stand w/1 rotor

Centrifuge refrigerated max 4 x 500ml

Aphresis unit

Platelet incubator

Platelet shaker

Analyser haematology

Coagulometer (automatic)

Diluter automatic

ESR system aspirator typeRoller mixer blood sample 5 roller

Stainer slide for blood smears auto

Haemoglobinometer

Container insulated 8 blood bag

Sealer hand/stripper cutter

Sealer blood bags electric

Scales blood bag donor

Glucometer hand held

Dispenser set

Cover slipper automaticMicrotome cryostat w/accessories

Microtome knife sharpener

Microtome rotary

Slide warmer

Stainer slide automatic w/timer

Tissue embedding system integrated

Tissue processor enclosed system

Water still

Hotplate with stirrer

Stirrer magnetic oscillatingMixer rotator platform

Cabinet fume

Laminar flow safety cabinet

Cabinet filing microslide

Electrophoresis sys gen

Centrifuge blood cell wash

Loop steriliser

Agglutination test tube viewer

Slide staining set

Cabinet solvent storage under benchCabinet block storage 3000 blocks


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Refractometer urine

Membrane filter set

Automated blood & tuberculosis culture systemIncubator 200 litre capacity 5 to 60

Incubator CO2

Oven sterilising

Microscope fluorescent

Microscope binocular 4x/10x/40x/100x lens

Microscope CCD colour TV system

Microscope phase contrast/dark field

Jar anaerobic with gas pack

Mixer vortex

Balance electronic 400g capUpright freezer ultra low -80O C

Autoclave lab 100 L integrated generator

MONITORING

ECG machine 12 lead

Monitor ECG/SPO2/pulse/temp/NIBP/Respiration

ECG 3 channel interpretive with trolley

Monitor multiparameter ICU

Monitor multiparameter CCU

Monitor multiparameter NICUCentral station 8 monitors

Vascular Doppler

Digital echocardiography

Portable echocardiograph with tee probe

Detector foetal heart portable

Cardio tocograph

Module invasive pressure

Module cardiac output

External pacemaker

EEG Machine 32 channelHolter monitor

Computerised exercise Tolerance Test system

Ergometer

EMG machine

NEONATOLOGY

Monitor apnoea non invasive

Warming unit babies bottles

Washer baby bottle

Incubator transportHead box infant oxygen


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Incubator infant ICU

Stethoscope foetal

Bath baby with standToys assorted play area

Trolley reanimation neonatal

Ventilator neonatal

Phototherapy unit freestanding

Water deioniser

Infant warmer

OFFICE EQUIPMENT

Computer, monitor & keyboard

Printer laserCalculator desk model w/print out

Typewriter electric English

Baskets filing 3 tier plastic

Trolley filing

Projector overhead

Projector slide

Screen projection

Projector direct

Stapler heavy duty

Scissors counterBoard notice

Board magnetic white

Photocopier enlarging/reducing

Safe floor standing 635x430x420mm

PHYSIOTHERAPY

Aid walking pulpit"type"

Aid walking frame height adjustable standard

Aid walking tripod height adjustable aluminiumCrutches underarm

Stick walking height adjustable

Couch heavy duty wooden frame

Couch manipulation & treatment

Table fixed height traction + unit

Chair polished hardwood

Couch treatment fixed height

Footrest for shortwave therapy

Diathermy unit short wave

Lo frequency electrotherapyRehabilitation theraputy


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Roller wrist

Balls medicine set of 4

Bicycle exercise stationaryMat exercise 2000x1000x50mm

Mirror posture

Rowing machine

Steps regulated

Treadmill motorised

Bracket for hanging exercise mats

Bars parallel foldaway

Lamp infra red

Lamp UV A and B

Pinch meterPin wheel

Goniometer hand

Gymmon goniometer

Shortening blocks

Interferential therapy w/suction

Electro stimulator diagnosis/therapy

Bench quadriceps

Pulley set Westminster

Wheel shoulder

Ultrasound unit 1 & 3 MHzBath wax

Patient bath hydro massage with lift

Hot pack heating unit

Packs cold set of 3

Packs hot universal set of 4

Bars wall mounted

HOLLOWWARE

Tray instrument glass w/ lidBrush nylon nail

Clippers hair

Tape measure linen

Apron full length PVC

Jug polypropylene 500ml

Vomit bowl with lid

Bucket 10L plastic

Tray instrument 300x250

Tray instrument 420x305

Gloves rubber heavy dutyBedpan perfection pattern S/S adult


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Dish kidney s/s 210 mm (8)"

Gallipot S/S 5 oz. cap

Gallipot S/S 6 oz. capJug graduated S/S 1000 ml

Urinal female S/S

Urinal male S/S

Bowl S/S lotion 210mm

Bucket with lid 9 litre S/S

Tray instrument S/S 300x250mm

REFRIGIRATION

Refrigerator blood bank 120 bag capacity

Refrigerator blood bank 240/250 bag capacityFreezer plasma storage

Refrigerator 5 cu.ft. Capacity

Refrigerator 6.8 cu.ft. Capacity

Refrigerator laboratory

Refrigerator drugs ward

Refrigerator pharmacy

STEEL FURNITURE

Cupboard metal double door

Drawer cabinet small parts 48 drawerDrawer cabinet 45 drawers

Drawer unit steel 7 drawers

Dispenser CSSD packs wire wall mounted

Locker four section 175x45x45 cms

Locker two unit 175x45x45 cm

Rack mobile for plastic boxes 1.65m high

Shelving unit metal 100x50x185cms high

Shelving unit single side

Shelving unit double side

OPERATION THEATER

Crutches knee w/antistatic pads pair

D shaped pillow antistatic universal

Holder x-ray cassette lateral

Stand for table accessories

Stirrups lithotomy with antistatic pads pair

Table arm square with antistatic pad

Table attachment/orthopaedic work

Tray douche with strainer

Accessory stand operating table basic


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Bucket s/s in wheeled holder

Stand bowl double horizontal

Stand bowl singleKickabout S/S

Cabinet instrument 152x91x40 cms

Cabinet lotion warming 6 bottle capacity

Diathermy unit mono & bipolar

Nd YAG Laser

Argon laser (solid state photocoagulator)

Cement removal system orthopaedic

Phacomachine

Chair anaesthetist

Step single antistaticStep surgeon two step antistatic

Stool surgeon mobile

Stool surgeon with stump feet

Table mayo height adjustable

Trolley anaesthesia 2 shelves/1 drawer

Trolley instrument S?S 46x60 cms

Lamp operating major (7 + 4 bulbs)

Lamp operating major (7 bulb)

Lamp operating minor (4 bulb)

Mattress heating/cooling w/motorTourniquet quick release

Tourniquet pneumatic

Prism loupe operating

Microscope operating eye

Microscope operating ENT

Rack swab

Rack shoe & boot OT. (12 pairs)

Vacuum extractor (malstrom)

Kidney bridge, lithotomy poles, urology acc.

Table operating 4 section with mattressTable operating 3 section with mattress

Scrub unit double

Dispenser soap foot operated

Dispenser nail brush elbow operated

MAINTENANCE

Tool kit workshop

Incinerator

Waste disposal system

MORTURY


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Body storage refrigerator 4 tier

Saw post mortem electric

Instruments - autopsy boxMaceration unit

Container-organ w/cooling device

Gloves - dissecting

Trolley display with rails

Table s/s 1500 x 600 with under shelf

Trolley concealment

Trolley elevating

Trolley body transport w/body tray

Scales organ - hanging

Worktop dissectingTable autopsy ventilated with sink

Table autopsy - basic with castors

Microphone/speaker & amplifier

Lamp autopsy - ceiling mounted

Disposal unit

Cupboard S/S wall mounted 2 door

Workbench S/S with 2 doors

Workbench S/S wall type

LAUNDRY

Scale floor 500kg capDryer tumble 50lb cap

Ironer flatwork single roller electric

Automatic air compressor

Wire shelving

Press multipurpose

Machine sewing

Trolley linen polybody white

Trolley linen storage clean

Table sorting s/s 1500 x 650 x 850mm

Trolley infected linen singleCompressor/boiler h2o treatment

Washer extractor 32 kg

Washer extractor 25 kg

Washer extractor hygienic

RADIOLOGY

C.T. scanner 16 slice

C.T. scanner 4 slice

X-ray unit dental wall mountedPanoramic x-ray dental


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Mammography

Copy/subtraction unit film

Processor film automaticProcessor film dental

Processor film manual

Recovery unit silver

Safelight ceiling mounted with filters

Safelight wall mounted with filters

Markers x-ray film (left & right)

Fluoroscopy System.

X-ray unit mobile

Surgical c-arm

Apron lead double sided .35 LE 85cm LRack lead gloves & aprons

Shield gonad adult male 1mm lead

Shield gonad boy 1mm lead

Shield ovarian 1mm lead set of 3

Contrast injector

Laser imager

X-ray radiography system

Ultrasound diagnostic colour Doppler

General purpose ultrasound system

Ultrasound portableIlluminator x-ray double dimming

Illuminator x-ray double separate switch

Illuminator x-ray single

Illuminator 4 over 4 dimming

Hatch cassette

Bench darkroom/ cassette / hopper /cupboard /sink

Cassette x-ray 13x18 cms



Cassette x-ray 24x30 cmsCassette x-ray 30x40 cms

Hanger tension film for 13x18 cms



Warmer contrast media

Chest cassette mobile lead lined

Positioning aids set of 7

GENERAL ITEMS

Laminar flow unitClock elapsed time mains operated


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Shelving wall mounted

GENERAL MEDICAL EQUIPMENT

Audiometric booth

Tympanometer

Audiometer clinical

Impedance audiometer

Diagnostic set adult

Hammer patella

Exam unit air/water/suction/cautery

Diagnostic set eye

Chart Ichihara colour

Auto refractro - keratometerLamp slit on gas sprung table

Ophthalmascope indirect

Ophthalmoscope with rechargeable handle

Screen bjerrum 2m

Screen hess electric with chin rest

Test maddox wing

Tester perimeter projection/visual field analyser

Testing Box four sided wall mounted (snell's)

Tonometer schoitz

Trail lenses/glass prisms/frame setExoptalmometer

Diagnostic lenses 20D, 30D, 90D , 7080

P.D. meter

Chart projector

Lensmeter

Stereo test wirt fly

Torsionometer

Prisms universal set of 22

Maddox rod franceschetti

3 mirrorGonioscope

Camera fundus / fluorescent angiography

Ophthalmic ultrasound

Orthoptic mini set

Instrument table

Electrolysis unit for ophthalmology

Bipolar coagulator

Cautery unit


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Annexure II

RECOMMENDED LIST OF DRUGS / MEDICINES

GENERIC NAME OF DRUG /

MEDICINEDESCRIPTION

ANAESTHETIC AGENTSSEVOFLURANE

LIQUID INHALATION BOTTLE 250

ML

HALOTHANELIQUID INHALATION BOTTLE 250

ML

ISOFLURANE LIQUID INHALATION BOTTLE 100ML

ATRACURIUM BESYLATEINJ. 10MG/ ML (2.5ML /3ML)

KETAMINEINJ. 500 MG / 10 ML


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THIOPENTONE SODIUMINJ. 500 MG.

PANCURONIUM BROMIDEINJ. 2 MG / ML

SUXAMETHONIUM CHLORIDEINJ. 100MG

PROPOFOLINJ. 10MG / ML AMP OF 20ML

BUPIVACAINE HCL 0.75%INJ.

BUPIVACAINE HCL 0. 5%INJ.

BUPIVACAINE HCL 0.25%INJ.

DIAZEPAMTAB. 5MG

DIAZEPAMINJ. IV 10MG/2ML

LIGNOCAINE SOLUTIONINJ. 2% 10ML

LIGNOCAINE WITH ADRENALINEINJ. 2 %

LIGNOCAINEGEL. 2 %

LIGNOCAINE SOLUTIONSOLUTION 4%

ATROPIN SULPHATEINJ. 1MG/ML

MIDAZOLAM (AS HCL)INJ. 5MG /ML

EPHEDRINEINJ. 30MG

ANTI PYRETICS / ANALGESICS

PARACETAMOLINJ. 300MG/ML

DICLOFENAC SODIUMINJ. 75 MG

INDOMETHACININJ. 200MCG WITH SOLVENT

IBUPROFENTAB. 200 MG 400MG

DICLOFENAC SODIUMTAB. 50 MG

MEFENAMIC SODIUMTAB. 250MG, 500MG

FLURBIPROFEN TAB. 100MG

PARACETAMOLTAB. 500MG

ASPIRIN TAB. 75MG,150MG (ENTERICCOATED)

ASPIRINTAB. SOLUBLE 300 MG

ALLOPURINOLTAB. 300 MG

TIZANIDINETAB. 2MG, 4MG

NAPROXEN SODIUMTAB. 250MG, 500MG

PIROXICAMTAB. 10MG/ 20MG


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PIROXICAMINJ. 20MG/ ML

PARACETAMOLSYP/ ELXIR/ SUSP. 120MG / 5ML

IBUPROFENSUSP. 100MG/5ML

NARCOTIC ANALGESICS

MORPHINEINJ. 15MG/ML

PETHIDINE HCLINJ. 100MG / 2ML

PENTAZOCINEINJ. 30 MG /ML

NALBUPHINE HCLINJ. 10MG /ML

TRAMODOLINJ. 50MG /ML

ANTIBIOTCSAMPICILLIN

CAP. 250 MG / 500 MG.

AMPICILLIN +CLOXACILLININJ. 250 MG , 500MG

AMPICILLIN + SALBACTUMINJ. 500MG + 250MG

CLOXACILLININJ. 500 MG

AMOXYCILLININJ. 250 MG, 500MG

BENZYL PENICILLININJ. 5 LAC , 10LAC UNITS

BENZATHINE INJ. 1.2MEGA UNIT, 0.6 MEGAUNIT VIAL

AMOXYCILLINSUSP. 250 MG / 5ML

AMPICILLIN + CLOXACILLINSUSP. 125 MG + 125MG / 5ML

AMPICILLINSUSP. 125 MG / 5ML

AMPICILLINCAP. 250 MG, 500 MG

AMPICILLIN +CLOXACILLINCAP. 250 MG 500 MG + 125MG

AMOXYCILLINCAP. 250 MG , 500 MG

AMOXYCILLIN AS SODIUM 500MG +

CLAVULANIC ACID 100MGINJ. 500MG + 100MG

AMOXYCILLIN AS SODIUM 500MG +

CLAVULANIC ACID 200MGINJ. 1000MG + 200MG

AMOXYCILLIN + CLAVULANIC

ACIDTAB. 375MG , 625MG, 1G

AMOXYCILLIN (AS TRIHYDRATE)

125MG + CLAVULNIC ACID (ASSUSP. 125MG + 31. 25MG/ 5ML


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POTASSIUM) 31. 25MG/ 5ML

AMOXYCILLIN (AS TRIHYDRATE)

250MG + CLAVULNIC ACID (AS

POTASSIUM) 62.50MG/ 5ML

SUSP. 250MG + 62.50MG/ 5ML

CEPHRADINE INJ. 250MG, 500MG, 1 G

CEFUROXIME INJ. 250, 750MG, 1.5G

CEFOTAXIME INJ. 250MG, 500MG, 1G

CEFTRIAXONE INJ. 250MG, 500MG, 1G

CEFUROXIME TAB. 125MG, 250MG

CEPHRADINE CAP. 250MG, 500MG

CEFACLOR CAP. 250, 500MG

CEFACLOR SUS. 125MG/5ML, 250MG/5ML

GENTAMYCIN INJ. 40MG, 80MG

AMIKACIN INJ. 250MG, 500MG

CLINDAMYCIN INJ. 150MG/ML (300MG, 600MG)

LINCOMYCIN INJ. 300MG, 600MG

ERYTHROMYCIN TAB. 250MG, 500MG

ERYTHROMYCIN SUSP. 200MG/5ML

CLINDAMYCIN CAP. 150MG, 300MG

LINCOMYCIN CAP. 500MGCIPROFLOXACIN INJ. 100MG /50ML

LEVOFLOXACIN INJ. 500MG

NORFLOXACIN TAB. 400MG

LEVOFLOXACIN TAB. 250MG , 500MG

CIPROFLOXACIN TAB. 250MG, 500MG

NALIDIXIC ACID SUSP. 250MG/5ML

COTRIMOXAZOLE DS(SULPHAMETHOXAZOLE 800MG +TRIMETHOPRIM 160MG)

TAB.

COTRIMOXAZOLE(SULPHAMETHOXAZOLE 200MG +TRIMETHOPRIM 40MG) PER 5ML

SUSP.

COTRIMOXAZOLE DS(SULPHAMETHOXAZOLE 400MG +TRIMETHOPRIM 80MG) PER 5ML

SUSP.

DOXYCYCLINE CAP / TAB. 100MG

OXYTETRACYCLINE CAP / TAB. 250MG

MINOCYCLINE CAP / TAB. 100MG

METRONIDAZOLE INJ. 500MG / 100ML

METRONIDAZOLE TAB. 200MG, 400MG

TINIDAZOLE TAB. 300MG, 500MGMETRONIDAZOLE SUSP. 200MG / 5ML


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FOSFOMYCIN CALCIUM SUSP. 250MG/5ML, 500MG/5ML

FOSFOMYCIN CALCIUM INJ. 250MG, 500MG, 1G

FOSFOMYCIN CALCIUM CAP. 250MG, 500MGANTITUBERCULOSIS DRUGS

STREPTOMYCIN INJ. 1 GM

ETHAMBUTOL TAB. 400MG

RIFAMPICIN + INH +PYRAZINAMIDE+ ETHAMBUTOL

TAB.150MG+75MG+400MG+275MG

ETHAMBUTOL HCL 300MG +INH75+RIFAMPICIN 150MG

TAB. 300MG + 75MG+ 150MG

ETHAMBUTOL HCL 275mg +INH75+RIFAMPICIN 150MG

TAB. 275MG + 75MG+ 150MG

RIFAMPICIN SYP. 2% 60ML

RIFAMPICIN TAB / CAP. 150mg, 300mg, 450mg,600mg

ISONIAZID TAB. 100MG

ISONIAZID SYP. 500MG/5ML

PYRAZINAMIDE TAB. 500MG

ANTIASTHAMATIC DRUGS

AMINOPHYLLIN INJ. 250MG / 10ML

AMINOPHYLLIN TAB. 100MG

THEOPHYLLIN TAB. 300MG

MONTELUKAST SODIUM TAB. 4 MG,10MG

SALBUTAMOL TAB. 2MG,4MGAMMONIUM CHLORIDE 100MG,SODIUM CITRATE 60MG,CPM 2MG,EPHEDRINE HCL 7MG

SYP.

AMMINOPHYLLINE 32MG,DIPHENHYDRAMINE 8MG,AMMONIUM CHLORIDE 30MG,MENTHOL 0.98MG, ALCOHAL 5%

SYP.

BECLOMETHASONE 100MCG +SALBUTAMOL 50MCG

INHALER.

INHALER SALBUTAMOL 100MG INHALER.

NEBULE IPRATOPIUM BROMIDE0.025%

250MCG/ML

SALBUTAMOL FOR NEBULIZER SOLUTION 20ML

ANTI HISTAMINES

CHLORPHENIRAMINE MALEATE INJ. 10MG/ ML

CLEMASTINEINJ. 1MG/ML

PHENIRAMINE MALEATE INJ. 22.7 MG/ML

CETIRIZINE DIHYDROCHLORIDESYP. 10 MG


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CHLORPHENIRAMINE MALEATE SYP. 2MG/5ML

KETOTIFEN SYP. 1MG / 5ML

PHENIRAMINE MALEATE SYP. 15MG / 5ML

PROMETHAZINE HCL SYP. 5MG/5ML

CETIRIZINE HCL TAB. 10 MG

CHLORPHENIRAMINE MALEATE TAB. 4MG

HYDROXYZINEDIHYDROCHLORIDE

TAB. 25MG

FEXOFENADINE TAB. 120MG, 180MG

KETOTIFEN TAB. 100MG

PHENIRAMINE MALEATE TAB. 25MG

NAPHAZOLINE 0.025% +PHENIRAMINE 0.3%

NASAL DROPS

CARDIOVASCULAR / ANTI-ANGINAL DRUGS

ADERNALINE INJ. 0.1% 1ML

DIGOXIN INJ. 0.25, 0.5 MG

VERAPAMIL INJ. 5 MG / 2ML

DOBUTAMINE INJ. 250MG / 5ML

ISO SORBIDE DINITRATE INJ. 10 MG/ 10 ML.DOBUTAMINE INJ. 250MG

DOPAMINE INJ. 40MG

METHYLDOPATE HCL TAB. 250 MG.

NOREPINEPHRINE ACIDTARTRATE

INJ. 2MG

SODIUM NITROPRUSSIDE INJ. 50MG/2ML

METHYLDOPA INJ. 250MG/5ML

PROPRANOLOL TAB. 10 MG, 40MG

ATENOLOL TAB. 50MG, 100MG

DIGXION TAB. 250MCG (0.25MG)

LEVODOPA CARBIDOPAMONOHYRATE

TAB. 25MG

VERAPAMIL TAB. 40MG, 80MG

GLYCERYL TRINITRATE TAB. 0.5MG

NIFEDIPINE TAB. 10MG, 20MG

AMLODIPINE TAB. 5MG

NITROGLYCERINE TAB. 0.5MG SUBLINGUAL

ISO SORBIDE MONONITRATE TAB. 20 MG

CAPTROPRIL TAB. 25MG, 50MG

LISINOPRIL TAB. 5 MG, 10 MG

ENALAPRIL MALEATE TAB. 5 MG, 10 MG, 20 MG.DILTIAZEM TAB. 30 MG, 60MG, 90MG, 180MG


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ATORVASTATIN TAB. 10 MG, 20 MG, 40 MG.

SIMVASTATIN TAB. 20MG, 40MG

METHYLDOPA TAB. 250MGLEVODOPA 250MG, CARBIDOPAMONOHYDRATE 25MG

TAB. 250MG + 25MG

LOSARTAN POTASSIUM TAB. 25MG, 50MG

ANTI-THROMBOTIC DRUGS

STREPTOKINASE INJ. 0.75MIU , 1.5MIU

DIURETICS

FRUSEMIDE INJ. 20MG/2ML

SPIRONOLACTONE TAB. 100MG

FRUSEMIDE TAB. 40MG

FRUSEMIDE 40MG + AMILORIDE

HCL 5MG TAB. 40MG + 5MGKCL TAB. 500MG

POTASSIUM CHLORIDE SYP. 40MEQ/15ML

SPIRONOLACTONE 25MG, +HYDROCHLORTHIAZIDE 50MG

TAB. 25MG + 50MG

SPIRONOLACTONE50MG+FRUSEMIDE 20MG

TAB. 50MG + 20MG

ANTI COAGULANTS

HEPARIN INJ. 5000IU. /ML

TRANEXAMIC ACID INJ. 250MG, 500MG

TRANEXAMIC ACID CAP. 250MG, 500MGCLOPIDOGREL TAB. 75MG

WARFARIN SODIUM TAB. 1 MG, 5 MG.

VITAMIN K INJ. 10MG/1ML

ANTACIDS / ANTI ULCER DRUGS

RANITIDINE INJ. 50 MG / 2ML

OMEPRAZOLE INJ. 40MG

OMEPRAZOLE CAP. 20MG, 40MG

CIMETIDINE INJ. 200MG

RANITIDINE TAB. 150MG, 300MG

SUCRALFATE TAB. 1GM

SUCRALFATE SUSP. 1GM/5MLALUMINIUM HYDROXIDE 125MG +MAGNESIUM HYDROXIDE 80MG +SIMETHICONE 15MG

SYP.

SALAZOPYRINE TAB. 500MG

ANTI EMETICS

METOCLOPRAMIDE INJ. 5MG / ML

DIMENHYDRINATE INJ. 50 MG / ML

CYCLIZINE INJ. 50MG /ML

DIMENHYDRINATE TAB. 50 MG.

METOCLOPRAMIDE. TAB. 10MGPROCHLORPARAZINE TAB. 5MG


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DOMPERIDONE TAB. 10 MG

METOCLOPRAMIDE SYP.

DOMPERIDONE SUSPCYCLIZINE SYP. 12.5MG/ 5ML

DIMENHYDRINATE SYP. 12.5MG/4ML

ANTI SPASMODICS

DROTAVIRINE HCL INJ. 40 MG/2ML

TAB DROTAVIRINE HCL TAB. 40 MG

HYOSINE N BUTYLBROMIDE TAB. 10MG

HYOSINE N BUTYLBROMIDE INJ. 20MG / ML

BACLOFEN TAB. 10MG

LAXATIVES

BISACODYL TAB. 5MG

MAGNESIUM HYDROXIDE 75% +LIQUID PARAFFIN 25%

EMULSION 120ML

GLYCERIN SUPPOSITORIES 1gm, 2gm, 4gm

LACTULOSE SYP. 120ML

SODIUM BIPHOSPHATE 19.2GM,SODIUM PHOSPHATE 7.2GM,SODIUM CONTENTS IN 120ML4.5GM

SYP. 120ML

ORAL REHYDRATION

ORAL DEHYDRATION SALT ORS

INSULIN AND OTHER ANTIDIABETIC AGENTSHUMAN INSULIN R INJ. 100IU / 10ML

HUMAN INSULIN NPH INJ. 100IU/10ML

HUMAN INSULIN 70/30 INJ. 100IU 10ML

GILBENCLAMIDE TAB. 5MG

METFORMIN TAB. 500MG

PIOGLITAZONE TAB. 15MG, 30MG, 45MG

GLIMEPIRIDE TAB. 1MG,2MG,3MG,4MG

GLICLAZIDE TAB. 30MG, 80MG

ANTI DIARRHOEALS

FURAZOLIDONE TAB. 100MG

LOPERAMIDE HCL TAB/ CAP. 2MG

KAOLIN PECTIN SUSP. 60ML, 120ML

FURAZOLIDONE SUSP. 60ML

ANTHELMINTICS

ALBENDAZOLE TAB. 100MG 200MG

PYRANTEL (AS PAMOATE) TAB. 250MG

ALBENDAZOLE SUSP. 200MG/ 5ML


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MEBENDAZOLE SUSP. 100MG/ 5ML

PYRANTEL (AS PAMOATE) SUSP. 250MG / 5ML

ANTI - MALARIALS

CHLOROQUINE PHOSPHATE INJ. 200MG / 5ML

ARTEMETHER INJ. 80MG/ML

QUININE DI HYDROCHLORIDE INJ. 300MG /ML

QUININE SULPHATE TAB. 300MG

PYRIMETHAMINE TAB. 25 MG

CHLOROQUINE PHOSPHATE TAB. 250MG

ARTEMETHER CAP. 40MG, 80MG

SULPHADOXINE 500MG +PYRIMETHAMINE 25MG

TAB. 500MG + 25MG

LUMEFANTRINE + ARTEMETHER TAB. 20MG + 120MGCHLOROQUINE PHOSPHATE /PHOSPHATE EQUIVALENT TO50MG BASE/5ML

SYP. 50MG BASE/5ML

ANTI VIRAL

ACYCLOVIR INJ. 250MG, 500MG

ZIDOVUDINE INJ. 10MG/ML IN 20ML VIAL

LAMIVUDINE TAB. 150MG / 100MG

RIBAVIRIN CAP / TAB. 400MG

ADEFOVIR DIPIVOXIL CAP / TAB. 10MG

INDIANAVIR AS SULPHATE CAP. 200MG, 333MG, 400MG

ZIDOVUDINE CAP. 100MG, 300MG

OSELTAMIVIR CAP. 75MG

ZIDOVUDINE ORAL SOLUTION

LAMIVUDINE ORAL SOLUTION. 50MG / 5ML

RECOMBINANT HUMANINTERFERON ALPHA 2A 3 MIU

INJ

RECOMBINANT HUMANINTERFERON ALPHA 2B 3 MIU

INJ

ANTICONVULSANTS / ANTIEPILEPTICS / PSYCHOTROPIC MEDICINES

SODIUM VALPROATE INJ. 500MG /5ML

HALOPERIDOL INJ. 5MG/1ML.

PROMETHAZINE INJ. 25MG

PROCYCLIDINE INJ. 10MG/2ML

LORAZEPAM TAB. 1MG

LETHIUM CARBONATE TAB. 400MGPROMETHAZINE TAB. 25MG, 50MG


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PROCYCLIDINE TAB. 5MG

ALPRAZOLAM TAB. 0.25MG, 0.5MG, 1 MG

HALOPERIDOL TAB. 5MG, 10MG.BROMAZEPAM TAB. 3MG

CLONAZEPAM TAB. 0.5MG, 2MG

DIVALPREX SODIUM TAB. 500MG

FLUOXETINE HCL CAPS. 20MG

RISPERIDONE TAB. 1MG, 2MG, 4MG

TRIFLUOPERAZINE HCL TAB. 5MG

DIVALPREX SODIUM SYP. 250MG/ 5ML

PAEDIATRIC DROPS CLONAZEPAM DROPS. 0.25%

HALOPERIDOL ORAL SOLUTION ORAL SOLUTION 2MG/ML

GLUCOCORTICOIDS

HYDROCORTISONE SODIUM

SUCCINATEINJ. 100MG, 250MG, 500MG

DEXAMETHASONEINJ. 4 MG / ML

DEXAMETHASONETAB. 0.5MG

PREDNISOLONETAB. 5MG

ANTIDOTES

NALOXONE HCLINJ. 0.4MG / ML

PROTAMINE SULPHATE INJ. 10MG / MLNEOSTIGMINE METHYLSULPHATE

INJ. 0.5MG/ML, 2.5MG / ML

PRALIDOXIME MESYLATE /

CHLORIDE / METHYLSULPHATEINJ. 1G

FLUMAZENILINJ. 100MCG/ML

ACTIVATED CHARCOALCAP. 260MG

ACTIVATED CHARCOALLIQUID 0.5 MG

ERGOT ALKALOIDMETHYL ERGOMETRINE INJ. 0.2MG / ML

UTEROTROPIC

OXYTOCIN INJ. 5IU / ML

LABOUR INDUCERS / INHIBITORS

PROSTAGLANDIN F2 ALPHA INJ. 5MG/ML

ALPROSTADIL, ALPHACYCLODEXTRIN

INJ. 20MCG + 646.7MCG/ML

DINOPROSTONE TAB. 3MG

MISOPROSTOL TAB. 200MCG

GONADOTROPHINS & OVULATION STIMULANTS

CONJUGATE ESTROGEN TAB. 0.625MG, 1.25MGCLOMIPHENE CITRATE CAP/ TAB. 50MG


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DANAZOLE CAP. 100MG, 200MG

INFUSIONS

10% DEXTROSE WAT

situational analysis report vol-i

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