Reading New Indian Express epaper http://www.readwhere.com/read/525636/#page/3/1 -- powered by readwhere.com https://play.google.com/store/apps/details?id=com.readwhere.app

For our Father

https://youtu.be/AQ2e_WUy6KU

Panarjeny

Take a look at this medical image on Figure 1. "Approx. 60y/o m s/p MVC, crushed between two vehicles at slow speed. Gross deformity on arrival. 10/10 pain with good pedal pulse. Tx by EMS to local trauma center. Closed tib/fib fx.": https://app.figure1.com/rd/image?imageid=5557fcf031f3b9e94863ecba&sb=5558b15eccf63be615b02fbe&st=s&utm_source=ishare&utm_medium=ImageLink

Proud .... be a doctor

I enjoy being a doctor. My businessmen, engineer and software friends might earn more than me, bankers may have more benefits than me. But I still enjoy being a doctor because I can make someone better, because I can save a family , because I am a part of a miracle many a times and because I am symbol of hope in despair.

People save a life by accident and feel proud for the rest of their lives. I do it for a living. Is there any better way of living than this?

My profession has given me enough. Being doctor I have more than enough money to raise my kids, have a decent house, enjoy little hobbies, needs are met. I am also amongst the most intelligent and the top elite professionals in the world . In the current scenario still the toppers of high schools , SAT exams and other entrance tests in India and abroad want to take medicine as a career.

I am grateful to all those people who invested in me to make me doctor. I am thankful to all my patients who waited for hours, so that I can present the case for teaching. I am thankful to God that he helped me to gain skills that now I can contribute and can have a meaningful life. Thankful to my patients who put their trust and faith in me and I wouldn't let them down .

Yes, it is stressful. I agree I worked very hard, without a doubt I had many sleepless nights. I have worked days together without holidays , vacations or weekends .

End of the day, it is my choice. I am leading a much easier life than those soldiers , army men , officers who stay in tents in snow, deserts and jungles and die every day for us, and what a shame they die unknown . They are doing a tremendous job as well . All professions have challenges but not all have such returns as this one .
My profession has given a meaning to my life, it is my turn to justify that. I love being a doctor , actually I feel blessed being one !!!
This one is dedicated to all my doctor colleagues and friends who are doing a great job wherever they are and whatever might be the circumstances, they are making a difference in someone's life !

Radio Talk on AIR - Socio medical aspects of Road accidents

ROAD TRAFFIC ACCIDENT

Road traffic accidents are the major killers in Kerala , which causes huge number of minor and major disabilities.  Presently road accidents created an unsafe feeling while we are moving out of home.  It created a situation that no guarantee for human life.

I remember the great words of M T Vasudevan Nair in novel Manju - “Death is a comedian who doesn't have any sense of scene”.  Nowadays, it is more appropriate in accident scenarios.

The statistics on road traffic accidents given by Government agencies like NATPAK is quite alarming.  It shows that more than 5000 people killed in the road in last year, more that 6 fold of this number disabled and huge number became bed ridden due to severe head injuries and spinal cord injuries.  More than that, statistics showed that 80% of the victims were between 20 – 50 years of age, out of this figure 90% were either two wheeler riders or pedestrians.  Across India, 80 people are dying in every minute.  In general, Kerala has the highest rates of accidents when compare to other states.

One interesting observation – as we know, in Kerala in 2015 January Kerala Police and Kerala Road Safety authority celebrated road safety week in very high pace.  Incidentally I came to face many accident cases during this period.  Out of curiosity I did  goggling to get some figures and found that we had more than 800 accident deaths in January alone.  This information from 'Kerala Police' face book page.  This figures really questioning the meaning of our great celebrations.
Why such accidents -  reasons are many; like road conditions, vehicle conditions, driver related issues, pedestrian related issues and some other unavoidable situations.

Contributory factors like alcohol and illicit drugs, using mobile phones are to worse the situation.  More than 80% incidents showed that violation of road traffic rules are single factor which lead to accidents.

I would say the 'Golden' period in Kerala road safety was the tenure when Mr Rishiraj Singh IPS was the Road Safety Commissioner.    Personally I felt that, there was 40 – 50% reduction in accident cases presentations in emergency rooms in the hospitals where I worked or supervised.  This reflection was  evident in Government Hospitals and Medical College accident registry as well.

What the Commission was trying to do that he tried to implement the rules little more strictly and did adequate monitoring, its implementation with passion.  It reflected on the road.  This tells a lesson to us, Kerala people are educated, can accept the rule.  But somebody should insist.

One major issue in our roads are, 80% people are not following any traffic rules or doesn't have any road culture.  It needs a huge awareness campaign on road safety to educate this major road users and in the authority should insist the road rules more strictly.

We already rejected express highway and other major road widening proposals.  It may not be possible to build international road standards  in Kerala with immediate effect, due to our special political, population related and land related issues.  Later, we may think about the projects like express high way through sea shore etc.  But we can't loss lives till such innovations to happen.

Two things that we can do immediately -
very strict and rigorous implementation of traffic rules with bold political will.  In our state, people have belief that, what ever crime you did, top most political leadership or some influenced people will save you.  People are considered that road traffic accident killings are not a big crime.
Huge awareness campaign on road culture and which should be inculcated in our mind and make it part of our children eduction.  School can be the huge platform for such activities

Few words about seat belt and helmet
Seat belts are just the part of safety of the passenger, just like brakes and head light etc.  A basic science that we learned in out school day, Newtons law which will be applied in all accidents.  In case a vehicle involved in an accidents, it is very obvious that all unrestrained objects and passenger will  moving forward and throw out of vehicle, at a speed rate at which the vehicle was traveled at the time to incident.

So naturally the people inside vehicle, who not worn seat belt will throw out or hit on dash board or steering wheel, will be injured badly and presented with life threatening injuries like head injury, chest injury, lung injury, bone injury and end up into very disaster our poly trauma situations.  This risks are equal for front seat and back seat passengers.  The risks are very high for the children inside the car, they are prone to throw out of car and instant death.

Two wheeler are more prone accidents and bad injuries.  Two organs in our body – Brain and Spinal cord are irreparable, if once damaged.  That is the reason why road safety rules insist helmet.  Good quality helmet can prevent 90% of major head injuries.  But the helmet should cover your whole head and face up to lower jaw and should be strapped properly.  An unhooked helmet has no value, in protecting head injury.  Because in the event of accident helmet will be thrown out of your head.  The head injury risk are equal for both front and back passengers.  Rather back seat riders are more prone for severe injuries.  I observe that, presently 75% of two wheeler drivers are wearing helmets.  But 95% are not used to put buckles.  100% back seat riders in Kerala are not using helmet.  Very interestingly, majority of back seat riders are females or children.  I surprise that, why we are not caring out better half and children in terms   of safely and love.

What is next once an accident occurs & How you care the accident victim -
All accident victim should get urgent medical care, need higher end life saving care within golden hour or platinum 10minutes

Accident cares are in three levels
on site cares
care during transport
care at hospital
At least two things should be taken care in all trauma victims on site
C-spine protection
Bleeding control
Victim should be transported to nearest healthcare facility in a Ambulance with back spine board protection.  In Kerala, we have health care facilities in every 15km, and this healthcare facilities should also equipped to manage at least primary level trauma care.

Destination care should be manged by trauma team, which involved Trauma Surgeon, Emergency Physician, Anesthetist, Ortho, Vascular, Neuro and Faciomaxillary surgeon.
Trauma facility include X ray, radiology, blood bank, operation theaters, post mortum facility rehabilitation centre.

Finally -
we don't know, who is going to be a trauma victim, it can happen any time to any body.  Once an accident occurred, if you unconscious, if you are not identified by somebody, you will become a destitute, you will continue in the destitute state till somebody recognize your identity.
I believe it is the right of a citizen to get quality trauma care at free or affordable cost, that come from site of accident, en route to hospital and then in the critical hours in the hospital emergency medical care system.

Grand function at Skin diseases hospital Chevayoor

Today  ...it  was a great and disturbing day for me. I attended a function at Skin diseases  hospital Chevayoor which was previously called Government leprosy hospital .SYS Sahayi group renovated two wards with modern amenities and the function was it's submission to the user's.  Usthad  AP Aboobacker Musliyar was the chief  guest.Dr.Ajith Kumar VT and other dignitaries  attended the function. The function was simple and elegant.
In my mbbs days 1981to  87 , I used to visit Chevayoor leprosy center very regularly. My senior Dr.Roy pulickan introduced my to the inmates in those days. We used to collect dresses and other useful items for them and used to spend time with them .There were more than 100 inmates there . All inmates were completely  cured victims of leprosy . But the social stigma and disfigured  facies and hands made them miserable and they were out casted from families. They forced to spend their whole life in the sanitarium.
I lost connection with this place and people ...may be my ignorance or changed my priority. The place was so cool and calm ,old and nostalgic. It is inside the city. .a 100 cents land with greens ..evening blessed with breeze and chirping of birds ...it is Devine too. But for the inmstes with cursed life may not feel it.
Very interestingly  in last 40 years Calicut city has been changed a lot. Now Calicut look like a well developed forgien city. But this leprosy sanitarium has no change. Old building ...poor facilities and few of the inmates are the same people that I met 40 years ago. Only change the center name changed to "Govt.Skin disease center "
We claimed that we are educated with 100 percent  literacy rate. But I believe that we are not . We are keeping the same stigma ...At least their on families don't want them. Leprosy is like TB .100 percent curable.
The day is disturbing when I am leaving the center.
SALUTE  SYS for the present initiatives.