Thursday, April 10, 2014

No second choice

(This is a purely medical post. There are images which can be quite revolting to most of you. User discretion advised)

Couple of days back, we had a very interesting patient in labour room. RD, a 30 year old mother of three came to us with the complaint that she had a spontaneous abortion early morning. She was in her fifth month. The problem was that she was diagnosed couple of weeks back that she had a twin pregnancy. Only one baby had come out. According to her, the second baby has not yet been expelled. 

I wish I had taken her snap when she was wheeled in. Her abdomen looked as if it contained one term pregnancy. On palpation, it was quite funny. There was a good fluid thrill and the abdomen contour was quite uneven. 

On ultrasound, she had huge ascites and there was a solid mass inside the abdomen. We got the ascitic fluid drained out. It was obviously a malignancy. She gave a history of 5 months . . . and she had attributed the gradual onset of her abdominal swelling to the pregnancy. And the ultrasound done couple of weeks back gave her a report 

Then the problems started . . . We discussed about referral and further treatment. She was quite young. She had little children. The family was very very poor. 

The husband and her mother made it very clear that they are taking her home to die. Both of them came and met me today morning and told that if we could do anything to relieve her pain. 

We discussed on what could be done. We took help from Dr. Hilda, our gynecologist colleague in Chattarpur. Considering the huge swelling, I was sure that some amount of debulking of the tumour would do her a lot of good. Of course, there could be secondaries. An ultrasound and X-Ray showed that the lungs and liver were clear. 

After a long interview with the family we decided to go ahead with the surgery. 



It was a huge swelling . . . certainly the largest we had recently. The mass weighed 3.6 kilograms. Thankfully, the mass which originated from the ovary did not have much adhesions. The sad thing was that she had seedling in the peritoneal cavity. 



Kindly pray as she recovers. We've send the mass for histopathology . . .  We would also like to people contributing for her treatment. The total costs would be about 20,000 INR. 

Angel practising her skills of 'grossing'
The cross section of the swelling

Monday, April 7, 2014

Finger Millet-Corn Meal Chocolate Cake (Gluten Free)

As we have been working with propagation (rather re-introduction) of millets in our region, we’ve had some excellent support from agriculturists, academicians and researchers. When we came up with the recipe booklet of traditional madwa (fingermillet/ragi) food-items, quite a few of them encouraged us to come up with original recipes of food-stuffs which are more acceptable to an urban population. 

Of course, there are quite a lot of recipes for making cakes etc. However, we thought of developing our own recipes. Over the last 6 months, few of us have been working quite hard on this and we’ve come up with 3 recipes for cakes.

This recipe has been voted the best by our kids.


Ingredients:

Unsalted butter: 1 cup
Sugar: 1 cup
Corn meal: ¾ cup
Ragi/Fingermillet flour: ¾ cup
Unsweetened cocoa: ¼ cup
Eggs: 3 large ones
Salt: ¼ teaspoon
Vanilla extract: 1.5 teaspoon
Baking powder: 1 teaspoon
Boiling hot water: ¼ cup

Method

1. Separate the whites and yolk of the eggs.
2. Whisk the whites.
3. Sift the corn meal, ragi flour and cocoa powder along with baking powder and salt.
4. Add ¼ cup of boiling hot water to the above flour mixture and mix it well. Keep aside to cool.
5. Cream the butter and sugar.
6. To this, add the yolk of the eggs and vanilla extract and mix well.
7. Add flour mixture (item nos. 4) to the butter-sugar-egg yolk mixture to get a medium consistency batter.
8. Fold the whisked egg whites (item nos. 2) to the batter.
9. Bake at 170 degree Celsius for 50-60 minutes. 



System of Wheat Intensification

As part of the CBA Project, we had started off doing demonstration plots in various crops since last October. In one small plot of approximately 70 square metres, we did wheat cultivation as per techniques used in System of Wheat Intensification. Abinash Biswal, one of our project staff took the leadership in doing it and he's put it in his blog

Snaps of the same . . . most of them taken by Mr. Thomas John, Co-ordinator, Climate Change, EHA. 



From left to right - Prabodh, Mahendar, Rajeev, Sr. Rita, Mathias, Dinesh, Amit William, Jeevan, Dr. Roshine, Ms. Meghala, Ebez, Rachel, Sheron, Abinash

A closer look

Beetroot

The champion plant - had 46 heads from a single plant