Of traditional remedies for balding hair and potbellies . . .

As we sit in outpatient departments, it is quite common to see patients come for the complaints of balding and pot belly. As your sincerely has a bit of both in quite a significant amount, of late, I've not had much patients asking me about remedies for the same. 

Last week, I happened to see a youtube video about very popular remedies very much available in my home state of Kerala - and I was quite relieved. Unfortunately, the narration is in Malayalam. 

Relief because - I've quite a number of dear friends and relatives who had been bugging me to try out these remedies. And, I actually tried some for the receding hairline - which I'm sure did not do much good. However, few of my friends think otherwise. 

The business involved is in crores and if the video is to be believed the whole business is a unethical, unscrupulous and criminal. 




So, if you have a receding hairline, just take it from the Lord that you have a beautiful scalp worth public display and if you happen to have a paunch, it's a warning that you need to careful about what you eat. . . .




Well, for those who had been looking earnestly for clinical stuff, we are quite busy in hospital. There is quite a lot of action. But, I thought that this matter needs to be given a bit of publicity so that you don't waste your money on these remedies . . . 

Remembering Andamans . . .

There was something unfortunate in our vernacular daily today. Later, I found out that it was all over in the international press. 

A significant shift in a stand leaning more towards primary healthcare and public health happened in me during a 6 month posting in Andaman soon after the Tsunami in December 2004. I was part of the initial disaster response team sent from EHA. 

Well, the first reaction you have of that place is the amazing beauty of the islands. I hope to share few of the snaps I took during the 6 months. I know that the snaps are too assorted. Unfortunately, I'm sure that I'll take quite a lot of time to sort them out . . .  So, kindly excuse . . . 

Snap taken to send home . . . 

One of the umpteen snaps taken of the rock formations along the sea . . .

Reminder of the independence struggle... Gallows at the cellular jail...

Cellular Jail . . . 

Reminder of the earthquake . . . 

Road to Mount Harriet

Ferry crossing at Baratang . . . On the way to Rangat . . . 

Again reminders of the earthquake . . . 

Tents at the relief camps . . . 

Our clinic in progress . . . 

Hutbay . . . 

Destruction at Hutbay . . . 

School in progress at Hutbay

The team . . . 

Crab Poo . . . 

Photo response to a friend who sent me a snap of his posh office . . . 

Mud volcano . . .

The First Rupture Uterus of 2012 . . .

And finally, although we had quite a busy day on my first duty of 2012, we were lucky not to have a rupture uterus.

But, then we had the first rupture uterus of 2012 on my next duty day (9th Jan, 2012).

The duty was not much busy – save for the night, when I had 3 patients with previous Cesarian sections landing up with in a time period of 1 hour. The first two were without much problems.

But, the third one, BD had tried to deliver at home and ended up with a rupture. It was her 4^th pregnancy. The first one was a normal delivery. The second one was the previous cesarian – but she had lost that baby during the surgery. The third one was a normal delivery – which may have prompted her to try to have her fourth one at home.

BD was visiting her parents when the labour pains started – most probably a reason for not trying to access health care. However, by the time she knew that something was amiss, she had called her husband, who was elsewhere. The husband was knowledgable enough to realize that she had ruptured and advised her to go straight to NJH.

 

So, she came straight to us. She was in shock – which she responded well to fluids. And the family arranged for couple of pints of blood.

Shishir did the surgery. By God’s grace, the rupture was clean and we were able to close the rent without much problems. She is making a good recovery.

But the family is quite upset that they lost a baby boy. The second delivery which involved a Cesarian section had also ultimately ended up with a dead baby boy.

Lesson learnt: The importance of finding out the decision maker in the family where a lady is expecting a baby soon and educating the decision maker about institutional delivery.

First working day of the New Year . . .

Today was my first day after the brief vacation and oh...my....it's turning out into a major one.

To start off, as I left chapel and entered the hospital, Dr Johnson requested me to convince MD to undergo a Cesarian section. Johnson was convinced that MD was obstructed - and I was also convinced. I was thankful when Johnson went out for one more round of negotiations and returned victorious.

MD had been in labour at her home since late afternoon of the previous day. She had also recieved 6 intramuscular injections, half of which were oxytocin. She had arrived sometime after midnight, and had not progressed.

And, I was glad we operated. The outer uterine muscle fibres were starting to snap, there was petechia in the lower uterine wall, the bladder was edematous and there was a part of the lower uterine wall through which I could see the flakes in the amniotic fluid. She would have ruptured within the next one hour. The baby girl had a surprising Apgar Score of 9 and 10.

As I was starting off MD's Cesarian Section, word came that there was a Previous Cesarian without any antenatal check up who had come in with labour pains. She was also posted for surgery as soon as MD's was over.

Patients such as KD actually prevent us from readily jumping in for Cesarian Sections even when there is a faint indication for one. It was unbelievable. KD, who had a previous Cesarian 2 years back, did not even have a tetanus toxoid injection leave alone a proper antenatal check up. KD's Cesarian section was also uneventful although we had to arrange blood as her hemoglobin was only 8 gm%.

Well, I forgot about LD - who was wheeled in as we were taking a decision on MD. LD was about 32 weeks and had come in all the way from Ranka - about 60 miles away. LD was hardly conscious , had convulsions the previous day and was being managed elsewhere before they referred her to us. There was no fetal heart and the abdomen looked too big for 32 weeks.

Shishir promptly did an ultrasound and confirmed dead twins in the uterus. Then we found out that her birthcanal was almost fully dilated. But, for some unknown reason, we ended up doing a craniotomy to deliver the first twin and then the other one was pulled out breech. LD is still not fully conscious.

Then, we had two more normal deliveries, one of which was a small for gestational age baby. And another one which was an Intrauterine Death.

I'm glad we do not yet have a case of Rupture Uterus. But, we do have a elderly primi with post dates whom we've induced. I hope she delivers normally - but sometime back, the labour room nurse has informed me of couple of high diastolic blood pressure readings . . .

Well, for all those who want to know about other patients - we had two proven malaria patients today. SK aged about 19 years had been sick since Wednesday. It was quite obvious - he was shivering as he came to OPD. Then we had VS, who just came in very sick. He has been sick since January 2. He was all yellow - I tried my best to refer him - but to no avail.

Rajeev, our lab technician telephoned me VS's blood tests - Falciparum malaria positive, Total Count 21,000/ cu mm, S. Bilirubin 9 mg%, Platelets 30000 / cu mm . . . I am yet to see the full reports.

I've the ventilator ready . . . And another 12 more hours before I hand over to Dr Johnson . . .

And to top it all, two more young ladies with attempted poisioning. One had taken organophosphorus and the other permethrin shampoo . . . Both are doing well . . .

Before I sign off, an X-Ray from OPD today. There was one more good one . . . but I forgot to take a snap . . .

2012 . . . Looking forward . . .

As I sat in the watchnight service yesterday, my thoughts strayed to the dreams I have about 2012. Our time so far at NJH has been quite challenging and demanding. The possibilities in that place are umpteen. However, the challenges we've seen throughout the last year have been daunting. Few of the challenges continue to remain. As was posted in my previous post, there are so many blessings that we are thankful about.

Today morning's Sunday service really lifted up my soul. Angel's dad preached on the wedding at Cana (John 2: 1-11). Among the many other things he preached, what touched me was the challenge to unwaveringly pursue fulfilling the Lord's will in our lives during 2012.

 

Once more, I would like to quote one of the good old Malayalam gospel songs which has always enthralled and inspired me. The translation goes something like this.

- Oh Father in heaven, your Holy Will

- Be done in earth, as it is in heaven

- As your Son who did Your Will on earth

- I surrender myself to do your Holy Will

- Oh, My Lord, To do Your desires

- I gladly come to Thee

- My dear Lord, I do not want anything of my desires

- May I be fulfilled/content in Your desires of me

I should say that many of the newer songs would hardly stand the time nor convey the meaning that many such songs of old.

V5 is very significant. I consider it as one of the greatest statements on faith in the Bible. 'Do WHATEVER He tells you.'

We have quite a lot of dreams. Our wishlist for 2012 conveys quite a lot. Well, if there are 10 things which I would pray earnestly to happen at NJH for 2012, they would be the following -

1. A group of leaders at NJH who would see the potential of that place, be willing to go down on their knees to intercede for the Chottanagpur region and work selflessly towards the mission and vision of NJH. This process would require newer staff including consultants for Internal Medicine and Pediatrics.

2. Completion of the burns unit and operationalising it. We need approximately 2.5 million Indian Rupees (48,000 USDs/Euros/AUDs, 30,000 GBPs) more for completion. One of my friends has started the initial process of fund raising.

3. Upgradation of the Acute Care Unit and the theatre for laparoscopy facilities.

4. External funding for our Community Health work is drawing to a close. My dream is to synchronise the clinical work with the community health work with our own funds. It is a tough ask but I'm quite sure that this would give more ownership towards CH work from the side of the hospital as well as the community.

5. Construction of newer residential buildings including major renovation in electrical and water connections is a major need.

6. Lasting peace in the region is something we would really want.

7. A newer school bus and the roads to become better would definitely encourage more qualified staff to explore the option of staying on at NJH.

8. Construction of a 'sarai' for our patients who come from far away is a big need.

9. There is a need for extra space for the Nursing School and Hostel.

10. There has been inital discussions about the possibility of operationalising a Community College. There is a huge potential for such an effort.

There are many many more. . . Our prayer as a family and as a community is that we do not end up doing anything which is outside the will of God in 2012.

We look towards a year which is devoted to prayer. A post by Jonathan Parnell has challenged me. I hope I will live up to this New Year resolution . . . And of course there are quite a lot of people who remember us in their prayers and continue to encourage us.  We are thankful . . .