The Gallery, Rail Museum, Delhi

Snaps from the gallery of the train museum. The kids enjoyed this much more than the bigger and real life exhibits outside. 

A working train model

Skull of an elephant which was hit by a train . . . In fact, the train also got derailed.

A must visit for kids if you are passing through Delhi . . .

Train Museum

Few snaps from the train museum. I could not take many as children were quite happy with the few engines we saw at the entrance of the museum. And we were also so tired. 

More snaps in the next post . . .

Delhi Visit . . . Day 1

Over the last month, we got the opportunity to plan out a vacation starting today. We are on our way to Kerala via Delhi. I had been planning to take out the family in Delhi. We had quite a lot of discussion on where to visit. 

The vote for Day 1 fell for the Train Museum from Shalom and Charis (Chesed is yet to start making choices) and for us parents, we decided on a second visit to the second hand books available in Daryaganj on Sundays. 

Snaps taken during the visit. 

Shalom is quite excited on seeing the first exhibit

On the joy ride. . .

Toy train

Exhibits inside the gallery . . .

Second hand books at Daryaganj

Today, the plan is to visit the Delhi Zoo and of course a peep into our Central Office. The kids always keep on asking about the Central Office where I go to once a while. 

She need not have died

5 days back, there was a lady who came to us with a history of hand prolapse. We shall called her PDD. The history was quite short. Which of course, was difficult to believe.

The problem was that of severe anemia. Of course, she was in bad sepsis too. Hemoglobin was 5 gm%.

As usual, we referred. And as most of the time, the family did not have much means of going beyond NJH. And the recent fear of draconian laws on blood transfusion ensured that we asked the family to bring blood.

The blood arrived after about 6 hours. This time, the blood was better than what SSD received. And there were 2 pints of this blood. 

The surgery was quite eventful. The baby was quite macerated. The uterus was stinking. We had to put an abdominal drain after the surgery. Quite unusual unless there is a rupture uterus involved. Post-operatively, PDD went into shock . . . most probably secondary to sepsis.

She was in the ventilator for almost 2 days. We prayed that she’ll recover well.

But by yesterday evening, she had become so sick that we had to put her on the ventilator. 

She needed more blood. Her Hemoglobin was still hovering around 5 gm%.

Overnight, she went into refractory shock. She arrested today morning. The mother of two was dead.

I am certain that UDBT (Unbanked Direct Blood Transfusion) would have given her a better quality of life post surgery and a better chance to live.

Anothercase for all those who advocate UDBT . . . at least for places like NJH. 

Complicated . . .

Yesterday night, we had a very obviously sick obstetric patient wheeled into the labour room.

SSD looked quite old for an 18 year old lady. She was all puffed up. The blood pressure was quite high. And she was quite breathless.

The history was very vague. The only aspect I could latch onto was that she had a blood transfusion at Daltonganj. The outside investigations showed haemoglobin of 8 gm%. Urine albumin showed 2+.

On clinical examination, it was obvious that she was into early cardiac failure. I was left wondering about her cause of cardiac failure. It was good that we have a Medicine consultant now. As usual Dr. Roshine was quick to arrive and assess the patient.

It seems that SSD was always breathless since her childhood. Dr. Roshine suspected valvular heart disease.

The investigations in the morning confirmed our diagnosis.

The management was easy now. Refer . . . refer . . . refer. Of course, she needed more evaluation.

Pregnancy in its last leg . . . with pre-eclampsia . . . valvular heart disease, most probably a mitral stenosis with regurgitation . . . there were features of pulmonary hypertension too . . . would have been the most critical patient in a high risk obstetric care set-up.

But, the relatives were quite certain that NJH was the best they could provide for SSD. Travel beyond NJH was something that they could not fathom. The problem was the necessary finances.. .. .. there was a fear of the big hospitals and the funds needed.

I tried all the tricks in my bag to somehow refer them . . .

Nothing worked . . .

We request prayers as we manage SSD.

As I mention about SSD, I also would like to put a word for help we would appreciate in the month of October and December. Quite a few of our doctor colleagues will be on leave. It would be a good opportunity for new graduates in medicine to have a feel of work at NJH.

Especially for those who dream to do a post-graduation in Internal Medicine . . . All the more when Dr. Roshine is around. But, more about that, in another of my posts.