Friday, 3 February 2012

Emedinews:Inspiration:Daddy, how much do you make an hour?




With a timid voice and idolizing eyes, the little boy greeted his Father as he returned from work, "Daddy, how much do you make an hour?" Greatly surprised, but giving his boy a glaring look, the Father said: "Look, son, not even your mother knows that. Don't bother me now, I'm tired." "But Daddy, just tell me please!? How much do you make an hour," the boy insisted.

The Father finally giving up replied: " Twenty dollars per hour." "Okay, Daddy? Could you loan me ten dollars?" the boy asked. Showing restlessness and positively disturbed, the Father yelled: "So that was the reason you asked how much I earn, right?? Go to sleep and don't bother me anymore!"

It was already dark and the Father was meditating on what he had said and was feeling guilty. Maybe he thought, his son wanted to buy something. Finally, trying to ease his mind, the Father went to his son's room.

"Are you asleep son?" asked the Father. "No, Daddy. Why?" replied the boy partially asleep. "Here's the money you asked for earlier," the Father said. "Thanks, Daddy!" rejoiced the son, while putting his hand under his pillow and removing some money. "Now I have enough! I have twenty dollars!" the boy said to his Father.

The Father sat there, gazing at his son, confused at what his son just said. "Now Daddy could you sell me one hour of your time?"

Thursday, 2 February 2012

Emedinews:Insights on Medicolegal issues: A medicolegal autopsy


  • A medicolegal autopsy means an examination of the body after death, which is conducted in cases where the circumstances of the death suggest that the death was caused by homicide, suicide or accident or is suspicious in nature where criminal investigation is instituted. 
  • The Police/magistrate are empowered by the law in India to order a designated doctor to perform a forensic autopsy; hence no consent from the family/legal heir is required for forensic autopsy.
  • Autopsia cadaverum or an autopsy is the post-mortem examination of corpse by a registered doctor. It is a specialized surgical procedure that consists of a thorough examination of a corpse to determine the identity of corpse, the cause and manner of death and to evaluate any disease or injury that may be present. The autopsy must be performed by a specialized experienced medical doctor; however if possible, it should preferably be done only by a doctor qualified/experienced in forensic medicine.
  • The autopsy ideally includes both a thorough external examination of the body and a probing examination of the internal organs of the body. During the external examination, the doctor examines the body searching for wounds and injuries, noting deformities, absence of limbs, state of nutrition, and unusual features.
  • The doctor should examine the hands, fingers, fingernails, feet, teeth, scalp, tattoos, scars, hair, skeleton remains, hair fibers, jewelry, and clothing.
  • While conducting the internal examination, the autopsy surgeon should remove the deceased’s chest plate, lungs, heart, liver, intestines, etc. and, with the use of a scalpel, examine these organs for wounds, disease, and deformities.
  • There should be an arrangement to videotape the autopsy and must release a detailed report, including the cause of death to the police as early as possible. It is best and most transparent if the postmortem report is handed over along with dead body.
  • Autopsies, as well as the reports released by the medical examiner, vary in quality. Some medical examiners take little care in their work. A small percentage is outright incompetent.
  • Once an autopsy is complete the body must be well reconstituted by sewing or suturing it back together with cosmetic care of deceased body. Suturing from chin to pubic prominence should be masked by resembling skin color paste. 

Emedinews:Makesure: Sir, he collapsed after sublingual nifedipine was given


Situation: Sir, he collapsed after sublingual nifedipine was given
Reaction: Oh, my God! I forgot to check for LVOT obstruction
Lesson: Make sure that the patient does not have LVOT obstruction (left ventricular outflow tract) before giving sublingual nifedipine.  

Emedinews:Inspiration:Life may not give a second chance


Think about it... 

It's another morning......... Again I have to go to the office. Ohh!! this is me... I shouted, having a glance at my ‘photo’ in today's news paper. But what the HELL is it doing in the death column??

Strange...

One second.......Let me think, last night when I was going to bed I had a severe pain in my chest, but I don't remember anything after that, I think I had a sound sleep. It's morning now, ohh....... It's already 10:00 AM, where is my coffee? I will be late for office and my boss will get a chance to irritate me.. Where is everyone...??? I screamed. "I think there is a crowd outside my room, let me check." I said to myself.
So many people..... Not all of them crying...... But why are some of them crying.... WHAT IS THIS??? I’m lying there on the floor...

"I AM HERE" ....... I shouted!!! No one is listening. "LOOK I AM NOT DEAD" .... I screamed once again!! No one is interested in me. They all were looking at me on the bed. I went back to my bed room. "Am I dead??" I asked myself...

Where is my wife, my children, my Mom, my Dad, my friends? I found them in the next room, all of them were crying...still trying to console each other. My wife was crying... she was really looking sad. My little kid was not sure what happened, but he was crying just because his Mom was sad. How can I go without saying to my kid that I really love him, I really do care for him? How can I go without saying to my wife that she is really the most beautiful and most caring wife in this world? How can I go without saying to my parents that I’m what I am ... just because of you??

How can I go without telling my friends that without them perhaps I would have done most of the wrong things in my life... thanks for being there always when I need them...and sorry for not being there when they really need me..

I can see a person standing in the corner and trying to hide his tears....Oh.... he was once my best friend, but a small misunderstanding made us part, and we both have a strong enough ego to keep us disconnected.

I went there..... and offered him my hand, "Dear friend.... I just want to say sorry for everything, we are still best friends, please forgive me." No response from other side, what the hell?? He is still preserving his ego, I am saying sorry... even then!!! I really don't care for such people. But one second...... It seems he is not able to see me!!!! He did not see my extended hand.

My goodness...... AM I REALLY DEAD??? I just sat down near ME; I was also feeling like crying... "OH ALMIGHTY!!!! PLEASE JUST GIVE ME FEW MORE DAYS..." I just want to make my wife, my parents; my friends realize how much I love them.....

My wife entered the room, she looks beautiful. "YOU ARE BEAUTIFUL" I shouted. She didn't hear my words, in fact she never heard these words because I never said this to her. "GOD!!!!" I screamed... a little more time plzzzzz... I cried... One more chance please... to hug my child, to make my mom smile just once, to feel my dad proud of me at least for a moment, to say sorry to my friends for everything I have not given to them, and thanks for still being in my life....

Then I looked up and cried!! I shouted....... "GOD!!!! ONE MORE CHANCE PLEASE!!!!"

"You shouted in your sleep," said my wife as she gently woke me up. "Did you have a nightmare?"
I was sleeping.... Ohh that was just a dream....

My wife was there... she can hear me... This is the happiest moment of my life... I hugged her and whispered....
"YOU ARE THE MOST BEAUTIFUL AND CARING WIFE IN THIS UNIVERSE..... I REALLY LOVE YOU, DEAR"

I can't understand the reason of the smile on her face with some tears in her eyes, still I’m happy....

"THANK YOU GOD FOR THIS SECOND CHANCE."

SO, now it's not late... Forget the egos, the Past... and express your love to others.......Be friendly... Keep smiling...... forever....It is another chance For you... Please let us do things more sincerely... and make our life worthwhile.

Wednesday, 1 February 2012

Emedinews:Insights on Medicolegal issues: What is a negative postmortem examination?


What is a negative postmortem examination?

  • Negative or obscure autopsy is when no significant finding are discovered in autopsy i.e. when in a postmortem examination all efforts i.e. gross, microscopic, chemical and toxicological results are not concluding enough about the cause, manner or other required medicolegal aspects of death
  • Negative autopsy is very useful in cases where there is no adequate history of death
  • Death from fear/fright or shock/cases of post fracture air embolism
  • Death due to lesion in neck as diphtheria, laryngeal bronchitis/swelling of glottis or choking on food
  • Cases like brown atrophy of heart associated with starvation, asthma or cancer
  • Sickle cell disease/lesion of adrenal gland/hemorrhage or destruction by tumor
  • Negative autopsy is also very informative; I have seen such a case in death due to distal coronary artery occlusion or coronary arteries spasm

Emedinews:Makesure:A patient was brought to the ICU in cardiogenic shock.


Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn't you take him for emergency angiography and subsequent PTCA.
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2, an ongoing trial suggest that this intervention is much better than thrombolytic therapy in such patients.

Emedinews:Inspiration:A little girl's prayer



One night I had worked hard to help a mother in the labor ward, but in spite of all we could do she died leaving us with a tiny premature baby and a crying two-year-old daughter. We would have difficulty keeping the baby alive, as we had no incubator (we had no electricity to run an incubator) and no special feeding facilities. Although we lived on the equator, nights were often chilly with treacherous drafts. One student midwife went for the box we had for such babies and the cotton wool the baby would be wrapped in. Another went to stoke up the fire and fill a hot water bottle. She came back shortly in distress to tell me that in filling the bottle, it had burst. Rubber perishes easily in tropical climates. "And it is our last hot water bottle!" she exclaimed.
As in the West it is no good crying over spilled milk, so in Central Africa it might be considered no good crying over burst water bottles. They do not grow on trees, and there are no drugstores down forest pathways.
"All right," I said, "Put the baby as near the fire as you safely can; sleep between the baby and the door to keep it free from drafts. Your job is to keep the baby warm."
The following noon, as I did most days, I went to have prayers with any of the orphanage children who chose to gather with me. I gave the youngsters various suggestions of things to pray about and told them about the tiny baby. I explained our problem about keeping the baby warm enough, mentioning the hot water bottle. The baby could so easily die if it got chills. I also told them of the two-year-old sister, crying because her mother had died.
During the prayer time, one ten-year-old girl, Ruth, prayed with the usual blunt conciseness of our African children. "Please, God," she prayed, "send us a water bottle. It'll be no good tomorrow, God, as the baby will be dead, so please send it this afternoon." While I gasped inwardly at the audacity of the prayer, she added by way of corollary, "And while you are about it, would you please send a dolly for the little girl so she'll know you really love her?"
As often with children's prayers, I was put on the spot. Could I honestly say, "Amen"? I just did not believe that God could do this. Oh, yes, I know that He can do everything. The Bible says so. But there are limits, aren't there? The only way God could answer this particular prayer would be by sending me a parcel from the homeland. I had been in Africa for almost four years at that time, and I had never, ever received a parcel from home. Anyway, if anyone did send me a parcel, who would put in a hot water bottle? I lived on the equator!
Halfway through the afternoon, while I was teaching in the nurses' training school, a message was sent that there was a car at my front door. By the time I reached home, the car had gone, but there, on the verandah, was a large twenty-two pound parcel! I felt tears pricking my eyes. I could not open the parcel alone, so I sent for the orphanage children. Together we pulled off the string, carefully undoing each knot. We folded the paper, taking care not to tear it unduly. Excitement was mounting. Some thirty or forty pairs of eyes were focused on the large cardboard box.
From the top, I lifted out brightly colored, knitted jerseys. Eyes sparkled as I gave them out. Then there were the knitted bandages for the leprosy patients, and the children looked a little bored. Then came a box of mixed raisins and sultanas - that would make a nice batch of buns for the weekend. Then, as I put my hand in again, I felt the... could it really be? I grasped it and pulled it out - yes! A brand-new, rubber hot water bottle! I cried. I had not asked God to send it; I had not truly believed that He could.
Ruth was in the front row of the children. She rushed forward, crying out, "If God has sent the bottle, He must have sent the dolly, too!"
Rummaging down to the bottom of the box, she pulled out the small, beautifully dressed dolly. Her eyes shone! She had never doubted!
Looking up at me, she asked, "Can I go over with you, Mummy, and give this dolly to that little girl, so she'll know that Jesus really loves her?"
That parcel had been on the way for five whole months! Packed up by my former Sunday school class, whose leader had heard and obeyed God's prompting to send a hot water bottle, even to the equator. And one of the girls had put in a dolly for an African child - five months before - in answer to the believing prayer of a ten-year-old to bring it "that afternoon."
When you realize you want to spend the rest of your life with somebody you want the rest of your life to start as soon as possible.