Member

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Via this tweet by @thestudentdoc.

[Raphael was alluding to these two posts]

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What makes a 300-year-old pocket watch tick? : Nature News

State-of-the-art X-ray scans have revealed the internal mechanisms of a corroded, barnacle-covered pocket watch recovered from a seventeenth-century wreck. The watch looks little more than a lump of rock from the outside, but the scans show that the mechanism inside is beautifully preserved, from delicate cogwheels and Egyptian-style pillars to the maker’s inscription.

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[Image source: Nature News online article]

Museum researchers Lore Troalen, Darren Cox and Theo Skinner saw a paper in Nature that described how X-ray computed tomography (CT) had been used to image an ancient Greek device called the Antikythera Mechanism1. This artefact had also been salvaged from a shipwreck. CT involves taking a series of slices through an object at different angles, and combining them using a computer to produce a three-dimensional reconstruction of the object’s internal structure. Andrew Ramsey and his colleagues at the company X-Tek Systems in Tring, Hertfordshire, UK, had developed an improved CT technique using small yet high-voltage X-ray sources, which enabled them to obtain very high-resolution images, even when penetrating dense metal. Troalen and Cox took the Swan watch to X-Tek (now owned by Nikon), and the resulting images taken by Ramsey and his colleagues have a resolution of 63 micrometres2 and show that much of the mechanism inside the watch is perfectly preserved. Any parts made of steel, including the watch’s single hand as well as the studs and pins that originally held the mechanism together, have corroded away. But most of the components are brass, and in excellent condition. “The results surpassed all of our expectations,” says Troalen. “We never thought that so much of the mechanism would have survived.” [Read the entire article here. Also watch the video flythrough of the CT 3D VR and the slideshow]

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Note: This a guest post by my colleague and neighbour, Dr. George Paul. He is a maxillofacial surgeon and lawyer. He writes and speaks on various legal and ethical issues in medical care. He is also an occasional blogger. This article is also cross-posted in his blog.

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In July 2010 the Madras High Court, in a landmark judgment, ruled that doctors qualified in Ayurveda, Siddha and Unani systems of medicine can practice ‘modern scientific medicine’ along with their respective systems. This Judgment was further buttressed by a Government Order (GO) issued by the Department of Health, Government of Tamilnadu, permitting practitioners of traditional systems of medicine to prescribe allopathic drugs and perform a range of surgical procedures including orthopedics, gynaecology, ENT, Ophthalmology etc. To understand the grave dangers posed by this unfortunate decision, one must understand the evolution of traditional and ‘modern’ medicine.

Conventional medicine that is practiced around the world is often referred to as modern medicine in India. About two hundred years ago western medicine was poorly developed and many of the practices like bloodletting caused more harm than good. It was in this setting that Samuel Hahnemann introduced the philosophy of Homeopathy in 1796 . Homeopathy became popular not because it was highly effective but because it was perceived as not being as dangerous as the conventional medical system of the time. In fact it was Samuel Hahnemann who referred to ‘the other treatment’ as Allopathy.

It was only in the last two hundred years with the discovery of microbes, antibiotics, anaesthesia, immunization, modern pharmacology and other aspects of medicine that conventional medical care in the West overtook the traditional practices all over the world. Unfortunately many traditional systems in India and China did not evolve with the times and remained rooted in ancient practices. Today Ayurveda, Siddha and Unani do have limited patronage in India. Their adherents are usually those who are wary of modern systems and perceive them as being unnatural and therefore dangerous. In fact these traditional medical systems have capitalized on the very same sentiments to promote themselves as an alternate system of medicine. For others, traditional systems carry a heritage charm of being ancient and therefore exotic - in fact, esoteric.

Unlike traditional systems that have strong cultural and religious overtones, popular modern medicine has freely rendered itself to change and criticism. Modern systems evolved because they are not steeped in ancient traditions that have a way of being sacrosanct and rigid.

It is therefore surprising that these traditional systems are now asking to obtain privileges for prescribing the very same drugs that were denounced by them as being foreign, dangerous and unsuitable to our heritage. The foundation of Ayurveda, Unani and Siddha systems are alien to conventional medicine. For example, the concept of health and disease is based on the balance of the three humors namely Vatha, Piththa and Kapa in Ayurveda and Siddha. While these concepts may have merit for those who wish to follow them, they are meaningless to the practitioners of modern conventional medicine. A medical graduate in Ayurveda or Unani, tutored in these tenets will not be capable of practicing a science that has a totally different outlook to disease and treatment.

The judicial as well as executive decisions to allow traditional practitioners the privilege of practicing conventional - Allopathic - medicine is obviously based on the interpretations of the word ‘modern.’ The argument that traditional medicine is ‘modern’ is based on the specious argument that the syllabi of degrees such as BAMS and BSMS include ‘modern’ medical subjects like anatomy, physiology and pathology. Modernity in medical terms does not mean the knowledge of subjects alone. It refers to the application of modern methods in diagnosis and treatment based on well documented concepts. Drugs used in modern medicine and the rationale for their use is certainly in conflict with traditional medical systems. Systems like Siddha, Ayurveda and Unani that do not recognize microorganisms as the cause for infections cannot prescribe antibiotics. The defining aspect of modernity in conventional healthcare is evidence-based medicine (EBM). All drugs in modern medicine go through a rigorous process from drug discovery to phase trials to marketing. Even advances in surgery are based on recent developments in infection control, anaesthesia and operating devices that have been developed on the basis of principles that are alien to traditional medicine.

In this context the decision of the Tamil Nadu state government to allow traditional medical graduates to practice modern medicine, even while they adhere to different concepts about basic physiology and pathology, is a dangerous tryst with the destiny of healthcare in India. If the adherents of traditional medicine feel the necessity to practice modern medicine and prescribe drugs that are alien to their system, they are free to do so if they obtain a regular medical degree like the MBBS. Alternate medicine degrees like BAMS and BSMS cannot be used as a shortcut to practice modern medicine. One cannot have the cake and eat it too!!

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I started writing this on the way back home from a meeting that I attended over last weekend. This has remained a rough draft for the past three days. I decided to publish it now with minimal changes. Else this too shall remain in my drafts folder for a long enough time to become irrelevant.

The meeting that I attended was the SOMATOM CT Users’ Meet 2010. The event was entirely sponsored by Siemens. They brought together about one hundred and fifty radiologists from all over India who use their high-end CT scanners and a few who are potential buyers. The meet was held in the opulent Oberoi Hotel in New Delhi. I could see Humayun’s tomb at a distance from the large window in my room.

Though an entirely Siemens sponsored event, the packed academic schedule was independently organized by a small committee of experienced radiologists from Mumbai and Delhi. There was one half hour session allotted to the company for demonstrating their new CT workstation. Other than that, there was no marketing pitch allowed.

In the initial email informing me about the meeting, the company representative had told me that the focus would be on Low Dose CT imaging. I was skeptical about that. I thought it would be the usual PR exercise with probably a short talk about radiation exposure and dosage awareness. When I got the full agenda, I was pleasantly surprised to see that a half day session with five speakers was dedicated to the topic of Radiation Dose Reduction in CT. That was the inaugural session of a two day meeting. I have never seen that happen in any radiology meeting in the past decade.

One of the points that was emphasized by all the speakers in that session was the need to do away with “pretty pictures.” All of us, radiologists and referring clinicians, like CT images of superb quality with life-like coloured 3D reformations. But that kind of quality comes with a price, especially with the newer multislice and dual source CT scanners - increased radiation exposure for the patient. What is required in radiological imaging of any kind is the procurement of images that are adequate to arrive at a diagnosis with reasonable accuracy. We do not have to produce images from every patient that are good enough to put on product brochures. This fundamental shift in thinking has to occur among radiologists and radiographers first. Then we have to educate referring clinicians that they do not always have to get “pretty pictures” in all their patients. They, the referring clinicians, will have to trust us, the radiologists, when we say that images of diagnostic quality can be obtained for significantly lesser radiation exposure to the patient.

Among the speakers were some vastly experienced radiologists who shared technical tips and modifications of existing body imaging protocols that would allow us to significantly reduce radiation exposure in our scanners. There was some lively discussion particularly about a modified CT Urography protocol presented by a radiologist from New Delhi.

Now that the role of Coronary CT Angiography has been established, the major worry is about the “excessive” radiation that patients are exposed to. I used the quotes for “excessive” because it has also been established that with the currently available 64 and higher slice CT scanners, the average radiation exposure falls under 10 mSv. On average the radiation dosage for CCTA in scanners similar to the one that I use is 5 - 7 mSv, which is equivalent to a CT scan of the chest. The kind of scanner that I use also allows me to further reduce exposure to less than 3 mSv (equivalent to a brain CT) by using a prospective-ECG-gating protocol. It takes anywhere between 4 to 7 seconds for the scanner in my department to complete a CCTA.

All of that changes with the latest scanner from Siemens. It’s a dual source 128 slice scanner, they call it the Definition Flash. The Siemens executive showed some current data from their worldwide installations of this particular scanner. After thousands of CCTAs being done on this scanner worldwide, the average radiation exposure is less than 1 mSV. And the scan time is less than 1 second. Mind-blowing stuff. This was independently confirmed to the audience in ensuing talks by a visiting academic radiologist from Erlangen, Germany and two Indian radiologists, one from New Delhi and the other from Mumbai.

There was a heated discussion about the indications for Coronary CT Angiography. The moderators stuck to the published and agreed upon guidelines, but there were some vociferous members in the audience who argued that with the current low radiation dosage; the non-invasive nature of CT and its speed make CCTA an attractive screening tool. Thankfully, that view was only held by a very small number of people. But that might change in the future. Which bodes ill for healthcare costs in India.

There was a collective jaw-drop moment for most of the audience when one of the company people mentioned that one particular hospital/diagnostic center in western India performed on average about fifty Coronary CTAs per day. Since there was a palpable sense of incredulity and there were some loud questions about how the workflow was managed, one of the radiologists from that center, who was sitting modestly way back in the hall, stood up and told all of us that they used three work stations and routinely did about fifty-five to sixty CCTAs EVERY DAY!! Wow!!!

We were also shown some great images of Pediatric cardiac anomalies diagnosed / confirmed on CT. There is no doubt that Echocardiography with or without cardiac catheterization and angiography are the standards for diagnosing congenital heart disease. Cardiac MRI and CT are relatively new things that have developed over the past decade. The problem with Echo & Catheter Angiography is that of availability and expertise. Echo is almost universally available, but the requisite expertise in pediatric echo is not available in all places. In fact there is no pediatric cardiologist / cardiothoracic surgeon in my town. MRI takes longer time and requires the child to be sedated or anesthetized. With the current multislice CT scanners, it’s a matter of few seconds, or less than a second if you are lucky to have the Definition Flash.

It was great to be in the presence of some of the brightest and most successful radiologists in the country. The sessions were very interactive with a good amount of active participation from the audience. Some members of the audience, especially a dashing young radiologist from Delhi, were extremely articulate and cogent. He put forth a radical idea: do we radiologists really have to give images on film in the current day? Why not just our typed report and a CD or DVD containing all the images? This again will depend wholly on the referring clinicians.

I liked how the focus of the entire meeting was on knowledge-sharing between users from various regions of the country. Siemens seems to be the only company that has consistently tried to have such user meets. Probably because they hold the lion’s share of the market in India.

The only bad thing about the meeting was the travel, more importantly the time it took to reach from Salem to Delhi and back.  The fledgling Salem airport only connects to Chennai. I opted to fly from Coimbatore. It seems there are no direct flights from Coimbatore to New Delhi. I had to wait for 50 minutes inside the plane in Mumbai airport during the the onward journey and for 30 minutes in Hyderabad airport during the return journey.

One thing I was genuinely thankful for - my mobile phone’s Aircel GPRS connection worked in Delhi. It did not work when I was in roaming mode in Bangalore last month. So I could keep up with emails and take a peek at twitter occasionally.

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An impressive and compelling editorial in the latest issue of the Journal of Ultrasound in Medicine.

First, Do No Harm . . . to Early Pregnancies - Doubilet and Benson 29 5: 685. [Excerpts here with emphases added by me. The editorial is free to view &/or download in India. Subscription may be required for others]

When a woman of childbearing age presents to a physician or other care-giver complaining of vaginal bleeding and/or pelvic pain, a pelvic ultrasound examination is often performed to assess the etiology of her symptoms. If she has a positive pregnancy test, the major role of ultrasound is to assess whether she has a normal intrauterine pregnancy (IUP), an abnormal IUP, or an ectopic pregnancy. The information provided by ultrasound can be of great value in guiding management decisions and improving outcome. Errors in ultrasound interpretation, however, can lead to mismanagement and, thereby, to bad pregnancy outcome. Potential interpretation errors include: (1) failure to conclude that there is a definite or probable IUP despite ultrasound images depicting such a finding; and (2) failure to conclude that there is a definite or probable ectopic pregnancy despite ultrasound images depicting such a finding. This editorial focuses on the former error.

Misuse of the concept of pseudogestational sac (also termed “decidual cast” in the early obstetric ultrasound literature) is another factor contributing to the type of error described here. “Pseudogestational sac” refers to fluid (blood or secretions) in the uterine cavity that is occasionally seen in a woman with ectopic pregnancy. The frequency of a pseudogestational sac in women with ectopic pregnancies was initially reported to be 20%, but more recent studies have found a somewhat lower incidence of approximately 10%. It is likely that many of the early descriptions of pseudogestational sacs were due to hypoechoic areas in the decidua appearing anechoic, since we have rarely seen pseudogestational sacs in recent years, despite a high volume of ectopic pregnancies scanned at our institution. Simple arithmetic shows that fluid in the uterus in a woman with a positive pregnancy test is far more likely to be a gestational sac than a pseudo-gestational sac, even if it is not surrounded by two echogenic rings. The relevant data are: ectopic pregnancies constitute about 2% of all pregnancies (based on the most recent data from the Centers for Disease Control and Prevention); the double sac sign appears in about half of early IUPs; and a pseudogestational sac appears in at most 10% of ectopic pregnancies. From these data, it follows that when a nonspecific intrauterine fluid collection is seen, the odds favoring a gestational sac over a pseudogestational sac are approximately 245:1. To see this, consider a sample of 1000 early pregnancy sonograms in which there is an intrauterine fluid collection with no visible yolk sac or embryo. Of these pregnancies, 980 will be intrauterine, of which about 490 will lack a double sac sign. Of the 20 ectopic pregnancies, 2 will have a pseudogestational sac. Hence the odds favoring an IUP are 490:2, or 245:1. The odds may be even higher if, as we suspect, the frequency of pseudogestational sacs in ectopic pregnancies is even lower than 10%. Translating odds into probabilities: if a nonspecific intrauterine fluid collection is seen in a woman with a positive pregnancy test, the probability of it being a gestational sac is more than 99.5%, while that of a pseudogestational sac is less than 0.5%. The likelihood of a gestational sac is even higher—virtually 100%—if the fluid collection is not “nonspecific,” but instead demonstrates a double sac or intradecidual sign or contains a yolk sac or embryo.

This arithmetic exercise indicates that the notion of “pseudogestational sac” is of little or no value. If a scan shows a definite extrauterine pregnancy (such as an adnexal mass with an embryo and cardiac activity), then the presence or absence of a pseudogestational sac is clinically irrelevant. In virtually all other cases, it would be inappropriate (and potentially dangerous) to call a nonspecific intrauterine fluid collection a pseudogestational sac, because of the powerful odds in favor of it being a gestational sac. In accordance with Occam’s razor (also known as the Law of Parsimony) or its more familiar variant when you hear hoofbeats, think horses, not zebras: when you see fluid in the uterus, think gestational sac, not pseudogestational sac.

Besides probabilities, medical factors also favor considering a nonspecific intrauterine fluid collection to be a gestational sac until proven otherwise instead of a pseudogestational sac until proven otherwise. Administering an embryotoxic agent to, or evacuating the uterus of, a woman with an IUP-which could occur if a gestational sac is erroneously called a pseudogestational sac-is a serious error, whereas delaying treatment in a woman with ectopic pregnancy-which could occur if a pseudogestational sac is erroneously called a gestational sac-will often have little effect on outcome if the patient is medically stable.

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The Times of India - Credibility of MCI will be restored, says Azad:

As MCI continues to reel under a severe crisis of credibility, health minister Ghulam Nabi Azad on Tuesday said it was the government’s immediate objective to ensure that the body responsible for regulating medical education in the country worked in a fair and transparent manner.

Replying to a calling attention motion in Rajya Sabha on MCI, whose chief Ketan Desai was recently arrested by CBI for taking Rs 2 crore from a medical college, Azad said an umbrella body like national council for human resources in health, once it is established, will take care of everything.

“Our first and immediate concern should be to restore the credibility of MCI and to enable the council to function in a fair and objective manner and also to restore the confidence of all those involved in medical education in the country,” he said, adding that he had sought the opinion of the law ministry on the proceedings against Desai.

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Right, go ahead and close the stable doors after the horse has bolted, Honourable Minister.

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Presenting one of the rare occasions in which radiology features in the mainstream media…

[Image source: Afghanistan, April, 2010 - The Big Picture. The Boston Globe]

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The caption to this image (photo number 3 in The Boston Globe’s The Big Picture article Afghanistan, April, 2010) reads…

A CAT Scan shows the placement of a 14.5 millimeter high explosive incendiary round which was removed from the scalp of an Afghan National Army solder at the Craig Joint Theater Hospital, Bagram Airfield, Afghanistan, March 18, 2010. The injury was sustained during an improvised ordinance device attack. (AP Photo/Staff Sgt. Richard Williams, US Air Force)

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For the record, this is a scanogram that is done prior to a CT scan. The important point to note is that the “high explosive incendiary round which was removed from the scalp.” This would have done colossal damage if it had penetrated the skull and had exploded inside the cranium. It could have been fatal.

This is one incredibly lucky soldier. Masha’Allah, he will live to fight the Taliban another day.

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[Image - Screen grab from The Hindu's online article]

Note: The post title relates to this older post

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Update (24.04.2010, 2:45 PM):

This news article from The Economic Times gives more details about the sordid story…

NEW DELHI: In an important step towards cleaning up the corruption in the medical education sector, the Central Bureau of Investigation arrested Medical Council of India president Ketan Desai for allegedly demanding a bribe of Rs 2 crore to give clearance to a medical college in Punjab to start student admissions.

The Prime Minister’s Office sought details from the health ministry about the developments. Mr Desai, who has been associated with the MCI in different capacities since 1990, was arrested late on Thursday along with alleged middleman Jitendar Pal Singh, Gyan Sagar Medical College Vice-Chairman Sukhvinder Singh and a faculty member of the college Kamaljeet Singh. [Read the rest of the story here. Emphases are mine]

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This online news article from MyNews.in gives some startling details…

Chennai: The Central Bureau of Investigation (CBI) which has arrested Medical Council of India(MCI) President Dr Ketan Desai last night, has allegedly seized Rs 212 crore from his Ahmedabad residence.
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Sources close to CBI here said after the arrest, searches were going on in New Delhi and other places, and Ahmedabad. The CBI is believed to have seized cash running into several crore of rupees from a “locker” which Desai had been maintaining at a private Medical College in Ahmedabad. [Read the full story here. Emphases are mine]

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Echoing what my friend TBCD said on twitter earlier today, I cannot fathom how a person can have Rs.212 crore  in cash! (that’s 2.12 billion Indian rupees, roughly equivalent to about US $ 47.7 million)

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You know, I am hearing a lot about March Madness from my American friends on twitter and facebook. I am not knowing what that really means, but I am thinking it must have something to do with their healthcare reform bill which I am growing sick of hearing about. So I was thinking I will use this March Madness thing as a theme for this edition of SurgeXperiences. Since I am already telling you that I am not knowing anything about what this March Madness is about, I am going to let you guess how I am using it as my theme. *

My good friend Jeffrey, the Creator of this Wonderful Blog Carnival, who is doing subinternships (that sounded very much like submarine ships to me, hee hee, I am just joking) in Neurosurgery and Upper GI Surgery in Down Under, asked me by email to host this edition of SurgeXperiences on short notice just a few days ago. It seems the poor chap could not find anyone else to host. So I am telling him not to worry, because I am not doing anything this weekend, of course I am doing all the usual work stuff, but I am not doing anything important, so I will do the hosting for this week. He was so happy and relieved and thanking me so profusely that I am almost feeling bad for him. Let me be assuring you my good friend Jeffrey, that I am honoured and humbled that you found me worthy to do the needful.

Only after accepting I started getting some doubts about whether this would be possible. Especially because the wonderful blogging team from Down Under at Life in the Fast Lane lead by my very good friend Dr. Mike (alias sandnsurf in twitter) were doing such a fantastic job with the last episode that they were hosting. I would like to apologize to all the regulars for not calling out for submissions. I also would like to apologise in advance for not putting my hundred percent effort into making this a memorable edition, blaming the lack of time and my own inadequacies.

Now without further much ado and wastage of time, I would like to be presenting to you, dear readers, the best of blog posts related to surgery:

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The esteemed Professor Bruce Campbell, is giving an example of how the small things that some of us are doing routinely as doctors actually are turning out to be very big things in the lives of some of our patients.  I am not personally agreeing that Dr. Bruce is doing a small thing. He is taking time out from his busy schedule as a Professor in a University and going all the way to El Salvador in Central America to helping people who are less fortunate and are not having the proper medical facilities. That is very noble and I am thinking, very fulfilling.

“¡Muchas gracias Profesor!”

The good Dr. Bruce, his wife and their group are being inconvenienced by an airport delay caused by bad weather on their return journey back home. They are spending the time in the airport lounge chairs exchanging stories…

…the extra time in that airport offered me both the opportunity to hear some more stories and the possibility to be grateful for a bit more of the healing that is best experienced by, sometimes, just living in the present.

Dr. Bruce is also sharing some of his thinking on “What Every Medical Student Should Know …“

That they should never be satisfied with how much they know about either the science or the art of Medicine.

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The highly respected blogger and general surgeon from South Africa, my good friend bongi is realising the sad truth that you can’t win them all.

bongi is also sharing an exemplary story of a surgical registrar who performed dharmic duty as a righteous man and a surgeon. I am thinking  The Great Lord Krishna is shaking his head in approval from the high heaven above at someone who is following to the letter what he was expounding to the reluctant Arjuna in the first day of The Great Mahabaratha War in the Bhagavad Gita.

“To action alone hast thou a right and never at all to its fruits; let not the fruits of action be thy motive; neither let there be in thee any attachment to inaction” (Bhagavad Gita 2.47)

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One of the most beloved of surgical bloggers, my respected friend and elder sister Dr. Ramona, from Arkansas, is gigantic in stature, but is sometimes being forced to use standing stools in the Operation Theatre. I know some of you are thinking I am being guilty of exaggeration or generalization, but I am finding in my limited experience that most great surgeons, like great warriors, are short people. Emperor Napoleon was a short person, I am reminding my readers. One notable exception to my theory will be my great South African friend bongi, of course. He is tall like a giraffe in stature and status.

Dr. Ramona is also giving us a nice little funny poem about counting skin lesions. I am remembering my kindergarten days when my esteemed teachers were teaching me and my little friends, one two buckle my shoe!!

I am also reminding to everyone that Dr. Ramona will be hosting the GrandRounds Medical Blog Carnival in her blog this week. I am hoping all of you all are remembering to sending your submissions early by email.

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Expatriated South African anesthetist Viva Tiva (I am wondering why they are not using the terminology NRSAs, like to our NRIs, i.e., Non-Resident Indians) is writing in his (it could be her also, I am not knowing for sure) blog,

…never ever to underestimate the power of the midnight angels watching over us…

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Dr.J, from amchi Mumbai, is not going to be thinking about water balloons for sometimes.

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Dr. Joseph Sucher, a general surgeon and surgical critical care specialist from Texas, who was spending some time as a US Army FaST (Forward Surgical Team) surgeon in Afghanistan is telling us about A Few Good Men, NO, not the movie starring the great supreme star Jack Nicholson, but about two civilian surgeons who joined the US Marine Corps after their sons are enlisting to fighting the good fight.

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911Doc, one of the good doctors in the blogging team M.D.O.D, is writing about David Beckham (the football super star who was immortalised in Gurindher Chadha’s movie Bend It Like Beckham) and the Thompson test for diagnosing Achilles’ tendon rupture.

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My good friend, Øystein Horgmo, a medical photographer-cum-videographer in Norway, is giving us a first-class post about Jan van Rymsdyk, the Drawer of Wombs.

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The Distinguished Surgeon Dr. Jeffrey Parks is offering another gem fit for the Annals of Dumb Science. This is a study that is being published in the JACS that is attempting to solve the historically vexing surgical conundrum of whether double gloving has a negative impact on manual dexterity. I am agreeing 100% with my friend Jeff’s closing lines…

I realize these journals have to fill their content quotas every month but sometimes it gets a little ridiculous.

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Almost one a year ago till date, Steve Jobs was undergoing a liver transplant and that ended up creating a lot of hullaballoo in popular press and among my fellow medical blogger brothers and sisters. I was putting some of them on the record in a previous edition of this blog carnival that I had the honour of hosting. Here is a video of Mr. Jobs talking about his liver transplant and the need for everyone to joining the organ donors registry. His speech is occurring about 13 minutes after the video is beginning. I am thinking it will be worth your valuable time to see the video from the beginning to hear some excellent points made by the Governator Arnold Schwarzenegger.

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Dr. Peter Allely, another member of the Life in the Fast Lane team, is giving a good review of occult scaphoid fractures. I am wanting to place on record that unlike what he is alleging in his post, may be with his tongue in his cheek, I am not receiving any sexual or other favours for giving appointments for MRI scanning. That is possibly because our hospital is not having an MRI scanner. I am thinking it is high time I have to initiate a conversation in this regard with our beloved hospital management.

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Dr. Cris Cuthbertson, surgeon from Australia, PhD student, Mac lover and author of the blog Scalpel’s Edge is being blessed with a son. I am sure other surgical and medical bloggers will be joining me in wishing her and her family All The Best.

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*Explanatory Note: I had very few submissions in hand and I did not have time to go hunting for surgery-related posts. So I tried to liven things up a bit by trying my hand at writing in  authentic Indian style Queen’s English. Hope I didn’t overdo it. In my defense, and in the defense of my fellow countrymen, I’d like to remind Her Highness that English is as much our language as hers now. My blog friends know I don’t usually write in this kind of bombastic twisted prose. I assure any new comers that this post is an exception. My apologies to my friend Jeff for sounding patronising in the second paragraph and to my friend bongi for comparing him with a giraffe!

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There is no host yet for the next edition

SurgeXperiences 320

to be posted on April 4, 2010.

If you are interested in hosting, contact Jeffrey Leow

Deadline for submissions is on Friday, April 2.

Please send in your submissions early via this form.

You can subscribe to SurgeXperiences via RSS feed or email.

An aggregated feed of credible, rotating health and medicine blog carnivals is also available.

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