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First aid box, the missing factor in buses March 31, 2006

Posted by scan man in Life in India, Medicine, News.

andal_temple.jpgThis is an article by Mr. Karthik Madhavan that was published in the front page of the local edition of 'The Hindu' today. Though it tells the story in Erode district, I am quite sure that it would be true of any district in the country.

(at left is the 'gopuram' of the Srivilliputtur Andal Temple which is the Tamil Nadu Stage Government's emblem)



Cricket on Grand Rounds! March 28, 2006

Posted by scan man in Medicine, Misc.
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This week's edition of Grand Rounds is truly fantastic.

Dr. Crippen (NHS Blog Doctor) has done a phenomenal job.

He begins with a 'thumbnail sketch' of 'cricket, the finest sport in the world' which I think deserves to be recorded in the annals of cricket writing as the 'Zen of Test Match Cricket'.

You have two sides, one out in the field and one in. Each man that's in the side that's in goes out, and when he's out he comes in and the next man goes in until he's out. When they are all out, the side that's out comes in and the side that's been in goes out and tries to get those coming in, out. Sometimes you get men still in and not out.When a man goes out to go in, the men who are out try to get him out, and when he is out he goes in and the next man in goes out and goes in. There are two men called umpires who stay out all the time and they decide when the men who are in are out. When both sides have been in and all the men have been out, and both sides have been out twice after all the men have been in, including those who are not out, that is the end of the game.

Anyone who visits Grand Rounds this week will realize that Dr. Crippen must have spent hours on the design & production.

What is more striking to me is his understanding of the Game and his command over the language. I am willing to bet that he spent almost as much time composing that paragraph as he spent compiling Grand Rounds.

Words fail me in the presence of such prowess.

Do Riders In A Video Game Need Helmets? March 27, 2006

Posted by scan man in Life in India, Medicine.

Thanks to Abs* and Philip K. Dick** for inspiring the title of this post.Traffic in India

*Abs is a friend from the US who visited India for the first time a few months ago. When asked what she thought about the traffic on Indian roads, she exclaimed "Traffic!! What Traffic? Its like a Video Game!!"

**I may not have done a good job of titling my post in the style of the author Philip K. Dick ('Do Androids Dream of Electric Sheep?', the book on which the movie Blade Runner is based). I wish the subject was something as abstract as an android exploring the meaning of life.

As a radiologist who has worked for some years in a Tertiary Referral Hospital which specializes in Trauma Care, I have seen more than what I consider my share of head injuries caused by vehicular accidents [RTA-HI in our referral forms: Road Traffic Accident – Head Injury]. A large percentage of the victims who I scanned have been riders or passengers on motorized two-wheelers who might have escaped unhurt if they had worn helmets.

My 'share' would seem microscopic if compared with the number of RTA-HI's that occur in our country. Like anything else that deals with India and her multitudes, the numbers would be mind-boggling.

India has the second largest road network in the world with over 3 million km of roads of which 46% are paved. These roads carry an estimated 60% of freight and 80% of passengers and they make a vital contribution to India’s economy. The road traffic contains an incredible mix of pedestrians, animal drawn vehicles, bicycles, motorcycles, cars, buses and trucks. On the whole the facilities for the large number of non-motorised road users are poor and the 40 million vehicles using the roads have a terrible toll on human life, killing over 80,000 people with over one third of a million victims requiring hospital treatment. These crashes not only cause considerable suffering and hardship but they also have a major impact on the country’s economy, costing an estimated Rs 300 billion or more than 3% of India’s GDP every year. (source)

Today one person dies every 6 minutes on Indian roads; by 2020 the rate is expected to be more than 1 every 3 minutes. According to the India Injury Report 2005, Injury is the third cause of mortality in India. The financial cost of road traffic injuries in direct and indirect socio economic losses amounts to Rs. 55000 crore (550 billion) or 3% of GDP. Trauma victims occupy 10-30% of India’s hospital beds (WHO SEARO January 2001) and trauma care systems can be improved in many ways. (source)

Given the abysmal status of public health record-keeping in many parts of our country, I believe that the numbers may be even more than what has been stated above.4 on a scooter
Mandatory helmet usage for riders of motorized two-wheelers is included in the Indian Motor Vehicles Act of 1988. However, implementation of the law has been left to the states. Only a few states have even attempted to implement the law. 7 on a moped

As can be seen from the pictures alongside, the authorities cannot control the number of people that are allowed to ride on a two-wheeler designed to carry two people. Forget about getting them to wear helmets.

(I got these pics from here and here)

This disregard for personal safety is pervasive throughout the country without regard to factors such as literacy, socio-economic background, etc. As proof, I would have to present myself as Exhibit A.

I confess. My behaviour on the road is less than exemplary. In fact, I have no right to be writing this because I don't wear a helmet when I use my motorized scooter. In my defense I have to state that I use it only to travel between my house and the hospital which are less than a kilometer apart and I don't go beyond 30 km per hour.

I conducted an informal survey, the results of which are more telling. There are ten other doctors in my hospital who use motorized two-wheelers (mopeds, scooters or motor cycles) for short commutes between home and hospital. None of them – old or young, men or women – use helmets. There are about twenty others who come to work at our hospital on two-wheelers. None of them use helmets.

We are healthcare workers. Most of us care for patients with horrendous head injuries which probably would have been less severe if helmets had been used. We supposedly know the preventive value of helmets.

Medice, cura te ipsum! – Physician, heal thyself!

Here is the plain language summary of a scientific review titled 'Helmets for preventing injury in motorcycle riders'.


Helmets shown to reduce motorcyclist head injury and death.

Motorcyclists are at high risk in traffic crashes, particularly for head injury. A review of trials concluded that helmets reduce the risk of head injury by around 72%. The risk of death is also reduced, although it is not possible to estimate a percentage figure for this reduction from the available evidence. It is likely that the protective effect of the helmet may depend on other factors, such as speed. There is, so far, insufficient evidence to compare the effectiveness of different types of helmet. Some studies have suggested that helmets may protect against facial injury and that they have no effect on neck injury, but more research is required for a conclusive answer. The review supports the view that helmet use should be actively encouraged worldwide for rider safety.

Perhaps we Indians with our profound belief in fate and karma do not feel the need for such preventive measures.

And of course there are those who argue about the existence of traffic rules, Indian style, which are beyond the comprehension of people who adhere to the western concepts of traffic rules.


The rationale could be less complicated….

'If you believe you are in a video game, you don't need a helmet'.


Good Grief! I’m a cult member!! March 25, 2006

Posted by scan man in Apple & OSX, Computers, Mac.

I’m home for the weekend. I can access the net, what a relief 😮

This post is not related to medicine. It is about computers.
I saw Suresh’s post about Steve Jobs a few days ago. I wrote this the same night, but wasn’t able to post it. I read through the post and followed the link to read the original interview by Inc. Magazine.

While reading the interview, I found that I was nodding to myself, smiling and was mentally checking up the facts that I knew about Jobs & Apple.

My reactions were scary. The horrible realization dawned that whether I like it or not, I am now a member of the Cult of Mac.Good grief

Good Grief! It was a terrible blow to my self-image! I am not a fanatic or a zealot. I don’t like cults. The very word evokes disturbing images: Aum Shinrikyo, Branch Davidians, Ku Klux Klan, Tamil Tigers, Al Qaeda 😦

Believe me. I’m cultophobic [I made up that word 😉 ].

My tastes are catholic. I’m not a Mac fanatic. In fact I’ve only been using a Mac for about 20 months. I used Windows and Microsoft DOS for about 15 years before that. I’m a doctor, not a tech geek.

…all that, sadly, was Denial.

The more I thought about my behaviour since I switched, the more I realized that I had to face up to the truth.

In the cold light of logic (?) the evidence was damning:

  • I feel a smug sense of of superiority whenever I see someone using Windows – which is pretty much all the time since the number of Mac users in my work place is – wait for it, don’t faint – 2. (Yes. Two! I did not miss any digits).
  • The home page in my default browser (Safari, of course) is the Apple start page. That said, I never was a fan of Internet Explorer. I used Opera in my pre-switch days. These days I use Safari & Firefox equally.
  • I feel uncomfortable when I use a Windows machine.
  • Increasingly I find myself trying to lead others to the light. *Horror* I’ve become a Mac evangelist.
  • I love the feeling of being unique – I am the only doctor in town who uses Keynote for presentations.
  • I love the looks on my Windows-using friends (?) faces when I show them nifty little Mac tricks like Exposé, the Genie effect on minimizing, the Dashboard and Widgets, I could go on & on…Maclogo.jpg
  • I can’t won’t rationalize. I KNOW.
    • OS X is better than Windows.
    • Apple is better than Microsoft.
    • Jobs is greater than Gates.
  • Apple innovates, Microsoft imitates.
  • I check TUAW daily and follow all interesting links. Then I talk to Suresh about what I read – if you didn’t know or haven’t guessed by now, he’s the other Mac user here. Actually he’s the one who converted me. My Guru…
  • I religiously download all of Apple’s periodic software updates – and pity Windows users and the apparent lack of interest shown by MS in keeping its customers up to date.
  • I am all agog whenever there’s a rumour of an Apple Special Event – trying to guess what new goodies will be unveiled.
  • I have an iBook, and I also use an eMac and a Mac mini – all of them running on PowerPC chips & I’ve already started making plans scheming to upgrade them to Intel Macs – a Mac Mini Core Duo, an Intel iMac G5 and a Macbook Pro.
  • I have 2 iPods – a Shuffle & an iPod Photo – the only reason I didn’t get a Video iPod was because I’m not interested in podcasts or vidcasts.
  • I was overjoyed when my friend became an Apple Dealer – I can now get Dealer prices for Apple products.
  • I can’t understand how Suresh can stand using an IBM Thinkpad after having used a PowerBook.
  • I can’t believe that he has not fixed his crashed hard disk even after 5 months. Before anyone asks – Macs don’t crash. That was faulty hardware – Toshiba, I think.
  • I have an Apple sticker on my laptop bag.
  • I read the unofficial biography of Jobs – iCon.
  • I was impressed by the Stanford University Commencement Address by Jobs.macmania.jpg
  • I think comics like this & this are funny.
  • & I collect such geeky stuff as this palindromic phrase – “Campus motto: Bottoms up, Mac!” (attributed to Bill Bryson, who’s books I love)

I give up.

I admit.

I am a Mac Maniac.

Yes!! Mac Rules!!

no phones, no internet… March 24, 2006

Posted by scan man in Computers, internet.

Our phone lines have been down for 48 hours. The unlimited internet access that I had taken for granted was down too.

I feel disturbed, anxious, fidgety….

Are these withdrawal symptoms…

Am I becoming an internet junky? 😦

I’m posting this from the Computer Department in the hospital which has an emergency line working full-time. I came to check my email and sneaked this in 😉