SUTURE - KSCASIkscasicon2020.kscasi.com/pdf/eSOUVENIR KSCASICON 2020-4.pdf · 2020-02-20 · Dr....

KARNATAKA STATE ASSOCIATION OF SURGEONS OF INDIA

KSCASICON 2020 38th ANNUAL CONFERENCE

Hosted by:

SURGICAL SOCIETY OF BENGALURU

ASI City Branch,Bengaluru.

14Februaryto16February,2020

Hotel Sheraton Grand, Bengaluru

www.kscasi.com

SUTUREe -souvenir

BENGALURU

THEME

.Technology .Technique .Teamwork

BENGALURU

http://www.kscasi.com/

SUTURE

This conference we ensure, would be a great

platform of learning. The various topics covered

will take each one of us through the old and the

new, covering the basics to the most advanced in

surgical practice. The focus remains the safety

of the patient through appropriate technology

for safer technique by incorporating team work.

Looking forward for a great participation.

Warm regards from the Souvenir

Committee.

Editorial ......Dear colleagues and Friends,

We welcome you all for the 38th Annual

conference of KSC-ASI. We are extremely

delighted to present to you the souvenir of the

conference.

This souvenir has been meticulously designed

and we have aptly named it Suture. This is a

No.1 absorbable suture that has been used to

anastomose the various layers of the thoughts

and ideas to create a perfect continuity of the

flow of knowledge through the lumen of

KSCASICON.

It incorporates various articles from very

knowledgeable and reputed names in KSCASI .

It is being prepared with a blend of topics to suit

the taste of vast number of readers, both

medical and other fields. We are hopeful that

this would be shared by each one of us so that

the efforts of preparing this memorabilia do not go

wasted .

Dedicated to the Scalpel...

that cuts to heal,

and...the Suture,

that sew to seal!!!

Dear Friends & Colleagues,

It is indeed a great pleasure to welcome you

all to the 38th Annual Conference of

Karnataka State Chapter of Association

Surgeons of India- KSCASICON 2020 to be

held at Hotel Sheraton Grand, Bangalore,

from 14th- 16th February 2020.

Bangalore today is a bustling metropolitan &

IT Hub City. It is the garden city of India and

evolved into Silicon Valley of India. It is the 3rd

largest city and loved for its pleasant weather,

beautiful parks and lakes all around the town.

It is renowned for its eateries, rooftop cafes &

night life.

I hope, all of you will find this conference

fruitful and enjoyable.

We, the members of Organizing committee

have made every effort to make you all

comfortable, as honored guests.

I take this opportunity to thank all my

colleagues in the Organizing committee for

their sincere efforts to make KSCASICON

2020 a grand success.

I would like to thank the sponsors/partners and

well wishers for their support.

Should there be lapses, please bear with me.

Organizing committee has put all the efforts to

give you best scientific program, atmosphere to

socialize with colleagues & enjoy our

hospitality in the conference.

Souvenir committee has put in lots of efforts to

design, the E-Souvenir with many interesting

articles by medical and general as well as

speciality designed programs.

The Theme of the Conference is “Technology,

Technique and Team work“ which is relevant in

the present scenario. This is an opportunity to

learn the recent advances in the Technology &

Technique for the benefit of the patients. The

Scientific Program which has been drawn

meticulously, includes 'CME, Orations,

Symposia, Guest Lectures, Free papers and

Video E Presentations.

Dr Uday M Muddebihal

Organizing Chairman

KSCASICON 2020

CHAIRMAN'S DESK

"A true dreamer is one who knows how to navigate in

the dark". Having serially dreamt to organize

KSCASICON 2020 amidst the best team of

Intellectual colleagues with a theme of TECHNIQUE,

TECHNOLOGY & TEAM WORK, convincing the

Team that "Old ways won't open new doors" was a

success.

The stage for KSCASICON 2020 was thus set under

the umbrella of an incredible venue SHERATON

GRAND at Brigade Gateway in Namma Bengaluru.

Having an ever supportive Organizing Chairman

leading the way, was like a pair of wings getting sewn

onto us and with such big mentors to advice

periodically was a Grace.

The journey of planning and executing this

conference was impeccable and was enjoyed.

It took a lot on Everyone's part but WE DID IT

TOGETHER!

In a climate of tight budgets, reduced workforces and

stiff competition, the entire team of the Organizing

Committee have worked relentlessly to ensure you all

an incredible hospitality engulfed by the innovative

academics, carefully designed and crafted food menu

to make your palate dance over the two and half days

which shall be filled with Excitement, Enthrallment

and Entertainment during evenings over a

magnificent Cultural Evenings with a nostalgic feel.

This conference shall give you all a fragrance of style

that Namma Bengaluru can offer you to cherish in

every possible ways. I'm sure you will carry home

those unforgettable moments and memories to

treasure.

In this KSCASICON 2020 at Bengaluru, we have

lead the scene and kept it Green. We have thought

Green and gone Green to support the environment.

I on behalf of the Organizing committee WELCOME

you all to join this initiative of NO PAPER, NO

PLASTIC during this conference. Welcome to the

Green Team!

Namma Bengaluru has a lot to give and more to

offer. Come and enjoy our hospitality.

Welcome to an "Celestial Academic Experience" at

KSCASICON 2020 in NAMMA BENGALURU!!

Dr Aravind Gubbi

Organizing Secretary

KSCASICON 2020

Happy to be in “Namma

Bengaluru!”

At the very outset, I commend the Organising

Committee very ably led by Dr. Uday Muddebehal

,Dr. Aravind Gubbi, Dr. Seshagiri Rao & the

‘DYNAMIC TEAM Karnataka’ for their tireless

efforts in making the 38th Annual Conference of

Karnataka State Chapter of ASI being held in

“Namma Bengaluru” a huge success.

I also extend my very best wishes to

Dr. Nanda Rajaneesh & everyone involved

in the making of the Souvenir.

Needless to state, a lot of attention to detail has

gone into planning the academic content of the

Conference & I am confident that the crisp

Scientific Programme would undoubtedly attract a

record number of delegates & trainees from all

over Karnataka and beyond.

My aim during the year would be to ensure

“CREATIVE LEADERSHIP & ACCOUNTABLE

GOVERNANCE”.

Surgical trainees of today are the future of ASI.

My focus therefore would be to implement

innovative initiatives to make them better Surgeons

with a humane touch.

Look forward very much to participatingat KSCASICON 2020.

Dr P Raghu Ram

President,

The Association of Surgeons of India

A number of c ourses for surgical trainees have already

been introduced this year across the Country & are

displayed prominently on ASI Website

(www.asiindia.org). I request members to please bring

these Courses to the attention of your trainees.

Dear colleagues and friends,

The 38th Annual conference is being hosted

at the Silicon city, Bengaluru. It is our

pleasure to invite each one of you to be a

part of this prestigious event.

A conference is an opportunity created for

learning and sharing knowledge and to

meet old and new friends. The focus of this

conference is on technique, technology and

team work which are the basic pillars of

success in surgery. The organisers have left

no stone unturned to make this event

successful. I applaud the whole organising

team led by Dr. Uday Muddebihal,

Dr. Aravind Gubbi and Dr. Sheshagiri Rao

for organising this event so successfully.

The conference is organised at Sheraton

Hotel and one can be assured of the

ambience and comfort at the venue. The

main success of the conference lies in the

strength of the participants. It is my

humble request to all the members to

participate in large numbers and make this

event successful.

I also take this opportunity to congratulate t

the organisers and pray for a successful

conference.

Warm regards Dr Vidyadhar Kinhal

Chairman

KSC - ASI

Dear Colleagues and Friends,

I, wholeheartedly welcome all the delegates and

faculty for the great conference being held at

Namma Bengaluru. It is our proud privilege to

host this great academic event. We have planned

scrupulously every part of the conference i.e.

selecting the venue with pleasing ambience,

audio-visuals and the scientific material.

The theme of the conference being “Technique,

Technology and Team work”, aims to keep up the

standards of the conference and to be up to date

in all academics.

The scientific material is meticulously

segregated based on the theme and system wise.

With the rise in violence and litigation on

doctors, we thought it would be ideal to discuss

on appropriate documentation and also on the

medicolegal implications on the same.

I request each one of you to make the fullest use

of the academic feast, either by gaining or by

disseminating knowledge and have an excellent

take home message and cherish every moment

spent at Bengaluru.

Dr Kalaivani V

President

Surgical Society of Bengaluru

My Namaskara to all.

It is matter of great pleasure and privilege for

me to write this message. I am extremely

delighted that Surgical Society of Bangalore is

hosting the 38th Annual Conference of

KSCASI.

A Lot of attention has gone in to planning the

academics of the conference with a stress to

harness and nurture the local talent. Focus is on

“Technology, Technique and Team work”.

Academic content has been arranged in an

attractive theme - based concept, which is all set

to establish a benchmark for the future.This

conference plans for deliberations with an intent

on learning new things in the light of what has

already been known with insight in to team

work.

For the first time conference is being held at a

five star hotel. So come, bring your family, and

have a nice time.

I wish all the best to the organizing team and

to all the delegates.

With best wishes & warmest personal regards.

Dr Gaddi Diwakar

Honorary Secretary

KSC - ASI

KSCASICON 2020

Dr. Agadi B M Dr. Shekar K S

CHIEF PATRONS

PATRONS

Dr. Ashok Kumar K V Dr. Nanda Kumar Jairam

Dr. Challani C RDr. D Somashekaraiah Dr. Vasudeva Rao U

Dr. M G Bhat

KSCASICON 2020ORGANISING COMMITTEE

Dr. Uday MuddebehalOrganising Chairman

Dr. Aravind GubbiOrganising Secretary

Dr. R MuralidharCo. Organising Secretary

Dr. K Seshagiri RaoTreasurer

Dr. Shivaram H VCo. Chairman

Dr. K Sampath KumarCo. Treasurer

Dr. Sreevathsa M RVice Chairman

Dr. Ramesh M KCo. Chairman

Dr. Kalaivani VVice Chairman

Dr. Rajan C SChairman,

Scientific Committee

Dr. Rajashekhara Reddy HVJt. Secretary

KSCASICON 2020OFFICE BEARERS

Dr. Vidyadhar KinhalChairman

Dr. Diwakar GaddiSecretary

Dr. Jaspal Singh TehaliaTreasurer

Dr. Sadashivayya SoppimathChairman Elect

National EC Members

Dr. H V Shivaram

Dr. Siddesh G

Dr. Ashok S Godhi

Dr. Rajgopal Shenoy

Ex-Officio

Dr. Dayanand Nooli

Dr. Narayan Hebsur

Co-Opted Member

Dr. Naaz Jahan Shaikh

EC Members

Dr. Dinesh H N

Dr. Rajshekhar Patil

Dr. Anilkumar Bellad

Dr. Prashanth S Murthy

Dr. Madhusudhana Karignuru

Dr. Aruna K Rao

Dr. Gurushanthappa Y

Dr. Hanumanthaiah K S

Dr. Sarvesha Raje Urs

State Scientific Committee

Dr. S S Soppimath - Chairman

Dr. G Siddesh

Dr. Aravind Patel

Dr. Ashok S Godhi

Dr. Dayanand Nooli

Dr. K Lakshman

Dr. Vidyadhar Kinhal

Dr. Gurushanthappa Y

KSCASICON 2020ORGANISING COMMITTEE

CHIEF ADVISORS

Dr. Anjanappa T H

Dr. GN Prabhakara

Dr. Ramadev K

Dr. Durganna T

Dr. Jaganmaya K

Dr. Vijaya Kumar M

ADVISORS

Dr. Rajashekar Nayak

Dr. Jayashankar M

Dr. Ramesh Reddy N

Dr. Shabber Zaveri

Dr. Somashekhar SP

Dr. Venkatesh Reddy K

Dr. Bagali Baba Saheb

Dr. Srikanth V Kulkarni

Dr. Rajeeva Shetty B

Dr. Sendhil Rajan

Dr. Rohit Krishnappa

Dr. Niranjana KP

Dr. Nagaraj Palankar

Dr. RajakumarNaik G

Dr. Dinesh Kumar GR

Dr. Basavaraj KM

Dr. Ganesh Shenoy K

Gp Capt (Dr) R Gangavatiker

Dr. Harindranath HR

Dr. Satish N

Dr. Srikanth Jagirdhar

Dr. Yella Reddy C

Dr. Shiva Kumar K

Dr. Giridhar BS

Dr. Deepak S Rohidekar

Dr. Hariprasad TR

Dr. Janardhan KC

Dr. Kamarshi Prasad

Dr. Murali Lingam

Dr. Pratap Balakrishna

Dr. Ravindranath GN

Dr. Raghunandan BV

Dr. Shiva Kumar HN

Dr. Sathya Krishna BR

Dr. Narayan Swamy Chetty

Dr. Prakash Annapur

Dr. Chandrashekhar Rai

Dr. Raju G H

Dr. Nagaraj A L

Dr. Rajiv Premnath

Dr. Sreedhara A M

Dr. Srikanth K Aithal

Dr. Venkatesh Vikram H C

Dr. Arjun Sampath Kumar

Dr. Ramanan V

Dr. Abdul Razack

Dr. Akhil Krishnanand Bhat

Dr. Sunil Kumar B Alur

Dr. Naghabhushan J S

Dr. Hemanth S Ghalige

Dr. S B Belani

Dr.Prabhakaran P S

Dr. Somasekharaiah D

Dr. Dattu Rao H

Dr. Srinivasa Murthy B G

Dr. Ramachandra C

Dr. Bhagvan B C

Dr. Nagesh N S

Dr. Satish Kumar R

Dr. Rudresh H K

Brig (Dr) Rajagopalan S

Dr. Ramesh BS

Dr. Subramanyam S G

Dr. Arun Kumar N

Dr. Sudarshan P

Dr. Ashok V Kulkarni

Dr. Ramesh Reddy G

Gp. Capt (Dr) Anil Kumar

Dr. Ravi Arjunan

Dr. Ramesh S

Dr. Lakkanna S

Dr. Sumit Talwar

Dr. Ashish R Shah

Dr. Ravishankar Bhat

Dr. Govind Nandakumar

Dr. Ravishankar H R

Dr. Anil Kumar N

Dr. Madan Mariyappa

: Kempegowda Institute of Medical Sciences

: BMCRI Dept of SGE, Victoria Hospital

: Kempegowda Institute of Medical Sciences

: M S Ramaiah Medical College Hospital

: Raja Rajeshwari Medical College

: Dr BR Ambedkar Medical College

: St Johns Medical College

: St Marthas Hospital

: MVJ Medical College

: Oxford Medical College

: Vydehi Institute of Medical Sciences

: Command Hospital

: Kidwai Memorial Institute of Oncology

: Indira Gandhi Institute of Child Health

: ESI Corporation Medical College

: Manipal Hospitals

: Fortis Hospitals

: Apollo Hospitals

: Columbia Asia Hospitals

: Sagar Hospitals

: Bangalore Baptist Hospital

: BGS GIMS

ADVISORS (HEADS OF MEDICAL COLLEGE & HOSPITALS)

Dr. Venkatesh Rao P S

Dr. Munireddy M

Dr. Ramesh M

Dr. Ashok Nayak K

Dr. Kulkarni MR

Dr. Sridhar M S

Dr. Manohar T M

Dr. Prakash B R

SCIENTIFIC COMMITTEE

Dr. Lakshman K

(Co-Chairman)

Dr. Rajan C S

(Chairman)

MEMBERS

Dr. Manish Joshi

Dr. Govind Nandakumar

Dr. Vinay Bhat

Dr. Prem Kumar A

Dr. LN Mohan

Dr.Rajan CS

(Chairman)

MEMBERS

Dr. Arun Kumar N

Dr. Shabnam Bashir

Dr. Sreekar Pai A

Dr. Niranjan P

Dr. Sunil Kumar VDr. Rajeev Lochan

(Co-Chairman)

CME COMMITTEE

MEMBERS

Dr. Manjunath B D

Dr. Hosni Mubarak Khan

Dr. Mahesha Chikkachannappa

Dr. Srikanth K N

Dr. Hanumanthaiah K S

(Chairman)

Dr. Rajashekhar C Jaka

(Co-Chairman)

RECEPTION,

REGISTRATION &

HOSPITALITY

COMMITTEE

MEMBERS


Dr. Anupama Pujar

Dr. Nagaraj Puttaswamy

Dr. Munireddy MV

Dr. Nischal Krishnappa

Dr. Nanda Rajaneesh

(Chairman)

Dr. Naaz Jahan Shaikh

(Co-Chairman)

SOUVENIR

COMMITTEE

KSCASICON 2020 ORGANISING COMMITTEE

Dr. Shivaram H V Dr Santhosh K

CATERING COMMITTEE

Dr. Arjun Anjanappa

(Co-Chairman)

Dr. Prashanth S Murthy

(Chairman )

MEMBERS

Dr. Priyadarshan Krishnamurthy

Dr. Amit Gaur

Dr. Prashanth C A

Dr. Vikram S

MEMBERS

Dr. Sai Kalyan

Dr. Sharath Kumar JG

Dr. Harisha Nindasale S

Dr.Monika Pansari

Dr. Ventakachala K

(Chairman)

Dr. Anand Kumar J

(Co-Chairman)

TRADE &

EXAHIBITION

COMMITTEE

MEMBERS

Dr. Sachin D Nale

Dr. Nivedita Mitta

Dr. Shruthi Rai

Dr. Vinay Gunashekhar

Dr. Anil B Agadi

(Chairman)

Dr. Wasim M Dar

(Co-Chairman)

ENTERTAINMENT &

CULTURAL

COMMITTEE

MEMBERS

Dr. Vijaylakshmi GN

Dr. Sangeetha

Dr. Bharathi V

Dr. Moksha Gowda

Dr. Usha Rani

(Chairman) LADIES COMMITTEE

MEMBERS

Dr. Pandu Dasappa

Dr. Subhash RC

Dr. Amit Kumar Jain

Dr. Ravindra G

Dr. Mallikarjun M N

(Chairman)

Dr. Sajeet Nayar

(Co-Chairman)

ACCOMODATION &

TRAVEL COMMITTEE


(Chairman) CONFERENCEPROMOTION

& DIGITAL MARKETING

MOTIVATION

Dr K LakshmanBengaluru

All of us talk about the need for motivation to

achieve our goals. When we are young, we

struggle to get the motivation to do things.

Probably, the young do not even know what it

is! When we are older and become leaders, we

crib about our juniors lacking motivation! But

do we really know what motivation means? Do

we know how to motivate people to do better?

Management gurus and psychologists have gone

into this aspect in depth. Having struggled with

the subject myself all my life, I can honestly

say that there are no magic formulae for either

motivating yourself or others! But we can try

and understand some basic principles governing

motivation, and this is what I am putting

forward here.

One of the definitions of Motivation goes

like this:

Motivation is the word derived from the word

'motive' which means needs, desires, wants or

drives within the individuals. It is the process of

stimulating people to actions to accomplish their

goals.

ARTICLES…

(From https://www.managementstudyguide.com>

what_is_motivation)

All of us know about the famous Maslow‘s

Hierarchy of needs:

Once the basic needs of food, clothing and

shelter are met, we move on and work towards

personal safety and health issues. Once this

need is met we get motivated to achieve

‘higher’ goals like esteem, respect and self-

actualization -being the best you can be.

This is good theoretical psychology. But how do

we understand and internalise this ourselves and

get others to do the same? I put forward a few

basic principles that might help us in this

direction.

1.Motivation has to come from within - You

have to think about your goals and how you

plan to reach them; do not let negative

comments from others stop you from your

attempt.

2. Get out of the comfort zone - we all get

into a groove and hesitate to explore. Without

change, there is no progress. Pull yourself out

of grooves.

(From https://www.simplypsychology.org/maslow.html)

SOUVENIR KSCASICON 2020

https://www.managementstudyguide.com/

3. Desire has to be matched with dedication and

discipline - we want many nice things in life.

We set ambitious goals. But we forget that this

needs a lot of hard work and discipline!

4.The timeline may not match our expectations -

we not only want nice things but want them

fast! It takes time to achieve success. Be patient.

Take the first step - the goal may be distant; the

path may be strewn with hardship. But take the

decisive first step. The rest will follow.

5. Failure is a part of life - Never stop trying

new things because of fear of failure.

Failure is but a stepping stone to success.

Remember, you learn a lot more from failure

than from success.

There are two fundamental truths which are

strong motivating factors. We are all born to

make the world a better place before we

depart.

And, as the Dalai Lama says,

"Love & compassion are necessities, not

luxuries. Without them,humanity cannot

survive.“If you want others to be happy,

practice compassion. If you want to be

happy, practice compassion.”

Incidentally, compassion means “ If

someone shows kindness, caring, and a

willingness to help others, they're showing

compassion.

This is a word for a very positive emotion that

has to do with being thoughtful and decent.

Giving to a charity takes compassion.

Volunteering to work with sick people or

animals takes compassion ” (From

https://www.vocabulary.com/dictionary/

compassion? f am ily=Compassion).

Friends, let us all motivate ourselves to try and

leave behind a better world than the one we

came into.


https://www.vocabulary.com/dictionary/

THE HUMBLE SCALPEL

Dr Naaz Jahan ShaikhHosapete

Surgeon has a power so very unique

He cuts and heals with a magical mystique.

His power is doubled with a scalpel in hand.

The decision to operate comes with

experience we understand.

The surgical knife has a history

interesting indeed ..

Evolving from shells, leaves, bamboos,

fingernails and shark teeth.

The Neolithic cutting edges made of flint, jade

and obsidian

Could incise precisely, including the skin and

the bone.

Metal slowly replaced the rock and stone

Efficiency improved with copper, bronze

and iron

Hippocrates named it Macairion,

And,the Romans called it Scalpellus.

Varieties emerged in its make and design

From double edged (catlins), to fixed or

foldin’.

Ambroise Pare and Chaulic preferred it very

ornamental.

But carbolic acid and heat to these were

detrimental.

Then came the era of disposable blade

with a handle resusable

Gillette with their safety razors became,

instantly sensational.

When blade exchange & fixing was irksome

Bard and Parker’s design was indeed awesome.

Studs replaced the ribs for a better blade hold

Stain less steel handle could now withstand

the heat and cold.

With new arrivals they had a hashtag(#) and

a number

But, they had no major features that we

had to remember.

The cutting edge was made more sharper and

stronger

With addition of zirconium, diamond and

a coating of polymer.

But evidence today confirms the fact

Neolithic obsidian blades had a sharper

impact.

Technology has added many a shade

Even, current passing can induce a heated

blade.

A high frequency vibration can cut and

coagulate

And, the cyberknife can precisely incise and

modulate.

To all those who hold a scalpel in the hand

one thing we must never fail to understand

A scar we create both,on the site and mindCut only if necessary, and never forget to be

very very kind!!


8000B.C.

Flint Knives used in Middle Stone

Age to cut through skulls

3000B.C.

Obsidian Knives found in a

Turkish Settlement suggest

Early Brain Surgery

260B.C.

Roman Medicine refers to "Scalpellus"

and Utilises Many Surgical Instruments

1600's

Scalpels are produced by Cutlery

houses with little/ no sterilisation

1905

King Gillette's Safety Razor inspires

the idea for a reusable Scalpel

1915

The Modern two-piece Scalpel is

patented by Morgan Parker.

The Bard-Parker Company Develops

the cold sterilization method

1930/40

Stainless steel becomes the p rimary

material for Scalpel.

TODAY

Traditional Scalpels are still preferred

by surgeons though newer methods of

cutting are introduced


Destiny….

Thy name is

Surgery?

It was the year 1982, in the month of June, on a

Friday evening when I was doing my internship

at KR Hospital attached to Mysore Medical

College. I had my posting at paediatric

department under Prof Anke Gowda at

Cheluvamba Block. There was an anemic child

in the ward and I was to get a bottle of blood

from the blood bank which was situated behind

the Pathology Block.

Between these two blocks there was a large

vacant space with grass and in the corner there

used to be a kitchen where food used to be

cooked for the patients. Those were the days

when all the menial work used to be the

responsibility of the poor “house Surgeon”! I

went to the blood bank, collected the bottle of

blood and started walking towards Cheluvamba

block to go to the pediatric ward. I was in a hurry

and looked at the watch- it was 6 o’clock in the

evening. I was thinking that my white coat

which I was wearing since a week needed a

wash on the weekend.

All of a sudden, a horse which was grazing in

the vacant space started chasing me! I

wasshell shocked and took to my heels to save

myself and the blood I was holding in my right

hand. To escape from the horse attack I had to

enter inside the building. I ran towards

Cheluvamba block with all my youthful

strength & energy. But I was not lucky!

The horse was faster than me (naturally)! Just

before I could enter Cheluvamba block, it caught

hold of my right lower arm near the elbow with

its mouth and started dragging me to the field.

Imagine the scenario - me holding the precious

blood bottle in my right hand and the horse

trying to trample me. I quickly realized that if I

fall down I am finished. In the spirit of the

moment I gathered all my energy and pushed the

horse in the opposite direction holding it’s right

fore leg. The only thing in my mind was that I

should not fall and the blood bottle should not

be broken. It was a fight between me and the

horse wherein the horse was trying to push me

down and I was defending myself pushing the

horse all the way back which was now standing

on its hind legs. The pain in my arm was now

unbearable and my hand was becoming numb

and blue! By this time a large onlooker crowd

had gathered around and there was a huge

commotion. Many of them threw stones at the

horse but the horse was not leaving me.

Dr Shivaram H VBengaluru

“Destiny is a name often given in retrospect to

choices that had dramatic consequences”

- J K Rowling


I was told it was a pathetic scene to watch. The

scenario was like the one from the famous Hindi

movie Satte Pe Satta where the hero fights with a

horse, lifting both its fore legs. The entire time

the horse, standing on its hind legs was trying to

push me and I was holding its fore leg, trying to

push it back.

The one thing in my favour was that it was a

slightly weaker & older horse and did not have

full horse power in it (so to speak)! I was

shouting for help. The crowd pelting stones on

the horse did not know what else to do. In the

bargain I also received some stones! By all

means it was a helpless situation. By this time I

had gently dropped the blood bottle on the grass

and someone took it to the pediatric ward.

Finally it was the presence of mind of an

illiterate cook in the neighboring kitchen which

saved the day. He brought a long kitchen knife

from his kitchen armamentarium and shoved it

into the horse’s anus from behind.

The horse felt severe pain and it opened its jaws

instantly releasing my damaged & crushed arm.

By that time I was totally exhausted. I happened

to glance at my watch and it was

6.20 PM and that’s all I remembered. I fell

unconscious the next second, and my friends and

fellow doctors who were helplessly watching

immediately took me to the emergency

department which used to be called as

“Casualty”. I was resuscitated there. My right

hand was numb and bluish. When I gained some

consciousness I overheard the surgical resident on

call discussing over phone with his boss - “sir

there is an intern with a bad crush injury of the

right arm due to a horse bite...brachial artery is

damaged...he needs above elbow amputation”

I was shell shocked! I looked at my right hand

again and again. I was unable to move it. It was

bluish and had no sensation. A dressing was

decorating my crushed arm.

Within no time I was shifted to the operation

theatre in the stone building. My only hope was

that it was the call duty day of Prof CB Murthy’s

unit and he may do his best to save my limb. He

was the best surgeon of that time in Mysore and

we all respected him very much. He graciously

came to the OT for this poor intern’s emergency

surgery. His plan was to explore the arm under

general anesthesia and check before taking it up

for amputation. There was no CT scan or

Doppler during those days for pre-operative

assessment.


I was told later that on exploration Prof CB

Murthy found that the brachial artery had

escaped the teeth bite injury of the horse

by a millimeter or so and it had gone into severe

spasm due to crush injury. There were deep bite

marks on the humerus bone! Prof Murthy wanted

to do everything possible to save the limb and

he was not in a hurry. He tried vasodilator

solution papavarine (how lucky I was –it was

readily available in the OT!) and waited for

some time. A miracle occurred again for the

second time (the first miracle came in the form

of the cook).

Gradually the brachial artery spasm was

relieved and the colour of the cyanosed hand

improved. Everyone in the OT heaved a sigh of

relief. When I gained my consciousness I was

pleasantly surprised that my right hand was

alive and pink. Was it destined to do some

surgeries in the future? None knew at that point

of time.Not even me.

It was such a strange and bizarre incident that it

became big news the next morning. Most of the

local newspapers carried the news on the front

page –“Mad Horse bites the Doc” was the

headline. There was a hot discussion in most of

the newspapers (thankfully there were no loud

TV news channels those days) that there is no

security in the hospital premises and the medical

superintendent was taken to task.

This newspaper coverage gave me a strange

kind of publicity and the public started pouring

in to see me in the ward. Suddenly I had become

a hero who had fought with a horse and

survived.

The students of Mysore medical College were

agitated and they went on strike asking for

proper security in the hospital premises. The

administration promptly erected cattle traps in

all the gates and also decided to post some

security personnel.

I was in the hospital for a fortnight recovering from

my injuries and receiving physiotherapy etc.

The worst part was to receive 14 injections of

those Anti Rabies Vaccine on the abdominal wall!

Luckily I recovered and my hand became fully

functional. And the rest, as they say, is history!


A “C S TRIBUTE” TO OUR

ANAESTHESIOLOGISTS

Dr C S RajanBengaluru

All of us Surgeons, owe a huge debt to our

Anesthesiology Colleagues, who work silently to

ensure the patients on whom we operate, are in a pain

free zone of safety, during the operation.

I have used the letters of my initials, C & S, to give 10

simple lines of Tribute to all our Anesthesiologists.

Competent and Sincere is their basic nature,

Caring and Selective to the patient's well being.

Cautious and Systematic approach to ensure

safe procedure.

Checking and Securing all equipment and drugs

before the procedure.

Correct and Steady induction to begin the case, and

Complete and Sleep maintained to allow surgery

to be performed, with

Clever and Skilful recovery on completion of

operation.

Chatty or Silent depending on case flow,

they are the

Classy of Successful component of

operative health care, while being the

Companion to the Surgeon par excellence.


Sushruta; Pride of India, Pride of a

Surgeon

Dr Kalaivani VBengaluru

Sushruta was a great physician of ancient India. He

is known today as the “Father of Indian Medicine”

& “Father of Plastic surgery” for inventing and

developing several surgical procedures. Sushrutha

Samhita is considered as the oldest text in the world

on plastic surgery. Sushrutha standardized medical

knowledge through careful descriptions of how a

physician should practice the art as well as specific

procedures including performing reconstructive

plastic surgery & cataract surgery.

Sushruta is dated back to 7th or 6th centuries BCE,

and very little is known about his life. Even his

birth name is unknown as “Sushruta” is an epithet

meaning “renowned”(1). It is believed that he

practiced medicine in Northern India around the

region of modern day Varanasi, by the banks of

River Ganga.(1)

The practice of surgery was well established in India

during his time and invented the practice of cosmetic

surgery. He performed rhinoplasty as rhinectomy

(amputation of the nose) was a form of punishment

for men & women. During his time the surgery was

performed after getting the patient drunk and

unconscious. He has used a pedicle graft from the

cheek for reconstruction. He was well aware of the

concept of anaesthesia and sterilization.

Sushruta attracted many disciples and they were

called “Saushrutas” who were required to study for

six years even before hands on training. They began

their studies by taking an oath to devote themselves

to healing and to do no harm to others. They were

instructed to practice cutting on vegetables or dead

animals to perfect the length and depth of the

incision. The dead bodies were kept in a cage and

were placed in cold water (running river or stream),

and as it gets decomposed the different anatomical

structures were learnt.

Sushruta wrote “Sushruta Samhita” as an instruction

manual for physicians to treat their patients

holistically where he describes the ideal medical

practitioner, focusing on a nurse in this way(1).

“That person alone is fit to nurse, or to attend the

bedside of a patient, who is cool-headed and pleasant

in his demeanour, does not speak ill of anyone, is

strong and attentive to the requirements of the sick,

and strictly and indefatigably follows the instructions

of the physician. (I.34)”

Sushrutha was aware of the concept of disease

caused by genetic factors, environmental factors and

that due to unhealthy lifestyle. A person’s diet was

considered of vital importance in maintaining health.

He recognized that optimal health could only be

achieved through a harmony of the mind and body,

and this state could be maintained through proper

nutrition, exercise and rational uplifting thoughts.


Sushruta considered surgery as the highest mode

of treatment in medicine because it could produce

the most positive results more quickly than other

methods of treatment.

The statue of Maharishi Sushruta at The Royal

Australia College of Surgeons (RCAS), has been

on display since early June 2018. It is installed

in the skills lab area and is a true work of art.(2)

A statue of Surgeon Sushrutha in the Royal

Australia College of Surgeons, Melbourne

The definition of an ideal surgeon according to the

great surgeon Sushruta is “A person who possesses

courage and presence of mind, a hand free from

perspiration, tremorless grip of sharp and good

instruments and who carries his operations to

the success and advantage of his patient who has

entrusted his life to the surgeon. The surgeon

should respect this absolute surrender and treat

his patient as his own son.”(3)

He developed surgical techniques and thus founded the

practice known as “Salya-tantra” or “Surgical Practice”.

References:

1.Sushrutha: by Joshua.J.Mark

2.Maharishi Sushrutha, a surgeon famous in

Melbourne: by Hindu Council Of Australia

3.Know all about Sushruta, the first ever plastic

surgeon who was Indian: by India Today Web desk

4.Singh V. Sushruta: The father of surgery. National

journal of maxillofacial surgery. 2017 Jan; 8(1):1.

The “Sushruta Samhita” devotes several chapters to

surgical techniques, listing over 300 surgical procedures

which includes ,cessarian sections ,rhinoplasty ,cataract

surgery etc and 120 surgical instruments in addition to

the 1120 diseases, injuries and their treatments and over

700 medicinal herbs and their application, taste and

efficacy.


Art of Scientific Writing

Dr Somashekhar S P

Bengaluru

Scientific writing is an essential component of

medical research as it determines the success or

failure of a trial. Scientific writing is the process

of the development of publications that deal

precisely with medicine or healthcare (Sharma,

2010).

Publishing of the medical outcomes are

important to communicate research findings.

Writing a scientific publication is a challenging

procedure that the surgeons may lack to report

(Quinn and Rush, 2009; Hoogenboom and

Manske, 2012). The skills of a surgeon as a

scientific writer should be advanced. Writing

and getting published the research findings is an

interesting and gratifying process of continuous

learning and improvement. Publishing a research

finding in a good scientific journal requires

strong background of science and an effective

strategy that includes generation of ideas and

their implementation. The period for becoming

a skillful scientific writer is generally long and

needs conscious self-learning (Sharma, 2010;

Balakumar et al., 2013).

Lack of proficiency in scientific writing skills

results in confusing conclusions leading the

scientific manuscripts to data dumps. Lack of

originality and presentation of obsolete result

are the main reason for rejection of scientific

manuscript (Ali, 2010). The preparation of

medical research manuscript is often taken

lightly and it leads to several problems such as

multiple rejections from scientific journals

(Dhammi and Rehan-Ul-Haq, 2018). Lack of

attention and failure to follow to the field of

the manuscript leads to rejection. Generally,

insertion of voluminous text in a manuscripts

walk away from the objective, mentioning to

details that are not within the scope of the trial.

Unclear writing in medical research is usually

difficult to interpret and it may transfer

misleading information (Ali, 2010).

The primary criteria for acceptation the

scientific manuscript are novelty and

unobviousness. The scientific writer should

have an adequate knowledge of how to interpret

the results of the research outcome (Ali, 2010).

If the results observed are out of specifications,

the writer should critically interpret the cause

of negative results. A research manuscripts

with undesirable results may support future

investigation if the writer exactly interpret the

root cause of these results. The common reason

for rejection of a research manuscript includes:

a) journal’s aim; b) writing is unconceivable;

c) the writing style of the journal is different;

d) results doesn’t add value to the journal;

e) unclear hypothesis; f) wrong methodology;

g) poor analysis; h) inconclusive result;

i) and violation of research ethics (Kumar and

Rao, 2018).


Writing does not come naturally for few

researchers and they need to be aware of few

basic rules in addition to regular practice. A

good scientific writer has the capability to

report the research outcomes at the highest

level (Zhang et al., 2014).

Surgeons or other scientific writers report their

research outcomes in a better way only if they

have acquired the essentials of the art of good

scientific writing (Sengupta et al., 2014). The

set of abilities required for a skilled surgical

writing includes logic, clarity, organization and

precision. A good surgical scientific writer can

only communicate his message to intended

audience in a better way (Derish et al., 2008). A

scientific writer requires a combination of

competences: such as understanding of the field,

writing skills, the knowledge of scientific

guidelines, the aptitude to understand, analyze

and report the scientific results in the required

format (Sharma, 2010).

Many sources are available for the scientific

writers to get the required writing skills.

The scientific writer needs to have a clear

thoughtfulness of the concepts and ideas, and

should present the research outcomes in a way

to be easily understood (Hoogenboom and

Manske, 2012). Nearly all the manuscripts are

prepared in the IMRAD structure: Introduction,

Methods, Results and Discussion. Organize your

Manuscript under these heads. The information

presented in the manuscript should suit the

understanding level of the target audience

(Dhammi and Rehan Ul Haq, 2018).

The qualities that distinguish a good scientific

writer from an ordinary one includes:

a) understanding of the purpose of the trial;

b) in-depth research of the subject; c) ability

to think and organization of ideas; and

d) Ability to write the research finding in a

suitable level.

Well written research manuscript helps in

advancing the knowledge of medical community.

The important fundamentals in writing a

scientific publication includes: a) reading of

good scientific publication; b) finding the basics

of research, planning and execution of

hypothesis and collecting and reporting the

results; c) interpretation and presentation of the

research outcomes with accuracy, grammar and

flare; d) clearly express and effectively deliver

the research outcomes; e) consideration to details,

clarity in writing and unbiasedness; f) and

reporting of organized information such as

background, medical history, physical

examination, treatment delivered and opinion is

suggested (Hoogenboom and Manske, 2012;

Balakumar et al., 2013).


In conclusion, scientific writing is both a science

and an art. Publishing in scientific manuscript in

scientific journal is a way to network within the

target audience.

Scientific writing requires an in-depth

knowledge ofspecific requirements for research

outcomes. Scientific writing requires

understanding of research methodologies,

procedures and awareness of relevant

guidelines. For patients and the target audiences,

it is the source of all health- related knowledge,

information and education. Scientific writing is

a complex process, from the foundation of an

idea, to the practical implementation at the time

of writing and lastly to the publication of the

manuscript in the scientific journal. Scientific

writing is an important tool for reporting

vivacious information that helps the community

lead a healthy and meaningful life.

References:

1.Ali J. Manuscript rejection: causes

andremedies. J Young Pharm. 2010;2(1):3- 6.

2.Balakumar P, Inamdar MN, Jagadeesh G. The

critical steps for successful research: The

research proposal and scientific writing: (A

report on the pre-conference workshop held in

conjunction with the 64(th) annual conference

ofthe Indian Pharmaceutical Congress-2012). J

Pharmacol Pharmacother. 2013;4(2):130-8.

3.Derish P, Eastwood S.A clarity clinic for

surgical writing. J Surg Res. 2008 Jun

1;147(1):50-8.Dhammi IK, Rehan-Ul-Haq.

Rejection of Manuscripts: Problems

andSolutions. Indian J Orthop. 2018;52(2):97-

9.Hoogenboom BJ, Manske RC. How to write

a scientific article. Int J Sports Phys Ther.

2012;7(5):512-7.

4.Johansen M, Thomsen SF.Guidelines for

Reporting Medical Research: A Critical

Appraisal. Int Sch Res Notices.

2016;2016:1346026.

5.Kumar R, Attri S, Hastir H, Goyal S. Surgical

ethics - Indian Perspective. IJCMR. 4(5):77- 83.

6.Kumar VP, Rao CS. A review ofreasons for

rejection of manuscripts. J Res Sch Prof Eng Lan

Tea. 2018;8(2):1-11.

7.Quinn CT, Rush AJ. Writing andpublishing

your research findings. J Investig Med.

2009;57(5):634-9.8.Sengupta S, Shukla D, Ramulu P, Natarajan

S, Biswas J. Publish orperish: The art ofscientific writing. Indian J Ophthalmol.

2014;62(11):1089-93.

9.Sharma S. How to become a competent

medical writer? Perspect Clin Res.

2010;1(1):33-7.

10.Zhang W.Ten simple rules for writing

research papers. PLoS Comput Biol.

2014;10(1):e1003453.


“SURGICAL SPIRIT” ? –

Forgotten role in clinical practice

Dr Rajasekhar M RBengaluru

We are all made of 3 components

Physical(body), emotional (mind) and

analytical (intellect). All of us use these

faculties in different proportions in our

activities, including professional ones.

As surgeons we are not simple technicians

showing our skills on someone’s body.

Technically we are equivalent to drivers,

mechanics, tailors etc. So as surgeons, we

have to hone our skills to the best and latest,

upgrading and improving forever.

This is a part of bodily involvement and so we

have to keep our bodies fit, agile and durable.

The third dimension, i.e., intellect, is

essential to analyze and evaluate the

information collected from thorough

history, clinical findings, investigation

reports and select the best option for the

individual’s treatment.

To balance all these three faculties, a stable hand,

an unwavering mind and a sharp intellect, the

fourth dimension is to be opened up. That is the

“Spirit” behind all these. This “Surgical spirit” is

the operating system, where all the other three

hardware and software components work.

The trick in getting the best out of ourselves,

without disturbing our happiness and peace, is

to have a proper identity of ourselves. We tend

to identify with our hardware (body) and its

extensions like name, fame, profession,

position, wealth, awards, rewards etc., which

are only the roles, given at a particular point of

time, but “we” are not the roles.

A computer is identified by a professional by its

O.S, rather than the monitor or keyboard.

Similarly we should identify withour O.S, which

is also called by various names - soul, self,

spirit, consciousness, intelligence, etc.

In the emotional part of surgical practice, we

have to be balanced, empathizing with the

emotions of the patients and their attendants.

For that we have to be confident in our

diagnostic and therapeutic approach and

considerate to the needs of the patients. Thus we

can give confidence and solace to them. A calm

and composed mind is to be developed for that.

So if our consciousness changes from being

body conscious to “Spirit” conscious, which is

“made” of happiness and peace, we do all our

activities including professional ones, “with”

happiness and peace, rather than “for” happiness

and peace.

This process is very simple, easy to achieve and

yields immense benefits to us as well as our

patients. With all our intellect, we can easily

learn in 1 hour and start practicing it. As we start

growing in that process the differences we see

as doctor and patient, customer and service

provider, Knowledgeable and ignorant, rich and

poor etc., will blur. Life processes including

taking tough decisions become less protocol

based or intellectual, more intuitive. This

surgical spirit should act as an antiseptic,

killing all the viruses entering into our system.

“Let’s all work with high spirits”.


EFFECTIVE COMMUNICATION

FOR QUALITY HEALTHCARE

Dr Sachin D NaleBengaluru

In the current era of cutting edge technology, one

fundamental component of quality Healthcare

often neglected, is communication. Addressing

communication issues amongst various

stakeholders in a hospital - the Patient, Patient's

family, Healthcare Providers, Administrators and

support staff is the key to solving systematic

problems.

The word communicate is derived from the

Latin word "communicare" which literally

means "to share". Communication is a

transactional process, the ultimate purpose

of which is to create "shared meaning"

between the sender and the receiver. The

effectiveness of communication depends

upon the extent to which the sender has

succeeded in making the receiver

understand the idea.

Stages of Communication Competence:

According to Neol Burech's paradigm, there are

four stages of communication competences.

In the first stage, a person is"Unconsciously

Incompetent" - they are making mistakes

without even knowing it.

Stage two represents "Conscious Incompetence" -

In this stage, the people are aware that they are

making mistakes and understand the nature of

their mistakes. Stage three is about "Conscious

Competence"- At this stage, one makes

conscious attempts to correct deficiencies in his

communication and be better communicator.

If one practices conscious competence every day

for a long time and becomes an expert in the art

of communication, then one has reached stage

four which is "Unconscious Competence".

Expert communicators make communication

look effortless.

Communication Styles:

a. Verbal Communication:

Interaction consists of four communication styles:

Aggressive, Passive, Passive- Aggressive and

Assertive.

1. Aggressive communicators are impulsive,loud

and blunt,often trying to blame or shame

someone else. They are poor, listeners who

interrupt frequently and tend to dominate. They

may succeed in the short term but in the long run,

stress others out considerably and end up

socially isolating themselves.

2. Passive communicators allows others to

infringe on their rights. They do not express

their feelings, opinions or needs. They usually

have a tough time recognizing their needs and

learning how to fulfill them.

3.Passive- aggressive communicators feel

resentful and mutter to themselves rather than

speaking up to the person about an issue.

Outwardly they deny that there is a problem.


4.Assertive communicators build and encourage

rapport .They make good eye contact, respect

personal space, have body language that

conveys sincerity and approach ability and

speak in a well modulated tone. While the first

three styles come from a position of emotional

insecurity, Assertive communication is the style

that makes for emotional health and well being.

Becoming assertive is a process that needs

constant practice.

b. Non Verbal communication:

It is that does not use words. The

commonly observed type of Non Verbal

communications are: Facial expression, Eye

contact, Body Language and Posture, Tone and

Volume of voice(also called paralanguage),

Gestures, Personal appearance touch and

proxemics.

Listening is by far the most challenging

communication skill, yet the most

important to master. An active listener

shares the responsibility of effective

communication with the patient and sometimes

even makes up for the patients lack of ability

to communicate.

Breaking bad news forms a necessary part of

patient professional care giver communication.

Done sensitively, it develops a constructive

partnership between the patient, the relative

and the healthcare provider.

There are four stages of Breaking bad

news:

1.Preparation : Before breaking bad news,

one must prepare oneself, the place and the

patient.

2.Performance: This stage concerns the

actual event of breaking the bad news.

3.Palliation: Palliation has to do with

furnishing supportive response to patients

when they react to the bad news.

4.Planning: This phase allows the planning of

treatment and continued care for the patient.

To Communicate bad news effectively, one has to

be in stage 3,conscious,competence, understanding

the patient needs and commnicating appropriately.

Communication among employees of a health

care organisation may be formal or informal.

Based on hierarchy patterns, formal

communication can be further divided into

verical, horizontal and diagonal communication.

1.Horizontal communication takes place

between employees at the same hierarchical

level.

2. Vertical communication takes place between

superiors and sub ordinates in an organization as

downward and upward flows of communication.

3. Diagonal communication refers to

communication which takes place between

managers and workers located in different

functional divisions.


Thus communication needs to be seen as a

systematic and strategic issue, focusing on all

parts of the organisation. A train the trainer

model where training is conducted by respected

and comparable employees on the organisatiion

(Physician training- Physicians) should be

followed.

The change occurs in small doses and over

time. It has been seen that with communication

intervention mindset towards quality care has

improved significantly, showing that there is a

strong connection between communication

effectiveness and quality care. The biggest

communication problem is we do not listen to

understand. We listen to reply.

If a Healthcare Organisation wishes to provide

quality care, it first needs to improve its

communication efficiency and effectiveness. It

also advocates that unless this attitide permeates

an entire organisation quality Helathcare will

always fall short of reaching its full Potential,

which in turn, will adversely affect interests of

the most important stakeholder in health care -

the patient!!

*************

ONELINERS.....

1. My best mates and I played a game of hide

and seek. It went on for hours...

Well , good friends are hard to find.

2. You’re not completely useless,

you can always serve as a bad example.

3. I broke my finger last week.

On the other hand, I’m okay.

4. Someone stole my Microsoft Office &

they’re gonna pay.

You have my Word.

5. eBay is so useless.

I tried to look up lighters and all they

had was 13,749 matches.

6. I can't believe I got fired from the

calendar factory.

All I did was take a day off.

7. My boss is going to fire the employee

with the worst posture.

I have a hunch, it might be me.

8. Don't spell part backwards.

It's a trap.

9. And the Lord said unto John, “Come forth

and you will receive eternal life.”

But John came fifth, and he got hell.

10. What is the best thing about living in

Switzerland?

Well, the flag is a big plus.

11. Did you hear about the guy who got hit in

the head with a can of soda?

He was lucky it was a soft drink.

12. How did I escape Iraq?

Iran…I Ran

14. Son: "Dad, can you tell me what a solar

eclipse is?"

Dad: "No sun."

15. My math teacher called me average.

How mean !

16. Clinic Receptionist: “Doctor, there's a

patient on line that says he's become

invisible".

Doctor: “Well, tell him I can't see him

right now."

13. To the mathematicians who thought of the

idea of zero.

Thanks for nothing!


M.S. = Master's in Surgery (really….?)

Dr Manish JoshiBengaluru

All of us are certified M. S. – Masters in

Surgery! Or are we certificate Master's..Still seeking Mastery?

It is a bitter pill to digest when faced with such

a thought provoking question?

As surgeon's, students and practitioners alike,

we are well aware of the learning curve which

each of us have to overcome to be an expert in

each surgery and also in each area of

specialisation. Does it mean Mastery? Or is

Mastery a never ending quest for life , an

illusion as we realise there's more to be done or

more to be learnt.

Can we derive some truths from fields other than

surgery?

Only if we can keep an open mind to begin

with….

“ The 10,000 hour rule”

Anders Ericsson in an often cited study from

1993, researched how do violinists become

expert's. To cut the long story short – the study

partly concluded that expert violinists were one's

who practiced atleast “10,000 hours “ before

they became expert's. Hence came the “10,000

hour rule” popularised by Malcolm Gladwell in

his bestseller book from 2008 called “Outliers”.

Does the same apply to Surgical students – in

my early opinion 'Why not – it comes close to

that'. In a 3 year postgraduate surgery course,

every student spends easily {approx 1000 days x

10 hours= 10,000 hours) that much time. The

one's who spend less time or one's in low

volumes centre's require furthermore hours as

senior residents or registrars.. There was much

to be said about the confounding factors like

varied teaching programs, government versus

private college's , lesser busy units,

infrastructure, resources, interest of students or

the lack of….

“ The tenet of * Deliberate practise*”

On thinking about it *the 10,000 hour rule* in

itself didn't satisfy the definition of Mastery. It

seemed like a half-truth. It'd mean that almost

every other student should come out as a Master

ready to don the gloves with confidence. That

hardly happens. So what is Mastery then, if not

by the easily describable “10,000 hour rule”.

Some deep work on this made another factor

come forward as a big thing to attain Mastery.

This path breaking concept was hidden in the

conclusion of the same study of how violinists

become expert's. Ericsson concluded that

violinists who became expert's were the one's

who did *deliberate practise* consistently and

not just fiddle with their time. This was even

more revealing and useful as a tool to seek and

gain Mastery in surgery and can be extrapolated

to Surgical students and practitioners alike. It is

this tenet of *deliberate practice* that leads to

the path to Mastery.

Does Mastery really occur?

The answer is 'YES'. Mastery is the elusive

just out of reach yet seemingly attainable inner

confidence that comes over time spent in

*deliberate practise* of any skill you'd like to

acquire.In Surgical parlance, it is that powerful

feeling of being in control and confident of

handling almost all possibilities and variations

to a given Surgical condition.


It means you are in control almost 95%

(confidence intervals) of times with a given

problem and that you've crossed the learning

curve. It's a sweet feeling to savour.

“ Mastery Formula = The 10,000 hour rule +

*Deliberate Practise*”

The good news is – Mastery can be cultivated, it

can be achieved. The bad news is – there's no

short cut to Mastery. It comes over time with

*10,000 hours of deliberate practise*. Earlier

surgeon's had limited tools, however the newer

generation is lucky to have ways to fastrack the

Mastery process – by joining Fellowship courses

(not for certificates) , working with an expert

mentor, attending skills workshop, etc. So are you

on a fastrack to Mastery or on a slowtrack.

Time for you to reflect….

*Good, Better Best, never will they rest

Till the good is better and the better is best*

Suggested Complete Reading and derive

more Truths and insights:

#The Role of Deliberate Practice in the

Acquisition of Expert Performance K.

Anders Ericsson, Ralf Th. Krampe, and

Clemens Tesch-Romer - Psychological

Review 1993, Vol. 100. No. 3, 363-406

Copyright 1993 by theAmerican

Psychological Association, Inc.

#Outliers: The Story of Success - written by

Malcolm Gladwell.

#The Greatest: The Quest for Sporting

Perfection by Matthew Syed.

***********

TO ALL SURGEONS .........WHY DO YOU CONSIDERSURGERY AS AN ART?

I guess,

Because the smell of spirit is sweeter than

perfume to YOU,

Because YOUR OT scrubs feel more

fashionable than any designer clothes,

Because the clicking sound of a needle

holder is music to YOUR ears,

Because proportions and symmetry cannot be

more important than in surgery,

Because when YOU walk into a hospital

YOU feel as calm as YOU would in a temple,

Because YOU know that YOU can take away

pain and make one smile,

Because YOU can make a connection with

fellow beings on a much deeper level than any

other profession,

Because although YOU may strive for success

every time, YOU accept failure too at times,

and that is why SURGERY is an ART and

not just a PROFESSION,

my dear friends...!!

Anonymous

Because when YOU operate YOU get in to a

zone deeper than meditation,

Because YOU can convert discomfort in to

comfort with a few gentle strokes,


REMINISCING FALLING INLOVE FOR FIRST TIME…

Dr Neha ChauhanBengaluru

“When love is real, it finds a way!” - Avatar Roku

It all started long back, maybe in early 1990s. I was

growing up reading books as voraciously as I was

eating food then (courtesy my pubertal spurt!) and

had slowly graduated from Noddy, Tintin, Asterix,

Famous five, Nancy Drew, Hardy Boys, Agatha

Christie to Shakespeare, Jane Austen and Dickens

by the time I reached 10th standard in 1998. After

10th board exams, I had to make that crucial

decision of whether to choose Science or

Commerce streams. I chose Science.

There was again a dilemma of whether to choose

Mathematics or Biology. I liked both but had no

clues as to what I wanted to be and went ahead to

study both. Studies had increased manifold, but my

love for literature continued. In 11th standard, I was

introduced to books on love and romance by my

English teacher, who was of the opinion that every

lover of literature must read “Gone with the Wind”

by Margaret Mitchell at least once in his/her

lifetime.

It was supposed to be an epitome of romance.

What followed was a rigorous study schedule

and a lot more novels on love. Fortunately, by

the time I finished school, I had already cleared

my medical and engineering entrance exams

along with getting selected for Bachelor of

Arts(English honours) at one of the most

prestigious college of India, St Stephens, New

Delhi. I was at the trifurcation of medicine,

engineering and literature and again had to

make a choice. I wished then and somewhere I

still wish that how nice it could have been if I

had had the option to continue higher education

in all three streams as I liked them all equally

but alas after 12th one could chose only one

stream and I chose (or was rather made to

choose by my parents) Medicine!

Though there was anxiety at leaving the

comforts of home, I was happy at joining

college and had already imaging falling in love

with someone special, the kind of love that I

had read in books at school/seen in movies, the

kind that sweeps one o ff his/her feet every

time one encounters it!

With my admission to Jawaharlal Nehru

Medical College, Aligarh Muslim University

in year 2000, started a journey of an

unconventional and unconditional love, a love

that would be the love at first encounter and

would last a lifetime…

First year of MBBS was a nightmare and I

actually spent the whole year thinking why on

earth I'm being taught subjects which seem to

have nothing to do with treating patients.

Thankfully in the hustle-bustle and

disorientation of the first year, juggling between

anatomy dissection halls, biochemistry labs and

pithing frogs in physiology labs in midst of

ragging and home sickness, I didn't realize

when time flew and I entered the second year of

MBBS.


But love that I had so imagined falling in with

was far beyond sight! Though it was second year

of MBBS (if counted by year since joining), we

were called as third year students, the logic

behind which I still haven't been able to

decipher! I was roll number 31 and was assigned

to “B” batch and was to start my first clinical

posting in the Department of Surgery. I still

remember a night before the clinical posting

when in excitement and anticipation of seeing

patients next day, I kept turning in bed whole

night. Not very dissimilar from what I had read

in novels at school about happening when one

falls in love!

Next day, I dressed up neatly and wore my new

apron (that I had got ironed twice by the dhobi

to get that crisp look of a serious doctor!) and

went to the Surgery department. Well-dressed

senior surgeons discussing some serious stuff

about something called as Whipple's procedure

(I had no clue about it at that time!) welcomed

us to the wards and assigned us to different

teachers for different days for case discussion

and teaching.

Everyday I would reach the ward ten minutes

before the time (just like one does when one is

waiting for someone one loves dearly!) and ask

the post-graduation seniors to allot us the case

and would start taking history and examination

of the patients along with my best friend,

Mehvash Haider. It was fun and the thing that

was most impressive about those surgery ward

postings was meticulous planning and

discussions.

The teachings were methodical and the teachers

were punctual. Besides this, we also had

evening wards where the surgery post-

graduation students would take our case

discussions.

Even those were interesting and meticulous.

Though it was my first posting and I hadn't

experienced clinical postings in other

departments, somewhere deep down my mind, I

had made a choice (this time it was my choice,

not of my parents!) that I would be a surgeon

one day. I kept the choice secretly to myself at

that time, similar to how one hides one's crush

from parents initially! Those three months of

surgery postings were the most wonderful time

of my graduation days. As the posting was about

to end, I was nearly in tears. I had fallen in love

with surgery but didn't know what future had in

store for me.

Would my relationship with surgery fructify

with me becoming a surgeon or would it end

like numerous affairs end, this question often

troubled my mind. Next I was posted in

gynaecology and I didn't like it a bit.

They were followed by Medicine, Orthopedics,

ENT, Ophthalomology, Community Medicine,

Dermatology, Psychiatry etc but nothing

impressed me as I had already given my heart to

surgery.

Maybe once one truly falls in love with

something, other things become

insignificant!


By the time I again had clinical postings in

surgery in the final year of MBBS, my resolve

to become a surgeon had turned more firm.

Post-graduation entrance exams followed

Internship and by God's grace I got a rank where

I could opt for any speciality (except

radiology!). Then came a tussle, the kind that

usually comes between society and two people

in love.

The tussle was at home between me and my

parents. My parents wanted me to opt for

paediatrics or medicine as they felt that I would

have a more stable life with better work hours in

those specialities and a better married life. But I

was hell bent on pursuing surgery. I argued that

choosing a speciality is like choosing a spouse

and how could one do justice to his/ her

profession if one didn't like it. A lot of drama

ensued at home with parents trying their best to

show me their logic, but does one see logic

when one is in love!? Finally they gave in to my

wish.

Though none of the ten surgery seats had been

taken before me, I clearly remember entering

the counselling room with trembling hands.

Only when I was finally allotted a seat in the

department of surgery, the tremors gave way to

an immense joy that one feels when one is

united with one's beloved! I nearly needed to

pinch myself to believe that finally I was going

to pursue the speciality of my dreams. The three

years of surgical residency was a rigorous

routine but it never felt like a burden, perhaps

because I was in love with the subject.

There were occasions when we had seventy two

hours continuous emergency duties that we did

without sleeping, feeling like zombies by the

end of the call days but next day we would

return back to the emergency with more

enthusiasm and zeal to learn and operate more.

Since then I have never looked back. I went on

to complete my general surgery training

followed by Master of Chirurgae in Plastic

Surgery and my love for surgery has grown

stronger over all these years.

Everyday when I enter the operation theatre, I

still feel the same excitement that I had as a

MBBS third year girl posted in surgery

department in the year 2001.

And yes, whenever there is a challenging case

lined up for next day, I still have flutters and

sleepless nights thinking of how best can I

handle it.

After all that's how true love that lasts for a

lifetime is supposed to be feeling like! And what

could be a better platform to share this love story

than in the souvenir of KSC- ASICON 2020 that

is being held in the month of love, between 14th-

16th February 2020!


ARTIFICIAL INTELLIGENCE IN HEALTHCARE

Dr Carunya MannanBengaluru

Artificial intelligence ( AI ) is simply,

simulation of human intelligence processes by

machines, where machines (or computers)

mimic cognitive functions that humans

associate with the human mind, such as

learning and problem solving ( machines are

taught and programmed to think like humans) .

AI works in a range of ways, drawing on

principles and tools, including from maths,

logic, and biology. An important feature of

contemporary AI technologies is that they are

increasingly able to make sense of varied and

unstructured kinds of data, such as natural

language text and images.

Machine-learning has been the most successful

type of AI in recent years, and is the underlying

approach of many of the applications currently in

use. Rather than following pre-programmed

instructions, machine learning allows systems to

discover patterns and derive its own rules when

it is presented with data and new experiences.

AI Transformation in Healthcare

The healthcare industry is evolving rapidly

with large volumes of data and increasing

challenges in cost and patient outcomes.

Artificial intelligence (AI) in healthcare is the

use of complex algorithms and software to

emulate human cognition in the analysis of

complicated medical data. Specifically, AI is the

ability for computer algorithms to approximate

conclusions without direct human input. ‘Good

Old-Fashioned AI’, which follows rules and logic

specified by humans, has been used to develop

healthcare software since the 1970s, though its

impact has been limited.

More recently there have been huge

technological developments in the field of

machine learning and especially with artificial

neural networks, where computers learn from

examples rather than explicit programming.

These technologies have the potential to

transform many aspects of patient care, as well

as administrative processes within provider,

payer and pharmaceutical organisations.

WHY AI is needed in healthcare?

Most of the times, errors and delay in decision

making and judgement happens due to work

overload, fatigue and also emotional instability

due to other responsibilities. AI plays an

important role to overcome these issues.

How AI has modified certain aspects of

healthcare?

1. Clinical Care – AI is being used for

reading radiological images, for faster

diagnosis and treatment. Better AI based

screening methods for cancer and image

prediction are underway, as Google and

similar centres are doing a lot of work. A

recent study has stated that “ Google based

AI, has the potential to exceed human

capacity to identify subtle cues that human

eye and brain aren’t able to perceive” in

identifying lesions on screening

mammograms. This means better

screening and treatment at a much faster

pace. Similarly ECG and ECHO are also

interpreted by AI in certain institutes and

awareness is increasing.


AI in the field of histopathology will make

a significant change, decrease reporting

time, leading to faster diagnosis and also

reduce human error.

2. Surgical Care - Robotic surgical systems,

with human input are widely used all

across the globe now for various surgeries.

The advantages are multiple including

technical precision,distant surgeries can be

done ( operating surgeon and patient at

different location is made possible ) ,

reduced hospital stay, fewer complications,

smaller incisions, lower rates of infection

and of course ergonomic comfort of the

operating surgeon. Complete AI controlled

robots are used for dental procedures at a

few centres at present.

3. Documentation & Medical research -

Electronic health records are crucial to the

digitalization of information in the

healthcare industry. However logging all of

this data comes with its own problems like

cognitive overload and burnout for users.

EHR developers are now automating much

of the process and even starting to use

natural language processing (NLP) tools to

improve this process. For example, daily

progress notes, operative notes, discharge

summaries can be documented with the

help of NLP, which could save a lot of time

and manpower. AI application in

documentation and EHR also paves way

for further use in medical research in

analysis of the data, for example, for

assessing a drug response.

4. Medical education - AI allows those in

training to go through naturalistic

simulations in a way that simple computer-

driven algorithms cannot. The advent of

natural speech and the ability of an AI

computer to draw instantly on a large

database of scenarios, means the response

to questions, decisions or advice from a

trainee can challenge in a way that a

human cannot. The training programme

can learn from previous responses from

the trainee, meaning that the challenges

can be continually adjusted to meet their

learning needs. And training can be done

anywhere; with the power of AI embedded

on a smartphone, quick catch up sessions,

after a tricky case in a clinic or while

travelling, will be possible.

These are just a few areas of importance that

AI has started to take over slowly.

AI based care is transparent and fair.

Malicious use can be easily monitored.

However, the controversy about AI taking over

humans may sound a bit ridiculous as however

precise and accurate AI is, ethically human

supervision, monitoring and confirmation will

be required at all important steps as patient

safety takes first priorty.

In short, use of AI in the medical field is to the

assist the doctors, and as quoted by Dr Simon

Eccles, “AI will allow doctors to be more

human ”.

Acknowledgements:

Many thanks to Nikita Rajaneesh – Software

engineering student ( AI ) for her contribution.


Dr Sadashivayya Soppimath, Hubballi

Dr Aravind Gubbi,

Bengaluru

SUPER CLICKS!!! - BROUGHT TO YOU

By the Shooting Surgeons!!


SUPER CLICKS!!! - BROUGHT TO YOU

By the Shooting Surgeons!!

Dr Aravind Patel,

Ballari

Dr Jaideep Ratkal,

HubballiSOUVENIR KSCASICON 2020

POETRY PAGE

Unleash....The real you!!

Climb, race, dance, fall and again rise..with a smile,

Unleash the zest to live and the holy spirit in you..

The Woman Magical!!!

- Dr Aruna Kamineni Rao

Born in the man's world, to be silently subservient,

to serve..as his want,

Weighed for looks,

that curvy body to pleasure...

your mind and soul he cares not.

The girl child unwanted, unworthy to live..From womb to tomb struggling to survive,Uncage yourself from restrictions,spread your wings and fly free... Unleash the limitless potential in you, the women undauntable.

Beaten and abused, used by the man you trust...

Enough, Unleash the fire in you,

burn the monster to rise like

a phoenix from the ashes...

the women unstoppable.

Let not all mistake your silence for cowardice...

Unleash the power within you,

the strength of your voice..be heard,

the women powerful.

Amidst the chaos and carnage around,

be not the victim.

Unleash the nurturer in you,

of life and love..

the women mystical.

ಹುಡುಕಾಟ

ಹುಡುಕುತತರುವಎಲಲಲಲ

ನನನೊ ಳಗನಕವಯ

ಕಣಣು ಕಂಡಲಲ

ಮನಸುಬಂದಲಲ

ಹುಡುಕುತತರುವ

ಮುOಜಾವನಇಬಬ ನಯಲಲಗೊಧೂಳಯದಗಂತದಲಲ

ಬಳದಂಗಳಅಂಗಳದಲಲ


ಚಗುರಲಲಗಳಲಲ ಅರಳದಹೂವನಲಲ

ಬಳಕುವಹೊನಲಲನಲಲ

ಅಬಬ ರಸುವಸಾಗರದಅಲಲಗಳಲಲ


ಮಗುವನಹಾಲನಗುವನಲಲ

ಮಕಕ ಳತಂಟತದಲಲ

ಮುದದಾ ದಮುಗಧ ಮನಸಸ ನಲಲ


ಹಡದವವ ನಅಮತವಾತ ಲಯ ದಲಲ

ಒಡಹುತತದವರಪರ ೀತತಯಅನನಯ ತಯಲಲ

ಸೊ ೀಹತರಸಾನಧಯ ದಲಲ


ಪರ ೀಮಗಳಅನುರಾಗದಲಲ

ಬಂಧವಯ ದವರಹದಲಲ

ತಂಪಾದಕಲಹದಲಲ


ಕಷಟ ಗಳಹಾಹಾಕಾರದಲಲ

ಮಾನವೀಯತಯಮಂಪರನಲಲ

ಬಂಡಾಯದಕಾಳಚ ನಲಲ


ಧಮಮದಅರಮದಲಲ

ಅಧಮಮದಚಾಣಾಕಶ ತಯಲಲ

ಸತಯ ಅಸತಯ ದತತಕಾಕ ಟದಲಲ


ಭಕತಯಪರಾಕಾಷಟಟ ಯಲಲ

ಆಧಯಯ ತಮ ದದೈವತವ ದಲಲ

ಸಮಪಮಣಾಭಾವದಲಲ

ಎಲಲರುವನುನನನೊ ಳಗನಕವ?ನನನೊ ಳಗನಅನುಭಾವದಲಲ

ಮನಸಗಭಮದಲಲ ಅಡುಗಹನು

ಪರ ಸವದಪರಪಕವ ತಯಪರ ತತೀಕಷಯಲಲ

ಡಾ ಅನುಪಮಪೂಜಾರ

Enough being oppressed…Deliberately suppressed,

Awaken the inner beauty of knowledge,

the quest to learn…

unleash the real you,

the women phenomenal.


ಬಲ ಚಕಾಶ ವಾಾಪಾರ ಈ ಬದುಕುನೂರಾರು ಕೇಳದರ ಹತತಪಪತನಟುುಸುಖವ ಕೇಳದಾಗ ಕಳವಳವ ಕೂಟುುದೂರ ನಂತು ನಕುು ಬಡುತದ...

ಕಲವೊಮಮ ಹಬಬದ ಸಪಶಲ ನಂತಅಂಜಂಜುತ ಒಂದನುು ಕೇಳದರಡಬಲ ಧಮಾಕಾಗಳನುು ತುರುಕಬರುನಗುತದ ಗಲಬಲಯ ಕಂಡು...

ಅಂತೂ ಸಾಗದ ಕೂಡುತ ಕಳಯುತಅತ ಎಳಯುತ ಇತ ಸಳಯುತಆದರೂ ಕೂನಗೂಮಮ ಭರವಸಯ ಬಳಕುಹದು ಏರಳಕಯಲಲದರ ಅದಂಥ ಬದುಕು...

ಈ ಬದುಕಂಬುದುಬಲ ಬರಕಏನನೂುೇ ಬರವಾಗಏನೂೇ ತತದ ತತರಚುವ'ಆಟೂೇಕರಕಶನ' ನಂತತನಗ ಬೇಕಾದಂತ ತತದನೇಪಥಾದಲಲ ನಂತುನಕುುಬಡುತದ...ಬರಯಲತತುಸದವ ಮಾತರಪಚಾಾಗುತಾನಏನೂಂದೂ ತತಳಯದೇ...ಆದರ ಮತ ಸಾಗುತದಹೂಸದೂಂದು ಬರವಣಗಜೂತಗೇಬದುಕನ ಮಮರವಣಗ...!!

ಹಲವು ಕನಸುಗಳ ಹರವಾಣಅದರಲಲಷುು ನನಸುಸಲೇಸು...ಉಳದವು ಎಂದೂಮುಗಯದಮಮಗಾಸೇರಯಲಇನುೇನು ಮುಗದೇತುಅನುುವುದರೂಳಗಹೂಸತತರುವುಗಳೊಡನ ಸಜುುಪರದಯ ಹಂದೂಬಬನದೇೇಶಕ....!ಇನುಷುು ಹಳವಂಡಗಳುಮುಗಲಾಚಗನ ಕನವರಕಗಳುಸಕುದಷೂು ದಕುದಷೂುಮುಷಟುಯೊಳಗಣ ಧಾನಾಬತತದರ ಹೂಲತುಂಬಮುಚಚಾಟುರ ಹಡ ಮಾತರ..!!

ಬದುಕು-ಡಾ॥ ಶವಾನಂದ ಕುಬಸದ


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