A reply from Wockhardt, Bangalore

Here is a reply posted on my Wordpress blog , by a doctor, supposed to be from a doctor working there.

Note - no one is maligning anybody. Just as media published both sides, I am publishing this reply.

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The author of this reply is Dr. Akhilesh Pateraya. akhilesh.pateraya@wockhardthospitals.com

Reputations take a lifetime to build, is it right to destroy them without understanding true facts and make a hospital and its doctors look inhuman? The true facts of Ms Rashmi BT’s case

Ms. Rashmi B.T. was under the care of a senior gynaecologist in Bangalore for her second pregnancy. She had a breech presentation (where the legs of the baby present itself first instead of the head during the time of delivery) in the earlier pregnancy which required a C-Section. She made a conscious decision to shift under Dr. Latha Venkatram’s care at Wockhardt Hospitals, Bangalore in the 35th week of her pregnancy largely because she was aware that Vaginal Birth after Caesarian Section (VBAC) was an option and wanted to select that option for her second delivery. She had collected information that Dr. Latha Venkatram was one of the senior gynecologists in the city who offered this option to her patients. From the OPD records filed by Dr Latha Venkatram it is evident that Rashmi was counseled and given ample information about the procedure and the risks associated with it and she took an informed choice to select this procedure.

Vaginal Birth after Caesarian Section (VBAC) is the term used when a woman gives birth vaginally, having had a caesarian delivery in the past. Worldwide VBAC, if possible, is being recommended and preferred over repeat C-Sections as its advantages substantially outweigh the disadvantages. According to the Royal College of Obstetricians and Gynaecologists patient information guideline 2008 “Birth after previous Caesarian Section”, overall three out of four women with an uncomplicated pregnancy would give birth vaginally following one caesarian section delivery. The short-term and long term complications inherent in a C-Section make it preferable that a woman is offered the choice of a VBAC. The American College of Obstetricians and Gynecologists and have set a goal of 37% VBAC deliveries by 2010

Repeat Caesarian sections are associated with:
o A possibly more difficult operation
o Longer recovery period
o Possibility of injury to bladder or bowel
o Possibility of blood clots developing in legs and pulmonary thrombosis
o Breathing problems for the baby. Higher in C-Section than in VBAC
o Serious risks increase with every Caesarian delivery
o Higher chance of infection
o Future complications for the mother who has had repeated opening of the abdomen
o Higher costs
VBAC has a shorter stay in the hospital, faster recovery as well as lower cost for the patient. There is a risk of uterine rupture but this risk is approximately 0.5%. In spite of this risk the benefits of VBAC far outweigh the risks. As in all medical procedures there is no way to predict which patient would fall under the 0.5% risk of uterine rupture or any way by which this rupture can be prevented. A VBAC delivery is more demanding of the gynaecologist, as it takes 6-8 hours as compared to a C-Section, which in a planned fashion would be over in less than 40-45 minutes. Also the mother and child need close monitoring it is estimated that one will have to do as many as 200+ unnecessary C-Sections to prevent the occurrence of 1 uterine rupture. In most cases a uterine rupture is not fatal. However in the best interest of Ms Rashmi, Latha Venkatram gave her both the choices and Ms Rashmi chose to opt for the VBAC option.
Ms. Rashmi B.T. was a fit candidate for a VBAC. She had a breech presentation in the earlier pregnancy which required a C-Section. A breech presentation in the earlier pregnancy which necessitated a C-Section is in fact an indication to offer a VBAC to the patient in the subsequent pregnancies. An age of 35 is not a contraindication to a VBAC. The fact that she was 5 days past her due date was also not a contraindication to a VBAC because less than 5% of patients deliver on their due date.
During her antenatal visits to Dr. Latha Venkatram, Ms Rashmi B.T. was explained in detail about the pros and cons of VBAC and she agreed to undergo the procedure. The OPD case records have these notations. She was also clearly informed by Dr. Latha Venkatraman that she works along with Dr. Prabha Ramakrishna as a team and either of them would be present during her delivery. Doctors particularly in the area of obstetrics frequently prefer to work as a team since many times an emergency may hold one of them which would make it possible for the other team member to attend to the delivery as the date and time of delivery cannot be predicted. In a VBAC considering that a consultant needs to be around for most of the labor period it is prudent that a team takes care of the patient. Both Consultants of the team Dr. Latha Venkatram and Dr. Prabha Ramakrishna are Fellows and Members of the Royal College of Obstetricians UK.
Ms Rashmi B.T was admitted to the hospital early morning on the 4th of March 2009 in spontaneous labour. She was connected to monitors for a close monitoring of both maternal and fetal parameters. She was visited by Dr. Latha Venkatram soon after admission. An experienced nurse and a fully qualified gynaecology registrar were monitoring her constantly. The Consultant Dr. Prabha Ramakrishna was also available on the same floor and repeatedly examined her. She was kept informed about the progress of the labour.
The labour progressed normally until 1.50 p.m when a sudden decrease in the fetal heart rate was noted (fetal bradycardia). The tracings before 1.50 p.m were normal. The moment fetal bradycardia occurred, the consultant Dr. Prabha Ramakrishna who was on the same floor was called in by the gynecology registrar. When Dr. Prabha Ramkrishna examined Ms Rashmi, the baby’s head position was a little high. She was asked to push to see if the baby’s head would come to +2 position in which case she could do a forceps in the labor room itself and deliver the child. When the baby’s head did not descend as required she asked for the patient to be shifted to the Operating room. After this Ms.Rashmi was not asked to bear down any further.

Shift to the OT was rapid since the dedicated Operation Theatre for Caesarian sections is situated within the labour room complex and this theatre is not used for any other procedure. Within 7-8 mins the patient was in the theatre. The anesthetist had a choice of going in for an emergency general anesthesia which has inherent risks for a pregnant woman or to go in for epidural anesthesia. Since the patient was already receiving pain medication (epidural analgesia) it was decided that for the safety of the mother increasing this analgesia to achieve anesthesia was the preferred option. In the OT the fetal heart rate was recorded as 180 b.p.m on the Doppler. On the OT table an examination was done and it was found that the head had receded and a forceps delivery was not attempted. An immediate emergency C-section was then performed.
The anesthetists, Neo-Natologists and the surgical nursing team had assembled in the theatre within a few minutes of the emergency being declared. The hospital has full- time anesthetists, Neo-Natologists and a surgical nursing team working round the clock to attend to all kinds of medical emergencies.
At the time of birth the baby did not have a heart beat or respiration. Resuscitation was started and the heart beat started about half a minute later. The child was immediately shifted to the Neonatal ICU and put on the ventilator. The baby’s weight at birth has been recorded in the NICU as about 3 Kg. The only reason an exact weight could not be taken in the NICU was that the child was already attached to various lifesaving equipments and the neonatologist had to make the closest estimate. However it must be noted here that a birth weight of 4 KG is not a contraindication for a VBAC.

In the neonatal ICU the clinical team met the family on a daily basis and kept them informed about the status of the baby and the prognosis. The poor prognosis was explained to the parents on the 2nd day itself. An opinion from an external eminent neonatologist was also sought who concurred with the poor prognosis. All decisions regarding further care were made only after extensive discussions with the parents of the baby. Dr.Prakash Vemgal our Neo-Natologist is not only highly experienced but has also gone through some of the highest training in Neo- Natology in high patient volume and reputed international centres.
The doctors and the management (including senior management personnel) of the Wockhardt Hospitals group spent long hours with the parents understanding and trying to address their concerns. As is the normal practice in such a case a complete internal review was done. The family sent to us a detailed list of areas they wanted us to look into during our investigation. We did go into each of these areas and sent them a detailed reply addressing most of these issues including taking the opinion of two leading and senior external gynecologists of the city who do substantial VBAC work. It is unfortunate to note that inspite of providing her all clarifications Ms Rashmi has been projecting an extremely poor image of Dr. Latha Venkatram and the hospital.
Our internal review involved discussions with our own team of gynaecologists, meetings with two external gynaecologists who practice VBAC and the entire clinical care team. Our findings after this detailed internal review are summarized below.
a. Ms Rashmi BT was a fit candidate for a VBAC. She would have been offered this procedure as a first choice by any gynecologist or hospital which practices advanced obstetrics anywhere in the world. Her age or the week of pregnancy were not contraindications to go in for a VBAC.
b. She had made a conscious and informed decision about going in for a VBAC. She had changed her senior gynecologist whom she was consulting until the 35th week of her pregnancy primarily because that gynaecologist was not in a position to offer VBAC.
c. The OPD case notes of which she was given the duplicate copy recorded that she was willing for VBAC and she was informed about all risks of her decision.
d. Both the mother and the child had been monitored carefully right through the labour
e. All medications used for progressing labor were prescribed agents and safe for use in VBAC
f. She did have a uterine rupture which in VBAC carries a risk of 0.5%. This rupture could in no way be predicted or prevented. In spite of the rupture the gynecology team was able to save the uterus for future child bearing.
g. The Operation theatre was ready at the time it was required.
h. All the staff were present in the Operation Theatre within a few minutes of the emergency being declared
i. While the baby was in the NICU Dr.Prakash Vemgal the head of Neo-Natology met up with the parents at regular intervals and kept the family clearly informed about the status and prognosis. All major decisions were taken only after discussion with the parents.
j. Senior management of the organization met up with the family on multiple occasions to understand and address their concerns
A minute by minute account of her story as is being spread through the various emails circulated by various people who were neither physically present during her admission to the hospital nor were involved in her care process exhibits to us a determined effort to harm the reputation of the gynecologist and the hospital without having any understanding of the clinical facts of the case.
Is medicine now going to be judged through the lens of only opinions running across chain mails or through the untiring efforts of institutions and doctors which toil endlessly to save lives but remain spectators to their actions being judged by emotive outbursts?
We do understand the pain and suffering of Ms Rashmi BT. As a hospital every life is precious to us but we are also are in the world of medicine where unfortunate rare complications can be counteracted but every procedure cannot be made risk free. There are many lives which we save each day when all has been given up and each such case teaches us that to pursue medicine is to pursue the limits of the unknown but does that mean that we become victims of public misinformation
We have taken all necessary care and followed every medical protocol that any reputed institution across the globe would have followed. However it is unfortunate that even though Ms Rashmi has not been a victim of any medical negligence she has chosen by this random spread of irrational mails to use a redressal system that is purposely harming the reputation of Dr Latha Venkatram, Dr.Prabha Ramakrisha and our institution.
The case can be subjected to analysis by any competent authority.

An interesting Story - From AB Senior's Blog

At the 1994 annual awards dinner given for  Forensic Science, AAFS President Dr. Don Harper Mills astounded his audience  with the legal complications of a bizarre death.
 
Here is the story: On March 23, 1994 the  medical examiner viewed the body of Ronald Opus and concluded that he died  from a shotgun wound to the head. Mr. Opus had jumped from the top of a  ten-storey building intending to commit suicide. He left a note to the effect  indicating his despondency.
 
 
 
As he fell past the ninth floor his life was  interrupted by a shotgun blast passing through a window, which killed him  instantly. Neither the shooter nor the deceased was aware that a safety net  had been installed just below the eighth floor level to protect some building  workers and that Ronald Opus would not have been able to complete his suicide  the way he had planned.
 
 
 
"Ordinarily," Dr Mills continued, "A person who  sets out to commit suicide and ultimately succeeds, even though the mechanism  might not be what he intended, is still defined as committing suicide." That  Mr. Opus was shot on the way to certain death, but probably would not have  been successful because of the safety net, caused the medical examiner to feel  that he had a homicide on his hands.
 
 
 
The room on the ninth floor, where the shotgun  blast emanated, was occupied by an elderly man and his wife. They were arguing  vigorously and he was threatening her with a shotgun. The man was so upset  that when he pulled the trigger he completely missed his wife and the pellets  went through the window striking Mr. Opus.
 
 
 
When one intends to kill subject "A" but kills  subject "B" in the attempt, one is guilty of the murder of subject "B." When  confronted with the murder charge the old man and his wife were both adamant  and both said that they thought the shotgun was unloaded. The old man said it  was a long-standing habit to threaten his wife with the unloaded shotgun. He  had no intention to murder her. Therefore the killing of Mr. Opus appeared to  be an accident; that is, if the gun had been accidentally loaded.
 
 
 
The continuing investigation turned up a  witness who saw the old couple's son loading the shotgun about six weeks prior  to the fatal accident. It transpired that the old lady had cut off her son's  financial support and the son, knowing the propensity of his father to use the  shotgun threateningly, loaded the gun with the expectation that his father  would shoot his mother.
 
 
 
Since the loader of the gun was aware of this,  he was guilty of the murder even though he didn't actually pull the trigger.  The case now becomes one of murder on the part of the son for the death of  Ronald Opus. Now comes the exquisite twist.
 
 
 
Further investigation revealed that the son  was, in fact, Ronald Opus. He had become increasingly despondent over the  failure of his attempt to engineer his mother's murder. This led him to jump  off the ten-storey building on March 23rd, only to be killed by a shotgun  blast passing through the ninth storey window. The son had actually murdered  himself so the medical examiner closed the case as a suicide.

--
Regards
Vijayashankar

Super 8 Line up for T20 ICC Wordcup 2009

Teams	Mat	Won	Lost	Tied	N/R	Pts	Net RR	For	Against
South Africa	2	2	0	0	0	4	3.275	339/40.0	208/40.0
India	2	2	0	0	0	4	1.227	293/35.3	267/38.0
Sri Lanka	2	2	0	0	0	4	0.626	352/39.0	336/40.0
England	2	1	1	0	0	2	1.175	347/40.0	300/40.0
Pakistan	2	1	1	0	0	2	0.85	312/40.0	278/40.0
West Indies	2	1	1	0	0	2	0.715	349/35.5	361/40.0
New Zealand	2	1	1	0	0	2	0.309	217/26.0	217/27.0
Ireland	2	1	1	0	0	2	-0.162	250/36.2	250/35.3

As above you can see that South Africa, India and Srilanka are formidable, and have the best chance to lift the up.

If Ireland wins next 3 matches, they are in Semi Finals. Will it happen?

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Regards
Vijayashankar

A Complete Health Guide

A Complete Health Guide...

EXERCISE AND FITNESS STAMINA EXERCISES

Walking: Excellent cardiovascular benefits for the advanced age groups.. Should be done briskly with swinging of the arms. Comfortable shoes must be worn. May be done morning or evening for 30-60 minutes. Jogging: Suitable for younger age group below 50 years. 30 minutes is all that is required and may be done continuously, or jog and walk in between when fatigued. The pace of jogging is equal to that of a brisk walk run on soft or grassy surface. Wear comfortable clothes and breathe freely. Swimming: For those who know how to swim, 20 minutes of continuous swimming is sufficient. Alternately swim the length of a pool 10-20 meters, rest at the end for 30 seconds, swim back. 10 such lengths is good. Use any stroke you know. They are all of almost equal cardiovascular and muscular benefit. Cycling: For any age group. Minimum time 45-60 minutes of continuous controlled fast cycling. Cycling up slopes gives added benefit. Ordinary cycles are good enough and indoor stationary exercises may also be used at low resistance for 45 minutes. Games: For the fitter younger age group. Get fit first before playing games such as squash, badminton, tennis, handball, basketball, football etc.. Warm up before the games. 30-45 minutes of the game is sufficient. Weekend or once a week games must be avoided unless other fitness programs are done on other days. Play within your capacity. .

YOGA

a) Yoga should preferably be done under expert supervision 2-3 times per week. b) In case you know Yoga, we suggest that the following 'asanas' be included in your program. c) Each Yogasana is repeated 2-3 times except serial Nos. 1, 14 & 15. d) Persons with back problems should avoid serial Nos. 2, 4, 10 & 12. e) Persons with Cardiac problems, HBP, etc. should avoid serial 4 and 5. f) This program will not only keep you fit, but is also beneficial for those persons who have high B.P., respiratory problem, mental strain, head - aches, digestive ailments, back problems, joint problems, etc.

STANDARD YOGASANAS
1 . Stand warm up for Pawan Muktasana series. 2. Suryanamaskar (Sun Salutation) Effect - on full body including heart and circulation. 3. Ardh-halasana (30, 60, 90 degrees, double leg raises) Effect - on abdomen, legs, back reproductive organs. 4. Sarbangasana (Shoulder stand) Effect - on brain, nervous system, thyroid, circulation. 5. Halasana (Plough pose) Effect - on spine, nervous system, back, lungs. 6. Matsyasana (Fish pose) Effect - on chest, neck, thyroid, lungs. 7. Bhujangasana (Cobra pose) Effect - on lower back, reproductive organs, lungs, spine, chest, abdominal organs. 8. Salabhasana, (Locust pose) Effect - an buttocks, legs, hips, constipation, gas, digestion, etc. 9. Dhanurasana (Bow pose) Effect - on abdomen, digestion, legs, back. 10. Naukasana (Boat pose) (V sit-ups) Effect - on spine, abdomen, chest, etc. 11. Bakrasana (Half spinal twist) Effect - on spine, fat on waist, gas, digestive organs. 12. Paschmottasana (Sitting toe touch) or Padahasatasana (Standing toe touch) Effect - on digestion, spine, legs. 13. Trikonasana (Triangle) Effect - on spinal nerves, waist, digestion. 14. Pranayama (Deep breathing) 10 rounds each. a) Anulome / Vilome - alternate nostril breathing, and b) Kapalbhatti. - Belly breathing Effect - on lungs and respiratory system. 15. Shavasana (Corpse pose) - as often as required. Effect - on physical / mental relaxation.
YOGASANAS
	GYM EXERCISES / WEIGHT TRAINING
	Weight training is basically for strengthening and building up the muscles. An all-round programme must have some stretching and cardio-vascular exercises as well. In addition, weight training loads the bones thereby strengthening and protecting against osteoporosis. The points to keep in mind in weight training are as follows: 1 The ideal weight training schedule is on alternate days i.e. 3 days a week with a complete rest on weekends. 2 The systems of training different muscle groups on different days, may be good for competitive sportsmen. The best system for non-competitive sportsmen is to exercise the entire body in each session. The major muscle groups are: Upper body - Shoulders, Arms, Chest and Lower body - Back, Abdomen, Legs. 3 Suppleness and stamina can also be built up through weight training by following a body builder-type schedule. Weights are also used to stretch muscles, build muscular endurance and cardiovascular stamina by repeating each exercise by using lighter weights with more repetitions. 4 If repetition are too easy, the weight used is too little. And in case it is not possible to complete the repetitions, it means the weight carried is too heavy. 5 A repetition is one complete exercise movement from the starting point to finish and then back again to the starting point. A set is a group of repetitions of the same exercise. Therefore, for the upper body 8 repetitions is one set. For the lower body, 15 repetitions forms one set. 6 We prescribe three sets of exercises for each muscle group. However, several systems of weight training prescribe different repetitions as well as different sets.
	Nutrition and Calorie Management: Generally speaking, our daily food intake must comprise a balanced diet of 1500-2000k calories with fibre (above 75 gm) and low fat (below 30 gm). Consult your nutritionist for specific advice.
	Micro - Nutrients:
	The guide to healthy eating pyramid provides you a balanced diet, with ample vitamins, minerals and anti-oxidants. The therapeutic benefit of these micro-nutrients are explained below..
	STRESS MANAGEMENT
	Stress has existed from the time of Early Man but has now become an omnipresent phenomenon in the life of 'Modern Man'. It has pervaded all layers of life. Stress is the bio-psycho-social response of the body to a demand, mental or physical. Stress is an arousal response the body makes, when a situation is perceived as being stressful. The impact of this arousal affects emotional as well as cognitive thinking. The impact is seen in behavioral and physiological change.. When stress is long term and chronic it leads to chronic psychosomatic ailments. While there is an undeniable link between stress and illness, optimal stress is a prerequisite for success in every task. Stress is the wind beneath your wings pushing you towards achievement. If stress can trigger off psychosomatic ailments in those living in the fast track, it can be a trigger even to those who suffer from monotony, boredom or frustration. It is therefore very essential to bring a balance between too much and too little stress. The first step in managing stress is to develop a stress-free personality. A high self-esteem, assertive behavior and a positive attitude help in building a stress-free perception. It also helps to focus on areas where control and change are possible. Locate the source of stress and use a problem solving approach to deal with it step by step. All stress you can understand. Some you can change. Some you may have little control over. You may then need to change your attitude and response towards these stressors. Thereby reducing stress. Any exercise program done regularly utilizes the body's stress hormones. Exercise not only makes the body fit, but also acclimatizes the heart and lungs to increased activity, as in stressful situations. Relaxation and meditation techniques result in calming brain waves, and reducing the effects of stress. This is especially effective with stress related ailments such as Hypertension, Headaches, Digestive ailments, Cardiac ailments, Sleep problems to name just a few. Stress may be an irritant in your life or it may be a factor of passive existence. Change of perspective will help change this stress to an active, rewarding life. One of the best gifts of nature is sleep. Daily sleep of 6 - 8 hours helps in relaxation and repair of the body and mind. It provides sufficient time for deep - NREM and dream REM sleep restoring physical and mental health. Stress may be an irritant in your life or it may be a factor of passive existence. Change of perspective will help change this stress to an active, rewarding life. One of the best gifts of nature is sleep. Daily sleep of 6 to 8 hours helps in relaxation and repair of the body and mind. It provides sufficient time for deep - NREM and dream REM sleep restoring physical and mental health.
	Use some of these stress defense mechanisms & optimize your stress.
	Quality time for family will ensure that you have a retreat called home. Plan your career well, it will give you challenge, satisfaction & security. An assertive personality is responsible to self & others. Learn this skill. Communication is the key to relationship building. Listen better and your conflicts will slowly dissolve. Develop a sense of humor. Learn to laugh at life, its paradoxes and at yourself. Plan a little idleness & quietness each day. You will be able to recharge. Exercise is arousal and relaxation is the opposite. Yet both are necessary on a daily basis. Practice both. Sleep well and you will have renewed energy to face the next day's Stresses.
	Plan your time well. You only have 24 /hours a day and many important areas to fit in. A simple formula for time & stress management. You could personalize it to suit your needs. Remember you can't delete any activity or reduce time for health factors.
	Hours Activity 6-8 Sleep 8-10 Work, Occupation, Study 1 Exercise 1 3 big and 2 small meals Quality family time 6 Relaxation, personal hygiene, social time, quiet personal time, others 24 Total time in a day
	EAR, NOSE, THROAT, TEETH, EYE CARE
	I. Ears Have periodic examination of your ears, especially if you notice your hearing decreasing. Do not put drops, oil, etc. in your ears without doctor's advise. Do not clean the ears with pins, keys, pens, etc. Do not remove foreign objects from the ear without a doctor's assistance. Do not unnecessarily- clean ears after bath with ear buds, etc. Loud noises are harmful for the ears. Do not slap children / others on the ears. Do not allow dirty water to enter into the ears. In all cases of ear ache, ringing in the ears, discharge from the ears, giddiness, vertigo, nausea, vomiting etc.- immediately consult your doctor.
	II. Nose Do not squeeze a boil or pimple around the area of the nose. Do not try and remove a foreign object from the nasal passage without a doctor's assistance. Do not unnecessarily pick the nose or blow the nose vigorously. Avoid unnecessary misuse of nasal drops inhalers, etc. without a doctor's approval. Consult your doctor immediately in case of injury and breathing difficulty.
	III. Throat Avoid the use of irritants to the throat such as smoking, chewing tobacco / pan, etc. Avoid putting coins, marbles, pins, etc. in the mouth. Do not shout, scream etc. this causes hoarseness. In cases of hoarseness - rest the throat without misuse till hoarseness passes. If hoarseness persists for more than 7 days, consult your doctor. Avoid eating excessively cold/hot spicy foods. Avoid talking when food/water is in the mouth. Eat food calmly- avoid hurry. In case of glandular swelling in the neck, consult your doctor.

All about Wockhardt, Bannerghatta Road, Bangalore

A Small Note... and a Request


I hardly know Rashmi. In the 30-odd days since I met her, I have grown to admire her courage and strength of conviction.

As many of you know, I have grown up around doctors, and tend to shy away from lending credence to "hospital horror stories". As you also know, I tend to be a very unemotional person. And very hard to convince.

So it's taken me a little over a month to agree to post this. A month in which I myself have presented the medical facts to several leading gynaecologists; met the medical services director of Wockhardt in an attempt to convince the hospital to conduct an unbiased investigation; done a lot of independent reading and research of my own. My conclusion: THIS IS JUST PLAIN WRONG.

Please do your bit to see that as many people as possible read it. Circulate it via email, via Facebook, and any other means you can think of. Talk about it. If it can help prevent even one more incident like this, it will have done its job. Hopefully, someone, somewhere will lend their voice to Rashmi's.

Thanks.
--
Regards
Vijayashankar

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Rashmi's Story


My name is Rashmi B.T. I am 35 years old, married to an air force officer, Vivek, and have a four year old son, Dhruv, delivered by emergency Cesarean section in 2004. On March 4th, 2009, my life was changed unalterably. I lost a baby that I had carried inside me, completely healthy, for a full 41 weeks.

I understand that doctors are human, that mistakes happen. However, I have come to believe that what happened to me could have been prevented if the doctor and the hospital had provided the most basic level of care and expertise. What's worse, they refuse to take steps to prevent someone else going through the same nightmare, simply because they want to protect themselves from the possibility of litigation - something I am not interested in unless it is the only way to force them to change their protocols.

The Beginning

In June 2008, Vivek and I learnt that we were expecting our second child. The pregnancy was uneventful. I was healthy and fit. Every prenatal visit and test showed that the baby was healthy and developing well. During my 35th week, I decided to consult Dr. Latha Venkataraman at The Nest, Wockhardt's Bannerghatta Road maternity facility to see me through the rest of my pregnancy.

Despite the fact that I had already undergone a C-section, she urged me to opt for a V-BAC (Vaginal Birth After Cesarean Section) or in layman's terms, a normal delivery. She brushed aside my concerns, telling me that a second C-section would be six times more risky and assuring me that a V-BAC would be less risky and almost pain-free.

My due date was estimated as 26 Feb 2009. I visited Dr. Latha on 28 Feb. She wrote on my record: "delivery will be attended by Dr. Latha/Dr. Prabha." Since I had neither met, heard of, nor been examined by Dr. Prabha before, I was concerned. Dr. Latha explained that Dr. Prabha Ramakrishna is another consultant at Wockhardt, and that it was a hospital requirement for her to write both their names down as possible attending doctors for my labor/delivery. However, she assured me that it was just a formality, and that she would be the one to attend to me when I went into labor.


On 3 March, I visited Dr. Latha again. Since I was so far past my due date, I requested that a scan be done to check on the baby.

When I called her to read out the results of the report, she did not want to know anything other than the liquor content, though I specifically asked her if there was any other information she would require from the scan. She told me I could either wait for labor to start or choose a day to come in and have my labor induced.


The Nightmare Begins

I went into labor at 2am on 4 March, and got admitted to the hospital at 5.15am.


By 7.45 am, I was experiencing contractions less than a minute apart. Dr. Latha came and did a quick examination. I was shifted to the labor ward at 8am where I remained until 1.50p.m., under the sole care of nurse Savitha. Dr. Latha was not present at all.

A junior doctor, Dr. Shirley, was available intermittently. She spent most of the time on her cell phone, talking to her husband. She was keen to see him before he left on an 11-day vacation. A Dr. Chetna substituted for her while when she went to see her husband off.

There was no other doctor present. Dr. Prabha was called each time the fetal heart rate fell (this happened a couple of times). She was seeing outpatients and attending two other deliveries simultaneously, so she was only able to come to the labor ward to see me four times, for less than 5 minutes each time.

At 10am, I was given Syntocinon, a drug used to enhance labor; the dosage was increased at 10.45am. At 12.30, there was vaginal bleeding, and the nurse phoned Dr. Prabha, who advised her to "keep a watch". The bleeding reduced, but I began to feel pain of increasing intensity during contractions. Dr. Shirley reappeared at 1.00 p.m., examined me vaginally and announced that I was almost fully dilated and would deliver by 1.30pm. I complained several times of excruciating pain but was told that it was normal. At 1.30pm, Dr. Prabha came in and was told by Dr. Shirley that I was fully dilated and would deliver any minute. Despite that, Dr. Prabha breezed off to visit another patient in the OPD.

I felt no urge whatsoever to push, yet was asked to do so. The stirrup on the delivery table kept breaking off - I was told that this is a recurring problem that "needed attention". At 1.50 pm, the fetal heart rate dropped to 80 beats per minute. Dr. Prabha was called again. She checked the fetal heart rate on the CTG, explained that this was normal when the baby was passing through the birth canal, and asked me to hold my breath and push hard. I felt no sensation in my cervical area, but felt intense pain tearing my stomach apart. I felt like my baby had rolled into my stomach and could see its body pushing up against my ribcage. I was screaming, pointing at my stomach, and telling them that my stomach was hurting, and there was no urge to push. But she told me to "push, push harder". I then heard Dr. Prabha saying "Get the OT ready". She told my husband that she was going to attempt to deliver by forceps - if that was unsuccessful, she'd have to do a Caesarian.

The OT wasn't on standby, wasn't ready. I was numb with pain. They wanted me to get up and move to the operation table. I couldn't move. They eventually slid something under my back and I pushed myself on to the OT table, as there was no transfer stretcher available. I complained of severe shoulder and chest pain. No one paid me any attention; everyone was busy preparing the OT, and the anesthetist was attempting to top up my epidural. The fetal heart rate was never monitored in the OT. Dr. Prabha unsuccessfully attempted a forceps delivery at 2.20 p.m., and then cut me open. I heard a deafening sucking sound, after which I must have passed out.
Later, I learnt that my uterus had ruptured along the scar of my previous Caeserian section. My baby was found floating in my abdomen. He had no heartbeat and he wasn't breathing. He had been deprived of oxygen for a long time - 43 minutes. They "resuscitated" my son and put him on a ventilator.

When I opened my eyes I saw Dr. Latha leave, followed by Dr. Prabha. Dr. Shirley was suturing me while laughing and talking with another nurse. I felt reassured that my baby was okay, even though I had neither seen nor heard him.
"Don't Worry, You Can Conceive Again"
At 3.30pm, a nurse struggled to take my BP reading; the BP apparatus wasn't working and had to be replaced. Dr. Latha met Vivek at the NICU and told him that the baby was doing fine and had to be kept under observation. She also told him that my scar had ruptured, but said that I was okay. At 4.30 pm, my husband repeatedly begged the nurses to give me pain relief. I was then shifted to the ward.

At 9.30 pm the neonatologist told Vivek that the baby had been deprived of oxygen for over 40 minutes, possibly resulting in "some extent" of brain damage. This was the first inkling we had that something had gone wrong.

The next morning, I was given a sponge bath at 6am. I then lay unattended until 2.30 p.m., when Dr. Prabha, Dr. Latha, and Dr. Prakash (the neonatologist) saw me for the first time after the operation. Dr. Latha unceremoniously ripped the dressing off my wound without using any gel or spirit, and pronounced the wound clean.


We were told that our baby would be kept under observation for another 24 hours. Later that night Dr. Latha came in at 9.50pm. Her only words to me: "Don't worry, you can conceive again. Your uterus is intact."
"Do Japa and Tapa To Get Better""
None of the consultants saw me on 6 March. That night, my milk came in, and my breasts became swollen and painful. I asked in vain for assistance. After repeatedly begging for help, I sent Dr. Latha a text message at noon on 7 March. At 4pm, a nurse told me that the doctor had instructed them to use a breast pump to relieve my pain - however, since the hospital didn't have one, I would have to go and buy one.

Dr. Latha finally visited me at 7.30 pm. She confessed that she was unaware that there had been a 43 minute delay in performing my C-section. She also admitted that instructions delivered over the phone could never substitute for personal supervision. She said, and again I quote, "Do some pranayama, japa, and tapa to help you get better."


Throughout my stay, nurses didn't know what medication I had been prescribed. They kept asking me what medication I was to be given. They had to be repeatedly reminded to give me medication.



For the next 13 days, Arnav was in the NICU on a ventilator. Throughout that time, he was completely reliant on ventilator support, his eyes were dilated and non-responsive to light, and there was no sign of movement. After a week, the neonatologist asked me to express milk and said they would feed the baby with a pipe inserted from his nose to the stomach. I did this for the next six days.


On 16 March, we decided to let Arnav go. We requested that he be removed from life support.

"We Would Do Exactly The Same For The Next Patient Who Walks In"
Vivek and I wanted to learn what had gone wrong with such a healthy pregnancy. Basic reading indicated that scar rupture is a well-known risk when you attempt to deliver vaginally after a first C-section, and must therefore be monitored very closely by a doctor if attempted at all.


We met with the hospital administration and the doctors. All we wanted was an explanation. To hear the words, "I made an error in judgment". Instead, we were met with a wall of defensiveness. Dr. Latha said that despite knowing the outcome, she would take exactly the same steps with the next patient who walked through her door.


I decided to get a second opinion. And then a third, and a fourth, and a fifth. Three of Bangalore's best-known gynaecologists (and other doctors too) categorically stated that given my age (35), the estimated weight of the baby (> 4 kilos), and the duration of gestation (>40 weeks), a vaginal birth should never have been attempted, and scar rupture was a logical, obvious outcome.


All reading I have done has backed this up. Even a layperson's book like "What to expect when you are expecting" (pages 363-364) says that abdominal pain during a V-BAC indicates a scar rupture and outlines the procedure for safe delivery of the baby. Given that I was complaining of excruciating abdominal pain, shoulder pain and chest pain, the doctor should have known my scar was rupturing. I should never have been asked to push; it exacerbated the rupture. Nor should I have been given a drug that intensified my contractions. By Dr. Prabha's own admission, she did not know about the rupture until she opened me up.

Several doctors have also told us that keeping Arnav on the ventilator for 13 days was an exercise in futility from the first. At no point were we told that he would never survive if taken off the ventilator - had we known that, we would never have subjected him, or ourselves to two weeks of anguish. All we were told was that he "might be" brain damaged to "some extent" but they couldn't predict how bad it would be.

A Brick Wall of Defensiveness; Discrepancies Galore

When I attempted to engage with the hospital to ask them to change their protocol of treatment based on an unbiased review conducted with the inputs of external gynecologists, I was met with a brick wall of defensiveness. They refused to conduct a fair, transparent investigation, claiming that their internal investigation showed that they had done everything right and that losing the baby was "my destiny". Dr. Latha went so far as to say that since I am educated, I should have been better informed about the procedure.

I don't want to sue them for money. I just want them to change their policies and protocols so that this doesn't happen to someone else. I have been hitting a brick wall for two months, and feel that the only way to make them pay attention is to tell my story to people.

There are many discrepancies and attempts to cover up the hospital's inefficiency (to name a few: baby's weight recorded as 3Kg despite the fact that he was never weighed; post-facto note of fetal heart rate as 180bpm despite the fact that the heart rate was never monitored in the OT; discharge summary says "live term baby extracted" even though Arnav had no heartbeat or respiration at birth; half-hour discrepancy between CTG trace and labor room clock). I asked questions to which I was given ludicrous answers (Eg: Our pediatrician is very experienced, so he can guess the weight of any baby just by looking at it).


We were charged approximately Rs. 2,20,000 by Wockhardt. Of this, we found over Rs. 7000 billed for things that had never been done (spinal anesthetic, an extra day of room rent, food not consumed). We subsequently found more extraneous charges, amongst them an amount billed for tests that were performed on 18 March, two days after Arnav's death.



My Story Has Just Begun...

My uterus is still healing. My back still hurts from the trauma. And my heart aches for Arnav, the baby I will never hold.

More than that, I am filled with the fear that this will happen again. After all, Dr. Latha says she would "do exactly the same again" even though she knows the outcome. And the hospital agrees that she - and they - did everything right.


Wockhardt delivers approximately 80 babies each month. With BP machines that don't work, a delivery room stirrup that's falling off and that has "needed to be fixed for a while", nurses who don't know what medication they are supposed to administer, and one (yes ONE) OT dedicated to emergency deliveries. That OT wasn't ready when I needed it. What guarantee do you have that it will be ready when you need it? Sure, they claim to have nine other OTs in the hospital - but if they are all as woefully unprepared as the one I was in, my story could be yours.


I want them to change their policies, and I won't give up until they do.

Thank you for reading.

The fallen tomato cart- very interesting read

(Author of this article is Subroto Bagchi, co-founder & COO of Mind Tree Consulting)

I pass through this very intersection every morning with so much ease. Today, the pace is skewed. There is a sense of disarray as motorists try to push past each other through the traffic light. The light here always tests their agility because if you miss the green, you have to wait for another three minutes before it lets you go past again. Those three minutes become eternity for an otherwise time-insensitive nation on the move. Today, there is a sense of chaos here. People are honking, skirting each other and rushing past. I look out of my window to seek the reason. It is not difficult to find because it is lying strewn all over the place.

A tomato seller's cart has overturned. There are tomatoes everywhere and the rushing motorists are making pulp of it. The man is trying to get his cart back on its four rickety wheels and a few passersby are picking up what they can in an attempt to save him total loss. Though symbolic in the larger scheme of things, it is not a substantive gesture. His business for the day is over.

The way this man's economics works is very simple. There is a money lender who lends him money for just one day, at an interest rate of Rs 10 per day per Rs 100 lent. With the money, he wakes up at 4 am to go to the wholesale market for vegetables. He returns, pushing his cart a good five miles, and by 7 am when the locality wakes up, he is ready to sell his day's merchandise. By the end of the morning, some of it remains unsold. This, his wife sells by the afternoon and takes home the remainder, which becomes part of his meal. With the day's proceeds, he returns the interest to the money lender and goes back to the routine the next day.

If he does not sell for a day, his chain breaks. Where does he go from here? He goes back to the money lender, raises capital at an even more penal interest and gets back on his feet. This is not the only time that destiny has upset his tomato cart. This happens to him at least six times every year. Once he returned with a loaded cart of ripe tomatoes and it rained heavily for the next three days. No one came to the market and his stock rotted in front of his own eyes. Another time, instead of the weather, it was a political rally that snowballed into a confrontation between two rival groups and the locality closed down. And he is not alone in this game of extraneous factors that seize not only his business but also his life. He sees this happen to the "gol-gappa" seller, the peanut seller and the "vada pao" seller all the time. When their product does not sell, it just turns soggy.

Sometimes they eat some of it. But how much of that stuff can you eat by yourself? So, they just give away some and there is always that one time when they have to simply throw it away.

Away from the street-vendor selling perishable commodity with little or no life support system, the corporate world is an altogether different place. Here we have some of the most educated people in the country. We don the best garbs. We do not have to push carts; our carts push us. We have our salary, perquisites, bonuses, stock options, gratuities, pensions and our medical insurance and the group accident benefit schemes. Yet, all the while, we worry about our risks and think about our professional insecurity. We wonder, what would happen if the company shifted offices to another city? What would happen if the department closed down? What would happen if you were to take maternity leave and the temporary substitute delivered better work than you did? What would happen if the product line you are dealing with simply failed? In any of those eventualities, the worst that could happen would still be a lot less than having to see your cartful of tomatoes getting pulped under the screeching wheels of absolute strangers who have nothing personal against you.

All too often we exaggerate our risks. We keep justifying our professional concerns till they trap us in their vicious downward spiral. Devoid of education, sophisticated reasoning and any financial safety net, the man with the cart is often able to deal with life much better than many of us. Is it time to look out of the window, into the eyes of that man to ask him, where does he get it from?

In his simple stoicism, is probably, our lost resilience.

--
Regards
Vijayashankar

Bill Gates Gyan

This should be posted in all schools and work places.



Love him or hate him, he sure hits the nail on the head with this! Bill Gates recently gave a speech at a High School about 11 things they did not and will not learn in school. He talks about how feel-good, politically correct teachings created a generation of kids with no concept of reality and how this concept set them up for failure in the real world.


Rule 1: Life is not fair - get used to it!

Rule 2: The world won't care about your self-esteem. The world will expect you to accomplish something BEFORE you feel good about yourself.

Rule 3: You will NOT make $60,000 a year right out of high school. You won't be a vice-president with a car phone until you earn both.

Rule 4: If you think your teacher is tough, wait till you get a boss.

Rule 5: Flipping burgers is not beneath your dignity. Your Grandparents had a different word for burger flipping: they called it opportunity.

Rule 6: If you mess up, it's not your parents' fault, so don't whine about your mistakes, learn from them.

Rule 7: Before you were born, your parents weren't as boring as they are now. They got that way from paying your bills, cleaning your clothes and listening to you talk about how cool you thought you were. So before you save the rain forest from the parasites of your parent's generation, try delousing the closet in your own room.

Rule 8: Your school may have done away with winners and losers, but life HAS NOT. In some schools, they have abolished failing grades and they'll give you as MANY TIMES as you want to get the right answer. This doesn't bear the slightest resemblance to ANYTHING in real life.

Rule 9: Life is not divided into semesters. You don't get summers off and very few employers are interested in helping you FIND YOURSELF. Do that on your own time.

Rule 10: Television is NOT real life. In real life people actually have to leave the coffee shop and go to jobs.

Rule 11: Be nice to nerds. Chances are you'll end up working for one.

If you agree, pass it on.
If you can read this - Thank a teacher!
--
Regards
Vijayashankar

மீண்டும் சில்லறை

இன்று மீண்டும் ஒரு சில்லறை, அனுபவம்.

மதியம், ஒரு குழந்தை பிறப்பு விசிட் முடித்த பிறகு, ஹெப்பல் எஸ்டீம் மாலுக்கு ( பெங்களூரு இண்டர்நேசனல் ஏர்போர்ட் போகும் வழி - 27 கி.மீ. முன்) சென்றோம்.

பையனுக்கு பர்த்டே துணி வாங்கிய பிறகு, லன்ச் அங்கே ஒரு "தி வெஜிடேரியன்" ஹோட்டல் - புட் கோர்ட்டில். இரண்டு தாளி, ஒரு சாட் பில் ரூ. 198/- ஐந்நூறு கொடுத்தேன். ரூ. 2 காயின் கொடுத்து விட்டு, சும்மா இருந்தாள் அந்த பெண்! நான் நின்றுக்கொண்டே இருந்தேன், மீதி சில்லறை வரும் என்று.

"சில்லற பேக்கு" என்றேன்.
"கொட்டாயித்து" என்றாள்.
"இன்ன முன்னூறு பரு பேக்கு" என்றேன்.
"இல்லே சார் நானு சுள்ளு (பொய்) ஏலல்லா" என்றாள்.
"சரியாக செக் மாடி" என்றேன்.

அப்படி இப்படி பார்த்துவிட்டு, மூன்று நூறு நோட்டுக்கள் எடுத்துக்கொடுத்தாள்.

அந்த கல்லாவில், ஒரே ஒரு ஐந்நூறு (நான் கொடுத்தது) ப்ரெஸ்ஸாக, கிடந்தது!

----*-----

அப்புறம், உணவு நன்றாக தான் இருந்தது, பட் பத்தவில்லை, அளவு குறைவு... வயிறு பெருசு... மீண்டும் எம்.டி.ஆர். மையாஸில் ஆளுக்கு ஒரு அக்கி ரொட்டி ( பெர்சுகளுக்கு ) மற்றும் ஆளுக்கு ஒரு பூரி செட் ( சிறிசுகளுக்கு ) என முடித்து, கிழே வரும் போது, பாஸ்கின் ராபின்ஸ் ஐஸ்க்ரீம் ஆளுக்கு ஒன்று... ஒன்றிற்கு விலை தான் அதிகம் ( ரூ. 51/-) முடித்துவிட்டு, ரிங் ரோடில், அரக்கரை அடைந்தோம்.

நாளைக்கு, பாஸ்கின் ராபின்ஸ், 31% தள்ளுபடி நாள். ரூ. 310 செலவு செய்ய வேண்டும்.

Why the US economy fell off the cliff

John Doe started the day early having set his alarm clock (made in Japan) for 6 am.

while his coffeepot (made in China) was perking, he shaved with his electric razor (made in Hong Kong), put on a dress shirt (made in Sri Lanka), designer jeans (made in Singapore) and tennis shoes (made in South Korea).

after eating breakfast cooked in his new electric skillet (made in India), he sat down with his calculator (made in Mexico) to see how much he could spend today.

he got in his car (made in Germany). set his watch (made in Taiwan) to the radio (made in India), filled it with gas (from Saudi Arabia) and continued his search for a good paying American job.

at the end of yet another discouraging and fruitless day, john got back home, checked his computer (made in Malaysia) and decided to relax for a while.

he put on his sandals (made in Brazil), poured himself a glass of wine (made in France) and turned on the TV (made in Indonesia) and then wondered why he couldn't find a good paying job in America.

…

and now he's hoping he can get help from a President made in Kenya.

Haiku

Found this Haiku on Twitter by Cisco CTO Padmasree

Black squirrel scurries,
Claws scrape the earth and tail up,
Curious friendship

--
Regards
Vijayashankar

சில்லறை

ஒரு கடையில் ஐந்நூறு நோட்டு குடுத்து சாமானம் வாங்கிவிட்டு மீதி நானூற்றி சொச்சம் சில்லறைக்கு பதில், நூறு என நினைத்து காஷியர் கொடுத்தார், குழந்தைகள் அடம் செய்ததால், சரியாக கவனிக்காமல் வீடு வந்துவிட்டேன். வீட்டில் வேறு ஒரு தேவைக்கு, ஆறுநூறு தேவைப்பட்டது. கையில் இருக்கும் என நினைத்து, பர்சை எடுத்து பார்த்தால், நூற்றி சில்லறை தான் இருந்தது. கடையில் சென்று கேட்டேன் ... காஷியர், நூறு தான் கொடுத்தேன் என்று அடித்து சொல்லிவிட்டான்.

மேலும் ஒரு நாள், நான் பிரெட் வாங்க சென்றேன். நூறு ருபாய் கொடுத்தேன், மீதி சில்லை, ஐந்நூறு என் நினைத்து அதே கேஷியர், நானூறு மற்றும் சில்லறை கொடுத்தான்.

இது தான் விதி என்பதா?

Silicon India Startup City

Hey,

Just wanted to let you know about an exciting event siliconindia is organizing on June 6th (Saturday in Bangalore). It's by far the largest and most exciting event of its kind in Bangalore.

It is your chance to know the building of companies like Rediff.com, Naukri.com and Tejas Networks as their founders come and share their journey with us: 
Ajit Balakrishnan, Founder & CEO, Rediff.com 
Sanjeev Bikhchandani, Founder & CEO, Naukri.com 
Sanjay Nayak, Founder, Managing Director & CEO, Tejas Networks

There will be 100 most promising technology startups showcasing their products. You can meet these entrepreneurs and also over 40 investors.

To attend this event, register FREE at http://www.siliconindia.com/startupcity_09/index.html

Watch live product demonstrations 
Get a peek into cutting edge technologies 
Lay hands on the best-of-breed solutions 
Meet young, energetic, passionate geeks 
Experience the culture of innovation in small companies 
Visionary Keynotes 
In-depth Panel Discussions

TIME: 8.45 AM to 5 PM 
WHEN: Saturday, June 6, 2009 
WHERE: Nimhans Convention Center, Bangalore (Near Dairy Circle)

Thanks

--
Regards
Vijayashankar

(Note - don't ask me about parking your cars, I hope they took care of it! It is at your risk...)

உன்னை நான் பார்த்தது வெண்ணிலா வேளையில்

உன்னை நான் பார்த்தது வெண்ணிலா வேளையில்
உன் வண்ணங்கள் கண்ணோடுதான்
உன் எண்ணங்கள் நெஞ்சோடுதான்
உன்னை நான் பார்த்தது வெண்ணிலா வேளையில்
உன் வண்ணங்கள் கண்ணோடுதான்
உன் எண்ணங்கள் நெஞ்சோடுதான்
நான் உனக்காகவே பாடுவேன்
கண் உறங்காமலே பாடுவேன்
உன்னை நான் பார்த்தது வெண்ணிலா வேளையில்
உன் வண்ணங்கள் கண்ணோடுதான்
உன் எண்ணங்கள் நெஞ்சோடுதான்
பப ரபபப பபபபபா
பப ரபபப பபபாப
பப ரபபப பபபபபபபா
பப ரபபப பபபபாப

அன்று ஒரு பாதி முகம்தானே கண்டேன்
இன்று மறுபாதி எதிர்பார்த்து நின்றேன்
கை வளையோசை கடல் பொங்கும் மலையோசையோ
என செவியாற நான் கேட்க வரவில்லையோ

உன்னை நான் பார்த்தது வெண்ணிலா வேளையில்
உன் வண்ணங்கள் கண்ணோடுதான்
உன் எண்ணங்கள் நெஞ்சோடுதான்

கம்பன் மகனாக நான் மாற வேண்டும்
கன்னித் தமிழால் உன் எழில் கூற வேண்டும்
என் மகராணி மலர்மேனி செம்மாங்கனி
என மடிமீது குடியேறி முத்தாடவா

உன்னை நான் பார்த்தது வெண்ணிலா வேளையில்
உன் வண்ணங்கள் கண்ணோடுதான்
உன் எண்ணங்கள் நெஞ்சோடுதான்

பபபபபபபபபபபபபபபா
பபபபபபபபபபபபபபபா
பபபபபாபா
பபாபாபா

எங்குத் தொட்டாலும் இனிக்கின்ற செந்தேன்
உன்னைத் தொடராமல் நானிங்கு வந்தேன்
நான் மறந்தாலும் மறவாத அழகல்லவா
நாம் பிரிந்தாலும் பிரியாத உறவல்லவா

உன்னை நான் பார்த்தது வெண்ணிலா வேளையில்
உன் வண்ணங்கள் கண்ணோடுதான்
உன் எண்ணங்கள் நெஞ்சோடுதான்

பட்டிக்காட்டு ராஜா என்ற இப்படம் (ராஜா காலத்தில் வந்திருக்கும் போல). 1975-இல் வெளிவந்தது என்றறிகிறேன்.

--
Regards
Vijayashankar

God's Food Pharmacy

It's been said that God first separated the salt water from the fresh, made dry land, planted a garden, made animals and fish... all before making a human. He made and provided what we'd need before we were born. These are best & more powerful when eaten raw.  We're such slow learners...

God left us a great clue as to what foods help what part of our body!

God's Pharmacy! Amazing!
A sliced Carrot looks like the human eye. The pupil, iris and radiating lines look just like the human eye... and YES, science now shows carrots greatly enhance blood flow to and function of the eyes.
A Tomato has four chambers and is red. The heart has four chambers and is red. All of the research shows tomatoes are loaded with lycopine and are indeed pure heart and blood food.
Grapes hang in a cluster that has the shape of the heart. Each grape looks like a blood cell and all of the research today shows grapes are also profound heart and blood vitalizing food.
A Walnut looks like a little brain, a left and right hemisphere, upper cerebrums and lower cerebellums.  Even the wrinkles or folds on the nut are just like the neo-cortex. We now know walnuts help develop more than three (3) dozen neuron-transmitters for brain function.
Kidney Beans actually heal and help maintain kidney function and yes, they look exactly like the human kidneys.
Celery, Bok Choy, Rhubarb and many more look just like bones. These foods specifically target bone strength. Bones are 23% sodium and these foods are 23% sodium. If you don't have enough sodium in your diet, the body pulls it from the bones, thus making them weak. These foods replenish the skeletal needs of the body.
Avocadoes, Eggplant and Pears target the health and function of the womb and cervix of the female - they look just like these organs. Today's research shows that when a woman eats one avocado a week, it balances hormones, sheds unwanted birth weight, and prevents cervical cancers. And how profound is this?  It takes exactly nine (9) months to grow an avocado from blossom to ripened fruit. There are over 14,000 photolytic chemical constituents of nutrition in each one of these foods (mo dern science has only studied and named about 141 of them).
 Figs are full of seeds and hang in twos when they grow. Figs increase the mobility of male sperm and increase the numbers of Sperm as well to overcome male sterility. 
 Sweet Potatoes look like the pancreas and actual ly bal ance the glycemic index of diabetics.
Olives assist the health and function of the ovaries 
  Oranges, Grapefruits, and other Citrus fruits look just l ike the mammary glands of the female and actually assist the health of the breasts and the movement of lymph in and out of the breasts.
Onions look like the body's cells. Today's research shows onions help clear waste materials from all of the body cells. They even produce tears which wash the epithelial layers of the eyes. A working companion, Garlic, also helps eliminate waste materials and dangerous free radicals from the body.
--
Regards
Vijayashankar

சில கேள்விகள்

சில கேள்விகள் (திரு லதானந்த் அவர்கட்கு )

யானைகள் ஊரு பக்கம் ( சிறுமுகை, சத்தி ) வருவது அதிமாகிவ்ட்டதே? ( சம்மர் )

தாய்லாந்தில் ஒரு மடத்தில், புலிகள் மனிதர்களோடு வளர்கின்றனவாம், எப்படி?

லஞ்சம் அதிமாகிறது நாட்டில்... அதனால் சம்பளம் அதிகம் செய்துவிட்டால் திருந்துவார்களா? (அமேரிக்காவில் போலீஸ சம்பளம், கிட்டத்தட்ட, ஐ.டி சம்பளம் அளவு )

இந்த சீர் செனத்தி என்கிறார்களே, கொஞ்சம் விவரமாக கூறுங்கள்.

ஊரில் என் இடத்தில, சில தேக்கு மரங்கள் நட்டுள்ளேன். நல்ல வளர்ச்சி நான்கு வருடங்களாக. எத்தனை வருடங்களில் வெட்டலாம்? காட்டிலாக அனுமதி தேவையா?

இப்போது சுப்ரீம் கோர்ட் உத்தரவு படி, சந்தன மரங்கள் வீட்டில் நடலாம், ஆனால் அரசாங்க விலைக்கு கொடுக்க வேண்டும் என்று நாத்து விற்பவர் கூறினார். உண்மையா? எத்தனை வருடங்களில் லாபம் பார்க்கலாம்?

"நடந்தது என்ன" விஜய் டிவி  நிகழ்ச்சியில், காண்பிக்கும் சின்ன குரங்கு ( சுண்டு விரல் சைஸ்) எந்த காட்டில் உள்ளது?

இன்னும் இருளர்கள், பட்டை சாராயம் காட்டில் காச்சுகிறார்கலாமே?

அரசாங்கம் யானை முடி வியாபாரம் செய்கிறதா?

வேலி ஓணானை வீட்டில் வளர்க்கிறார்களே, நாய் மாதிரி.. அது பற்றி?

மிருக பாசையில் பேசுபவர்களை ( டாக்டர் டுலிட்டில் மாதிரி) கேள்விப்பட்டுள்ளீர்களா?

கூகிள் நிறுவனம், காட்டு ஏரியாவையும் படம் பிடிக்கிறார்களே? இந்தியாவில் உங்கள் உதவி எடுப்பார்களா?

--
Regards
Vijayashankar

PLEASE FORWARD IT TO ALL WHOM YOU CARE

PLEASE FORWARD IT TO ALL WHOM YOU CARE  READ CAREFULLY -- IT MAY HELP YOU SOMEWAY   1) Mobile   Don't put your mobile closer to your ears until the  recipient answers, Because directly after dialing, the  mobile phone would  use it's maximum signaling power,  which is: 2watts = 33dbi. Please Be Careful. Please use left ear while  using cell (mobile), because if you use the right one it may affect brain  directly. This is a true fact from Apollo medical team.    2) APPY FIZZ   Do not drink APPY FIZZ . It contains cancer causing  agent.    3) Mentos   Don't eat Mentos before or after drinking Coke or  Pepsi coz the person will die immediately as the mixture  becomes cyanide. Please fwd to whom u care    4) Kurkure   Don't eat kurkure because it contains high amount of  plastic if U don't Believe burn kurkure n u can see  plastic melting. Please forward to all!!!!!!!!! !! News  report from Times of India    5) Avoid these tablets as they are very dangerous   * D cold  * Vicks action- 500  * Actified  * Coldarin  * Co some  * Nice  * Nimulid  * Cetrizet-D  They contain Phenyl- Propanol -Amide PPA.Which Causes strokes, and these  tablets are banned in U.S.    6) Cotton Ear Buds   Cotton Ear Buds... (Must read it) Please do not show sympathy to people  selling buds on roadside or at Signals..... Just wanted to warn you people  not to buy those packs of ear buds you get at the roadside. It's made from  cotton that has already been used in hospitals. They take all the dirty,  blood and pus filled cotton, wash it, bleach it and use it to make ear  buds. So, unless you want  to become the first person in the world to get Herpes Zoster Oticus (a  viral infection of the inner, middle, and external ear) of the ear and  that too from a cotton bud, DON'T BUY THEM! Please forward to all this may  be helpful for someone..... ....... Please forward to all your near and  dear  ones....!    PLEASE FORWARD IT TO ALL WHOM YOU CARE.   Dr Rima Dada, M.D.,  Dr. T. S. Roy MD, PhD Ph.D(Genetics) , MAMS  Professor Associate Professor,  Department of Anatomy Dept of Anatomy,  All India Institute of All India Institute of  Medical Sciences Medical Sciences(AIIMS)  New Delhi - 110 029 New Delhi  Phone: 91-11-26594880 110029-INDIA  Fax: 91-11-26588663,  26588641

Total Votes polled for Tamilnadu 2009 Loksabha elections

TOTAL VOTES	30238932
BJP	705937		2.33%
DMDK	3054620		10.10%
KNMK	579704		1.92%
ADMK	6892996		22.80%
CPI	861944		2.85%
CPM	669058		2.21%
MDMK	1112908		3.68%
PMK	1736684	11273590	5.74%	37.28%
DMK	7572247		25.04%
INC	4206255		13.91%
VCK	732833	12511335	2.42%	41.37%
OTHERS	6454007		21.34%

As seen above it is very clear that, DMDK is the major force to reckon with. They were mostly in the 3rd place except Kanyakumari and few seats in Kongu belt. Next time probably Congress might align with DMDK, and with a vote share of 25% plus they should get 130+ Assembly seats or like 25 MP seats (if the same voting pattern, vote bank holds good).

Kongu Munnetra Peravai Katchi spoilt the winning chances of DMK+ combine in 6 seats in Kongu belt ( Kovai, Pollachi, Erode, Namakkal, Tiruppur, Salem). Heard that they had spent about 50 C in total for 12 seats with contributions from major gounders, that translates to Rs 863 per vote. They could bargain for 20 seats in the 2011 Assembly with Congress + DMDK combine.

If DMK had spent Rs 1000 crores as certain investigative mags claim and opposition, that translates to Rs 1321 per vote an I bet ADMK combine would have spent half of that too!

CNN IBN forecast was right in the end. They gave 47% to DMK+, 34% to ADMK+, 10% to DMDK and rest 9% for others! Always exclude independents and buy them out to withdraw!

(This is posted as a matter of data analysis only....)