So long.....!

The last time I blogged, I was an undergraduate student. Dreaming to become a doctor. Five and a half years years have flown by. By the mercy of the Almighty, I am a doctor now. The girl I was, seems to be a stranger to the woman I am . No regrets. Just amused by the change that a few years bring about.

FRoZeN FLaMeS

Twilight..

That mysterious part of the day,

When the mind, like a sorcerer

Retrieves lost memories

Of a pair of Dark eyes

Daunting, yet inviting

As I lost myself

Into their twin depths;

Wild untamed passion,

Flames of passion

Transformed into words,

Into secret whispers

Ringing in my ears;

Of a touch:

More subtle than a feather's kiss,

Yet more lasting

In the pages of my thoughts;

Of the warm breath

Washing over me,

Expelling the cold

In seconds..

..Those seconds,

When I could hear my own heart beat,

Counting the minutes,

The days, the years..

And now,

The Sun has gone;

Leaving behind

A moonless night;

Phantoms from the Past

Are all that remain,

Of Broken Hearts

And Frozen Flames

Quintessence

I hold a flower in my hand
And I gaze into its infinite depths;
All around me I hear whispers
Of nature and its mysteries.

Stories as old as eternity
Of how the soil beneath my feet,
Was once a towering mountain
Before its humble retreat.

I wonder at the royal rays of the Sun-
Sheets of the purest Gold;
Sea waves that gently rise and fall
All in perfect rhythm.

The dew drops that never fail
To welcome me each dawn;
The curious rustling of the leaves
In the cool breeze of morn.

The roar of the thunder frightens me
I tremble, but for a while,
For hither comes the rainbow
To paint the Sapphire sky.

The drops of rain that fell from the Heavens
Join the seven seas,
Leaving behind a rich aroma
Wafting from the wet soil.

Evening time, time for rest,
The little birds return to their nests,
Colorful wings flap in synchrony
As they prepare themselves for the night.

And now a curtain of black satin
Sprawls across the canopy above,
Slowly, like precious diamonds
The stars peep out and shine.

The Moon – the Queen of the Dark
Casts her silver beams
That gracefully alight on the tree tops
Giving them a soft shimmer.

I stand still and marvel
At nature’s age old wisdom,
As she cleverly hides within her cloaks
All her deepest secrets.

Here I am, a harmony-
Between mind, body and soul,
An integral part of the Earth
But a speck in the all its vastness.

The Earth completes the Universe
In a strange limitless space,
Performing a celestial dance
Intricate, yet exquisite.

Each planet remembering its path
Rotating and revolving,
To the tune of a flawless melody
That no man can comprehend.

Who is the Great Conductor
Of this divine orchestra?
Who is the creator
And the law giver?

Quintessence- 
Some call it Science.
Others call it God.

The Story of the Caesarean Section

Childbirth and its complications have always intrigued man. The challenge is to save the life of both the mother and the child. Experiments and experience have taught us methods of achieving the same. Cesarean section is one of them.
During ancient times, C-section was done on the dying mother as a “last resort” to keep the baby alive.
But today, birth by C-section has started to increase globally. Almost one out of every five births in urban India is through a C-section.
How did this change take place between then and now?
To understand this we need to travel back time and trace the history of the Cesarean Section.

Switzerland, 1500
The story goes that there was a sow gelder named Jacob Nufer whose wife had a prolonged labor. To relieve her pain he supposedly cut open her uterus and pulled out the baby. The mother was alive and the child lived till the age of 77. The accuracy of this incident has often been questioned. But nevertheless the story spread and this novel method set the physicians thinking.

1543
The period of Renaissance.
Andreas Versalius published De Corpus Humani Fabrica. The book explained the anatomy of the female genital system. Aspiring surgeons began to study the human cadaver in detail.
But on the darker side, women were not allowed to attend schools of medicine till the late 19th century.
Here comes the interesting story of Miranda Stuart Barry who disguised herself as a man and performed one of the most successful C-sections in the history of the British Empire.

Around the same time, travelers to Uganda were spectators to a procedure that increased the curiosity of the Western world.
Each tribe in Uganda had a Healer. Whenever a woman went into prolonged labor, the Healer would semi-intoxicate her with banana wine and make a mid line incision on her abdomen to gain access to her uterus. He would then massage the uterus and take the baby out. The incision was then sutured using iron needles and the wound was dressed using a paste obtained from indigenous roots.
This was one of those rare incidents in history when the civilized world seemed to be way behind times.

1800-1875
Back in the Western World surgeons now had a thorough knowledge about the anatomical structures within the female body. But C-section still did not make any progress because of 2 reasons:
-Pain. C-section was a very painful procedure and the people looked at the surgeons as butchers and barbarians.
-Infection. Sterile practices were not known then and opening the peritoneal cavity naturally gave rise to many infectious diseases.

Anesthetics were invented in 1846 and this helped the surgeons operate with precision. It also helped them record the details of the surgery.
Soon antiseptics came into picture and the situation seemed ideal for the much dreaded C-section to become widely accepted.

But this did not happen.
And this time it was because the surgeons were afraid to suture the uterus after childbirth. They thought it would lead to infections; they also believed that the uterine muscles would contract spontaneously and stop the bleed. Thus, many young women died due to hemorrhage and shock.
To overcome this, hysterectomy was suggested by a few doctors. But the idea was discarded for obvious reasons.

1882
Max Sauminger introduced the silver wire stitches and a few years later surgeons started experimenting with transverse incisions on the lower segment of the uterus. This greatly reduced the chances of scar rupture in subsequent pregnancies which was a common occurrence with the previously employed mid line incisions.

1928
Discovery of Penicillin. Antibiotics were used to prevent many hospital-acquired infections.

1950 onwards..
Heart monitors and Ultrasound scan were invented. This helped to foresee the complications that might arise during the course of labor. Patients with pelvic abnormalities, placenta praevia, etc. were advised to get a C-section done.

Thus, The Cesarean section is not a procedure that evolved overnight. It had its own history. Mistakes were committed. Lives were lost.
But it has taken a giant leap from being a near-death or postmortem operation to a life saving one. And to the family of the mother and the operating surgeon, it makes all the difference in the world…

Vaccine no guarantee against Cervical Cancer!

The excitement surrounding the Human Papilloma Virus vaccine for cervical cancer is not surprising given that "10 women die of cervical cancer every hour in South East Asia... and shockingly, 8 out of the 10 are Indian women".

The All India Institute of Medical Sciences has declared HPV types 16 and 18 as the main culprits causing havoc in India. They account for almost 70% of the cervical cancer cases in India.

So what exactly is a HPV vaccine?
The HPV vaccine is a quadrivalent prophylactic vaccine which offers protection against HPV types 6, 11, 16 and 18. It is prepared from a non-infective, DNA free, virus-like particle produced by recombinant technology.

What is the Target Age group?
HPV vaccine is most effective when administered to women falling under the age group of 9 - 26 yrs. This is because a woman who has crossed 26 yrs of age might already be infected with the virus before she gets vaccinated.

How efficient is the Vaccine?
The vaccine prevents HPV infection for a period of 5yrs.
But the recipient of the vaccine should not develop a false sense of freedom from cervical cancer because the vaccine does not offer protection against all types of HPVs. In fact it fails to cover over 30% of oncogenic HPVs.
Thus, regular screening for cancer should be continued.

Moreover, the following risk factors must be kept in mind:-
- Multiple sex partners
- Male partner with multiple sex partners
- Intercourse at a young age
- High parity
- Immunosuppressive states (esp. AIDS)
- Use of Oral Contraceptive Pills
- Use of Nicotine

What are the Side Effects of HPV vaccination?
In most cases there are transient side effects like:
- Erythema and tenderness at the site of injection
- Pruritis
- Nausea
- Headache
- Fever
- Dizziness
A few cases of syncope have also been reported which is why it is wise to keep the recipient under supervision for a minimum of 15 minutes.

Are there any contraindications to the administration of this vaccine?
Yes. The vaccine should not be given to patients who are
- Pregnant
- Suffering from acute illnesses
- Allergic to yeast
- Hypersensitive (to a previous dose of the vaccine)

The WHO rightly states that while the vaccine reduces the prevalence of the cancer, it does not completely eradicate it.
Therefore, spreading awareness about cervical cancer would go a longer way in reducing its incidence than vaccination.

21st century DOC

SUNRISE

How gently the pall of darkness
Slowly lifts,
And the cry of the cuckoo
Pierces the silence of the morning.
The green leaves bathe
In the crystal clear dew,
And the trees stand silently
Watching the slowly fading mist.
Slowly the creatures stir-
Calm and well rested,
And venture out of their homes
To welcome the new day.
The lakes reflect the mountains
Shimmering in the first rays of the Sun,
That sweeps across the valleys
And enters the narrowest alleyways.
Soon the milkman begins his day,
The laughter of children fills the air,
And the whole world experiences
The magic of a new morning.
How gently the Creator smiles
At His marvellous creation-
That was once again basking
In the glory of Sunrise.