Hello everybody , wish you a Happy New Year

This year has been a very memorable year for me and my family. We spent the year in Chennai and visited many parts of India and had a great time. Definitely one of the high points for me was the KMC class reunion in August 2009. Just the group photo of our class at MGM was worth the effort. But I hope this would be the start of a live long friendship. Organising reunions every 5 years is probably realistic (in my view) and maybe groups could meet locally every 2 years. Whatever the circumstances maybe; we will meet again.

In the mean time , Happy New Year and hope there is less conflict and more peaceful times in 2010. After all the world has reason to come together- Soccer World Cup is scheduled in June 2010.

Prabhakar Devavaram

PS - I remember a Tamil movie song starring Kamal from the 80s titled- hello everybody, wish you a very happy new year. I don't remember the movie, it was played at almost all of our college parties.

A second full moon in a calendar month is called a blue moon and its expected on this new year's eve in India. Picture from google images.

Happy Christmas

For those celebrating Xmas, Happy Christmas to  you.  India is an unique country, there are many things which could divide us- Language, Religion , Caste etc. But still we are able to live together and be inclusive. I know that we have had serious problems, but for the most part we have the freedom  to lead the lives we want to live.

In keeping with that spirit,  the blog will be celebrating all holidays in the coming years. Though I am familiar with most festivals, please remind me when important days come up. And people who follow Jainism, Sikhism, Bahai faith, Buddhism, zoroastrianism and other religions or Atheism, please let us know when important days come up in your spiritual calender.

Prabhakar

PS- Picture of the star is from the balcony of our flat in Annanagar.

MGR

What a coincidence, Raghu mentioning Puratchi Talaivar - MRG  in the comment section. Today happens to be the 22 nd death anniversary of MGR. I learnt this the hard way. I thought of taking  a scenic route to work today and took the Marina Beach road. But traffic was particularly bad and soon learnt the cause . MGR fans and party members were paying homage to their leader at the samadhi on beach road.

I remember MGR's passing  and it came during our exams (maybe it was ENT orals for me)

Prabhakar

The Lonely Blog

Its been quite difficult to find time to blog, just as people don't  have time to write comments. I plan to request about 4 people in different continents to blog so that we can have one posting per week. So pls get involved and hope everyone is having a good time this holiday season.

Prabhakar

My Back Pages

I am a news junkie, often drawn to the news which is not main stream. These are some stories which caught my eye.

Now Cooum clean up has been in the news a lot in Chennai. Since I studied at MCCHS and  Loyola college, one could say that the banks of the Cooum have been part of my youth. But finally there is a serious effort to clean up the river. Mr Stalin, our Deputy CM has visited San Antonio , Texas and Singapore to get a first hand look at their ability  to clean rivers in their cities. It been reported that the Singapore model is one which may fit the Cooum restoration.

The second photo is about the Mantra Surf Club. The Surfing Swamijis  are an unique group of seers who help others achieve spiritual advancement, thro the adrenaline pumping sport of surfing. The surfing ashram is located at Murfi which is 30 Km north of Mangalore. Its reported that there are only 12 surfers in India of which 7 are Swamijis.

The final photo is about how tough its to get into good schools in Chennai. This is a picture of parents standing in line to get application forms for their children to get admission at the DAV school at Gopalapuram.

Thanks for all the comments. We will start our account soon. But please contribute generously to all our causes, including Meera's.

Prabhakar

Meera Charity Contribution Details

               

Its taking a longer time to open our association account . In the meantime,I have included info to contribute to Meera's Charity below. Please read carefully and make sure the contribution goes to Meera's ICU care. please email Meera or me for questions.

Prabhakar

MANIPAL EDUCATION & MEDICAL FOUNDATION

                                          1756 North Wilmot Street

                                          Chicago, Illinois  60647

Manipal Education & Medical Foundation is recognized by the United States Internal Revenue Service as an I.R.C. Section 501(c) (3) tax exempt organization.

Applicable for people looking for US tax exemption.

 

2.    US Tax # is 23-7105960

 

 

3.       Bankers

           MB Financial Bank - Routing number 071 001 737.

 

credit: Manipal Education & Medical Fnd. - account # 162 000 7436.

               

Contact Person

Joseph Kure

Private Banking

MB Financial Bank

800 W. Madison

Chicago, IL. 60607

  

The donor cheque can be mailed to above address or direct transfer effected, under advise to our secretary

and Board member-  Nikhil Verma, at the Chicago Address.

 A receipt will be issued from that office, in due course

For Indian transfers :
The funds are to be credited to a/c no 016901000488 of Manipal Foundation with ICICI bank Indranagar,Bangalore. May be transferred via NEFT/IFSC/RTGS. Code is ICIC0000169.

If any one sends money ,I request them to mail  vrinda.raman@manipalgroup.com & inform her that the amount is meant for PICU . They will otherwise use it for other charities. Also please mark a copy to me ramakrishnan13@hotmail.com. This is for me to keep track that the money is being doubled.

About the Photos

The photos were taken at the Aquarium at KL and in Penang in Oct, when I went to visit Malaysia with my father and nephew. My father grew up in Malaysia and came to India after age 14. So it was an emotional trip for him to return to his city of Penang. Nagarajan and Mohanan were the most gracious hosts and it felt so great to travel with Naga for a week and then spend a weekend with Mohanan. 

In India, Malaysia is often promoted as a shopping place and more importance is given to Singapore. I was pleasantly surprised by the natural beauty of Malaysia and the national parks in Malaysia. It would be a crime not to mention the food in Malaysia. Street hawkers make food 24/7 and Naga the epicurean was always in search of the best street food. My only regret in Penang was that we; Guna(Naga's friend), Naga and myself, could not eat at the Thai food place we went in search of at 2.30 AM. It was closed.

Thanks again Naga and Mohanan.

Meera's Charity Request - Part 2

Please read Part 1

Case 1 (photos 1 and 2)

7 year old presented following attempted care at 3 different hospitals

Presenting complaints; fever for 7 days, rash for 2 days, dyspnea and anuria for 24 hours

Above problems started following needle injury to Lateral aspect of Rt Knee

Significant findings ; Cellulitis over thigh , rash all over body, cardiovascular collapse and worsening respiratory distress.

Initial Resuscitation- Intubation, invasive monitoring,Fluid management, vasopressor support(Norad and Dopamine). Included CPR for cardiac arrest on Day 1.

Provisional diagnosis- Toxic Shock Syndrome

Subsequent course-  Debridement of cellulitis, Blood culture positive for Beta strep, Antibiotics(Ceftriaxone, Amikacin and Clindomycin),unresponsive to Steroids . Complications included ARDS (treated with ventilation for 10 days , inclusive of high frequency ventilation for 5 days), Acute renal failure (treated with SLED for 20 days).

Patient fully recovered without loss of digits, normalised renal function and was discharged after 40 days. Since the father was a driver and could not afford this care (Rs 7000/per day), Meera's team had to raise over 3 lakhs.

Case 2 (photo 3)

13 year old from TN presented with fever for 10 days, anuria and dyspnea for 24 hours

significant findings ; Shock , Respiratory  Distress, Renal failure, Hepatosplenomegaly

Course- Intubated /Ventilated with high PEEP 18 , currently 10

             Vasopressors- shock resolved

             Renal F resolved

Workup negative for cause initially, later H1N1 was confirmed. Pt did well and was discharged recently.

This pt family is from a low socioeconomic category and also under severe  financial difficulties since another sibling in the family was in an accident a year ago and is currently in a vegetative state.

Prabhakar

Meera's Charity Request - Part 1

Meera works in a  corporate teaching hospital, but is  able to provide help for the poor patients who come to her PICU. She has been working hard to help the needy and is looking for help. Whatever help we could provide will depend on the the contributions we receive. Once we start the bank account, I will send in the information.

Meera has a clear picture of her needs in this endeavour. Please read her letter she usually sends to her sponsors. In time, I  think we will be able to help Meera with contributions, but she reports that any equipment or near expiration date devices(like CVP lines , LMA ) would be put to good use. If anyone has any other ideas or venues to raise money , please comment.

Meera has been able to raise a third of the required amount on her own. Any fund she raises will be matched by the management. 

Part1 is the letter and Part 2 will be the next blog entry with a couple of cases from her PICU.

PART - 1  Meera's Letter (Unedited)

Although I  work in a corporate hospital,the Management has always let me take care of poor patients. In my earlier stay in India,I was fortunate to have Rohini Nilekani sponsor all my needy patients.

However now she is sponsoring some other venture & I am looking for sponsors to help us have 3 free beds in the ICU -ie 1095 patient days .

About our ICU:

PICU  is a 8  bedded unit (becoming a 10  bedded unit next month) which provides care for patients from 1 month to 17 years of age. They suffer from varying illness such as cancer, trauma, liver failure, kidney failure, sepsis , ARDS etc . We have about 550 admissions/year .

The ICU mortality is 6%. If we discount the mortality within the first 24 hours it fall down to about 3% .  Most patients are referred to us in extremis. It is very gratifying to see patients do well despite various limitations. (We have Conventional ventilators-Servo-i ,HFO- Sensor Medics,CVVHD, Plasmapharesis etc)

I have doctors and nurses to assist me so that as a team we  strive to provide excellent care .We have paediatric Critical Care Fellowship which is recognised by National Board. (We are one of the 3 programs in the country to have a FNB)  

The main limitation that we find in our ongoing care is the financial part. Even to run a not for profit organization we need funds. Since all admissions to the PICU are an emergency the family is emotionally and financially ill prepared for the same. Further more parents of most of the children are young and do not have any savings to fall back on. Most do not have insurance and have to choose between an ICU like ours where the care and support is state of the art but unaffordable and government hospitals .In a country like ours I don't think the government can spend on ICU care. However it does not mean it is not important .

The following is the financial details of our ICU

Average cost of care in the PICU for a ventilated patient  -                Rs 15,000/day

Average cost of care in the PICU for an unventilated patient -            Rs 7,000/day

Average cost includes – Bed charges, Oxygen charges, investigations, Procedure and Consultation charges and Ventilator charges (for ventilated patients).

The hospital has agreed to waive off the Bed charges and Procedure and Consultation charges. It has further agreed to provide a 50% concession in Oxygen, Ventilation and Lab charges. This will result in a concessional rate of Rs 7,000/day for ventilated patients and Rs. 3,500/day for unventilated patients admitted under this arrangement. For most families even this is a huge amount and hence to make care completely free except for medicines we need to raise about Rs 75,00,000.(Assuming all the patients need ventilation )

Any fund that will be raised by the employees of the organisation will be matched by Manipal Foundation (NGO arm of the organisation)

I assure you your faith will not be misplaced. Your help will not only help these patients but will help me to train junior staff  as well . We are starting Critical care nursing as well from Jan .Proper education is the only way forward .

regards

Meera

Photo Caption - fruits of labour

A Close Shave

We should be glad that we had the reunion in August when it was still the old KMC. Walking through this construction site would not be nostalgic. I was alerted by Dr Rao and MPV of these changes to our old stomping ground. Its very hard for administrators to see  a nice garden  and  not imagine a big building in its place.  I wonder if they transplanted the trees. I wouldn't bet on it.

Prabhakar

Deepavalli

The Kmc1984reunion blog wishes its readers a Happy Deepavalli. We will take a 10 days break and when we come back  will blog about the charitable initiative .

Chennai has a number of malls and many more in construction and most of the famous stores in Chennai have branches all over  the city. But T.Nagar is still  the place to shop. I would think the thrill of bargaining and haggling over the price is the main attraction here. 

 Hiding in the news was the fact that 150 people(including children) were lost from their groups that day. Its concerning to me that this was not a front page news headline. The news also reported that the public announcements by the police were drowned out by the honking and all other  sounds of the city.

We  hope all were reunited and wishing them a safe Deepavalli.

From The Annals of Improbable Research

Though most of you  look forward to the Nobel prize awards, I follow the Ig Nobel Awards which is given out a week before the  Nobel prize announcements. The Ig Nobel awards is an annual exercise in irreverence that celebrates research that " cannot, or  should not , be repeated". These are given to scientists whose results first make people laugh, and then make them think.

The event took place in early October, at Harvard University in Cambridge,US  and was hosted by the Harvard based journal -Annals of Improbable Research. This year ceremony was covered by most newspapers , even The Hindu and Indian Express.

Presenting the winners;

1) Veterinary Medicine Prize - Catherine Douglas at Newcastle University School of Agriculture for the groundbreaking discovery that giving cow's names such as Daisy increases their milk yield.

2) Peace prize- Awarded for research on whether it is better to be smashed over the head with a full beer bottle or an empty one. Bolliger at Univ of Bern, Switzerland  accepted the prize for "Empty beer bottles are sturdier than full ones". However the reseachers conceded that the both full and empty bottles are theoretically capable of fracturing the human neurocranium.

3) Public health Prize- Awarded to Bodnar of Illinois, US for patenting a bra that, in an emergency , can be converted into a pair of gas masks, one for the owner and one for a needy passerby.

4) Medicine Prize- Donald Unger  a physician in California, US  who cracked the knuckles of his left hand  but never those of his right( Control), every day for 60 years to investigate whether it caused arthritis. Dr Unger, now 83 years reported that there's not the slightest sign of arthritis in his left hand.

5) Biology Prize -  Fumiaki Taguchi et al from Kitasato Univ Graduate school of medical sciences , Japan demonstrated that kitchen waste can be reduced by more than 90% by using bacteria extracted from giant panda excrement. Taguchi suspected that panda excrement must contain bacteria capable of breaking down even the hardiest of foods because of panda bear's vast consumption of bamboo,

6) Literature Prize- Awarded to the entire police force of Ireland for issuing more than 50 penalties to a man they supposed to be the most persistent driving offender in Ireland. Mr Prawo Jazdy , was the name , which in Polish means "Driver's License". An investigation done subsequently revealed that that the officers had mistakenly taken down the wrong details from the offender's  Polish driver's license.

Hope you enjoyed this as much I did. There is more, if  you google for Ig awards.

Happy Deepavalli.

Prabhakar

The Front Page

Dr Sankarabarathi operated on a 7 month old  suffering from a rare condition called Nesidioblastosis. An article with Sankarabarathi's  photo and his accomplishment appeared in The Hindu on Sept 27th. This condition is rare cause of persistent hyperinsulinemic  hypoglycemic in infancy. These patients require continuous feeding/glucose supplementation, even  during sleep.

A subtotal pancreatectomy ,  95% of the pancreas was surgically removed by Sankarabarathi's team. Patient continues to do well. 

If others have any accomplishment the would like to share, you can email it to me.

Prabhakar

Joy of Giving (Advisory- Medical content)

THIS BLOG HAS MEDICAL PICTURES AND NOT APPROPRIATE FOR CHILDREN. 

A few of us met recently to discuss reunion matters and particularly talk about the available funds. We have about 45,000 rupees surplus. In the past we have heard different view points , but the common thread is that everyone would like it to be put to good use , a deserving project etc . So this is what we propose.

1) Set up a bank account  - KMC Reunion account . This is be managed by 3 classmates. Will have  an auditor involved. The accounts will have to be very transparent. Will request for voluntary donations. This money will not be used for reunion activities.

2) Will request classmates to submit  projects which deserve funding. They will have to be (initially ) small projects.  For example ,I have taken part in a surgical camp in Tamil Nadu/Karnataka border a few times. I donated a Nellcor Pulse Oximeter in 2005 which was collected from  Children's Hospital, Boston. It still works well and has helped anaesthetists at these surgical camps which are conducted every 3 months

Another  project proposed is an  A/C installation for the Post Operative ward at the Surgical Oncology division in Royapettah which we will discuss. But it  could be anything - pulse oximeter for a medical camp where our classmates are involved, a water well in a village which needs it, adopt and improve a ward ,  a deserving poor student who is unable to cont studies for lack of funds etc. 

But  personal involvement of the classmate requesting this project is required , for this to work. We will also have  a group to decide on such proposals, with the classmate who is interested in its implementation. 

Once we set this up, it would be required for the recipients to talk about these contributions and its impact at future reunions. I  hope everyone would like to be involved in this charitable wing of the class. This kind of  communication and work will keep us together.  

We also propose reunion to be conducted every 2 years and the subsequent one at 3 years. Using 1989  for calculation , 2009 was the 20th year reunion and reunion will be  in 2011 and the 25th year reunion will be in 2014. 

PROPOSED PROJECT - 1

ONE A/C  UNIT AT ROYAPETTAH SURGICAL ONCOLOGY POST OP WARD

As most of you know Chennai can be brutal in summer. I am told that  Chennai has 2 summers these days ; one in May and then in July/August. MP Viswanathan is an Assistant Professor at Royapettah Surgical Oncology division and indicated a need for an A/C for the post operative ward at Royapettah in his unit. I recently attended rounds with him. They have  excellent clinical material and provide quality care. They perform about 12 Major surgeries per week. While the post op ward is very  functional and quality care is being provided , I agree that the patients would benefit greatly to recover in some comfort , instead of having to deal with the elements. There is one big floor fan and it makes more noise than cool air.

I have included some photos from my visit;

1) Dr SNEHALATHA

2)   Patient with Incisional Scar Rt Temporal Region- 40 year old male with CA middle ear, post RT recurrence. Post - En bloc resection of tumour , Rt temporal bone resection .

2) Patient with Tracheostomy /NG tube-  50 yr old female with CA  Lt alveolus . Post - Lt composite resection, P. major myocutaneous flap for lining, tracheostomy for anticipated post op airway issues.

3) Patient with Incisional scar Lt shoulder-  55 yr old male with chondrosarcoma of lt humerus. Post - Type 1 resection (Malawar) and prothetic instrumentation.

Our class has another connection to this surgical division. Dr Snehalatha , our anatomy teacher started this unit in Royapettah.  She was the Professor and HOD of this unit and was instrumental in starting the surgical oncology MCh program at Royapettah. Unfortunately , she succumbed to  malignancy  and pass away in 2003. To me this is a even more compelling reason to take  this as the first project. 

Some of you may ask why cant the govt  install an  A/C ; the answer is- that is not seen as a priority. If others have such ideas in mind , I would be happy to visit your site.  I understand we are doing this without much of a  blueprint, but our class has always been different and willing to explore different areas/ideas.

Prabhakar Devavaram

Thank you, Kamal

Since we have had very few comments in the previous blog entry, I thought of a light topic this time. Currently we are working behind the scenes to set up a charitable arm to our class. More on that later , but first give it up for Kamal Haasan.

 Kamal's 50 years in cinema is being celebrated in Chennai. It brings special memories for me. I think I was in 8th standard when the movie"16 Vayadhinilae" came out. Though I was not allowed to see the movie, I claimed that it was the best movie ever.  Well, I grew up with some serious movie fans. My friends would go to the first day /first show of all important movies , survive getting beaten up  by the police while standing in line for the 90 paisa ticket, then would tell/act out the whole movie to the less fortunate ones like me. 

Kamal Haasan is a special actor to me and my favourite movies of his are - 16 Vayadhinilae, Hey Ram and Nayagan.

If you have any special memories please share, or if you want to honour any other actor or actress, that would be welcome too.

Dont forget

  

I have listed the classmates who we were not able to contact to inform about the reunion. Please keep looking for them , so that we invite them for future reunions.
  
 
  
 
  
 
  
1.Gayatri Bharadwaj
  
2.Jayalakshmi Natarajan
  
3.Jayanthi Christina George
  
4.Josephine Rani
  
5.S.Jothi
  
6.Krishna Jee
  
7.Malathi
  
8.Mangayarkarasi
  
9.Nuniz Derena
  
10.Radha Krishnan
  
11.Savitha Rawal
  
12.Selvaraj
  
13.Sunitha Jacob Kuriyan
  

Finding time to post blogs is getting to be a problem. If classmates can email essays or topics , I would be happy to post them.For example-  Currently there is a health care debate going on in the US , and US docs can educate docs working in rest of the world about that.
  
 Staying on the same subject, when most people in US talk about socialised medicine they talk  with such revolt and anger. Now UK doctors can write about the success and faults of the NHS there. Similarly Docs in India can write about the benefits and faults here. So please help in keeping this blog going.
  
About the picture- I have a regret, that I have never been able to climb a coconut tree. So whenever I see an expert climbing a cocconut tree , I stand back and watch with envy.
  
 
  
prabhakar
     

From the Accounts Department

Being the treasurer of the reunion committee was not my choice, but I had to take it up for lack of volunteers. I am glad to report that we have a surplus of about Rs 50,000. 

As David Byrne  sang; And you may ask yourself... how did I get here?

As seen in the photos :

Credit - Rs 315475.48

Debit- Rs 251028.00

Balance- Rs 64447.48

I am waiting for 2 more cheques to clear , about 11,000.

We knew that we were working with a small budget for expenditure; about 50, 000,  we thought at that time. I decided to look at the big picture. After discussing with the rest of the organising committee , we decided not cut back on any projects we thought were essential to the event.  I also estimated that if the cost should overrun, it would be in the range of 10- 20,000 . I hoped to collect it at that time. 

And many of you kindly donated Rs 500 or more on August 9th, 2009. Though in retrospect we didn't need the money, it gave me peace of mind while settling the bills. So thank you again.If any of you who paid Rs 500 or more on August 9th, 2009 would like a refund , please email me.

Now what do we do with the surplus. Please comment, on this issue. In the mean time I am going to set up the KMC reunion account and this will be managed by 3 of our classmates and transfer the surplus amount to the account. Any decision to spend will have to be approved by all three.

I would like to thank everyone for their help and support in this.

Prabhakar Devavaram.

Share and Care - Poet Kaveri

The talent in our class is brilliant. Just another example of great poetry, this time in Tamil by Poet Kaveri. Since sending the poem  via Email , I have one english translation by Kumaran. And what a great job by Kumaran.

This blog will entertain poetry or writings in any language Indian or foriegn- Hindi, Telugu , Malayalam, Marathi, Manipuri or Malay, French and Espanyol.

Kaveri’s Poetry- Share and care through the wires and waves of the web

By Kaveri

English Translation by Kumaran

Title by Prabhakar

  

KMC

Our student days….

Emerging from the warmth of our parent’s care

We sought out friends to love and share

 

The exciting years of learning and training

Between eighty four and eighty nine

We strove through praise and our stars were shining

It had to end with gloom descending

 

Birds of the KMC nest had flown all over

Taking pride and fortune world over

No time to meet, no time to talk

We flew away in distance and lived away in silence

Where was the time to stop and search?

For the long lost friend of the distant past

 

New friendships, new relationships took up our space

The old ones sank to the background

We were so busy, caught up in our work-position-fame-service race

We couldn’t keep our ears very much to the ground

 

Twenty five years went by

The world has become smaller

The distances have been bridged

Relationships rekindled

We are back together

Through the enormous efforts of friends

My heart goes out for them….

 

Time to rejoice – time to pour your heart out

Lots of flowers have blossomed

Lots of promises kept

It is time to take stock

It is time to take note

Time is the healer

And

There is pure innocence still…..

 

Twenty five years ago…we were not even twenty five

But now

We are closer to forty five

Lots of water has flown

Lots of hairs have been dyed

Lots of hearts withered

Lots of lives lived

Just a day of reunion - enough to share it all…?

 

Let us share and care through the wires and waves of the web

The faces may have changed but the heart still goes lub-dub-J

As long as the heart is with us let us strive to keep in touch

And may god help us with his much…

 

Kaveri