suture - kscasikscasicon2020.kscasi.com/pdf/esouvenir kscasicon 2020-4.pdf · 2020-02-20 · dr....
TRANSCRIPT
KARNATAKA STATE ASSOCIATION OF SURGEONS OF INDIA
KSCASICON 2020 38th ANNUAL CONFERENCE
Hosted by:
SURGICAL SOCIETY OF BENGALURU
ASI City Branch,Bengaluru.
14Februaryto16February,2020
Hotel Sheraton Grand, Bengaluru
www.kscasi.com
SUTUREe -souvenir
BENGALURU
THEME
.Technology .Technique .Teamwork
BENGALURU
SUTURE
This conference we ensure, would be a great
platform of learning. The various topics covered
will take each one of us through the old and the
new, covering the basics to the most advanced in
surgical practice. The focus remains the safety
of the patient through appropriate technology
for safer technique by incorporating team work.
Looking forward for a great participation.
Warm regards from the Souvenir
Committee.
Editorial ......Dear colleagues and Friends,
We welcome you all for the 38th Annual
conference of KSC-ASI. We are extremely
delighted to present to you the souvenir of the
conference.
This souvenir has been meticulously designed
and we have aptly named it Suture. This is a
No.1 absorbable suture that has been used to
anastomose the various layers of the thoughts
and ideas to create a perfect continuity of the
flow of knowledge through the lumen of
KSCASICON.
It incorporates various articles from very
knowledgeable and reputed names in KSCASI .
It is being prepared with a blend of topics to suit
the taste of vast number of readers, both
medical and other fields. We are hopeful that
this would be shared by each one of us so that
the efforts of preparing this memorabilia do not go
wasted .
Dedicated to the Scalpel...
that cuts to heal,
and...the Suture,
that sew to seal!!!
Dear Friends & Colleagues,
It is indeed a great pleasure to welcome you
all to the 38th Annual Conference of
Karnataka State Chapter of Association
Surgeons of India- KSCASICON 2020 to be
held at Hotel Sheraton Grand, Bangalore,
from 14th- 16th February 2020.
Bangalore today is a bustling metropolitan &
IT Hub City. It is the garden city of India and
evolved into Silicon Valley of India. It is the 3rd
largest city and loved for its pleasant weather,
beautiful parks and lakes all around the town.
It is renowned for its eateries, rooftop cafes &
night life.
I hope, all of you will find this conference
fruitful and enjoyable.
We, the members of Organizing committee
have made every effort to make you all
comfortable, as honored guests.
I take this opportunity to thank all my
colleagues in the Organizing committee for
their sincere efforts to make KSCASICON
2020 a grand success.
I would like to thank the sponsors/partners and
well wishers for their support.
Should there be lapses, please bear with me.
Organizing committee has put all the efforts to
give you best scientific program, atmosphere to
socialize with colleagues & enjoy our
hospitality in the conference.
Souvenir committee has put in lots of efforts to
design, the E-Souvenir with many interesting
articles by medical and general as well as
speciality designed programs.
The Theme of the Conference is “Technology,
Technique and Team work“ which is relevant in
the present scenario. This is an opportunity to
learn the recent advances in the Technology &
Technique for the benefit of the patients. The
Scientific Program which has been drawn
meticulously, includes 'CME, Orations,
Symposia, Guest Lectures, Free papers and
Video E Presentations.
Dr Uday M Muddebihal
Organizing Chairman
KSCASICON 2020
CHAIRMAN'S DESK
"A true dreamer is one who knows how to navigate in
the dark". Having serially dreamt to organize
KSCASICON 2020 amidst the best team of
Intellectual colleagues with a theme of TECHNIQUE,
TECHNOLOGY & TEAM WORK, convincing the
Team that "Old ways won't open new doors" was a
success.
The stage for KSCASICON 2020 was thus set under
the umbrella of an incredible venue SHERATON
GRAND at Brigade Gateway in Namma Bengaluru.
Having an ever supportive Organizing Chairman
leading the way, was like a pair of wings getting sewn
onto us and with such big mentors to advice
periodically was a Grace.
The journey of planning and executing this
conference was impeccable and was enjoyed.
It took a lot on Everyone's part but WE DID IT
TOGETHER!
In a climate of tight budgets, reduced workforces and
stiff competition, the entire team of the Organizing
Committee have worked relentlessly to ensure you all
an incredible hospitality engulfed by the innovative
academics, carefully designed and crafted food menu
to make your palate dance over the two and half days
which shall be filled with Excitement, Enthrallment
and Entertainment during evenings over a
magnificent Cultural Evenings with a nostalgic feel.
This conference shall give you all a fragrance of style
that Namma Bengaluru can offer you to cherish in
every possible ways. I'm sure you will carry home
those unforgettable moments and memories to
treasure.
In this KSCASICON 2020 at Bengaluru, we have
lead the scene and kept it Green. We have thought
Green and gone Green to support the environment.
I on behalf of the Organizing committee WELCOME
you all to join this initiative of NO PAPER, NO
PLASTIC during this conference. Welcome to the
Green Team!
Namma Bengaluru has a lot to give and more to
offer. Come and enjoy our hospitality.
Welcome to an "Celestial Academic Experience" at
KSCASICON 2020 in NAMMA BENGALURU!!
Dr Aravind Gubbi
Organizing Secretary
KSCASICON 2020
Happy to be in “Namma
Bengaluru!”
At the very outset, I commend the Organising
Committee very ably led by Dr. Uday Muddebehal
,Dr. Aravind Gubbi, Dr. Seshagiri Rao & the
‘DYNAMIC TEAM Karnataka’ for their tireless
efforts in making the 38th Annual Conference of
Karnataka State Chapter of ASI being held in
“Namma Bengaluru” a huge success.
I also extend my very best wishes to
Dr. Nanda Rajaneesh & everyone involved
in the making of the Souvenir.
Needless to state, a lot of attention to detail has
gone into planning the academic content of the
Conference & I am confident that the crisp
Scientific Programme would undoubtedly attract a
record number of delegates & trainees from all
over Karnataka and beyond.
My aim during the year would be to ensure
“CREATIVE LEADERSHIP & ACCOUNTABLE
GOVERNANCE”.
Surgical trainees of today are the future of ASI.
My focus therefore would be to implement
innovative initiatives to make them better Surgeons
with a humane touch.
Look forward very much to participatingat KSCASICON 2020.
Dr P Raghu Ram
President,
The Association of Surgeons of India
A number of c ourses for surgical trainees have already
been introduced this year across the Country & are
displayed prominently on ASI Website
(www.asiindia.org). I request members to please bring
these Courses to the attention of your trainees.
Dear colleagues and friends,
The 38th Annual conference is being hosted
at the Silicon city, Bengaluru. It is our
pleasure to invite each one of you to be a
part of this prestigious event.
A conference is an opportunity created for
learning and sharing knowledge and to
meet old and new friends. The focus of this
conference is on technique, technology and
team work which are the basic pillars of
success in surgery. The organisers have left
no stone unturned to make this event
successful. I applaud the whole organising
team led by Dr. Uday Muddebihal,
Dr. Aravind Gubbi and Dr. Sheshagiri Rao
for organising this event so successfully.
The conference is organised at Sheraton
Hotel and one can be assured of the
ambience and comfort at the venue. The
main success of the conference lies in the
strength of the participants. It is my
humble request to all the members to
participate in large numbers and make this
event successful.
I also take this opportunity to congratulate t
the organisers and pray for a successful
conference.
Warm regards Dr Vidyadhar Kinhal
Chairman
KSC - ASI
Dear Colleagues and Friends,
I, wholeheartedly welcome all the delegates and
faculty for the great conference being held at
Namma Bengaluru. It is our proud privilege to
host this great academic event. We have planned
scrupulously every part of the conference i.e.
selecting the venue with pleasing ambience,
audio-visuals and the scientific material.
The theme of the conference being “Technique,
Technology and Team work”, aims to keep up the
standards of the conference and to be up to date
in all academics.
The scientific material is meticulously
segregated based on the theme and system wise.
With the rise in violence and litigation on
doctors, we thought it would be ideal to discuss
on appropriate documentation and also on the
medicolegal implications on the same.
I request each one of you to make the fullest use
of the academic feast, either by gaining or by
disseminating knowledge and have an excellent
take home message and cherish every moment
spent at Bengaluru.
Dr Kalaivani V
President
Surgical Society of Bengaluru
My Namaskara to all.
It is matter of great pleasure and privilege for
me to write this message. I am extremely
delighted that Surgical Society of Bangalore is
hosting the 38th Annual Conference of
KSCASI.
A Lot of attention has gone in to planning the
academics of the conference with a stress to
harness and nurture the local talent. Focus is on
“Technology, Technique and Team work”.
Academic content has been arranged in an
attractive theme - based concept, which is all set
to establish a benchmark for the future.This
conference plans for deliberations with an intent
on learning new things in the light of what has
already been known with insight in to team
work.
For the first time conference is being held at a
five star hotel. So come, bring your family, and
have a nice time.
I wish all the best to the organizing team and
to all the delegates.
With best wishes & warmest personal regards.
Dr Gaddi Diwakar
Honorary Secretary
KSC - ASI
KSCASICON 2020
Dr. Agadi B M Dr. Shekar K S
CHIEF PATRONS
PATRONS
Dr. Ashok Kumar K V Dr. Nanda Kumar Jairam
Dr. Challani C RDr. D Somashekaraiah Dr. Vasudeva Rao U
Dr. M G Bhat
KSCASICON 2020ORGANISING COMMITTEE
Dr. Uday MuddebehalOrganising Chairman
Dr. Aravind GubbiOrganising Secretary
Dr. R MuralidharCo. Organising Secretary
Dr. K Seshagiri RaoTreasurer
Dr. Shivaram H VCo. Chairman
Dr. K Sampath KumarCo. Treasurer
Dr. Sreevathsa M RVice Chairman
Dr. Ramesh M KCo. Chairman
Dr. Kalaivani VVice Chairman
Dr. Rajan C SChairman,
Scientific Committee
Dr. Rajashekhara Reddy HVJt. Secretary
KSCASICON 2020OFFICE BEARERS
Dr. Vidyadhar KinhalChairman
Dr. Diwakar GaddiSecretary
Dr. Jaspal Singh TehaliaTreasurer
Dr. Sadashivayya SoppimathChairman Elect
National EC Members
Dr. H V Shivaram
Dr. Siddesh G
Dr. Ashok S Godhi
Dr. Rajgopal Shenoy
Ex-Officio
Dr. Dayanand Nooli
Dr. Narayan Hebsur
Co-Opted Member
Dr. Naaz Jahan Shaikh
EC Members
Dr. Dinesh H N
Dr. Rajshekhar Patil
Dr. Anilkumar Bellad
Dr. Prashanth S Murthy
Dr. Madhusudhana Karignuru
Dr. Aruna K Rao
Dr. Gurushanthappa Y
Dr. Hanumanthaiah K S
Dr. Sarvesha Raje Urs
State Scientific Committee
Dr. S S Soppimath - Chairman
Dr. G Siddesh
Dr. Aravind Patel
Dr. Ashok S Godhi
Dr. Dayanand Nooli
Dr. K Lakshman
Dr. Vidyadhar Kinhal
Dr. Gurushanthappa Y
KSCASICON 2020ORGANISING COMMITTEE
CHIEF ADVISORS
Dr. Anjanappa T H
Dr. GN Prabhakara
Dr. Ramadev K
Dr. Durganna T
Dr. Jaganmaya K
Dr. Vijaya Kumar M
ADVISORS
Dr. Rajashekar Nayak
Dr. Jayashankar M
Dr. Ramesh Reddy N
Dr. Shabber Zaveri
Dr. Somashekhar SP
Dr. Venkatesh Reddy K
Dr. Bagali Baba Saheb
Dr. Srikanth V Kulkarni
Dr. Rajeeva Shetty B
Dr. Sendhil Rajan
Dr. Rohit Krishnappa
Dr. Niranjana KP
Dr. Nagaraj Palankar
Dr. RajakumarNaik G
Dr. Dinesh Kumar GR
Dr. Basavaraj KM
Dr. Ganesh Shenoy K
Gp Capt (Dr) R Gangavatiker
Dr. Harindranath HR
Dr. Satish N
Dr. Srikanth Jagirdhar
Dr. Yella Reddy C
Dr. Shiva Kumar K
Dr. Giridhar BS
Dr. Deepak S Rohidekar
Dr. Hariprasad TR
Dr. Janardhan KC
Dr. Kamarshi Prasad
Dr. Murali Lingam
Dr. Pratap Balakrishna
Dr. Ravindranath GN
Dr. Raghunandan BV
Dr. Shiva Kumar HN
Dr. Sathya Krishna BR
Dr. Narayan Swamy Chetty
Dr. Prakash Annapur
Dr. Chandrashekhar Rai
Dr. Raju G H
Dr. Nagaraj A L
Dr. Rajiv Premnath
Dr. Sreedhara A M
Dr. Srikanth K Aithal
Dr. Venkatesh Vikram H C
Dr. Arjun Sampath Kumar
Dr. Ramanan V
Dr. Abdul Razack
Dr. Akhil Krishnanand Bhat
Dr. Sunil Kumar B Alur
Dr. Naghabhushan J S
Dr. Hemanth S Ghalige
Dr. S B Belani
Dr.Prabhakaran P S
Dr. Somasekharaiah D
Dr. Dattu Rao H
Dr. Srinivasa Murthy B G
Dr. Ramachandra C
Dr. Bhagvan B C
Dr. Nagesh N S
Dr. Satish Kumar R
Dr. Rudresh H K
Brig (Dr) Rajagopalan S
Dr. Ramesh BS
Dr. Subramanyam S G
Dr. Arun Kumar N
Dr. Sudarshan P
Dr. Ashok V Kulkarni
Dr. Ramesh Reddy G
Gp. Capt (Dr) Anil Kumar
Dr. Ravi Arjunan
Dr. Ramesh S
Dr. Lakkanna S
Dr. Sumit Talwar
Dr. Ashish R Shah
Dr. Ravishankar Bhat
Dr. Govind Nandakumar
Dr. Ravishankar H R
Dr. Anil Kumar N
Dr. Madan Mariyappa
: Kempegowda Institute of Medical Sciences
: BMCRI Dept of SGE, Victoria Hospital
: Kempegowda Institute of Medical Sciences
: M S Ramaiah Medical College Hospital
: Raja Rajeshwari Medical College
: Dr BR Ambedkar Medical College
: St Johns Medical College
: St Marthas Hospital
: MVJ Medical College
: Oxford Medical College
: Vydehi Institute of Medical Sciences
: Command Hospital
: Kidwai Memorial Institute of Oncology
: Indira Gandhi Institute of Child Health
: ESI Corporation Medical College
: Manipal Hospitals
: Fortis Hospitals
: Apollo Hospitals
: Columbia Asia Hospitals
: Sagar Hospitals
: Bangalore Baptist Hospital
: BGS GIMS
ADVISORS (HEADS OF MEDICAL COLLEGE & HOSPITALS)
Dr. Venkatesh Rao P S
Dr. Munireddy M
Dr. Ramesh M
Dr. Ashok Nayak K
Dr. Kulkarni MR
Dr. Sridhar M S
Dr. Manohar T M
Dr. Prakash B R
SCIENTIFIC COMMITTEE
Dr. Lakshman K
(Co-Chairman)
Dr. Rajan C S
(Chairman)
MEMBERS
Dr. Manish Joshi
Dr. Govind Nandakumar
Dr. Vinay Bhat
Dr. Prem Kumar A
Dr. LN Mohan
Dr.Rajan CS
(Chairman)
MEMBERS
Dr. Arun Kumar N
Dr. Shabnam Bashir
Dr. Sreekar Pai A
Dr. Niranjan P
Dr. Sunil Kumar VDr. Rajeev Lochan
(Co-Chairman)
CME COMMITTEE
MEMBERS
Dr. Manjunath B D
Dr. Hosni Mubarak Khan
Dr. Mahesha Chikkachannappa
Dr. Srikanth K N
Dr. Hanumanthaiah K S
(Chairman)
Dr. Rajashekhar C Jaka
(Co-Chairman)
RECEPTION,
REGISTRATION &
HOSPITALITY
COMMITTEE
MEMBERS
Dr. Hosni Mubarak Khan
Dr. Anupama Pujar
Dr. Nagaraj Puttaswamy
Dr. Munireddy MV
Dr. Nischal Krishnappa
Dr. Nanda Rajaneesh
(Chairman)
Dr. Naaz Jahan Shaikh
(Co-Chairman)
SOUVENIR
COMMITTEE
KSCASICON 2020 ORGANISING COMMITTEE
Dr. Shivaram H V Dr Santhosh K
CATERING COMMITTEE
Dr. Arjun Anjanappa
(Co-Chairman)
Dr. Prashanth S Murthy
(Chairman )
MEMBERS
Dr. Priyadarshan Krishnamurthy
Dr. Amit Gaur
Dr. Prashanth C A
Dr. Vikram S
MEMBERS
Dr. Sai Kalyan
Dr. Sharath Kumar JG
Dr. Harisha Nindasale S
Dr.Monika Pansari
Dr. Ventakachala K
(Chairman)
Dr. Anand Kumar J
(Co-Chairman)
TRADE &
EXAHIBITION
COMMITTEE
MEMBERS
Dr. Sachin D Nale
Dr. Nivedita Mitta
Dr. Shruthi Rai
Dr. Vinay Gunashekhar
Dr. Anil B Agadi
(Chairman)
Dr. Wasim M Dar
(Co-Chairman)
ENTERTAINMENT &
CULTURAL
COMMITTEE
MEMBERS
Dr. Vijaylakshmi GN
Dr. Sangeetha
Dr. Bharathi V
Dr. Moksha Gowda
Dr. Usha Rani
(Chairman) LADIES COMMITTEE
MEMBERS
Dr. Pandu Dasappa
Dr. Subhash RC
Dr. Amit Kumar Jain
Dr. Ravindra G
Dr. Mallikarjun M N
(Chairman)
Dr. Sajeet Nayar
(Co-Chairman)
ACCOMODATION &
TRAVEL COMMITTEE
Dr. Hosni Mubarak Khan
(Chairman) CONFERENCEPROMOTION
& DIGITAL MARKETING
MOTIVATION
Dr K LakshmanBengaluru
All of us talk about the need for motivation to
achieve our goals. When we are young, we
struggle to get the motivation to do things.
Probably, the young do not even know what it
is! When we are older and become leaders, we
crib about our juniors lacking motivation! But
do we really know what motivation means? Do
we know how to motivate people to do better?
Management gurus and psychologists have gone
into this aspect in depth. Having struggled with
the subject myself all my life, I can honestly
say that there are no magic formulae for either
motivating yourself or others! But we can try
and understand some basic principles governing
motivation, and this is what I am putting
forward here.
One of the definitions of Motivation goes
like this:
Motivation is the word derived from the word
'motive' which means needs, desires, wants or
drives within the individuals. It is the process of
stimulating people to actions to accomplish their
goals.
ARTICLES…
(From https://www.managementstudyguide.com>
what_is_motivation)
All of us know about the famous Maslow‘s
Hierarchy of needs:
Once the basic needs of food, clothing and
shelter are met, we move on and work towards
personal safety and health issues. Once this
need is met we get motivated to achieve
‘higher’ goals like esteem, respect and self-
actualization -being the best you can be.
This is good theoretical psychology. But how do
we understand and internalise this ourselves and
get others to do the same? I put forward a few
basic principles that might help us in this
direction.
1.Motivation has to come from within - You
have to think about your goals and how you
plan to reach them; do not let negative
comments from others stop you from your
attempt.
2. Get out of the comfort zone - we all get
into a groove and hesitate to explore. Without
change, there is no progress. Pull yourself out
of grooves.
(From https://www.simplypsychology.org/maslow.html)
SOUVENIR KSCASICON 2020
3. Desire has to be matched with dedication and
discipline - we want many nice things in life.
We set ambitious goals. But we forget that this
needs a lot of hard work and discipline!
4.The timeline may not match our expectations -
we not only want nice things but want them
fast! It takes time to achieve success. Be patient.
Take the first step - the goal may be distant; the
path may be strewn with hardship. But take the
decisive first step. The rest will follow.
5. Failure is a part of life - Never stop trying
new things because of fear of failure.
Failure is but a stepping stone to success.
Remember, you learn a lot more from failure
than from success.
There are two fundamental truths which are
strong motivating factors. We are all born to
make the world a better place before we
depart.
And, as the Dalai Lama says,
"Love & compassion are necessities, not
luxuries. Without them,humanity cannot
survive.“If you want others to be happy,
practice compassion. If you want to be
happy, practice compassion.”
Incidentally, compassion means “ If
someone shows kindness, caring, and a
willingness to help others, they're showing
compassion.
This is a word for a very positive emotion that
has to do with being thoughtful and decent.
Giving to a charity takes compassion.
Volunteering to work with sick people or
animals takes compassion ” (From
https://www.vocabulary.com/dictionary/
compassion? f am ily=Compassion).
Friends, let us all motivate ourselves to try and
leave behind a better world than the one we
came into.
SOUVENIR KSCASICON 2020
THE HUMBLE SCALPEL
Dr Naaz Jahan ShaikhHosapete
Surgeon has a power so very unique
He cuts and heals with a magical mystique.
His power is doubled with a scalpel in hand.
The decision to operate comes with
experience we understand.
The surgical knife has a history
interesting indeed ..
Evolving from shells, leaves, bamboos,
fingernails and shark teeth.
The Neolithic cutting edges made of flint, jade
and obsidian
Could incise precisely, including the skin and
the bone.
Metal slowly replaced the rock and stone
Efficiency improved with copper, bronze
and iron
Hippocrates named it Macairion,
And,the Romans called it Scalpellus.
Varieties emerged in its make and design
From double edged (catlins), to fixed or
foldin’.
Ambroise Pare and Chaulic preferred it very
ornamental.
But carbolic acid and heat to these were
detrimental.
Then came the era of disposable blade
with a handle resusable
Gillette with their safety razors became,
instantly sensational.
When blade exchange & fixing was irksome
Bard and Parker’s design was indeed awesome.
Studs replaced the ribs for a better blade hold
Stain less steel handle could now withstand
the heat and cold.
With new arrivals they had a hashtag(#) and
a number
But, they had no major features that we
had to remember.
The cutting edge was made more sharper and
stronger
With addition of zirconium, diamond and
a coating of polymer.
But evidence today confirms the fact
Neolithic obsidian blades had a sharper
impact.
Technology has added many a shade
Even, current passing can induce a heated
blade.
A high frequency vibration can cut and
coagulate
And, the cyberknife can precisely incise and
modulate.
To all those who hold a scalpel in the hand
one thing we must never fail to understand
A scar we create both,on the site and mindCut only if necessary, and never forget to be
very very kind!!
SOUVENIR KSCASICON 2020
8000B.C.
Flint Knives used in Middle Stone
Age to cut through skulls
3000B.C.
Obsidian Knives found in a
Turkish Settlement suggest
Early Brain Surgery
260B.C.
Roman Medicine refers to "Scalpellus"
and Utilises Many Surgical Instruments
1600's
Scalpels are produced by Cutlery
houses with little/ no sterilisation
1905
King Gillette's Safety Razor inspires
the idea for a reusable Scalpel
1915
The Modern two-piece Scalpel is
patented by Morgan Parker.
The Bard-Parker Company Develops
the cold sterilization method
1930/40
Stainless steel becomes the p rimary
material for Scalpel.
TODAY
Traditional Scalpels are still preferred
by surgeons though newer methods of
cutting are introduced
SOUVENIR KSCASICON 2020
Destiny….
Thy name is
Surgery?
It was the year 1982, in the month of June, on a
Friday evening when I was doing my internship
at KR Hospital attached to Mysore Medical
College. I had my posting at paediatric
department under Prof Anke Gowda at
Cheluvamba Block. There was an anemic child
in the ward and I was to get a bottle of blood
from the blood bank which was situated behind
the Pathology Block.
Between these two blocks there was a large
vacant space with grass and in the corner there
used to be a kitchen where food used to be
cooked for the patients. Those were the days
when all the menial work used to be the
responsibility of the poor “house Surgeon”! I
went to the blood bank, collected the bottle of
blood and started walking towards Cheluvamba
block to go to the pediatric ward. I was in a hurry
and looked at the watch- it was 6 o’clock in the
evening. I was thinking that my white coat
which I was wearing since a week needed a
wash on the weekend.
All of a sudden, a horse which was grazing in
the vacant space started chasing me! I
wasshell shocked and took to my heels to save
myself and the blood I was holding in my right
hand. To escape from the horse attack I had to
enter inside the building. I ran towards
Cheluvamba block with all my youthful
strength & energy. But I was not lucky!
The horse was faster than me (naturally)! Just
before I could enter Cheluvamba block, it caught
hold of my right lower arm near the elbow with
its mouth and started dragging me to the field.
Imagine the scenario - me holding the precious
blood bottle in my right hand and the horse
trying to trample me. I quickly realized that if I
fall down I am finished. In the spirit of the
moment I gathered all my energy and pushed the
horse in the opposite direction holding it’s right
fore leg. The only thing in my mind was that I
should not fall and the blood bottle should not
be broken. It was a fight between me and the
horse wherein the horse was trying to push me
down and I was defending myself pushing the
horse all the way back which was now standing
on its hind legs. The pain in my arm was now
unbearable and my hand was becoming numb
and blue! By this time a large onlooker crowd
had gathered around and there was a huge
commotion. Many of them threw stones at the
horse but the horse was not leaving me.
Dr Shivaram H VBengaluru
“Destiny is a name often given in retrospect to
choices that had dramatic consequences”
- J K Rowling
SOUVENIR KSCASICON 2020
I was told it was a pathetic scene to watch. The
scenario was like the one from the famous Hindi
movie Satte Pe Satta where the hero fights with a
horse, lifting both its fore legs. The entire time
the horse, standing on its hind legs was trying to
push me and I was holding its fore leg, trying to
push it back.
The one thing in my favour was that it was a
slightly weaker & older horse and did not have
full horse power in it (so to speak)! I was
shouting for help. The crowd pelting stones on
the horse did not know what else to do. In the
bargain I also received some stones! By all
means it was a helpless situation. By this time I
had gently dropped the blood bottle on the grass
and someone took it to the pediatric ward.
Finally it was the presence of mind of an
illiterate cook in the neighboring kitchen which
saved the day. He brought a long kitchen knife
from his kitchen armamentarium and shoved it
into the horse’s anus from behind.
The horse felt severe pain and it opened its jaws
instantly releasing my damaged & crushed arm.
By that time I was totally exhausted. I happened
to glance at my watch and it was
6.20 PM and that’s all I remembered. I fell
unconscious the next second, and my friends and
fellow doctors who were helplessly watching
immediately took me to the emergency
department which used to be called as
“Casualty”. I was resuscitated there. My right
hand was numb and bluish. When I gained some
consciousness I overheard the surgical resident on
call discussing over phone with his boss - “sir
there is an intern with a bad crush injury of the
right arm due to a horse bite...brachial artery is
damaged...he needs above elbow amputation”
I was shell shocked! I looked at my right hand
again and again. I was unable to move it. It was
bluish and had no sensation. A dressing was
decorating my crushed arm.
Within no time I was shifted to the operation
theatre in the stone building. My only hope was
that it was the call duty day of Prof CB Murthy’s
unit and he may do his best to save my limb. He
was the best surgeon of that time in Mysore and
we all respected him very much. He graciously
came to the OT for this poor intern’s emergency
surgery. His plan was to explore the arm under
general anesthesia and check before taking it up
for amputation. There was no CT scan or
Doppler during those days for pre-operative
assessment.
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I was told later that on exploration Prof CB
Murthy found that the brachial artery had
escaped the teeth bite injury of the horse
by a millimeter or so and it had gone into severe
spasm due to crush injury. There were deep bite
marks on the humerus bone! Prof Murthy wanted
to do everything possible to save the limb and
he was not in a hurry. He tried vasodilator
solution papavarine (how lucky I was –it was
readily available in the OT!) and waited for
some time. A miracle occurred again for the
second time (the first miracle came in the form
of the cook).
Gradually the brachial artery spasm was
relieved and the colour of the cyanosed hand
improved. Everyone in the OT heaved a sigh of
relief. When I gained my consciousness I was
pleasantly surprised that my right hand was
alive and pink. Was it destined to do some
surgeries in the future? None knew at that point
of time.Not even me.
It was such a strange and bizarre incident that it
became big news the next morning. Most of the
local newspapers carried the news on the front
page –“Mad Horse bites the Doc” was the
headline. There was a hot discussion in most of
the newspapers (thankfully there were no loud
TV news channels those days) that there is no
security in the hospital premises and the medical
superintendent was taken to task.
This newspaper coverage gave me a strange
kind of publicity and the public started pouring
in to see me in the ward. Suddenly I had become
a hero who had fought with a horse and
survived.
The students of Mysore medical College were
agitated and they went on strike asking for
proper security in the hospital premises. The
administration promptly erected cattle traps in
all the gates and also decided to post some
security personnel.
I was in the hospital for a fortnight recovering from
my injuries and receiving physiotherapy etc.
The worst part was to receive 14 injections of
those Anti Rabies Vaccine on the abdominal wall!
Luckily I recovered and my hand became fully
functional. And the rest, as they say, is history!
SOUVENIR KSCASICON 2020
A “C S TRIBUTE” TO OUR
ANAESTHESIOLOGISTS
Dr C S RajanBengaluru
All of us Surgeons, owe a huge debt to our
Anesthesiology Colleagues, who work silently to
ensure the patients on whom we operate, are in a pain
free zone of safety, during the operation.
I have used the letters of my initials, C & S, to give 10
simple lines of Tribute to all our Anesthesiologists.
Competent and Sincere is their basic nature,
Caring and Selective to the patient's well being.
Cautious and Systematic approach to ensure
safe procedure.
Checking and Securing all equipment and drugs
before the procedure.
Correct and Steady induction to begin the case, and
Complete and Sleep maintained to allow surgery
to be performed, with
Clever and Skilful recovery on completion of
operation.
Chatty or Silent depending on case flow,
they are the
Classy of Successful component of
operative health care, while being the
Companion to the Surgeon par excellence.
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Sushruta; Pride of India, Pride of a
Surgeon
Dr Kalaivani VBengaluru
Sushruta was a great physician of ancient India. He
is known today as the “Father of Indian Medicine”
& “Father of Plastic surgery” for inventing and
developing several surgical procedures. Sushrutha
Samhita is considered as the oldest text in the world
on plastic surgery. Sushrutha standardized medical
knowledge through careful descriptions of how a
physician should practice the art as well as specific
procedures including performing reconstructive
plastic surgery & cataract surgery.
Sushruta is dated back to 7th or 6th centuries BCE,
and very little is known about his life. Even his
birth name is unknown as “Sushruta” is an epithet
meaning “renowned”(1). It is believed that he
practiced medicine in Northern India around the
region of modern day Varanasi, by the banks of
River Ganga.(1)
The practice of surgery was well established in India
during his time and invented the practice of cosmetic
surgery. He performed rhinoplasty as rhinectomy
(amputation of the nose) was a form of punishment
for men & women. During his time the surgery was
performed after getting the patient drunk and
unconscious. He has used a pedicle graft from the
cheek for reconstruction. He was well aware of the
concept of anaesthesia and sterilization.
Sushruta attracted many disciples and they were
called “Saushrutas” who were required to study for
six years even before hands on training. They began
their studies by taking an oath to devote themselves
to healing and to do no harm to others. They were
instructed to practice cutting on vegetables or dead
animals to perfect the length and depth of the
incision. The dead bodies were kept in a cage and
were placed in cold water (running river or stream),
and as it gets decomposed the different anatomical
structures were learnt.
Sushruta wrote “Sushruta Samhita” as an instruction
manual for physicians to treat their patients
holistically where he describes the ideal medical
practitioner, focusing on a nurse in this way(1).
“That person alone is fit to nurse, or to attend the
bedside of a patient, who is cool-headed and pleasant
in his demeanour, does not speak ill of anyone, is
strong and attentive to the requirements of the sick,
and strictly and indefatigably follows the instructions
of the physician. (I.34)”
Sushrutha was aware of the concept of disease
caused by genetic factors, environmental factors and
that due to unhealthy lifestyle. A person’s diet was
considered of vital importance in maintaining health.
He recognized that optimal health could only be
achieved through a harmony of the mind and body,
and this state could be maintained through proper
nutrition, exercise and rational uplifting thoughts.
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Sushruta considered surgery as the highest mode
of treatment in medicine because it could produce
the most positive results more quickly than other
methods of treatment.
The statue of Maharishi Sushruta at The Royal
Australia College of Surgeons (RCAS), has been
on display since early June 2018. It is installed
in the skills lab area and is a true work of art.(2)
A statue of Surgeon Sushrutha in the Royal
Australia College of Surgeons, Melbourne
The definition of an ideal surgeon according to the
great surgeon Sushruta is “A person who possesses
courage and presence of mind, a hand free from
perspiration, tremorless grip of sharp and good
instruments and who carries his operations to
the success and advantage of his patient who has
entrusted his life to the surgeon. The surgeon
should respect this absolute surrender and treat
his patient as his own son.”(3)
He developed surgical techniques and thus founded the
practice known as “Salya-tantra” or “Surgical Practice”.
References:
1.Sushrutha: by Joshua.J.Mark
2.Maharishi Sushrutha, a surgeon famous in
Melbourne: by Hindu Council Of Australia
3.Know all about Sushruta, the first ever plastic
surgeon who was Indian: by India Today Web desk
4.Singh V. Sushruta: The father of surgery. National
journal of maxillofacial surgery. 2017 Jan; 8(1):1.
The “Sushruta Samhita” devotes several chapters to
surgical techniques, listing over 300 surgical procedures
which includes ,cessarian sections ,rhinoplasty ,cataract
surgery etc and 120 surgical instruments in addition to
the 1120 diseases, injuries and their treatments and over
700 medicinal herbs and their application, taste and
efficacy.
SOUVENIR KSCASICON 2020
Art of Scientific Writing
Dr Somashekhar S P
Bengaluru
Scientific writing is an essential component of
medical research as it determines the success or
failure of a trial. Scientific writing is the process
of the development of publications that deal
precisely with medicine or healthcare (Sharma,
2010).
Publishing of the medical outcomes are
important to communicate research findings.
Writing a scientific publication is a challenging
procedure that the surgeons may lack to report
(Quinn and Rush, 2009; Hoogenboom and
Manske, 2012). The skills of a surgeon as a
scientific writer should be advanced. Writing
and getting published the research findings is an
interesting and gratifying process of continuous
learning and improvement. Publishing a research
finding in a good scientific journal requires
strong background of science and an effective
strategy that includes generation of ideas and
their implementation. The period for becoming
a skillful scientific writer is generally long and
needs conscious self-learning (Sharma, 2010;
Balakumar et al., 2013).
Lack of proficiency in scientific writing skills
results in confusing conclusions leading the
scientific manuscripts to data dumps. Lack of
originality and presentation of obsolete result
are the main reason for rejection of scientific
manuscript (Ali, 2010). The preparation of
medical research manuscript is often taken
lightly and it leads to several problems such as
multiple rejections from scientific journals
(Dhammi and Rehan-Ul-Haq, 2018). Lack of
attention and failure to follow to the field of
the manuscript leads to rejection. Generally,
insertion of voluminous text in a manuscripts
walk away from the objective, mentioning to
details that are not within the scope of the trial.
Unclear writing in medical research is usually
difficult to interpret and it may transfer
misleading information (Ali, 2010).
The primary criteria for acceptation the
scientific manuscript are novelty and
unobviousness. The scientific writer should
have an adequate knowledge of how to interpret
the results of the research outcome (Ali, 2010).
If the results observed are out of specifications,
the writer should critically interpret the cause
of negative results. A research manuscripts
with undesirable results may support future
investigation if the writer exactly interpret the
root cause of these results. The common reason
for rejection of a research manuscript includes:
a) journal’s aim; b) writing is unconceivable;
c) the writing style of the journal is different;
d) results doesn’t add value to the journal;
e) unclear hypothesis; f) wrong methodology;
g) poor analysis; h) inconclusive result;
i) and violation of research ethics (Kumar and
Rao, 2018).
SOUVENIR KSCASICON 2020
Writing does not come naturally for few
researchers and they need to be aware of few
basic rules in addition to regular practice. A
good scientific writer has the capability to
report the research outcomes at the highest
level (Zhang et al., 2014).
Surgeons or other scientific writers report their
research outcomes in a better way only if they
have acquired the essentials of the art of good
scientific writing (Sengupta et al., 2014). The
set of abilities required for a skilled surgical
writing includes logic, clarity, organization and
precision. A good surgical scientific writer can
only communicate his message to intended
audience in a better way (Derish et al., 2008). A
scientific writer requires a combination of
competences: such as understanding of the field,
writing skills, the knowledge of scientific
guidelines, the aptitude to understand, analyze
and report the scientific results in the required
format (Sharma, 2010).
Many sources are available for the scientific
writers to get the required writing skills.
The scientific writer needs to have a clear
thoughtfulness of the concepts and ideas, and
should present the research outcomes in a way
to be easily understood (Hoogenboom and
Manske, 2012). Nearly all the manuscripts are
prepared in the IMRAD structure: Introduction,
Methods, Results and Discussion. Organize your
Manuscript under these heads. The information
presented in the manuscript should suit the
understanding level of the target audience
(Dhammi and Rehan Ul Haq, 2018).
The qualities that distinguish a good scientific
writer from an ordinary one includes:
a) understanding of the purpose of the trial;
b) in-depth research of the subject; c) ability
to think and organization of ideas; and
d) Ability to write the research finding in a
suitable level.
Well written research manuscript helps in
advancing the knowledge of medical community.
The important fundamentals in writing a
scientific publication includes: a) reading of
good scientific publication; b) finding the basics
of research, planning and execution of
hypothesis and collecting and reporting the
results; c) interpretation and presentation of the
research outcomes with accuracy, grammar and
flare; d) clearly express and effectively deliver
the research outcomes; e) consideration to details,
clarity in writing and unbiasedness; f) and
reporting of organized information such as
background, medical history, physical
examination, treatment delivered and opinion is
suggested (Hoogenboom and Manske, 2012;
Balakumar et al., 2013).
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In conclusion, scientific writing is both a science
and an art. Publishing in scientific manuscript in
scientific journal is a way to network within the
target audience.
Scientific writing requires an in-depth
knowledge ofspecific requirements for research
outcomes. Scientific writing requires
understanding of research methodologies,
procedures and awareness of relevant
guidelines. For patients and the target audiences,
it is the source of all health- related knowledge,
information and education. Scientific writing is
a complex process, from the foundation of an
idea, to the practical implementation at the time
of writing and lastly to the publication of the
manuscript in the scientific journal. Scientific
writing is an important tool for reporting
vivacious information that helps the community
lead a healthy and meaningful life.
References:
1.Ali J. Manuscript rejection: causes
andremedies. J Young Pharm. 2010;2(1):3- 6.
2.Balakumar P, Inamdar MN, Jagadeesh G. The
critical steps for successful research: The
research proposal and scientific writing: (A
report on the pre-conference workshop held in
conjunction with the 64(th) annual conference
ofthe Indian Pharmaceutical Congress-2012). J
Pharmacol Pharmacother. 2013;4(2):130-8.
3.Derish P, Eastwood S.A clarity clinic for
surgical writing. J Surg Res. 2008 Jun
1;147(1):50-8.Dhammi IK, Rehan-Ul-Haq.
Rejection of Manuscripts: Problems
andSolutions. Indian J Orthop. 2018;52(2):97-
9.Hoogenboom BJ, Manske RC. How to write
a scientific article. Int J Sports Phys Ther.
2012;7(5):512-7.
4.Johansen M, Thomsen SF.Guidelines for
Reporting Medical Research: A Critical
Appraisal. Int Sch Res Notices.
2016;2016:1346026.
5.Kumar R, Attri S, Hastir H, Goyal S. Surgical
ethics - Indian Perspective. IJCMR. 4(5):77- 83.
6.Kumar VP, Rao CS. A review ofreasons for
rejection of manuscripts. J Res Sch Prof Eng Lan
Tea. 2018;8(2):1-11.
7.Quinn CT, Rush AJ. Writing andpublishing
your research findings. J Investig Med.
2009;57(5):634-9.8.Sengupta S, Shukla D, Ramulu P, Natarajan
S, Biswas J. Publish orperish: The art ofscientific writing. Indian J Ophthalmol.
2014;62(11):1089-93.
9.Sharma S. How to become a competent
medical writer? Perspect Clin Res.
2010;1(1):33-7.
10.Zhang W.Ten simple rules for writing
research papers. PLoS Comput Biol.
2014;10(1):e1003453.
SOUVENIR KSCASICON 2020
“SURGICAL SPIRIT” ? –
Forgotten role in clinical practice
Dr Rajasekhar M RBengaluru
We are all made of 3 components
Physical(body), emotional (mind) and
analytical (intellect). All of us use these
faculties in different proportions in our
activities, including professional ones.
As surgeons we are not simple technicians
showing our skills on someone’s body.
Technically we are equivalent to drivers,
mechanics, tailors etc. So as surgeons, we
have to hone our skills to the best and latest,
upgrading and improving forever.
This is a part of bodily involvement and so we
have to keep our bodies fit, agile and durable.
The third dimension, i.e., intellect, is
essential to analyze and evaluate the
information collected from thorough
history, clinical findings, investigation
reports and select the best option for the
individual’s treatment.
To balance all these three faculties, a stable hand,
an unwavering mind and a sharp intellect, the
fourth dimension is to be opened up. That is the
“Spirit” behind all these. This “Surgical spirit” is
the operating system, where all the other three
hardware and software components work.
The trick in getting the best out of ourselves,
without disturbing our happiness and peace, is
to have a proper identity of ourselves. We tend
to identify with our hardware (body) and its
extensions like name, fame, profession,
position, wealth, awards, rewards etc., which
are only the roles, given at a particular point of
time, but “we” are not the roles.
A computer is identified by a professional by its
O.S, rather than the monitor or keyboard.
Similarly we should identify withour O.S, which
is also called by various names - soul, self,
spirit, consciousness, intelligence, etc.
In the emotional part of surgical practice, we
have to be balanced, empathizing with the
emotions of the patients and their attendants.
For that we have to be confident in our
diagnostic and therapeutic approach and
considerate to the needs of the patients. Thus we
can give confidence and solace to them. A calm
and composed mind is to be developed for that.
So if our consciousness changes from being
body conscious to “Spirit” conscious, which is
“made” of happiness and peace, we do all our
activities including professional ones, “with”
happiness and peace, rather than “for” happiness
and peace.
This process is very simple, easy to achieve and
yields immense benefits to us as well as our
patients. With all our intellect, we can easily
learn in 1 hour and start practicing it. As we start
growing in that process the differences we see
as doctor and patient, customer and service
provider, Knowledgeable and ignorant, rich and
poor etc., will blur. Life processes including
taking tough decisions become less protocol
based or intellectual, more intuitive. This
surgical spirit should act as an antiseptic,
killing all the viruses entering into our system.
“Let’s all work with high spirits”.
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EFFECTIVE COMMUNICATION
FOR QUALITY HEALTHCARE
Dr Sachin D NaleBengaluru
In the current era of cutting edge technology, one
fundamental component of quality Healthcare
often neglected, is communication. Addressing
communication issues amongst various
stakeholders in a hospital - the Patient, Patient's
family, Healthcare Providers, Administrators and
support staff is the key to solving systematic
problems.
The word communicate is derived from the
Latin word "communicare" which literally
means "to share". Communication is a
transactional process, the ultimate purpose
of which is to create "shared meaning"
between the sender and the receiver. The
effectiveness of communication depends
upon the extent to which the sender has
succeeded in making the receiver
understand the idea.
Stages of Communication Competence:
According to Neol Burech's paradigm, there are
four stages of communication competences.
In the first stage, a person is"Unconsciously
Incompetent" - they are making mistakes
without even knowing it.
Stage two represents "Conscious Incompetence" -
In this stage, the people are aware that they are
making mistakes and understand the nature of
their mistakes. Stage three is about "Conscious
Competence"- At this stage, one makes
conscious attempts to correct deficiencies in his
communication and be better communicator.
If one practices conscious competence every day
for a long time and becomes an expert in the art
of communication, then one has reached stage
four which is "Unconscious Competence".
Expert communicators make communication
look effortless.
Communication Styles:
a. Verbal Communication:
Interaction consists of four communication styles:
Aggressive, Passive, Passive- Aggressive and
Assertive.
1. Aggressive communicators are impulsive,loud
and blunt,often trying to blame or shame
someone else. They are poor, listeners who
interrupt frequently and tend to dominate. They
may succeed in the short term but in the long run,
stress others out considerably and end up
socially isolating themselves.
2. Passive communicators allows others to
infringe on their rights. They do not express
their feelings, opinions or needs. They usually
have a tough time recognizing their needs and
learning how to fulfill them.
3.Passive- aggressive communicators feel
resentful and mutter to themselves rather than
speaking up to the person about an issue.
Outwardly they deny that there is a problem.
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4.Assertive communicators build and encourage
rapport .They make good eye contact, respect
personal space, have body language that
conveys sincerity and approach ability and
speak in a well modulated tone. While the first
three styles come from a position of emotional
insecurity, Assertive communication is the style
that makes for emotional health and well being.
Becoming assertive is a process that needs
constant practice.
b. Non Verbal communication:
It is that does not use words. The
commonly observed type of Non Verbal
communications are: Facial expression, Eye
contact, Body Language and Posture, Tone and
Volume of voice(also called paralanguage),
Gestures, Personal appearance touch and
proxemics.
Listening is by far the most challenging
communication skill, yet the most
important to master. An active listener
shares the responsibility of effective
communication with the patient and sometimes
even makes up for the patients lack of ability
to communicate.
Breaking bad news forms a necessary part of
patient professional care giver communication.
Done sensitively, it develops a constructive
partnership between the patient, the relative
and the healthcare provider.
There are four stages of Breaking bad
news:
1.Preparation : Before breaking bad news,
one must prepare oneself, the place and the
patient.
2.Performance: This stage concerns the
actual event of breaking the bad news.
3.Palliation: Palliation has to do with
furnishing supportive response to patients
when they react to the bad news.
4.Planning: This phase allows the planning of
treatment and continued care for the patient.
To Communicate bad news effectively, one has to
be in stage 3,conscious,competence, understanding
the patient needs and commnicating appropriately.
Communication among employees of a health
care organisation may be formal or informal.
Based on hierarchy patterns, formal
communication can be further divided into
verical, horizontal and diagonal communication.
1.Horizontal communication takes place
between employees at the same hierarchical
level.
2. Vertical communication takes place between
superiors and sub ordinates in an organization as
downward and upward flows of communication.
3. Diagonal communication refers to
communication which takes place between
managers and workers located in different
functional divisions.
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Thus communication needs to be seen as a
systematic and strategic issue, focusing on all
parts of the organisation. A train the trainer
model where training is conducted by respected
and comparable employees on the organisatiion
(Physician training- Physicians) should be
followed.
The change occurs in small doses and over
time. It has been seen that with communication
intervention mindset towards quality care has
improved significantly, showing that there is a
strong connection between communication
effectiveness and quality care. The biggest
communication problem is we do not listen to
understand. We listen to reply.
If a Healthcare Organisation wishes to provide
quality care, it first needs to improve its
communication efficiency and effectiveness. It
also advocates that unless this attitide permeates
an entire organisation quality Helathcare will
always fall short of reaching its full Potential,
which in turn, will adversely affect interests of
the most important stakeholder in health care -
the patient!!
*************
ONELINERS.....
1. My best mates and I played a game of hide
and seek. It went on for hours...
Well , good friends are hard to find.
2. You’re not completely useless,
you can always serve as a bad example.
3. I broke my finger last week.
On the other hand, I’m okay.
4. Someone stole my Microsoft Office &
they’re gonna pay.
You have my Word.
5. eBay is so useless.
I tried to look up lighters and all they
had was 13,749 matches.
6. I can't believe I got fired from the
calendar factory.
All I did was take a day off.
7. My boss is going to fire the employee
with the worst posture.
I have a hunch, it might be me.
8. Don't spell part backwards.
It's a trap.
9. And the Lord said unto John, “Come forth
and you will receive eternal life.”
But John came fifth, and he got hell.
10. What is the best thing about living in
Switzerland?
Well, the flag is a big plus.
11. Did you hear about the guy who got hit in
the head with a can of soda?
He was lucky it was a soft drink.
12. How did I escape Iraq?
Iran…I Ran
14. Son: "Dad, can you tell me what a solar
eclipse is?"
Dad: "No sun."
15. My math teacher called me average.
How mean !
16. Clinic Receptionist: “Doctor, there's a
patient on line that says he's become
invisible".
Doctor: “Well, tell him I can't see him
right now."
13. To the mathematicians who thought of the
idea of zero.
Thanks for nothing!
SOUVENIR KSCASICON 2020
M.S. = Master's in Surgery (really….?)
Dr Manish JoshiBengaluru
All of us are certified M. S. – Masters in
Surgery! Or are we certificate Master's..Still seeking Mastery?
It is a bitter pill to digest when faced with such
a thought provoking question?
As surgeon's, students and practitioners alike,
we are well aware of the learning curve which
each of us have to overcome to be an expert in
each surgery and also in each area of
specialisation. Does it mean Mastery? Or is
Mastery a never ending quest for life , an
illusion as we realise there's more to be done or
more to be learnt.
Can we derive some truths from fields other than
surgery?
Only if we can keep an open mind to begin
with….
“ The 10,000 hour rule”
Anders Ericsson in an often cited study from
1993, researched how do violinists become
expert's. To cut the long story short – the study
partly concluded that expert violinists were one's
who practiced atleast “10,000 hours “ before
they became expert's. Hence came the “10,000
hour rule” popularised by Malcolm Gladwell in
his bestseller book from 2008 called “Outliers”.
Does the same apply to Surgical students – in
my early opinion 'Why not – it comes close to
that'. In a 3 year postgraduate surgery course,
every student spends easily {approx 1000 days x
10 hours= 10,000 hours) that much time. The
one's who spend less time or one's in low
volumes centre's require furthermore hours as
senior residents or registrars.. There was much
to be said about the confounding factors like
varied teaching programs, government versus
private college's , lesser busy units,
infrastructure, resources, interest of students or
the lack of….
“ The tenet of * Deliberate practise*”
On thinking about it *the 10,000 hour rule* in
itself didn't satisfy the definition of Mastery. It
seemed like a half-truth. It'd mean that almost
every other student should come out as a Master
ready to don the gloves with confidence. That
hardly happens. So what is Mastery then, if not
by the easily describable “10,000 hour rule”.
Some deep work on this made another factor
come forward as a big thing to attain Mastery.
This path breaking concept was hidden in the
conclusion of the same study of how violinists
become expert's. Ericsson concluded that
violinists who became expert's were the one's
who did *deliberate practise* consistently and
not just fiddle with their time. This was even
more revealing and useful as a tool to seek and
gain Mastery in surgery and can be extrapolated
to Surgical students and practitioners alike. It is
this tenet of *deliberate practice* that leads to
the path to Mastery.
Does Mastery really occur?
The answer is 'YES'. Mastery is the elusive
just out of reach yet seemingly attainable inner
confidence that comes over time spent in
*deliberate practise* of any skill you'd like to
acquire.In Surgical parlance, it is that powerful
feeling of being in control and confident of
handling almost all possibilities and variations
to a given Surgical condition.
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It means you are in control almost 95%
(confidence intervals) of times with a given
problem and that you've crossed the learning
curve. It's a sweet feeling to savour.
“ Mastery Formula = The 10,000 hour rule +
*Deliberate Practise*”
The good news is – Mastery can be cultivated, it
can be achieved. The bad news is – there's no
short cut to Mastery. It comes over time with
*10,000 hours of deliberate practise*. Earlier
surgeon's had limited tools, however the newer
generation is lucky to have ways to fastrack the
Mastery process – by joining Fellowship courses
(not for certificates) , working with an expert
mentor, attending skills workshop, etc. So are you
on a fastrack to Mastery or on a slowtrack.
Time for you to reflect….
*Good, Better Best, never will they rest
Till the good is better and the better is best*
Suggested Complete Reading and derive
more Truths and insights:
#The Role of Deliberate Practice in the
Acquisition of Expert Performance K.
Anders Ericsson, Ralf Th. Krampe, and
Clemens Tesch-Romer - Psychological
Review 1993, Vol. 100. No. 3, 363-406
Copyright 1993 by theAmerican
Psychological Association, Inc.
#Outliers: The Story of Success - written by
Malcolm Gladwell.
#The Greatest: The Quest for Sporting
Perfection by Matthew Syed.
***********
TO ALL SURGEONS .........WHY DO YOU CONSIDERSURGERY AS AN ART?
I guess,
Because the smell of spirit is sweeter than
perfume to YOU,
Because YOUR OT scrubs feel more
fashionable than any designer clothes,
Because the clicking sound of a needle
holder is music to YOUR ears,
Because proportions and symmetry cannot be
more important than in surgery,
Because when YOU walk into a hospital
YOU feel as calm as YOU would in a temple,
Because YOU know that YOU can take away
pain and make one smile,
Because YOU can make a connection with
fellow beings on a much deeper level than any
other profession,
Because although YOU may strive for success
every time, YOU accept failure too at times,
and that is why SURGERY is an ART and
not just a PROFESSION,
my dear friends...!!
Anonymous
Because when YOU operate YOU get in to a
zone deeper than meditation,
Because YOU can convert discomfort in to
comfort with a few gentle strokes,
SOUVENIR KSCASICON 2020
REMINISCING FALLING INLOVE FOR FIRST TIME…
Dr Neha ChauhanBengaluru
“When love is real, it finds a way!” - Avatar Roku
It all started long back, maybe in early 1990s. I was
growing up reading books as voraciously as I was
eating food then (courtesy my pubertal spurt!) and
had slowly graduated from Noddy, Tintin, Asterix,
Famous five, Nancy Drew, Hardy Boys, Agatha
Christie to Shakespeare, Jane Austen and Dickens
by the time I reached 10th standard in 1998. After
10th board exams, I had to make that crucial
decision of whether to choose Science or
Commerce streams. I chose Science.
There was again a dilemma of whether to choose
Mathematics or Biology. I liked both but had no
clues as to what I wanted to be and went ahead to
study both. Studies had increased manifold, but my
love for literature continued. In 11th standard, I was
introduced to books on love and romance by my
English teacher, who was of the opinion that every
lover of literature must read “Gone with the Wind”
by Margaret Mitchell at least once in his/her
lifetime.
It was supposed to be an epitome of romance.
What followed was a rigorous study schedule
and a lot more novels on love. Fortunately, by
the time I finished school, I had already cleared
my medical and engineering entrance exams
along with getting selected for Bachelor of
Arts(English honours) at one of the most
prestigious college of India, St Stephens, New
Delhi. I was at the trifurcation of medicine,
engineering and literature and again had to
make a choice. I wished then and somewhere I
still wish that how nice it could have been if I
had had the option to continue higher education
in all three streams as I liked them all equally
but alas after 12th one could chose only one
stream and I chose (or was rather made to
choose by my parents) Medicine!
Though there was anxiety at leaving the
comforts of home, I was happy at joining
college and had already imaging falling in love
with someone special, the kind of love that I
had read in books at school/seen in movies, the
kind that sweeps one o ff his/her feet every
time one encounters it!
With my admission to Jawaharlal Nehru
Medical College, Aligarh Muslim University
in year 2000, started a journey of an
unconventional and unconditional love, a love
that would be the love at first encounter and
would last a lifetime…
First year of MBBS was a nightmare and I
actually spent the whole year thinking why on
earth I'm being taught subjects which seem to
have nothing to do with treating patients.
Thankfully in the hustle-bustle and
disorientation of the first year, juggling between
anatomy dissection halls, biochemistry labs and
pithing frogs in physiology labs in midst of
ragging and home sickness, I didn't realize
when time flew and I entered the second year of
MBBS.
SOUVENIR KSCASICON 2020
But love that I had so imagined falling in with
was far beyond sight! Though it was second year
of MBBS (if counted by year since joining), we
were called as third year students, the logic
behind which I still haven't been able to
decipher! I was roll number 31 and was assigned
to “B” batch and was to start my first clinical
posting in the Department of Surgery. I still
remember a night before the clinical posting
when in excitement and anticipation of seeing
patients next day, I kept turning in bed whole
night. Not very dissimilar from what I had read
in novels at school about happening when one
falls in love!
Next day, I dressed up neatly and wore my new
apron (that I had got ironed twice by the dhobi
to get that crisp look of a serious doctor!) and
went to the Surgery department. Well-dressed
senior surgeons discussing some serious stuff
about something called as Whipple's procedure
(I had no clue about it at that time!) welcomed
us to the wards and assigned us to different
teachers for different days for case discussion
and teaching.
Everyday I would reach the ward ten minutes
before the time (just like one does when one is
waiting for someone one loves dearly!) and ask
the post-graduation seniors to allot us the case
and would start taking history and examination
of the patients along with my best friend,
Mehvash Haider. It was fun and the thing that
was most impressive about those surgery ward
postings was meticulous planning and
discussions.
The teachings were methodical and the teachers
were punctual. Besides this, we also had
evening wards where the surgery post-
graduation students would take our case
discussions.
Even those were interesting and meticulous.
Though it was my first posting and I hadn't
experienced clinical postings in other
departments, somewhere deep down my mind, I
had made a choice (this time it was my choice,
not of my parents!) that I would be a surgeon
one day. I kept the choice secretly to myself at
that time, similar to how one hides one's crush
from parents initially! Those three months of
surgery postings were the most wonderful time
of my graduation days. As the posting was about
to end, I was nearly in tears. I had fallen in love
with surgery but didn't know what future had in
store for me.
Would my relationship with surgery fructify
with me becoming a surgeon or would it end
like numerous affairs end, this question often
troubled my mind. Next I was posted in
gynaecology and I didn't like it a bit.
They were followed by Medicine, Orthopedics,
ENT, Ophthalomology, Community Medicine,
Dermatology, Psychiatry etc but nothing
impressed me as I had already given my heart to
surgery.
Maybe once one truly falls in love with
something, other things become
insignificant!
SOUVENIR KSCASICON 2020
By the time I again had clinical postings in
surgery in the final year of MBBS, my resolve
to become a surgeon had turned more firm.
Post-graduation entrance exams followed
Internship and by God's grace I got a rank where
I could opt for any speciality (except
radiology!). Then came a tussle, the kind that
usually comes between society and two people
in love.
The tussle was at home between me and my
parents. My parents wanted me to opt for
paediatrics or medicine as they felt that I would
have a more stable life with better work hours in
those specialities and a better married life. But I
was hell bent on pursuing surgery. I argued that
choosing a speciality is like choosing a spouse
and how could one do justice to his/ her
profession if one didn't like it. A lot of drama
ensued at home with parents trying their best to
show me their logic, but does one see logic
when one is in love!? Finally they gave in to my
wish.
Though none of the ten surgery seats had been
taken before me, I clearly remember entering
the counselling room with trembling hands.
Only when I was finally allotted a seat in the
department of surgery, the tremors gave way to
an immense joy that one feels when one is
united with one's beloved! I nearly needed to
pinch myself to believe that finally I was going
to pursue the speciality of my dreams. The three
years of surgical residency was a rigorous
routine but it never felt like a burden, perhaps
because I was in love with the subject.
There were occasions when we had seventy two
hours continuous emergency duties that we did
without sleeping, feeling like zombies by the
end of the call days but next day we would
return back to the emergency with more
enthusiasm and zeal to learn and operate more.
Since then I have never looked back. I went on
to complete my general surgery training
followed by Master of Chirurgae in Plastic
Surgery and my love for surgery has grown
stronger over all these years.
Everyday when I enter the operation theatre, I
still feel the same excitement that I had as a
MBBS third year girl posted in surgery
department in the year 2001.
And yes, whenever there is a challenging case
lined up for next day, I still have flutters and
sleepless nights thinking of how best can I
handle it.
After all that's how true love that lasts for a
lifetime is supposed to be feeling like! And what
could be a better platform to share this love story
than in the souvenir of KSC- ASICON 2020 that
is being held in the month of love, between 14th-
16th February 2020!
SOUVENIR KSCASICON 2020
ARTIFICIAL INTELLIGENCE IN HEALTHCARE
Dr Carunya MannanBengaluru
Artificial intelligence ( AI ) is simply,
simulation of human intelligence processes by
machines, where machines (or computers)
mimic cognitive functions that humans
associate with the human mind, such as
learning and problem solving ( machines are
taught and programmed to think like humans) .
AI works in a range of ways, drawing on
principles and tools, including from maths,
logic, and biology. An important feature of
contemporary AI technologies is that they are
increasingly able to make sense of varied and
unstructured kinds of data, such as natural
language text and images.
Machine-learning has been the most successful
type of AI in recent years, and is the underlying
approach of many of the applications currently in
use. Rather than following pre-programmed
instructions, machine learning allows systems to
discover patterns and derive its own rules when
it is presented with data and new experiences.
AI Transformation in Healthcare
The healthcare industry is evolving rapidly
with large volumes of data and increasing
challenges in cost and patient outcomes.
Artificial intelligence (AI) in healthcare is the
use of complex algorithms and software to
emulate human cognition in the analysis of
complicated medical data. Specifically, AI is the
ability for computer algorithms to approximate
conclusions without direct human input. ‘Good
Old-Fashioned AI’, which follows rules and logic
specified by humans, has been used to develop
healthcare software since the 1970s, though its
impact has been limited.
More recently there have been huge
technological developments in the field of
machine learning and especially with artificial
neural networks, where computers learn from
examples rather than explicit programming.
These technologies have the potential to
transform many aspects of patient care, as well
as administrative processes within provider,
payer and pharmaceutical organisations.
WHY AI is needed in healthcare?
Most of the times, errors and delay in decision
making and judgement happens due to work
overload, fatigue and also emotional instability
due to other responsibilities. AI plays an
important role to overcome these issues.
How AI has modified certain aspects of
healthcare?
1. Clinical Care – AI is being used for
reading radiological images, for faster
diagnosis and treatment. Better AI based
screening methods for cancer and image
prediction are underway, as Google and
similar centres are doing a lot of work. A
recent study has stated that “ Google based
AI, has the potential to exceed human
capacity to identify subtle cues that human
eye and brain aren’t able to perceive” in
identifying lesions on screening
mammograms. This means better
screening and treatment at a much faster
pace. Similarly ECG and ECHO are also
interpreted by AI in certain institutes and
awareness is increasing.
SOUVENIR KSCASICON 2020
AI in the field of histopathology will make
a significant change, decrease reporting
time, leading to faster diagnosis and also
reduce human error.
2. Surgical Care - Robotic surgical systems,
with human input are widely used all
across the globe now for various surgeries.
The advantages are multiple including
technical precision,distant surgeries can be
done ( operating surgeon and patient at
different location is made possible ) ,
reduced hospital stay, fewer complications,
smaller incisions, lower rates of infection
and of course ergonomic comfort of the
operating surgeon. Complete AI controlled
robots are used for dental procedures at a
few centres at present.
3. Documentation & Medical research -
Electronic health records are crucial to the
digitalization of information in the
healthcare industry. However logging all of
this data comes with its own problems like
cognitive overload and burnout for users.
EHR developers are now automating much
of the process and even starting to use
natural language processing (NLP) tools to
improve this process. For example, daily
progress notes, operative notes, discharge
summaries can be documented with the
help of NLP, which could save a lot of time
and manpower. AI application in
documentation and EHR also paves way
for further use in medical research in
analysis of the data, for example, for
assessing a drug response.
4. Medical education - AI allows those in
training to go through naturalistic
simulations in a way that simple computer-
driven algorithms cannot. The advent of
natural speech and the ability of an AI
computer to draw instantly on a large
database of scenarios, means the response
to questions, decisions or advice from a
trainee can challenge in a way that a
human cannot. The training programme
can learn from previous responses from
the trainee, meaning that the challenges
can be continually adjusted to meet their
learning needs. And training can be done
anywhere; with the power of AI embedded
on a smartphone, quick catch up sessions,
after a tricky case in a clinic or while
travelling, will be possible.
These are just a few areas of importance that
AI has started to take over slowly.
AI based care is transparent and fair.
Malicious use can be easily monitored.
However, the controversy about AI taking over
humans may sound a bit ridiculous as however
precise and accurate AI is, ethically human
supervision, monitoring and confirmation will
be required at all important steps as patient
safety takes first priorty.
In short, use of AI in the medical field is to the
assist the doctors, and as quoted by Dr Simon
Eccles, “AI will allow doctors to be more
human ”.
Acknowledgements:
Many thanks to Nikita Rajaneesh – Software
engineering student ( AI ) for her contribution.
SOUVENIR KSCASICON 2020
Dr Sadashivayya Soppimath, Hubballi
Dr Aravind Gubbi,
Bengaluru
SUPER CLICKS!!! - BROUGHT TO YOU
By the Shooting Surgeons!!
SOUVENIR KSCASICON 2020
SUPER CLICKS!!! - BROUGHT TO YOU
By the Shooting Surgeons!!
Dr Aravind Patel,
Ballari
Dr Jaideep Ratkal,
HubballiSOUVENIR KSCASICON 2020
POETRY PAGE
Unleash....The real you!!
Climb, race, dance, fall and again rise..with a smile,
Unleash the zest to live and the holy spirit in you..
The Woman Magical!!!
- Dr Aruna Kamineni Rao
Born in the man's world, to be silently subservient,
to serve..as his want,
Weighed for looks,
that curvy body to pleasure...
your mind and soul he cares not.
The girl child unwanted, unworthy to live..From womb to tomb struggling to survive,Uncage yourself from restrictions,spread your wings and fly free... Unleash the limitless potential in you, the women undauntable.
Beaten and abused, used by the man you trust...
Enough, Unleash the fire in you,
burn the monster to rise like
a phoenix from the ashes...
the women unstoppable.
Let not all mistake your silence for cowardice...
Unleash the power within you,
the strength of your voice..be heard,
the women powerful.
Amidst the chaos and carnage around,
be not the victim.
Unleash the nurturer in you,
of life and love..
the women mystical.
ಹುಡುಕಾಟ
ಹುಡುಕುತತರುವಎಲಲಲಲ
ನನನೊ ಳಗನಕವಯ
ಕಣಣು ಕಂಡಲಲ
ಮನಸುಬಂದಲಲ
ಹುಡುಕುತತರುವ
ಮುOಜಾವನಇಬಬ ನಯಲಲಗೊಧೂಳಯದಗಂತದಲಲ
ಬಳದಂಗಳಅಂಗಳದಲಲ
ಹುಡುಕುತತರುವ
ಚಗುರಲಲಗಳಲಲ ಅರಳದಹೂವನಲಲ
ಬಳಕುವಹೊನಲಲನಲಲ
ಅಬಬ ರಸುವಸಾಗರದಅಲಲಗಳಲಲ
ಹುಡುಕುತತರುವ
ಮಗುವನಹಾಲನಗುವನಲಲ
ಮಕಕ ಳತಂಟತದಲಲ
ಮುದದಾ ದಮುಗಧ ಮನಸಸ ನಲಲ
ಹುಡುಕುತತರುವ
ಹಡದವವ ನಅಮತವಾತ ಲಯ ದಲಲ
ಒಡಹುತತದವರಪರ ೀತತಯಅನನಯ ತಯಲಲ
ಸೊ ೀಹತರಸಾನಧಯ ದಲಲ
ಹುಡುಕುತತರುವ
ಪರ ೀಮಗಳಅನುರಾಗದಲಲ
ಬಂಧವಯ ದವರಹದಲಲ
ತಂಪಾದಕಲಹದಲಲ
ಹುಡುಕುತತರುವ
ಕಷಟ ಗಳಹಾಹಾಕಾರದಲಲ
ಮಾನವೀಯತಯಮಂಪರನಲಲ
ಬಂಡಾಯದಕಾಳಚ ನಲಲ
ಹುಡುಕುತತರುವ
ಧಮಮದಅರಮದಲಲ
ಅಧಮಮದಚಾಣಾಕಶ ತಯಲಲ
ಸತಯ ಅಸತಯ ದತತಕಾಕ ಟದಲಲ
ಹುಡುಕುತತರುವ
ಭಕತಯಪರಾಕಾಷಟಟ ಯಲಲ
ಆಧಯಯ ತಮ ದದೈವತವ ದಲಲ
ಸಮಪಮಣಾಭಾವದಲಲ
ಎಲಲರುವನುನನನೊ ಳಗನಕವ?ನನನೊ ಳಗನಅನುಭಾವದಲಲ
ಮನಸಗಭಮದಲಲ ಅಡುಗಹನು
ಪರ ಸವದಪರಪಕವ ತಯಪರ ತತೀಕಷಯಲಲ
ಡಾ ಅನುಪಮಪೂಜಾರ
Enough being oppressed…Deliberately suppressed,
Awaken the inner beauty of knowledge,
the quest to learn…
unleash the real you,
the women phenomenal.
SOUVENIR KSCASICON 2020
ಬಲ ಚಕಾಶ ವಾಾಪಾರ ಈ ಬದುಕುನೂರಾರು ಕೇಳದರ ಹತತಪಪತನಟುುಸುಖವ ಕೇಳದಾಗ ಕಳವಳವ ಕೂಟುುದೂರ ನಂತು ನಕುು ಬಡುತದ...
ಕಲವೊಮಮ ಹಬಬದ ಸಪಶಲ ನಂತಅಂಜಂಜುತ ಒಂದನುು ಕೇಳದರಡಬಲ ಧಮಾಕಾಗಳನುು ತುರುಕಬರುನಗುತದ ಗಲಬಲಯ ಕಂಡು...
ಅಂತೂ ಸಾಗದ ಕೂಡುತ ಕಳಯುತಅತ ಎಳಯುತ ಇತ ಸಳಯುತಆದರೂ ಕೂನಗೂಮಮ ಭರವಸಯ ಬಳಕುಹದು ಏರಳಕಯಲಲದರ ಅದಂಥ ಬದುಕು...
ಈ ಬದುಕಂಬುದುಬಲ ಬರಕಏನನೂುೇ ಬರವಾಗಏನೂೇ ತತದ ತತರಚುವ'ಆಟೂೇಕರಕಶನ' ನಂತತನಗ ಬೇಕಾದಂತ ತತದನೇಪಥಾದಲಲ ನಂತುನಕುುಬಡುತದ...ಬರಯಲತತುಸದವ ಮಾತರಪಚಾಾಗುತಾನಏನೂಂದೂ ತತಳಯದೇ...ಆದರ ಮತ ಸಾಗುತದಹೂಸದೂಂದು ಬರವಣಗಜೂತಗೇಬದುಕನ ಮಮರವಣಗ...!!
ಹಲವು ಕನಸುಗಳ ಹರವಾಣಅದರಲಲಷುು ನನಸುಸಲೇಸು...ಉಳದವು ಎಂದೂಮುಗಯದಮಮಗಾಸೇರಯಲಇನುೇನು ಮುಗದೇತುಅನುುವುದರೂಳಗಹೂಸತತರುವುಗಳೊಡನ ಸಜುುಪರದಯ ಹಂದೂಬಬನದೇೇಶಕ....!ಇನುಷುು ಹಳವಂಡಗಳುಮುಗಲಾಚಗನ ಕನವರಕಗಳುಸಕುದಷೂು ದಕುದಷೂುಮುಷಟುಯೊಳಗಣ ಧಾನಾಬತತದರ ಹೂಲತುಂಬಮುಚಚಾಟುರ ಹಡ ಮಾತರ..!!
ಬದುಕು-ಡಾ॥ ಶವಾನಂದ ಕುಬಸದ
SOUVENIR KSCASICON 2020