BMH Connect - Vol 2 - Issue 4

VOL: 2 ISSUE: 4 October 2021

World Heart Day September , World Patient Safety Day Experiences Amalgamated COVID Warriors: A Digital Platform for Management of COVID- in Hospitals

STORIES POEMS NEWS AWARENESS GALLERY AWARDS

For private circulation only

From the

Editorial Desk

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Editorial Board Members: Mr. Saji S. Mathew (C.O.O.), Dr. Shaji Thomas John (Chief of Clinical Support Services), Ms. Sukritha K. (Assistant Manager - HR), Mr. Kamal K. (Deputy Manager - Branding & Community Connect), Ms. Indu Dayanand (Deputy Manager - Front Office)

Contents 02 From the

20

Editorial Desk

Joke

04 - 05

21 - 24

Articles

World Heart Day - September 29, 2021 September 8 - World Physiotherapy Day

06 World Physiotherapy Day Celebration

07

Poem Venus

08 - 09 Story The King's Sculptor

10

Article World Patient Safety Day

11 World Patient Safety Day Celebration 2021

Article First aid handbook for trauma

25 Health Tips

26 Article Handout On Vocal Hygiene Tips for post Covid patients

27 - 30 Achievements

31 Baby Pics

32 Weddings

33

12 - 13

Gandhi Jayanti Celebration

Auto Biography

34 - 35

Experiences Amalgamated

14 - 15

Spot Light

16 - 19 Article

The Pen and the Stethoscope: two doctor-novelists from Scotland COVID Warriors: A Digital Platform for Management of COVID-19 in Hospitals

Onam Celebration

36 - 37 Prize

38 Inauguration

39 Newly Joined

Article

WORLD HEART DAY SEPTEMBER 29TH 2021 Dr. K. V. Sahasranam Sr. Consultant - Cardiology

Friends, September 29th is the World Heart Day every year.

The World Heart Federation introduced the concept of celebrating World Heart Day every year to raise the awareness about cardiovascular diseases, its warning signs and steps to take to right it and help those around who may be suffering from heart disease.

Every year there is a theme and a slogan for the heart, this year it is 'Use Heart to Connect'.

Let us initially know some basic facts about our heart.

The heart is a hollow muscular organ roughly the size of a person's clenched fist encased within our chest wall. It is approximately 250-300 grams in weight in an adult. The heart beats spontaneously about 1,00,000 times a day and pumps about 7570.824 liters of blood per day. It works day and night tirelessly, taking a few milliseconds of rest in between each beat.

Over 18.6 million deaths in the world are caused by cardiovascular disease in a year. Of all the deaths heart diseases constitute about one-third of all deaths.

What should be the important measures that one should adopt to avoid heart diseases?

1. Eat a Healthy Diet: The food that we take to a large extent influences our risk of developing heart disease. From young age, we should reduce the quantity of oils and fats in our diet. The main things to avoid are fried items, too many bakery items and red meat. For non-vegetarians, fish is a good choice of food as it is rich in fish oil which is good for the heart. But frying fish reduces this advantage. Hence fish should be preferably consumed as cooked.

2. Exercise Regularly: Adequate exercise is needed to keep your heart healthy and fit. Children should be exercising or playing for 45 minutes to one hour daily whereas for adults, 30 to 45 minutes of vigorous activity may suffice. Walking briskly is the best exercise for all. It is both easy and cheap.

One should not resort to exercising in a gym to get adequate exercise for the heart.

3. Control your Weight: Increase in weight, be it for children or adults can increase the chances of getting heart disease. Both diet and exercise are ways to keep a healthy weight always.

4. Control your Blood Pressure: This is mainly for adults. When one becomes middle aged, high blood pressure may start manifesting. Ideally, after the age of thirty, one should have the blood pressure checked at least once a year. When it is detected, the doctor will prescribe medicines for it and also advice changes in your lifestyle to control the high blood pressure.

5. High Lipids (Fats): High levels of fats namely, cholesterol and triglycerides in your blood also can increase the risk of developing heart disease in adulthood. One has to check the levels of these fats in blood at least once after the age of thirty and at yearly intervals thereafter.

6. Do Not Smoke: Cigarette smoking raises blood pressure and causes many adverse effects which are bad for one's heart. Besides this smoking can cause other diseases like lung cancer, chronic obstructive airway disease etc. and make life miserable. If a person is smoking, quitting immediately is the only way to save the heart.

7. Managing Stress: Stress is very common now a days and is linked to high blood pressure and heart diseases in many ways. Extreme stress can also suddenly trigger a heart attack or a cardiac arrest.

To reduce stress exercise, soft music, meditation, yoga and getting adequate sleep are important.

8. Managing Diabetes: Heart attacks are two times higher in patients with diabetes than in others.

This is because high blood sugar can, over a long period of time damage the blood vessels that supply the heart. Hence, a strict control of one's blood sugar is important to prevent a heart attack.

In addition, there are other factors that no one can change, like hereditary causes, masculinity and aging which may be causes of heart disease. In these circumstances, one should be very careful in following the lifestyle advice given above to lead a healthy and heart disease free life.

Article

Ms. Anuradha P. Lead Physiotherapist & Assistant Manager Physical Medicine & Rehabilitation Department

September 8 World Physiotherapy Day World Physiotherapy Day is observed to generate awareness about the crucial contribution physiotherapists make to society, enabling people to be mobile, well and independent. This is observed on 8th of September since 1966, when it was designated as World PT Day. This is the date world physiotherapy was founded in 1951.

Every year, World Physiotherapy Day is celebrated to raise awareness about the important role of physiotherapists in keeping people fit and well.

The day marks the unity and solidarity of the global physiotherapy community. It is an opportunity to recognise the work that physiotherapists do for their patients and community. Using World PT Day as a focus, world physiotherapy aims to support member organisations in their efforts to promote the profession and advance their expertise.

Reports from around the world indicate that World PT Day activities have a positive impact on the profession's profile and standing with both the public and policy makers.

The tool kit for World PT Day 2021 includes information sheets and posters aimed at the general public promoting the role of physiotherapists and rehabilitation in the treatment and management of people affected by long COVID. On this day, the contribution of physiotherapists in society and how they motivate people to stay fit and independent is celebrated.

Article

World Physiotherapy Day Celebration

Poem

BINDU S.

Associate Professor, College of Nursing

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Story

The King's Sculptor Dr. K.V. Sahasranam Sr. Consultant - Cardiology

My son in law was painting the patio, Jaya and Vijaya were enthusiastically helping him fetch brushes, rags for wiping, newspaper to spread on the floor and other routine chores. But along with that they were giving advice to him on how to paint the patio wall, “Appa”, one would say, “Don't dip the whole brush in the paint, you will drop paint on the floor”.

The other would chirp in, “Appa, I think that the colour should be a little darker on the left side than on the right side”.

This was going on for about twenty minutes when my son in law lost his patience and shouted, “Will someone please take these advisers away from here”?

I rose to the occasion and told the children, “Hey Jaya and Vijaya, have you heard what happened when too many people gave advice to the King's sculptor”?

That was incentive enough to get the kids away from the patio. And I began telling them the story……. *

*

*

Once upon a time there was a king in a far off land. The king was very fond of different forms of arts and encouraged all sorts of arts in his kingdom. He liked to get artists from different parts of the country and ask them to showcase their arts and crafts in his palace.

One day, an itinerant sculptor from a foreign land came to the kingdom and was received cordially by the king.

The artist said that he had made sculptures of kings of many lands, and they had paid him handsomely. The king was impressed and asked the sculptor if he could make a sculpture of himself for display in the royal gardens.

The sculptor readily agreed, but, he said, “Your majesty, I have but one condition for making the sculpture. I will make it in marble in thirty days. But nobody should come to see the sculpture till it is finished and ready to be unveiled.

The king was a bit taken aback. He wanted to visit the sculptor's workshop from time to time to see the progress but held himself and agreed. But the other ministers in the King's council did not like it.

Story

“Oh King!” they objected, “What if the sculpture turns out to be different and not your highness's true self?

Some of the ministers here should go and see the sculpture from time to time and give him a feedback and suggestions if there are any flaws or shortcomings.”

The sculptor thought for a moment and then agreed and said that all the ministers were welcome to the workshop, but the king should see the sculpture at the end of the work only. The king readily agreed.

The next day, the sculptor started work. Every other day one or other minister used to visit the workshop and give suggestions.

“The nose is too long, shorten it”, one minister would say. Another would comment, “The king's arms are too short, they should be longer”. A third would say the king's ears are too small, they should be bigger”, and a fourth would comment that the king's tummy was too small and should be bigger”. This went on for a long time and the last day – the thirtieth day was fast approaching. The king never went to see his own sculpture even once.

At last, the thirtieth day arrived, and the king was all excited to see the sculptor's work which he wanted to place in the centre of his royal gardens.

The king, along with his queen and a retinue of ministers eagerly reached the workshop of the sculptor. At the centre of the workshop stood a tall statue covered in a white silk garment. It was seven feet tall. The king was impressed by the height. He asked the sculptor to unveil it.

The sculptor bowed humbly and said, “Honourable Majesty, this sculpture was made by me on the advice and alterations suggested from time to time by various ministers. Hence, they are the architects of the sculpture more than me. Would you like to see it?”

All the ministers were there and were preening themselves with pride for having advised the sculptor as to how to sculpt the king's statue.

“Yes, unveil it”, ordered the king,” Let me see the sculpture which you made upon the advice of my council of ministers.”

With one sweep, the sculptor removed the silk cloth from the statue. Taking one look at the sculpture and everyone gasped! The statue was a grotesque image of the king, nowhere resembling the emperor's face or features. The king's face reddened with fury, he looked angrily at the sculptor and thundered, “Is this what you call the best sculpture of me? It is totally ugly and misshapen. Look at the nose, it is so long and curved like a parrot's, the ears are like the those of an elephant, the eyes are like that of an owl and the hands look like that of a gorilla. What punishment should I give you to caricature me like this?”.

The sculptor bowed sincerely before the king and said, “Your majesty, this sculpture was made on the advice of each one of your ministers standing here and all of them regularly visited me and wanted changes made to the statue from time to time according to their advice. It is not my mistake”.

“However,” continued the sculptor, “If your majesty steps this way, I will show you something else”. Saying so, the sculptor led the king and his group to another room at the back of the workshop. There in the middle of the room stood a tall statue covered in a yellow silk vestment. The sculptor drew the silk aside and revealed another statue of the king made in pure white marble. Everyone gasped in wonder. Before the king stood an exquisite sculpture of the king adorned in intricately carved jewellery, holding a sword in one hand and a sceptre in the other. The king gazed at the statue in wonder. He had never in his life seen such a superb sculpture of any king till now.

“This sculpture was made by me without accepting anybody's advice. I used my skill and imagination alone to craft it” said the sculptor bowing before the king He turned towards his ministers with a sneer and said, “See, my courtiers, how your advice has disfigured the former statue. Do not give advice on a matter if you know nothing about it. Let it be a lesson to all of you.”

The king rewarded the sculptor with a bagful of gold coins and sent him on his way. He installed the marble statue at the centre of his royal gardens on a raised platform.

Moral: Too many cooks spoil the broth. Do not give advice on a matter if you know nothing about it.

Safety Day Celebration

World Patient Safety Day l

Gracy Mathai Chief Executive Officer Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care. A cornerstone of the discipline is continuous improvement based on learning from errors and adverse events. The purpose of World Patient Safety Day is to promote patient safety by increasing public awareness and engagement, enhancing global understanding and working towards global solidarity and action.

Highlight specific patient safety themes such as Medication Safety, Education and Training in Patient Safety, Reporting and learning systems, Patient Engagement .

WPSD 2021 theme “Safe maternal and newborn care”

Every day, around 810 women die from avoidable causes connected to pregnancy and delivery, according to WHO data. Furthermore, around 6700 infants die every day, accounting for 47 percent of all fatalities among children under the age of five. Also, around 2 million babies are stillborn each year, with over 40% happening during labour. Since maternity care is also affected by issues of gender equity and violence, women's experiences during childbirth have the potential to either empower or to inflict damage and emotional trauma on them. Therefore, this year's campaign slogan – “Act now for safe and On Friday 24th May 2019 the World Health respectful childbirth!”, calls on all stakeholders to Organization(WHO) Member States from all 194 accelerate the actions necessary for ensuring safe and countries, on its 72nd World Health Assembly, respectful childbirth. endorsed the establishment of a World Patient Safety Day to be marked annually on 17 September and We at BMH celebrated World Patient Safety Week officially including it on WHO list of health dates.The from 13th – 17th September 2021 with various World Patient Safety Day (WPSD) is a campaign for activities. all stakeholders in the health care system to work We have participated an E-poster based on the topic together to improve patient safety. It is a recognition Maternal and Neonatal Safety, Mime based on the of the scale of avoidable harm linked with medical topic Infection Control Practices in the Labour room errors. and Skit competitions based on the theme: Communication skills – Lifeline for the Labour room Objectives of WPSD with CAHO (Consortium of Accredited Healthcare Organisations) and BMH won second prize in the skit l Raise awareness of patient safety issues globally competition. l Enhance global understanding on the central role of patient safety in achieving Universal Health Sessions arranged on Laboratory and Radiation Safety, unfolding the theme “Safe Maternal and Coverage Newborn Care” by the members of Safety l Encourage development of systems and Committee, panel discussion on Maternal and Child procedures for the elimination of all avoidable Safety, Session on Maternal and Child Safety for health care related harm to patients, and clinicians, quiz competition on various aspects of management of risks in health care patient safety. On 17th September 2021 we have taken an Oath in front of C block to ensure safety at all l Encourage governments to commit to and support the implementation of strategies for ensuring corners. A bunch of orange coloured balloons with patient safety, managing risks and fostering World Patient Safety Day printed on it was released by our CMD, Badges were worn by all the staff to supportive, learning cultures create awareness among the public. l Strengthen collaboration and partnerships at global, regional, national and local levels for A 4 minute video on Patient Safety based on the implementing patient safety strategies and for theme was also released on September 17th during the valedictory session. improving safety of health care

Safety Day Celebration

World Patient Safety Day Celebration 2021

Auto Biography

EXPERIENCES AMALGAMATED Dr. Shaji Thomas John Chief of Paediatrics & Chief of Clinical Support Services

Off to Saudi Twenty second April 1984… I left Bombay (as Mumbai was called then) for my assignment in Saudi Arabia under the Ministry of Health. I had no previous intention of taking up a job in the Middle East and the sequence of events that led me to Saudi appeared quite pre-destined.

I was given my posting orders in the Kerala Health Services while I was doing my post graduation in Paediatrics. The rule clearly stated that I should not join and then take leave, but that I can apply for extension of joining time if it is for the purpose of acquiring higher education.

I applied for extension and continued my studies. The health department decided to maintain a monthly correspondence with me asking for various copies of certificates, posting orders and so on. Ultimately just before the completion of my course they wanted another course certificate to sanction my extension order. I sent the required certificate, appeared for my examination and then applied for my posting order as I did not need the extension any more.

It was then that I got my biggest surprise. I was asked to show the cause for not having joined earlier. Rushing to the capitol I had the 'privilege' to get acquainted with quite a few bureaucrats and 'çhotta' politicians who showed me how 'easy' it was to get things done.

I only had to show my extension order to get my posting order. And the extension order…… well I had to wait since the minister had changed and according to the health secretary the new minister wanted to personally study all the pending files; as there had been some allegations against the previous minister.

So, my next step was to meet the minister. And he promptly directed me back to the health secretary. Seeing my face almost every day, the health secretary who was a former district collector of Calicut took pity on me and gave me a small piece of advice: “Doctor, what's so charming about this job in the health services? The only advantage is the pension you get after retirement. And that's going to be only a meagre sum, as per the present scale. Why don't you get yourself a job in the Middle East and relax?”

A week later, a friend and senior Paediatrics tutor in Calicut Medical College informed me that he has been called for an interview for an assignment in Saudi for which he had applied earlier. I jokingly asked him to inform me if they entertained gate-crashers.

They did, and I dashed to Bombay. The interview was over and having just completed my PG, they were quite impressed with my performance. But only then did they realize that I was not a Muslim.

“We are extremely sorry. We are selecting doctors for Medina region. Our non-Muslim quota is filled and we now need only Muslim Paediatricians”.

My Muslim friend was selected and I came back. He went to trivandrum to get his leave sanctioned and I went to an advocate to get my posting order in the Health services through the legal channel. But before the lawyer could draft my petition, I received a telegram (as it was the practice in yesteryears) asking me to sign my Saudi contract immediately.

To go or not to go was the big question. Should I kick off the good fortune just because I was not fully prepared to leave the country at the time? Should I stay back and seek justice and qualify for the 'pension after retirement'?

Auto Biography

A bird in the hand is worth two in the bush. And the job in hand was worth more than the job for which I had to fight for.

I decided to go and signed the contract. It was then that I came to know that my tutor friend who had been selected was unable to go. His promotion was due in a month and if he took long leave, he would have to forgo his promotion till he rejoins. The authorities, naturally, were not prepared to give his promotion earlier and the Arabs were not willing to wait for a month.

He had applied earlier, was a Muslim, was more qualified and experienced; and yet it was I who crossed the sea. Que sera, sera.

Ahlan-wa-sahlan Riyadh International Airport …… The biggest airport in the world at that time was really a sight to see, especially for a first-time international traveller like me. My first impression was that of a fairy land. The queue for customs clearance was really big and so when I saw a new officer take up his position in a vacant counter, I immediately submitted myself to be checked after a “Good Morning”.

He did not seem to like that, maybe because I walked up to him without being called or asked to; and muttered something back in Arabic. I opened my suitcase and he started digging in. He then stared at me and asked: ”You new?”

“Yes” “If you new, why you bring many many clothes?”

I just couldn't understand him. Only later I came to know that the novice expatriates usually took in the bare minimum and the rest were bought from there. Somehow my delay in answering the question made him suspicious. He made a thorough search and after that literally sliced the padding of my leather suitcase (and people never took leather suitcases the first time) to see if I had hidden any narcotics inside. Ultimately, utterly disappointed, he shoved me out even without an apology for damaging my suitcase. What a welcome!

Meanwhile the other members of my batch had cleared out and nobody was to be seen when I came out. I then saw some ladies of my group being escorted out and recognizing one of them, I ran to join the troupe. But I was kicked out.

“Why you follow these ladies? These are lady doctors from India” “I am also a doctor who came with this batch” “I don't know about you. My duty only to take care of ladies. You go away. Your flight to Medina only at 6 AM; five more hours. You come only then.”

The place was deserted by then and the few around could not understand English. Those who could were helpless. I made my way to the domestic terminal pushing my luggage on a trolley. The departure terminal being on the upper floor, I had to take my luggage physically as trolleys were not allowed on the escalator. Just then a person in uniform appeared and told me that they were allowed to take the luggage with the trolley; and before I could say anything, he pushed my trolley on to the escalator and was on his way up. I followed him and on reaching the top I gave him a sweet smile and said “Thank you”, for having been so kind to have helped me with the luggage.

“Ten riyals sir” was his reply. But why? Because he carried my luggage up and that was his rate.

I had just 60 riyals with me. That was the maximum currency exchange I could get from the Bombay counter as per government regulations at that time, since I was not a tourist. To part with 1/6 of it immediately for no reason sounded ridiculous. Moreover, I had not even reached my destination. I decided to complain.

The personnel at the information booth listened to both our versions. He smiled at me and very politely in good English said: “I know that he is asking too much. But it is not our business to interfere in such matters. Both of you are expatriates and so you can decide among yourselves. An official complaint if desired can be lodged only after 8 AM.” I was in no mood to argue any further with anybody. I gave him his money and told him to just get lost.

The day dawned and my batch mates started coming in. The ladies were brought in by their escort. The men had been asked to take rest at the arrival lounge itself; and they also trickled in. It was only then that I felt relieved. After all I was not lost.

The domestic flight from Riyadh to Medina made me change my opinion about the internal flights in India. The services in Indian Airlines were much superior though we used to constantly complain about their indifference.

“Ahlan-wa-sahlan” (welcome) to Medina, the holy city. We had a warm welcome from the Ministry of Health (MoH).

We were politely received and both the men and women were taken in the same van to the prestigious Malik Fahd Hospital just outside the city limits, adjacent to the royal palace in Medina. (to be continued)

Spotlight

Dr. Ravindran C. Chief of Medical Services & Sr. Consultant - Pulmonology

Spotlight SPOTLIGHT 1. How would you define yourself with three main traits?

It is difficult to define my trait. But mostly I fall in to 'Type A' personality trait. I am very organized and want to do everything in advance or within time. I don't postpone things and I dislike wasting time. I am honest and straight forward. I am competitive and focused on result. I have lot of ambitions and work hard to achieve my targets. I am ready to accept any adverse situations and try to overcome by reasoning and logical thinking. Sometimes I feel stressed due to multitasks, but mostly work overtime and complete.

2. Who inspired you to pursue the career you have today?

I consider all my teachers as my motivators in one way or other. But my mother had a great influence in me by silently supporting my activities for over 50 years. If you want me to pick up a mentor, I would certainly select Dr. C.B.C. Warrier, my professor and head of Dept. of Medicine. I wanted to be a good, patientfriendly doctor and at the same time a student- friendly teacher. Dr. Warrier inspired me by his knowledge, hard work, teaching skills and patient care. He was also a good administrator.

3. What do you believe, is leadership's role in fostering a healthy workplace?

I believe in management by participation. Everybody should be taken into confidence and each individual's diverse capabilities are tapped to get maximum output. Job satisfaction is very important in a work environment and each individual should feel that they are well taken care of. Grievances in work place should be settled then and there. If there is a problem between two individuals, each should be heard and counselled separately and judgment should not be based on hearsay.

Spot Light

4. Most memorable experience in your career that you wish to share with the team as a word of inspiration?

There were many moments in my life which gave me satisfaction both as a doctor and a teacher. I remember one patient whom I have seen in the early part of my career. As doctor who just passed out, I did not have that much knowledge and confidence to treat all diseases, especially when I was working in a remote village without much facility. But this incident was one which gave me lot of confidence, courage and value in life.

One young female was brought with acute severe asthma. She was sweating, exhausted and distressed.

Blood pressure could not be measured. I knew that I cannot send this patient to higher centre as death was imminent. I asked the nurse to start an IV infusion and push hydrocortisone, aminophylline and soda bicarb.

By the time, I took my handkerchief and it put it on the patient's mouth and started giving mouth to mouth breathing. This I continued till the aminophylline was completely pushed. I could see the patient slowly opening her eyes. I observed the patient for one hour; I gave another shot of hydrocortisone and sent the patient to a higher centre. She came back to see me after 5 days and it is a moment of achievement for me. All doctors will have similar stories in their life to narrate, I am sure. Most important thing is each incident becomes a learning lesson for us.

5. If you could compare yourself with a leader, whom would you choose and why?

It will be too much if I say Indira Gandhi, the former prime minister of India. I liked her. She was hard working, bold and result-oriented. She never bothered criticism when she put a step forward in decisionmaking. Such leaders can bring big changes in the society. Unfortunately we don't have too many leaders like her.

6. What are some new initiatives that you are planning to perform in your new role as Chief of Medical Services?

Baby Memorial Hospital is an advanced centre in healthcare sector and various specialties and superspecialties working in tandem. My role, I believe in overlooking the smooth running of all its sections. I think we need to focus more on academics and research. Many departments are running PG programmes and a co-ordinated effort to improve teaching and learning is needed. There are a lot of rare cases being diagnosed and treated in BMH. We should focus on writing scientific papers and publishing them. There are experienced teachers who can guide us in this field. Each DNB department should prepare teaching modules and upload in the website. Cases and case series presented in clinical meetings are important materials to publish. BMH should promote research and encourage consultants with incentives and other supports.

7. What skill do you think everyone should learn?

In an organization with a large number of staff and students, the most important skill to develop is communication. Effective communication can solve many problems especially egoistic issues. It can improve interpersonal relationship which will foster smooth functioning of the organization.

8. What is your secret talent that no one knows?

I am a straight forward person who can take unbiased decisions in critical situations. This ability has brought more enemies than friends, but I am always proud of this.

9. What is the best compliment you have ever received?

The farewell function at the time of my retirement from the post of Principal was the best compliment I have received for my service. It was a public function with staff, students and public. It brought me happiness and satisfaction. Such a function was for the first time in the history of Kozhikode Medical College.

10. What is a skill you would like to improve upon?

Difficult to smile and face harsh words are two important aspects, I have to improve upon. I don't think that it is possible during this life time. I can only pray that if there is another birth, I should be given a more pleasant smiling face which will reflect my inner character. “ Mama hridayathinu mardhavamillengil, udhesa shudhiyil mappu nalka”

Article

The Pen and the Stethoscope: two doctor-novelists from Scotland Dr. R. Krishnan Sr. Consultant, General Medicine

Among our favourites at school were Sir Arthur Conan Doyle, creator of the legendary Sherlock Holmes and A.J Cronin, best known for his epic tear-jerker ‘Citadel’, which whipped up a maelstrom in Britain and led to the creation of its National Health Service. Both were from Scotland, known and loved universally for their literary genius, less for their medical contributions.

Sir Arthur Ignatius Conan Doyle (May 1859 -July 1930) was forty years senior to Cronin. Doyle was from Edinburgh, had formal training as Ophthalmologist; he had to contend with an alcoholic father and straitened circumstances.Cronin was from Glasgow and a stable home; he was a respiratory physician who got interested in Ophthalmology much later. Both chose medicine over the church.They were writers of repute; many of their works were converted into movies and television series, highly popular even today.

Conan Doyle started writing stories as a young medical student at Edinburgh. He graduated in 1881, served awhile as ship's surgeon before becoming a GP in 1882, first at Plymouth later shifting to Southsea, Portsmouth.

He took to fiction seriously as practice did not flourish initially. He also wrote extensively on public health problems and advocated compulsory vaccination. His interest in Botany, Chemistry and Toxicology served him well throughout his literary career. In 1885, he took his MD with “Tabes Dorsalis” as thesis. The same year he married Louisa “Touie” Hawkins. He went off to Vienna in 1891 to specialise in Ophthalmology, but found German terms too difficult, so ended up ice-skating with his wife and generally enjoying himself, before returning to London, where he set up an office and a consulting room on Wimpole Street.

Doyle was only 27 years old when his first novel, A Study in Scarlet appeared, featuring Sherlock Holmes, master sleuth, "Consulting Detective" and Dr. John Watson, friend, and assistant, who lived together at an imaginary address, 221-B, Baker Street, London, now retained as a museum of Holmes memorabilia. Doyle modelled Holmes after his own teacher at the Edinburgh Royal Infirmary, Joseph Bell (1837-1911) who always underscored the importance of close observation and deductive logic to arrive at a clinical diagnosis. This Bell is not the same as another and more famous Bell, Sir Charles (1774 - 1842), also from Edinburgh, who had described, some years earlier, Facial (Bell's) Palsy and noted the differences between motor and sensory nerves.

Three more novels and fifty-six short stories of Holmes flowed from Conan Doyle’s pen. Doyle tried to 'kill' Holmes several times, but was forced to revive him time and again - so great was Holmes’ popularity among the reading public of the day- because he rated the literary merit of his other fiction higher, especially his seven historical novels. Doyle also wrote the Professor Challenger Sci-fi series, The Lost World, The Poison Belt, When the World Screamed and The Land of Mist , revolving around a fictional scientist and basing the character on two of his own friends. Brigadier Gerard, the Napoleonic officer who, in his own opinion, was the greatest swordsman and bravest soldier, was a satire with Doyle poking fun at the French.

Conan Doyle was a keen sportsman, footballer, cricketer, weightlifter, boxer, and golfer. He fought in the Second Boer War and wrote a book on it. Ever an advocate of lost causes, he tried to overturn the conviction of George Edalji, son of an Indian vicar of Parsi lineage convicted for injuring a pony. His efforts resulted in reforms in the existing laws of Criminal Procedure. Doyle stood for Parliament and lost. He dabbled in architecture and magic and was a close friend of Houdini. After Touie died of tuberculosis, he married Jean Elizabeth Leckie who survived him by ten years. Doyle was knighted in 1903 and died of a heart attack, aged 71, in his house at Crowborough, 30 miles southeast of London and north of Brighton and Eastbourne.

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Archibald Joseph Cronin (July 1896 -Jan 1981), A.J. Cronin for short, was yet another prolific writer, who churned out 5000 words daily, meticulously planning his plots. Cronin grew up near Glasgow; his father had died of tuberculosis when he was only seven. Although he excelled in athletics, football, golf, and fishing, he was also a precocious student who won a scholarship to study Medicine at Glasgow. During the 1914-18 First World War, he was drafted into the Navy. He served as ship's surgeon while still in medical school, so graduated only in 1919. He then set up practice in Clyde, near Glasgow, before moving to Tredegar, a small mining town in South Wales, 20 miles north of Cardiff. After a Diploma in Public Health in 1923 and MRCP in 1924, his MD in 1925 had as thesis "The History of the Aneurysm". His appointment as Medical Inspector of Mines for Great Britain gave him an opportunity to pursue his life-long interest in occupational diseases and to study the regulations on working conditions of miners. His reports had far-reaching effects – and improved the lot of those who worked in the coal mines.

In 1930, when he was ordered complete rest for his duodenal ulcer, he took to writing seriously. His first novel, Hatter's Castle came out in 1931. Others followed, many of them best sellers: Shannon's Way, Keys of the Kingdom, The Stars Look Down, A Thing of Beauty, Northern Light, The Minstrel Boy. But he became a household name because of Citadel, his fifth and most famous novel, published in 1937, the story of Andrew Manson, a young idealistic newly qualified doctor, whose life and values changed as money started pouring in.

It created quite a sensation, awakened the conscience of War-torn Britain, and stirred up intense debate on the abject poverty of miners, their far-from-satisfactory working and living conditions, the total inadequacy of medical care and the vast iniquities in the prevailing health care system. He shone a spotlight on unethical practices, causing quite a ripple and consternation among colleagues and peers. But Cronin had a friend in Aneurin Bevan, who had worked with him at Tredegar. When Clement Attlee took over after Churchill’s war years, Bevan was the Minister for Health in the new Labour government. Bevan it was who went hammer and tongs for the establishment of the National Health Service in Britain, much against the wishes of the establishment, including senior doctors. The NHS served as our model when Kerala was formed in 1956.

Cronin’s well written autobiography, Adventures in Two Worlds perhaps did not get proper recognition. He recounts graphically his impecunious medical school days, his voyage to India as ship’s surgeon, which instead of ‘making a fast buck’, nearly ended in disaster, because inexperienced as he was, he had to tackle a small pox epidemic among the crew without letting passengers know. He tells us of his life as GP’s assistant near Glasgow,his marriage, the medical officer’s job he takes up in a colliery hospital in a remote grimy Welsh village just for a steady income. Old timers will resonate with him, relive their trials and tribulations trudging several miles in the dead of night, after a long exhausting day, to attend to a delivery or an emergency, or worse, to find that the person who imagined she was serious had no illness at all! He speaks of patients who feign illness, including pseudocyesis, ones that walk away without payment. There are high points too, the satisfaction of seeing a patient recover after hours of bedside vigil, gratitude from the poor often expressed in kind, a fish or some flowers. Dr Finlay's Casebook based on his Adventures of a Black Bag was a popular series on BBC radio and television between 1962 and 1971. The black bag was the insignia or trademark of a country practitioner, the ‘tool kit’ he carried on home visits to patients. It contained essential medicines, even instruments for a minor surgical procedure or a domiciliary delivery- small snapshots, incidents, stories out of a GP’s daily routine, engaging, fascinating, interesting to doctors, young and old. Believe it or not, Doctor Finlay of Tannochbrae, as hard cover costs Rs. 12, 401 and as paperback Rs.11443 (!) today, but Kindle versions are cheap and affordable.

Cronin married Agnus Wilson who was with him in medical school. She helped him in his practice and later with his manuscripts. His books were made into popular films, necessitating long visits to Hollywood. He counted as personal friends, Sir Lawrence Olivier, Audrey Hepburn, and Charlie Chaplin. Many Indian films borrowed heavily from him- Kala Paani in Hindi, starring Dev Anand and Madhubala, Sabar Uparey in Bengali, Poola Rangadu in Telugu,all of them blockbusters and drawing from Beyond This Place. Tere Mere Sapne in Hindi with Dev Anand and Mumtaz in lead roles and S D Burman’s music had Citadel as the base plot, remade in Bengali as Jiban Saikate and in Telugu as Madhura Swapnam . The Judas Tree was adapted by Gulzar into Mausam, starring Sanjeev Kumar and Sharmila Tagore; its Tamil remake Vasnthathil Or Naal had Sivaji Ganesan and Sripriya. Cronin lived the last 25 years of his life at Montreux, Switzerland, where he died and was buried, but his heart was always where he had grown up, in Dumbarton, Scotland.

Article

COVID Warriors: A Digital Platform for Management of COVID-19 in Hospitals Dr. Bijoy Johnson Consultant in Healthcare Data Analytics challenges posed by COVID-19. Ensuring the safety of healthcare workers and patients was of prime importance. Improving operational efficiency to handle manpower shortages and streamlining the capture and dissemination of data were other focus areas.

The COVID-19 pandemic has a significant impact on our daily lives. Hospitals are the tip of the spear in the battle against COVID-19. Even though various systems and protocols are established to address this challenge, coordinating these efforts and managing the system is indeed a daunting task. The huge amount of data that need to be captured proved to be challenging when utilizing paper based forms.

Patient education, COVID patient tracking and management of patients in the COVID wards and ICUs were also challenging. To address these concerns, we developed a technology enabled platform for effective management of COVID-19.

Patient Experience

Research

COVID Warriors Employee Experience & Safety

Patient Care

Resourse Optimization

The systems devised in the pre-COVID era had to be redesigned and re-engineered to address the

In the initial days of the pandemic, we created a chatbot to help people assess their risk for COVID-19. Available in both Malayalam and English, it was based on guidelines published by WHO and MOHFW. By answering a series of simple questions about their symptoms, travel and contact history, a COVID-19 risk score was calculated. The bot provided users with instructions on how to proceed if they had a high risk of disease.

To tackle the challenge of performing COVID risk assessment of hospital visitors, we created a chat-bot based self-declaration platform. The link was sent to patients with their appointment reminders on the day prior to consultation. Posters with QR-codes were displayed outside hospital entry points prompting visitors to complete their self declaration. Low risk individuals were provided with a QR-code enabled digital entry pass. High-risk individuals were requested to report to the emergency department for evaluation.

The system also had the capability to automatically identify visitors from COVID hotspots based on the location provided.

Article

We created a pre-registration chat-bot for patients to submit their information before reaching the hospital. Online appointment with integrated p ay men t en s u r ed a to u ch les s ex p er ien ce.

Smartphone based geo-tagged self check-in functionality helped bypass the queue.

A platform was created to view the COVID patient list, track their daily progress and review test results.

This allowed the infection control team to easily generate reports for submission to the government.

They could also perform the risk assessment of staff exposed to COVID patients.

An integrated video consultation platform enabled consultants to communicate with patients without being physically present.

cardiac monitors as a low cost alternative to fully connected ICU monitors. Critical values were highlighted in the monitoring app for consultants.

Voice recognition was used to capture relevant parameters from text dictated by consultants. The COVID discharge summary application could automatically generate a major portion of the discharge summary based on pre-existing data. We also created a system to track our employee vaccination drive.

With our new COVID home care application, requests are geo-coded based on the address submitted and visualized on a map. The estimated travel distance and duration is calculated based on current traffic conditions. The patient can track the real-time status of the request and make online payments. We also utilized conversational AI in WhatsApp chat-bots for COVID home care. This ensures constant monitoring of home care patients, with the option to escalate to the clinical team whenever required.

Outcomes Achieved:

Computer Vision

1. COVID risk assessment chat-bot used by 15000+ users across the country.

2. 2.5 lakh visitors screened using the selfdeclaration system.

3. 70% reduction in time for COVID discharge summary generation.

4. Additional revenue generation through optimizing home care service delivery.

5. Robotic Process Automation (RPA) for submission of data to government authorities.

6. Use of AI powered chat-bots enhanced user experience.

7. Geo-tagging with real-time travel time estimation helped streamline home care services.

Natural Language Processing For management of critically ill COVID patients in the ICU, computer vision technology was utilized to capture the patient vital parameters from images of

8. The project focused on low-cost incremental innovation and was developed by the in-house IT team. This helped keep the development costs low while ensuring that the system could meet our requirements.

Jokes

Contributed by Dr. R. Krishnan Sr. Consultant - General Medicine

JOKE

A woman brought a very limp duck in to a veterinary surgeon.

As she laid her pet on the table, the vet pulled out his stethoscope and listened to the duck's chest.

After a moment or two, the vet shook his head sadly and said, “I'm sorry, your duck Cuddles, has passed away.”

The distressed woman wailed, “Are you sure?”

“Yes, I am sure. The duck is dead,” replied the Vet. “How can you be so sure?” she protested.

“I mean you haven't done any testing on him or anything. He might just be in a coma or something.”

The vet rolled his eyes, turned around and left the room.

He returned a few minutes later with a ‘Labrador’.

As the duck's owner looked on in amazement, the dog stood on his hind legs, put his front paws on the examination table and sniffed the duck from top to bottom. He then looked up at the vet with sad eyes and shook his head.

The vet patted the dog on the head and took it out of the room.

A few minutes later he returned with a ‘Cat’.

The cat jumped on the table and also delicately sniffed the bird from head to foot. The cat sat back on its haunches, shook its head, meowed softly and strolled out of the room.

The vet looked at the woman and said, “I'm sorry, but as I said, this is most definitely, 100% certifiably, a dead duck.”

The Vet turned to his computer terminal, hit a few keys and produced a bill, which he handed to the woman.

The duck's owner, still in shock, took the bill. “Rs. 3000!” she cried, “Rs. 3000 just to tell me my duck is dead!”

The vet shrugged, “I'm sorry. If you had just taken my word for it, the bill would have been Rs.100, but with the "Lab Report” and the "Cat Scan", it's now Rs 3000."

This is healthcare today.

Article

Shabeer M. Nursing officer

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Health Tips

Dr. Muhlisa V. Consultant, Physical Medicine & Rehabilitation

For children, being physically active daily has many benefits. l

Improves strength & endurance

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Maintains healthy weight

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Healthy growth and development

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Climbing, running, pushups, sit-ups, weight training, gymnastics, tug-of-war 3.

Improves concentration, coordination skills & social skills

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Learns teamwork, confrontation with challenges & co-operative skills

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WHO Recommendations l

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At least 60 minutes of moderate to vigorous intensity activity, daily Vigorous intensity aerobic activities and activities which strengthen bones and muscles should be done at least 3 days a week

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Limit the sedentary behavior; especially the screen time

Few activities 1.

Moderate to vigorous activities Cycling, swimming, football, basketball, dancing etc.

Light activities Household chores- washing dishes, mopping, cooking, unpacking groceries, playing with pets, gardening etc.

Improves self confidence

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Muscle and bone strengthening activities

Make physical activity part of daily routine Allow time for free play which burn calories and children have more fun Arrange games and sports equipments at home Balls, hula hoop, basket ball hoop, skipping rope, Frisbee, bicycle Play with your kids so that you can spend quality time with them Plan and go for family fitness outings like trekking, nature walk, etc., Be a role model to your kids by regularly exercising yourself

Children and adolescents (5 to 17 years) living with disability also have the same recommendations. They need to consult healthcare professional or disability specialist to determine the type and amount of activity appropriate for them.

Regular physical activity, balance diet and adequate hydration help us to lead a healthy life…..

Article

Ms. Neethu Koroth Clinical Supervisor Department of Audiology & Speech Language Pathology BMCAMS

Handout On Vocal Hygiene Tips for post Covid patients l l

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Keep well hydrated. Drink 1½ – 2 liters of fluid that does not contain caffeine or alcohol per day.

Try gentle steaming with hot water (nothing added to the water). Breathe in and out gently through your nose or mouth. The steam should not be so hot that it brings on cough.

When the virus is at its peak, coughing is likely to be intense and unavoidable. However, once this stage of the illness passes, try to avoid persistent, deliberate throat clearing and, if you can't prevent it, make it as gentle as possible. Taking small sips of lukewarm water can help to suppress the urge to cough.

Chewing gum or sucking sweets can help promote saliva flow, which lubricates the throat and can help to reduce throat clearing. Avoid medicated lozenges and gargles, as these can contain ingredients that irritate the mucosal lining of the throat.

You do not need to be on total voice rest, i.e. silence. Even in the early stages of the virus, when the voice is at its worst, using the vocal cords for a few short utterances every so often during the day keeps them mobilized, and this is a good thing.

Always aim to use your normal voice. Don't worry if all that comes out is a whisper or a croak; just avoid straining to force the voice to sound louder.

Don't deliberately choose to whisper; this does not “save” the voice; it puts the voice box under strain.

Avoid smoking or vaping.

Avoid attempting to talk over background noise such as music, television or car engine noise, as this causes you to try to raise the volume, which can be damaging.

If your voice is no more than a whisper do not attempt telephone, online chat, or video conversations. Once the voice starts to improve, avoid prolonged (to use more than 5 minutes) conversations by telephone, online chat, or video. Try to use text-based options instead.

You may notice that your voice fatigues more rapidly than normal. This is to be expected. Take a break from talking when you experience vocal fatigue; this gives the vocal cords time to recover.

In addition to irritation from COVID-19, reflux can also irritate the throat. To minimize any possible reflux, avoid oily foods and highly acidic foods and drinks such as citrus fruits and juices, vinegar and pickles, tomatoes and tomato sauces, fizzy (aerated), caffeinated and alcoholic drinks etc.

Until the voice has returned to normal it is best to avoid “athletic” vocal activities such as shouting and singing.

Achievements

Achievements

Ratnakala, Accountant, Finance Department featured in short film called

'Ennum koode’ which will be released in the first week of December 2021.

Housekeeping department participating in the Sundara Theeram Campaign in association with Kozhikode Corporation Health Department, by cleaning the surrounding area of the hospital and Cannoli Canal.

Achievements

Two of our senior consultants have been selected to the reconstituted Boards of Studies of the Kerala University of Health Sciences:

Prof T. Kesavan Board of Studies, Paramedical & Allied Health Sciences- Radiation & Imaging Sciences

Prof. R. KrishnanBoard of Studies, Medical PG

Their tenure will be for 3 years, till July 2024

Head Nurse, Mrs Sheena A.M. became the first Runner-up at the Asianet News Nursing Excellence Award 2021 in the Category of Clinical Excellence.

Achievements

OT Assistant, Mr. Rineesh has won Gold medal in 110 meters, Bronze in 100 meters and silver in 400 meters, at the State Masters Athletic Championship held at Kozhikode Medical College

Baby Pics

B/o Dhanya Babu Nursing Officer

B/o Joicy K. Lead Nursing Officer

B/o Sini Mathew Nursing Officer

B/o Ahlad T.O. Asst . Professor - BAMS & Maneesha M. Joseph Asst . Professor - BAMS B/o Athulya K. Pharmacist

Weddings

Vipin Raj P.

Abhinand M.K.

Pharmacist

Supervisor - Front Office

Sanju Joy Finance Department

Gandhi Jayanti

Onam Celebration - BMH Academy

Onam Celebration

BMH MAVELI 2021

Congratulations to the winners !

Thanks to all for your wholehearted Participation, Support & Voting. Team - HR

Prize

NABH 5th Edition Quiz Winners First Prize

Smitha M Pillai, Manager - Customer Relations

Second Prize

Prajula M P, Nursing Supervisor

Third Prize

Sukritha K, Assistant Manager - HR

Prize

Patient Safety Quiz Winners First Prize

Sukritha K, Assistant Manager - HR

Second Prize

Third Prize

Dr. Joe Davis, Fellowship - Orthopaedics

Juliet Thresia Dy Manger - IP Operations

Inauguration

Newly Joined

Dr. Nidhin Chandradas Specialist, Anaesthesiology

Dr. Shikhil P Specialist, Endocrine Surgery

Indira Gandhi Road, Kozhikode - 673 004, Kerala, India. Call: +91 495 2777777 | www.babymhospital.org