This is an article I am writing for increasing the awareness of bone and joint disorders among the public and the medical community alike.I hope you find it useful
World Health Organisation [WHO] endorsed the launch of “Bone and Joint Decade [BJD]- 2000 to 2010” in Geneva in January 2000. The key goal is “to keep the people moving by prevention and treatment of bone and joint problems. This will in turn reduce the cost and the burden to the individuals, the carers and the society at large”.
BJD-India duly followed with National Action Network launched from Pune by eminent doctors. This was endorsed by the Government of India. As we are on the verge of this decade behind us, it is time for us to reflect and hence this article.
Arthritis affecting a joint such as knee and hips are very common in India. Every other person over the age of 65 in India is affected with arthritis. Unfortunately the treatment is not sought or often delayed.
The road traffic accidents are not only common, but also results in severely injured people. The deaths are frequent and multiple numbers of people are involved in the same accident. This is reflected in the Official statistics of the department of Road Transport and Highways, Government of India.
Unfortunately such affections of the bone and joints leave people with physical disability. The patients become dependent on the family and the society adding to the mental suffering. Some of the patients are left crippled due this pain. The true extent of their suffering is revealed in the limitation of their activities of daily living let alone their limitations in the society.
When one is not able to do even routine activities such as walking, secondary health problems arise. These include sedentary lives, increasing obesity, diabetes, high blood pressure and heart diseases. WHO recognised this growing trend in the society often leaving a financial burden.
Diet and exercise play important role in the health of our bone and joints as much as for our heart. Yet our life style had become sedentary. Increasing incidence of overweight and obesity has aggravated the bone and joint problem such as arthritis. Specific remedies for certain arthritis such as Rheumatoid are not sought. These lead to crippling deformities and disabilities. On the other hand, there is misuse of pain killers leading to other problems such as kidney failure.
Wearing a seat belt is the most effective way to prevent injuries when travelling in a car or a bus. Yet many of us remove the seat belts or consider it a hindrance to wear. Traffic rules and restrictions are rarely followed resulting in serious and disabling injuries.
“A painful advanced arthritic joint can be cured with a joint replacement” is a well known fact to many in a Western country such as UK. However people in our villages are left suffering due to the lack of awareness. This lack of awareness is present even in educated persons living in cosmopolitan cities.
With this launch of Bone and Joint Decade, WHO highlighted the need for the improvement in the diagnosis and treatment of such disorders. WHO encouraged prevention through education campaigns. Ten years on since the Bone and Joint Decade launch by the WHO, the real question had there been an any improvement at all ?
In spite of all being written early in this article, there is certainly more awareness created by this WHO initiative. The government of India through its participation in this Bone and Joint Decade has shown its commitment in prevention and treatment of these disabling conditions.
Government Welfare schemes helping them finance the treatment ensures that poor are not left alone in this treatment reach. One has to mention one such scheme for the people below the poverty line at this juncture which has benefited and continues to a huge number of financially disadvantaged section of our society.
More people are seeking treatment rather than neglecting these ailments. They are asking for the accurate diagnosis as much as the treatment itself. This is especially facilitated when they see others benefited due to the treatment options such as joint replacements. People have started to recognise the fact that “Early and appropriate treatment of injuries prevents long term disability”. Technological advances such as key hole treatment of joint problems with arthroscopy are now known.
Every year many hospitals follow the activity week to focus their year long efforts to the public in October[ 12th to 20th of October of 2010 for this year]. Many hospitals and doctors are conducting free camps to facilitate such an awareness. Their efforts should be lauded with reverence for the public service.
There is certainly a larger section of our public where the awareness has not reached as we still see a significant number of disabled people due to the bone and joint problems. Hence more concerted efforts should be done from the community in general and the medical community in particular.
Education in road traffic accident prevention should reach the “prospective road users” namely our children. Public awareness campaigns should increase in number and reach the inner villages. Medical schools should increase the training given to the doctors in dealing with bone and joint problems. There is a need for the entire community to celebrate this bone and joint week in October.
May I conclude this article saying that “Let the end of the Bone and joint Decade -2000-2010 herald a new beginning in spreading awareness of the increasing number of Bone and Joint problems. These are either preventable and when affected, many of them are certainly curable”
Dr S Chockalingam
Consultant Trauma and Orthopaedic Surgeon
KMC and KMC Speciality Hospitals,
Trichy
Saturday, May 28, 2011
Friday, May 27, 2011
Health Awareness among men over forty years of age, meet by Sugam Charity
Sugam Charity Health Awareness meeting 2 on 11th of April 2010
Following the successful meet organized for women over forty on the 13th feb 2010, Sugam Charity organized the second meet for gents over the age of forty years. The aim of the meeting was to spread the awareness of life style diseases which are rife in this age group.
The format of the meet is to give awareness talk to spread the knowledge and to provide an individual assessment of these people. This is different to the master health check up though one part of it is based on the master health check up as described below.
Master Health Check up is now given as a standard to most corporate employees as part of their corporate social responsibility. The corporate bodies also take up this role to ensure they have healthy employees who in turn will take less sick leave and increase their productivity.
However this type of check up is not given to the people in the villages, one due to the lack of model of someone giving them the option of health check up as corporate bodies. but it is mainly due to the lack of awareness. sporadically the Sons and Daughters who are working in cities bring their kith and kin for these health check up, however the common man misses out.
This type of health check up can bring up the problems, hopefully at an earlier stage so that the treatment can be effective. It would also ensure people with risk factors are advised accordingly so that life style diseases do not affect them in the future.
The second part of this activity is where the charity wants to concentrate. Spreading the awareness by giving them not only their health information but also with an interactive forum at their doorstep.
This has been made very much possible by the talks given by the doctors and more importantly by the Nursing School Principal of KMC, Trichy and her Team. We at Sugam Charity cannot thank them enough as they do this on a sunday when most of us would rather spend relaxing at home. We also thank the Management of the KMC and KMC speciality hospitals for allowing us to use their team the education materials for this public exercise activity.
We at Sugam Charity hope that we have done some good to these people, only time can tell us so.
Regards
Chockalingam
"savour this moment, time is as important as money and health"
You would have read my previous blog on money and health the conundrum, if not please read before this blog.
I discussed the importance of health over money and in fact described a way of combining money and health. Thus we spend time to acquire money and assets to make us happy in the future.
Some of us would spend more time on acquiring health than the time we spend on acquiring money. this may be due to the fact that we value health more than money or we have lots of money already.
Acquiring health, we may do by going to a gym, for a swim, jog in the park, eat healthy as opposed to indulging in junk foods etc. Acquiring money, we may do by doing a job, working overtime, have a second job, work harder in further education to acquire a better job which will result in a better paid job.
But life is not entirely tomorrow. life is not yesterday either. Life is today with work towards a better tomorrow. Working in a health sector, we do see people who do not have a choice in a better tomorrow. A 39 year old, a father of two young kids, presents to me with shoulder pain, only to be diagnosed to be suffering a cancer which has already spread all over his body! shocking is it not ? this makes you think
What is life, is it more money with an ability to enjoy the wordly pleasures, or is it being healthy which we can acquire with good food and exercise. not completely. it is an ability to enjoy the worldly pleasures with a healthy mind and body at this point of time. as i said today we can plan to an extent for tomorrow, however can be unpredictable.
This brings me to the title of this blog, namely "savour this moment". Today at this point of time, be happy and healthy. Being happy and healthy now will not be enough for tomorrow which is also going to be your life. Hence whatever you do to acquire money and health for tomorrow, enjoy the act of doing so.
i.e enjoy your job which you will have to do today for a better tomorrow. If you cannot enjoy the job you are doing now, please look for your job which you will enjoy and savour the moment. Similarly if you do exercise, choose an activity which you enjoy and choose a healthy food which you enjoy.
feel sorry for people who do not do their job with pleasure and well, as they are not only wasting their life. Also feel sorry for people who do not care for their and their kith and kin's health as they are also wasting their life. Appreciate the person who enjoys doing something to a wealthier and healthier tomorrow.
now to the second part of my title,"Time is as important as the money and health". I hope you would have got this by now. Essentially savour this moment of time, as your life is the time now, .
If we savour this moment doing our job happily and keeping ourselves healthy, then we are indeed enjoying our life. Is is not what we all want.
Regards
Chockalingam
I discussed the importance of health over money and in fact described a way of combining money and health. Thus we spend time to acquire money and assets to make us happy in the future.
Some of us would spend more time on acquiring health than the time we spend on acquiring money. this may be due to the fact that we value health more than money or we have lots of money already.
Acquiring health, we may do by going to a gym, for a swim, jog in the park, eat healthy as opposed to indulging in junk foods etc. Acquiring money, we may do by doing a job, working overtime, have a second job, work harder in further education to acquire a better job which will result in a better paid job.
But life is not entirely tomorrow. life is not yesterday either. Life is today with work towards a better tomorrow. Working in a health sector, we do see people who do not have a choice in a better tomorrow. A 39 year old, a father of two young kids, presents to me with shoulder pain, only to be diagnosed to be suffering a cancer which has already spread all over his body! shocking is it not ? this makes you think
What is life, is it more money with an ability to enjoy the wordly pleasures, or is it being healthy which we can acquire with good food and exercise. not completely. it is an ability to enjoy the worldly pleasures with a healthy mind and body at this point of time. as i said today we can plan to an extent for tomorrow, however can be unpredictable.
This brings me to the title of this blog, namely "savour this moment". Today at this point of time, be happy and healthy. Being happy and healthy now will not be enough for tomorrow which is also going to be your life. Hence whatever you do to acquire money and health for tomorrow, enjoy the act of doing so.
i.e enjoy your job which you will have to do today for a better tomorrow. If you cannot enjoy the job you are doing now, please look for your job which you will enjoy and savour the moment. Similarly if you do exercise, choose an activity which you enjoy and choose a healthy food which you enjoy.
feel sorry for people who do not do their job with pleasure and well, as they are not only wasting their life. Also feel sorry for people who do not care for their and their kith and kin's health as they are also wasting their life. Appreciate the person who enjoys doing something to a wealthier and healthier tomorrow.
now to the second part of my title,"Time is as important as the money and health". I hope you would have got this by now. Essentially savour this moment of time, as your life is the time now, .
If we savour this moment doing our job happily and keeping ourselves healthy, then we are indeed enjoying our life. Is is not what we all want.
Regards
Chockalingam
Thursday, May 26, 2011
Understand the "Shortest Possible Route in the Shortest possible Time" Logic
If you want to succeed in life, you have to be ahead of others. this is applicable in education, work, business and life in general. The logic then sounds right meaning that "it is an efficient way of finishing a job or work", right?. The logic then sounds OK eh!. no not really.
But not really in certain situations. you would understand this very well if you see the traffic in India. When you understand this "shortest possbile route in the shortest possible time" strategy is being followed by the driver on the other side, you begin to explain the so called accidents in road traffic.
In Other words the title logic cannot and should not be followed where you want a system to be streamlined and everyone following the same rule. this not only applies in traffic, also in a work place, education, health sector. In short it should not be followed wherever you need people in a organized area such as work place or society in general to follow a prescribed path.
Back to the traffic analogy, driving in a country like UK where the people are prepared to take a longer route so that there is an order is easier and safer, as they do not follow the logic as safety is more important.
however this does create a problem. if everyone follows the exact route, you do not get eccentrics who are often the one who would move in leaps and bounds and often change the world. so you do need eccentrics who are going to be different and think laterally. hence you do need to nurture them and not discourage them completely. for example a person who leaves a college in the middle of his course may be thought of not following the order. but he might be the next Richard Branson!
Back to the title, sounds right and it is right in certain situations. But not really in lot of situations where you do need order when many people are involved.
Hence the best thing we can do is to understand the logic and see the benefits and use them. It is also important to understand when there are dangers when this logic is being used.
For example in Indian Traffic, when you see a pedestrian or cyclist crossing in front of you in a car attempting to move forward. instead of thinking, " is he a maniac trying to kill himself being hit by my car", you would think " go on, i understand your logic"
I will detail how understanding this logic helps you in other situations in future blogs
Regards
Chockalingam
But not really in certain situations. you would understand this very well if you see the traffic in India. When you understand this "shortest possbile route in the shortest possible time" strategy is being followed by the driver on the other side, you begin to explain the so called accidents in road traffic.
In Other words the title logic cannot and should not be followed where you want a system to be streamlined and everyone following the same rule. this not only applies in traffic, also in a work place, education, health sector. In short it should not be followed wherever you need people in a organized area such as work place or society in general to follow a prescribed path.
Back to the traffic analogy, driving in a country like UK where the people are prepared to take a longer route so that there is an order is easier and safer, as they do not follow the logic as safety is more important.
however this does create a problem. if everyone follows the exact route, you do not get eccentrics who are often the one who would move in leaps and bounds and often change the world. so you do need eccentrics who are going to be different and think laterally. hence you do need to nurture them and not discourage them completely. for example a person who leaves a college in the middle of his course may be thought of not following the order. but he might be the next Richard Branson!
Back to the title, sounds right and it is right in certain situations. But not really in lot of situations where you do need order when many people are involved.
Hence the best thing we can do is to understand the logic and see the benefits and use them. It is also important to understand when there are dangers when this logic is being used.
For example in Indian Traffic, when you see a pedestrian or cyclist crossing in front of you in a car attempting to move forward. instead of thinking, " is he a maniac trying to kill himself being hit by my car", you would think " go on, i understand your logic"
I will detail how understanding this logic helps you in other situations in future blogs
Regards
Chockalingam
Monday, May 23, 2011
A Typical Road Traffic Accident in India -Seat Belt is important
A middle class family now can afford a car or can certainly rent a car for their trip on the road. I have now treated several accident victims at Trichy for the last two years. The injuries are quite typical.
1. The driver either dies or suffers from chest injuries with multiple rib fractures. He would end up having pneumo or hemothorax namely collection of air or blood around the lungs which can be life threatening.
2. The front seat passenger suffers from facial injuries, head injuries as he or she is thrown on to the windscreen and either dies or presents to the hospital. They have problems with air going to the wind pipe and may die if not recognized. As they are trying to protect themselves going forward, they put their hands forwards and suffers from upper limb injuries on both sides. They may also suffer from disocated hip joints
3. The rear seat passengers suffer from lower limb and upper limb injuries, chest injuries and abdominal injuries. They are like the toy within a shell which is popular toy with the children. you shake the shell and the toy inside rattles inside. The rear seat passengers are rattled inside the hard car shell and get multiple injuries.
4. Children often escape due to the pliability of the tissues though it is not guaranteed.
Now the big question then is, what should one do
1. understand the local traffic paths. most accidents happen when a driver goes into an area without experience of local traffic. Meaning that the traffic path of pedestricans, cyclists, two wheelers, tractors, lorries, buses can be in any direction at a given place. hence following traffic rules in India is not enough, but understand the traffic rules as followed by the other person.
to understand the first point, remember the shortest possible route would be taken by an Indian wherever he or she goes and whatever possible method of transport he is using.
2.Always wear a helmet and Seat Belt when riding in in a two wheeler and a car respectively. The injuries as i had listed can be largely prevented by seat belt and i stress most of the times.
3. Remember using a vehicle such as a two wheeler or a car is for comfort and not for speed of access to reach a given point. I am not saying that you should not go fast, but keep telling yourselves that i am having a nice comfortable ride as opposed to going in a crowded bus .i am not using the car to go quickly from point A to B
4. Do not drive the car if you are the driver if your passengers would not wear a seat belt, i.e your family for example. This should be one of the golden rules you must follow to protect your family. do not yield to reasons for not wearing seat belts.
5. When driving during the day time, be aware of smarties driving into your lane from the opposite side. the left lane is safer in a dual carriage way
6. when driving at the night time. be aware of smarties who have parked their vehicles or driving without any lights at the back. you will smash to their back
7.If you can avoid, and i must say that you should avoid any night time driving as a family or in business. It is not worth it
8. Traffic awareness is not there in India with most road users and when combined with lack of speed awareness, then it is a lethal combination.
One of my good friends advised that preferrably avoid going anywhere or reduce the amount of time you spend travelling to increase your chances of living in India.
I felt sad when i learnt of the death of the minister today and i felt that it is time i Shared some of the road safety issues to you
Chockalingam
1. The driver either dies or suffers from chest injuries with multiple rib fractures. He would end up having pneumo or hemothorax namely collection of air or blood around the lungs which can be life threatening.
2. The front seat passenger suffers from facial injuries, head injuries as he or she is thrown on to the windscreen and either dies or presents to the hospital. They have problems with air going to the wind pipe and may die if not recognized. As they are trying to protect themselves going forward, they put their hands forwards and suffers from upper limb injuries on both sides. They may also suffer from disocated hip joints
3. The rear seat passengers suffer from lower limb and upper limb injuries, chest injuries and abdominal injuries. They are like the toy within a shell which is popular toy with the children. you shake the shell and the toy inside rattles inside. The rear seat passengers are rattled inside the hard car shell and get multiple injuries.
4. Children often escape due to the pliability of the tissues though it is not guaranteed.
Now the big question then is, what should one do
1. understand the local traffic paths. most accidents happen when a driver goes into an area without experience of local traffic. Meaning that the traffic path of pedestricans, cyclists, two wheelers, tractors, lorries, buses can be in any direction at a given place. hence following traffic rules in India is not enough, but understand the traffic rules as followed by the other person.
to understand the first point, remember the shortest possible route would be taken by an Indian wherever he or she goes and whatever possible method of transport he is using.
2.Always wear a helmet and Seat Belt when riding in in a two wheeler and a car respectively. The injuries as i had listed can be largely prevented by seat belt and i stress most of the times.
3. Remember using a vehicle such as a two wheeler or a car is for comfort and not for speed of access to reach a given point. I am not saying that you should not go fast, but keep telling yourselves that i am having a nice comfortable ride as opposed to going in a crowded bus .i am not using the car to go quickly from point A to B
4. Do not drive the car if you are the driver if your passengers would not wear a seat belt, i.e your family for example. This should be one of the golden rules you must follow to protect your family. do not yield to reasons for not wearing seat belts.
5. When driving during the day time, be aware of smarties driving into your lane from the opposite side. the left lane is safer in a dual carriage way
6. when driving at the night time. be aware of smarties who have parked their vehicles or driving without any lights at the back. you will smash to their back
7.If you can avoid, and i must say that you should avoid any night time driving as a family or in business. It is not worth it
8. Traffic awareness is not there in India with most road users and when combined with lack of speed awareness, then it is a lethal combination.
One of my good friends advised that preferrably avoid going anywhere or reduce the amount of time you spend travelling to increase your chances of living in India.
I felt sad when i learnt of the death of the minister today and i felt that it is time i Shared some of the road safety issues to you
Chockalingam
Sunday, May 22, 2011
Sugam Charity and health awareness camp at Thatchankurichi, a village in South India
27th of February 2011
As part of our health awareness campaign from the charity we conducted this camp at Thatchankurichi a village in Tamil Nadu, South India. At the outset, i would like to thank the volunteers from the village without their help this would not have materialised. We would also like to thank the School Headmaster, The District Educational Officer and the Collector who have agreed for this camp to be conducted.
KMC and KMC Speciality Hospital provided their technical expertise of the Nursing School Prinicipal and the senior Nurses and their team. they worked hard over the entire session without any break. The doctors were again Dr Rajarathinam, Dr Mathimaraiselvan, Dr Geetha Ravi who worked for nothing at the end of the day, and in fact leaving their work commitments for the charitable work.
There was no treatment given at this site of the camp and no free medication were distributed. The aim of the camp to identify the problems and give free advice.
i am attaching couple of photos
with regards
Chockalingam
health awareness activities at Trichy
I am adding some of the articles written in press and some of the photos of the health awareness activities done at Trichy with KMC speciality and KMC hospitals.
Orthopaedic problems of bones and joints are many and we took on only four issues last year at KMC Speciality Hospital named by WHO bone and Joint Decade. they are 1. osteoporosis 2. arthritis 3. road traffic accidents 4. back and neck problems.
We have done Meet our Patients Meet where the press and the public could freely interact with our patients benefited from advanced ortho care treatment at KMC and KMC speciality hospitals.
We have done Bone and Joint Walk to raise awareness on Bone and joint problems as listed above.
We have given awareness talks to senior citizens who are pensioners in a standard format.
We have done first aid program to traffic personnel twice in the last two year to raise awareness on road traffic accidents 2. we have done many free orthopaedic consultations starting in march 2009 at KMC Speciality hospital both as camps and regular free clinics on Fridays for patients who cannot afford to attend a hospital such as ours. These have mainly targeted arthritic patients though osteoporosis and back problems have been covered.
We have done two ATLS type courses named Essentials of Initial Trauma Management at KMC Hospital for doctors sponsored entirely by KMC Hospital and all the consultants have gifted their time and efforts to teach the fundamental principles in trauma management.
I will elaborate all our activities in the next blog and list them and post more articles.
Regards
Chockalingam
Awareness article written on joint replacements
Article written on 24th December 2008
Advanced Ortho Treatment facilities at KMC Speciality Hospitals
Joint Replacements and Key Hole Surgery
What are joints and why do I get pain in my joints?
Joints are present when two bones meet allowing movement to occur.
The ends of bones are lined with a tissue called cartilage. This tissue is strong and smooth. This is lubricated with fluid in the joint.
Ligaments are tissues which hold the bones and allow movement in a certain direction.
Joints are damaged by commonly by diseases, injury, ageing or infection.
Problems with the joints are major causes of immobility and disability. We often see people who can only walk slowly, or for short distances due to pain due to the joint problems. Knee arthritis is very common as one gets old.
What is arthritis?
Arthritis means inflammation of joints. It can be due to many causes.
Your Orthopaedic Surgeon would be able to diagnose the cause of arthritis by taking a history from yourselves and examination. He would need to request specific tests if the cause is not clear by examination alone.
Is there a cure for my arthritis?
It depends on the cause of arthritis. The most common cause of arthritis is Osteoarthritis, which is wear and tear of the joint lining called cartilage with age alone. This can come earlier if there had been previous injury.
The treatment of joint disorders has greatly improved in the last thirty years in other countries and over the past ten years in India. This is partly due to the option of treatment with artificial joint replacements.
What are artificial joint replacements?
Artificial joints replace worn out [arthritic] joints. They are very commonly performed for pain and are very successful in relieving pain. Knees and hips are very commonly replaced, though artificial joint replacements are done for shoulder, elbow, hand and ankle as well.
How do they actually look like?
The picture shows some of the actual prostheses in joint replacements. These are not all inclusive as advanced designs are available for patients
What are current advances in joint replacements?
Only part of the knee replaced as shown in the picture below. Advances in metallurgy and materials in the prosthetic design are available to a patient in Trichy. Management before and after surgery has changed over the past few years. The surgeon at KMC Speciality would use the up to date management practised in UK due to his recent return from England.
Are these new or experimental?
No. These have been successfully performed for over thirty years. The joints are manufactured by advanced engineering methods. They are made of very high quality metal, ceramic and polyethylene. Over 60000 patients are receiving these prostheses by surgery in one year in Australia alone [2003-2004 figures]
Who will perform this at KMC and what is his experience
The surgery would be performed by a senior surgeon who has returned to Trichy after more than fifteen years of experience in UK. He has performed surgeries routinely for the past seven years as a senior surgeon. He had been practising in the largest centre for joint Replacements in UK where more than 4200 patients are treated per year alone [2007 figures]
He has performed research in this field in UK. This has been published and his article which is commonly quoted in the international literature.
“ Outcome of cemented-v-cementless fixation of femoral component in TKR with the identification of radiological signs for the prediction of failure
THE KNEE Dec 1; 7(4): 233-238 2000”
Is this treatment without any problems?
This treatment is very successful in relieving pain. However some patients can have complications. The surgery performed by an experienced surgeon can reduce the complications. Hence it is essential to know your Doctor and his experience who performs this surgery.
Will I be able to walk without limp and will my joint move normally after surgery?
As pain goes your walking will actually improve than before surgery. Hip replacement patients return to normality sooner even though it is a deeper joint. Knee replacement patients will return comparatively slower, however there would be no difference in the success of this surgery.
Treatment after surgery improves the success greatly and your Surgeon would advise you accordingly.
What Should I do?
If you or someone you know suffers from joint pain, please understand that one should not have to live with pain.
Not all patients with joint pain will need joint replacements.
Other causes of joint pain can be treatable completely by medication such as gouty arthritis. Some of the patients’ joint pain can be treated by medication such as Rheumatoid arthritis, though surgery can remarkably change one’s life with surgery.
Other patients can be treated by key hole surgery to the joints.
What is key hole surgery of knee?
I am sure you are aware of sportsmen twisting their knee and disappear from the sports scene for couple of months before returning to normality. They often sustain cartilage injuries which are treatable by key hole surgery. Surprisingly quite a lot of general population have cartilage problems, but choose to live with pain. They can also be treated by key hole surgery.
Advanced Ortho Treatment facilities at KMC Speciality Hospitals
Joint Replacements and Key Hole Surgery
What are joints and why do I get pain in my joints?
Joints are present when two bones meet allowing movement to occur.
The ends of bones are lined with a tissue called cartilage. This tissue is strong and smooth. This is lubricated with fluid in the joint.
Ligaments are tissues which hold the bones and allow movement in a certain direction.
Joints are damaged by commonly by diseases, injury, ageing or infection.
Problems with the joints are major causes of immobility and disability. We often see people who can only walk slowly, or for short distances due to pain due to the joint problems. Knee arthritis is very common as one gets old.
What is arthritis?
Arthritis means inflammation of joints. It can be due to many causes.
Your Orthopaedic Surgeon would be able to diagnose the cause of arthritis by taking a history from yourselves and examination. He would need to request specific tests if the cause is not clear by examination alone.
Is there a cure for my arthritis?
It depends on the cause of arthritis. The most common cause of arthritis is Osteoarthritis, which is wear and tear of the joint lining called cartilage with age alone. This can come earlier if there had been previous injury.
The treatment of joint disorders has greatly improved in the last thirty years in other countries and over the past ten years in India. This is partly due to the option of treatment with artificial joint replacements.
What are artificial joint replacements?
Artificial joints replace worn out [arthritic] joints. They are very commonly performed for pain and are very successful in relieving pain. Knees and hips are very commonly replaced, though artificial joint replacements are done for shoulder, elbow, hand and ankle as well.
How do they actually look like?
The picture shows some of the actual prostheses in joint replacements. These are not all inclusive as advanced designs are available for patients
What are current advances in joint replacements?
Only part of the knee replaced as shown in the picture below. Advances in metallurgy and materials in the prosthetic design are available to a patient in Trichy. Management before and after surgery has changed over the past few years. The surgeon at KMC Speciality would use the up to date management practised in UK due to his recent return from England.
Are these new or experimental?
No. These have been successfully performed for over thirty years. The joints are manufactured by advanced engineering methods. They are made of very high quality metal, ceramic and polyethylene. Over 60000 patients are receiving these prostheses by surgery in one year in Australia alone [2003-2004 figures]
Who will perform this at KMC and what is his experience
The surgery would be performed by a senior surgeon who has returned to Trichy after more than fifteen years of experience in UK. He has performed surgeries routinely for the past seven years as a senior surgeon. He had been practising in the largest centre for joint Replacements in UK where more than 4200 patients are treated per year alone [2007 figures]
He has performed research in this field in UK. This has been published and his article which is commonly quoted in the international literature.
“ Outcome of cemented-v-cementless fixation of femoral component in TKR with the identification of radiological signs for the prediction of failure
THE KNEE Dec 1; 7(4): 233-238 2000”
Is this treatment without any problems?
This treatment is very successful in relieving pain. However some patients can have complications. The surgery performed by an experienced surgeon can reduce the complications. Hence it is essential to know your Doctor and his experience who performs this surgery.
Will I be able to walk without limp and will my joint move normally after surgery?
As pain goes your walking will actually improve than before surgery. Hip replacement patients return to normality sooner even though it is a deeper joint. Knee replacement patients will return comparatively slower, however there would be no difference in the success of this surgery.
Treatment after surgery improves the success greatly and your Surgeon would advise you accordingly.
What Should I do?
If you or someone you know suffers from joint pain, please understand that one should not have to live with pain.
Not all patients with joint pain will need joint replacements.
Other causes of joint pain can be treatable completely by medication such as gouty arthritis. Some of the patients’ joint pain can be treated by medication such as Rheumatoid arthritis, though surgery can remarkably change one’s life with surgery.
Other patients can be treated by key hole surgery to the joints.
What is key hole surgery of knee?
I am sure you are aware of sportsmen twisting their knee and disappear from the sports scene for couple of months before returning to normality. They often sustain cartilage injuries which are treatable by key hole surgery. Surprisingly quite a lot of general population have cartilage problems, but choose to live with pain. They can also be treated by key hole surgery.
Open Doors For More Patients:Raising Awareness of Knee replacement in rural India
The Fourth of September 2010
We decided to make a video of one of my patients who had a knee replacement. The video showed the impact this operation can make to a lady in a rural place in India. This video raises awareness significantly of a disability which is silently crippling people in India. With so many other life threatening issues and health hazards, the disability due to arthritis is not well known or written.
Arthritis not only limits one's walking ability, also disables a person in activities of daily living. I quantify my patients' disability tailored to Indian conditions and also use international scoring systems. But seeing is believing and for the public, there could not be any better educational method than a video play back.
please visit the sugam charity web site from the useful links site to view this video.
Warm Regards
Chockalingam
Wednesday, May 18, 2011
"Invest health for your loved ones"
When i had the book given to me by one of our good friends at the hospital i work, it helped me greatly. i will elaborate on the book itself in another blog. The book opened up my thoughts and creativity quite a bit. Then, when i saw the mother of a cardiologist who was morbidly obese coming for a knee replacement with the associated risks, the thoughts started flowing to this subject of "Money and Health, the conundrum"
This blog is the continuation of the blog and if you have not read my earlier blog please go and read and continue>
How to combine money which is so well associated with comforts and health which is so associated with well being? Being healthy would enable one to enjoy the money and its comforts.
Saving money when you need to spend the money is one of the models i have been following since 1993. Saving money when you spend time for a good cause is a concept i had been exposed to when i started doing the charity walk for the cancer in UK.
is a new conceptWe at Sugam Charity thought of a model when one can save money for the time you spend for being healthy! after many trials, the model which we have come up with are the following. one can choose the method one wants depending on his circumstances.
1. Save money in a separate account or pot for the time you spend exercising for example. this could be pounds/dollars/rupees for the time you spend on trying to become healthy. Use this pot as exclusive pot for spending later when you want to have comforts like buying your hi tech headphones for example.
2. Save money for your loved ones when they do exercise is gifting someone money when they spend time for their health. one may say i do not have anyone whom i would like to see them healthy! or do not want to save money for someone else!
3. Spend time for your loved ones to become healthy for them to be able to spend time with you longer in the longer run is even better. this would be for you to exercise more for your loved ones as much as for yourselves. Quantfication can be in the form of money which you can save for them or for yourselves!
Think about these options and start using them in your life. i know few who have started already.
Hang on, it is time for me to exercise! no for work!!!!!!. The anaesthetist has anaesthetised my patient for surgery and the patient is waiting!!!!!!!!!!!!!!!!!!
Regards
Chockalingam
This blog is the continuation of the blog and if you have not read my earlier blog please go and read and continue>
How to combine money which is so well associated with comforts and health which is so associated with well being? Being healthy would enable one to enjoy the money and its comforts.
Saving money when you need to spend the money is one of the models i have been following since 1993. Saving money when you spend time for a good cause is a concept i had been exposed to when i started doing the charity walk for the cancer in UK.
is a new conceptWe at Sugam Charity thought of a model when one can save money for the time you spend for being healthy! after many trials, the model which we have come up with are the following. one can choose the method one wants depending on his circumstances.
1. Save money in a separate account or pot for the time you spend exercising for example. this could be pounds/dollars/rupees for the time you spend on trying to become healthy. Use this pot as exclusive pot for spending later when you want to have comforts like buying your hi tech headphones for example.
2. Save money for your loved ones when they do exercise is gifting someone money when they spend time for their health. one may say i do not have anyone whom i would like to see them healthy! or do not want to save money for someone else!
3. Spend time for your loved ones to become healthy for them to be able to spend time with you longer in the longer run is even better. this would be for you to exercise more for your loved ones as much as for yourselves. Quantfication can be in the form of money which you can save for them or for yourselves!
Think about these options and start using them in your life. i know few who have started already.
Hang on, it is time for me to exercise! no for work!!!!!!. The anaesthetist has anaesthetised my patient for surgery and the patient is waiting!!!!!!!!!!!!!!!!!!
Regards
Chockalingam
Tuesday, May 17, 2011
standards and Health Awareness among the public
As a professional, we are striving to give the best to our people who approach us. For this we constantly update ourselves and bring the current and the best accepted international standards we acquire to the place we practice our profession. The traditional models of spreading the awareness of @this provision of the current best practices, had been one of the following.
1. Patients who have benefited spreading the information. In India this had been the best method so far but it takes time. But the problem here can be the mass followers who may be barking at the wrong tree for sometime before realising!
2. Media and news and not everyone will have equal access to them
3. Presentations to our learned colleagues who in turn will spread the news! as it were. These can me informal meets, formal meetings and publications
4. Self advertising by the professional or the hospital itself. But there are no restrictions at the moment on these and can mislead to wrong treatment or health care.
But i think there is another way which is to make the health care delivery and advances to be transparent for the end user i.e the patient and the relatives to make their own informed choice. Though this may not be applicable universally at the moment to the common man in India, i feel that this is the best way.
This would involve in making the options available to the end user directly.
I may be wrong as the UK health care delivery model is completely opposite in that it sets the standards for the professional to practice and frees the end user in making these complex decisions of choosing.
For India this UK model will not be acceptable and the end user i.e the patient has to make lot of the decisions in choosing!. Hence the best way forward would be to make the best available options of healthcare transparent and widely available to the common man.
One needs to be very careful in choosing what is best and accepted current practice to be able to present them. We are at the moment started analysing this as a project and i will let you know the outcome soon!
Regards
Chockalingam
1. Patients who have benefited spreading the information. In India this had been the best method so far but it takes time. But the problem here can be the mass followers who may be barking at the wrong tree for sometime before realising!
2. Media and news and not everyone will have equal access to them
3. Presentations to our learned colleagues who in turn will spread the news! as it were. These can me informal meets, formal meetings and publications
4. Self advertising by the professional or the hospital itself. But there are no restrictions at the moment on these and can mislead to wrong treatment or health care.
But i think there is another way which is to make the health care delivery and advances to be transparent for the end user i.e the patient and the relatives to make their own informed choice. Though this may not be applicable universally at the moment to the common man in India, i feel that this is the best way.
This would involve in making the options available to the end user directly.
I may be wrong as the UK health care delivery model is completely opposite in that it sets the standards for the professional to practice and frees the end user in making these complex decisions of choosing.
For India this UK model will not be acceptable and the end user i.e the patient has to make lot of the decisions in choosing!. Hence the best way forward would be to make the best available options of healthcare transparent and widely available to the common man.
One needs to be very careful in choosing what is best and accepted current practice to be able to present them. We are at the moment started analysing this as a project and i will let you know the outcome soon!
Regards
Chockalingam
Setting Standards in Health Care
Setting Standards always has motivated me to work harder. There are areas where standards will improve with time alone as developments creep in as there will be exposure to everyone. however one should not wait for these and have to be actively engaged in these activities.
It is not just important for setting standards by yourself as the long term goal maintaining the standards largely revolve around the fact that everyone follows them. I have found this as the hard way as setting standards being easier, only to find out in dismay later that these are not followed.
It is possible for us to set standards and see them maintained only if the stakeholders are taken into confidence and even be involved in setting the standards themselves by discussion. On the otherheand,forcing them enforces the changes only if two conditions are met.. 1. If you are the paymaster or the employer and the people will do with fear. 2. they will do when you are around and will not necessarily follow them when you are not there.
This is a new learning experience for myself as the culture, ethics and the society is different to my exposure in the last few years. However people's needs and the necessities are the same! Hence we trod along and find ways to set standards and maintain them.
It is also important that standards have to be constantly reviewed as the present standards are not necessarily acceptable in the future and in fact they often are not. Hence persisting the standards one learns during their earlier experience will be detrimental by not bringing new standards.
This appears to be a complex post even to me after writing this but i will elaborate by a simmple illustration.
Pain after surgery or after major trauma is perceived to be normal or acceptable to most health care workers, but from the patient point of view it is not acceptable. Hence the standards for assessing and acting on the pain of the patient by the health care worker had to be changed when i started my practice two and half years ago in India.
We brought our own version of Pain assessment and management in colloboration with the nurse leadership. I found setting the standard was not the most difficult part as the hospital management were very receptive. however the maintainance of this simple standard as we set out is difficult even after two years.
This may be the fact that i did not involve all the stakeholders when designing the standard in the first place. I am still learning.
I hasten to add that our standard of assessing and managing pain is much much better than two years ago with the awareness and the attitude to be significantly in the right direction. Hence i am happy with what we are doing and we have implemented so many other standards in the past two years.
I will elaborate on these in the future blogs
Regards
Chockalingam
It is not just important for setting standards by yourself as the long term goal maintaining the standards largely revolve around the fact that everyone follows them. I have found this as the hard way as setting standards being easier, only to find out in dismay later that these are not followed.
It is possible for us to set standards and see them maintained only if the stakeholders are taken into confidence and even be involved in setting the standards themselves by discussion. On the otherheand,forcing them enforces the changes only if two conditions are met.. 1. If you are the paymaster or the employer and the people will do with fear. 2. they will do when you are around and will not necessarily follow them when you are not there.
This is a new learning experience for myself as the culture, ethics and the society is different to my exposure in the last few years. However people's needs and the necessities are the same! Hence we trod along and find ways to set standards and maintain them.
It is also important that standards have to be constantly reviewed as the present standards are not necessarily acceptable in the future and in fact they often are not. Hence persisting the standards one learns during their earlier experience will be detrimental by not bringing new standards.
This appears to be a complex post even to me after writing this but i will elaborate by a simmple illustration.
Pain after surgery or after major trauma is perceived to be normal or acceptable to most health care workers, but from the patient point of view it is not acceptable. Hence the standards for assessing and acting on the pain of the patient by the health care worker had to be changed when i started my practice two and half years ago in India.
We brought our own version of Pain assessment and management in colloboration with the nurse leadership. I found setting the standard was not the most difficult part as the hospital management were very receptive. however the maintainance of this simple standard as we set out is difficult even after two years.
This may be the fact that i did not involve all the stakeholders when designing the standard in the first place. I am still learning.
I hasten to add that our standard of assessing and managing pain is much much better than two years ago with the awareness and the attitude to be significantly in the right direction. Hence i am happy with what we are doing and we have implemented so many other standards in the past two years.
I will elaborate on these in the future blogs
Regards
Chockalingam
Monday, May 16, 2011
Advanced Ortho Care at KMC Speciality Hospital
Sports Injury Service and Advanced Arthorscopic Surgery Service At KMC Speciality Hospital
Sports is becoming more of a passion as much as a hobby in our Country. Winning World level events has attracted more of our young boys and girls to partake in sports and even take this as their profession. As each profession carries its risks, sports poses us the biggest risk to these young generation in the form of injuries.
Injuries in sports mostly affect the musculoskeletal system. The muscles, tendons, bones and the joints are the components of this system. The joints are complex structures having cartilage, ligaments attached to the bone through soft tissues.
Most sports injuries are managed initially with the following fundamental principles. Remember the mnemonic RICE whenever one gets injured. Rest the injured part, apply Ice, apply Compression and Elevate the injured part. The practice of applying warmth in the form of hot water pack/bottle to the injured part is not recommended.
Physiotherapists either at the sports arena or at the hospital can treat majority of minor injuries to the muscles and tendons. The spasm associated with the muscle and tendon injuries can be treated with stretching and local treatment as described above. Some of these injuries especially the minor ligament injuries need rehabilitation by attending a dedicated physiotherapy department.
KMC Speciality Hospital has a dedicated Physiotherapy department to treat these injuries. The devices available in the department cover all areas of the body. They are designed to treat with mobilisation, stabilisation and retraining.
Though the initial pain and suffering improve with these simple measures and physiotherapy treatment, the long term recovery depends on detection and treatment of major injuries. These major injuries often feel like minor injuries after rehabilitation. However the key to return to sports and normality relies on recognising these as needing further treatment.
Hence we need experts who can diagnose and be able to treat them with the modern treatment methods. At KMC Speciality Hospital, we have surgeons trained and practiced abroad in treating these injuries. Treating them with modern treatment methods practiced in western countries is the key for getting back to normality.
Modern methods of treatment of the sports injuries often involve keyhole surgery to the joints. This is called Arthroscopic Surgery. Arthroscopy started as far as back in 1910s, though the treatment with this technique was possible after 1970s in Japan.
The Advanced Ortho Care at KMC Speciality Hospital has a dedicated state of the art High Definition Arthroscope with HD monitor for excellent visualisation and treatment of the injured part. The supportive power instruments, electronically controlled pump system and Radiofrequency Ablation techniques are at par with the most advanced hospitals in the world.
The problems, which can be treated with these Arthroscopic techniques, are many and can only be listed as a guide as follows.
1. Cartilage injuries of the knee: Meniscus Injuries in the knee and Wrist cartilage injuries
2. Ligament Injuries: Anterior and Posterior Cruciate Ligament Injuries in the knee
3. Tendon injuries of the muscles in the shoulder: Rotator Cuff Injuries and SLAP lesions
4. Recurrent Dislocations: Dislocations of the shoulder and kneecap, which often recur in young sports people
5. Recurrent and persistent pain in joints: Impingement of the joints, which affect mostly shoulders, ankles and elbow
6. Post trauma stiffness of the joints
7. Instabilities of the joints: shoulders and ankles
8. Infections of joints
9. Arthroscopic fusions of joints especially ankle
The technical expertise in delivering the treatment methods listed above is as important as the facility available in our Hospital. The surgeons who deliver this World Class treatment have not only acquired these skills in countries around the world, but also have been practising surgeons in UK before their return to their homeland Trichy.
Some of the other Advanced Ortho treatment Methods provided at KMC Speciality Hospital are as follows
1. Joint Replacements of Knee, Hip, Shoulder, Elbow and Ankle using imported implants with international standards [Swedish, UK and Australian Standard]
2. Partial joint replacements with implants originating from Oxford,UK.
3. World Class treatment methods of simple and major Trauma using principles of international Swiss [AO] and American Standards [ATLS]
4. Treatment of Pelvic, Acetabular and Spinal Injuries
5. Treatment of deformities in Children with Ponseti Method [Canada]
6. Treatment of complex trauma and deformities using Russian Technique [Ilizarov technique]
7. Treatment of Fractures in Children using French Technique [Nancy]
Warm Regards
Chockalingam
Sports is becoming more of a passion as much as a hobby in our Country. Winning World level events has attracted more of our young boys and girls to partake in sports and even take this as their profession. As each profession carries its risks, sports poses us the biggest risk to these young generation in the form of injuries.
Injuries in sports mostly affect the musculoskeletal system. The muscles, tendons, bones and the joints are the components of this system. The joints are complex structures having cartilage, ligaments attached to the bone through soft tissues.
Most sports injuries are managed initially with the following fundamental principles. Remember the mnemonic RICE whenever one gets injured. Rest the injured part, apply Ice, apply Compression and Elevate the injured part. The practice of applying warmth in the form of hot water pack/bottle to the injured part is not recommended.
Physiotherapists either at the sports arena or at the hospital can treat majority of minor injuries to the muscles and tendons. The spasm associated with the muscle and tendon injuries can be treated with stretching and local treatment as described above. Some of these injuries especially the minor ligament injuries need rehabilitation by attending a dedicated physiotherapy department.
KMC Speciality Hospital has a dedicated Physiotherapy department to treat these injuries. The devices available in the department cover all areas of the body. They are designed to treat with mobilisation, stabilisation and retraining.
Though the initial pain and suffering improve with these simple measures and physiotherapy treatment, the long term recovery depends on detection and treatment of major injuries. These major injuries often feel like minor injuries after rehabilitation. However the key to return to sports and normality relies on recognising these as needing further treatment.
Hence we need experts who can diagnose and be able to treat them with the modern treatment methods. At KMC Speciality Hospital, we have surgeons trained and practiced abroad in treating these injuries. Treating them with modern treatment methods practiced in western countries is the key for getting back to normality.
Modern methods of treatment of the sports injuries often involve keyhole surgery to the joints. This is called Arthroscopic Surgery. Arthroscopy started as far as back in 1910s, though the treatment with this technique was possible after 1970s in Japan.
The Advanced Ortho Care at KMC Speciality Hospital has a dedicated state of the art High Definition Arthroscope with HD monitor for excellent visualisation and treatment of the injured part. The supportive power instruments, electronically controlled pump system and Radiofrequency Ablation techniques are at par with the most advanced hospitals in the world.
The problems, which can be treated with these Arthroscopic techniques, are many and can only be listed as a guide as follows.
1. Cartilage injuries of the knee: Meniscus Injuries in the knee and Wrist cartilage injuries
2. Ligament Injuries: Anterior and Posterior Cruciate Ligament Injuries in the knee
3. Tendon injuries of the muscles in the shoulder: Rotator Cuff Injuries and SLAP lesions
4. Recurrent Dislocations: Dislocations of the shoulder and kneecap, which often recur in young sports people
5. Recurrent and persistent pain in joints: Impingement of the joints, which affect mostly shoulders, ankles and elbow
6. Post trauma stiffness of the joints
7. Instabilities of the joints: shoulders and ankles
8. Infections of joints
9. Arthroscopic fusions of joints especially ankle
The technical expertise in delivering the treatment methods listed above is as important as the facility available in our Hospital. The surgeons who deliver this World Class treatment have not only acquired these skills in countries around the world, but also have been practising surgeons in UK before their return to their homeland Trichy.
Some of the other Advanced Ortho treatment Methods provided at KMC Speciality Hospital are as follows
1. Joint Replacements of Knee, Hip, Shoulder, Elbow and Ankle using imported implants with international standards [Swedish, UK and Australian Standard]
2. Partial joint replacements with implants originating from Oxford,UK.
3. World Class treatment methods of simple and major Trauma using principles of international Swiss [AO] and American Standards [ATLS]
4. Treatment of Pelvic, Acetabular and Spinal Injuries
5. Treatment of deformities in Children with Ponseti Method [Canada]
6. Treatment of complex trauma and deformities using Russian Technique [Ilizarov technique]
7. Treatment of Fractures in Children using French Technique [Nancy]
Warm Regards
Chockalingam
Sunday, May 15, 2011
Money and Health, the conundrum!
Money is something we find as a commodity to have our life go smoothly. we start saving it by various means.this could be a current account, savings account, investment account, fixed assets such as land and assets such as gold. We spend time acquiring this to be able to spend them at some time. The spending is meant to give us worldly pleasures. This could be something like spending money to buy a nice Television so that we could enjoy watching something we enjoy.
We also know that we need to be healthy to be able to enjoy the worldly pleasures. The importance of health is though not as well transparent to our thoughts as money's importance. Healthy persons are able to live without pain and suffering and hence can be quite happy even if they have less money.
We know that we cannot take money and its various forms to where our soul go after we are rest to peace at the end of our life. hence we see some people denounce the need of money to and give importance to health. we see them suffering in some way as money's importance soon becomes apparent.
Money is also needed to keep yourself healthy. for example we need money to be able to buy good fruits and healthy food to keep us healthy. being healthy helps us to be able to get more money. for example, if one is healthy, he is able to get more work and do more work and hence can command more money.
Should one give more importance to money or health. A conundrum indeed!
The answer lies in somewhere in the middle. May be Being Healthy will win over Being Wealthy to most people when cornered into answering one over the other. however no one can not deny the fact that having some wealth is essential to be able to survive and be happy when you have good health.
I am then working on a model to be able to combine these into one in one way for a common man approach for us to follow in real life.
I will elaborate in my next blog.
Meanwhile i have not forgotten to follow up my other blog on traffic and speed awareness!
Warm Regards
Chockalingam
We also know that we need to be healthy to be able to enjoy the worldly pleasures. The importance of health is though not as well transparent to our thoughts as money's importance. Healthy persons are able to live without pain and suffering and hence can be quite happy even if they have less money.
We know that we cannot take money and its various forms to where our soul go after we are rest to peace at the end of our life. hence we see some people denounce the need of money to and give importance to health. we see them suffering in some way as money's importance soon becomes apparent.
Money is also needed to keep yourself healthy. for example we need money to be able to buy good fruits and healthy food to keep us healthy. being healthy helps us to be able to get more money. for example, if one is healthy, he is able to get more work and do more work and hence can command more money.
Should one give more importance to money or health. A conundrum indeed!
The answer lies in somewhere in the middle. May be Being Healthy will win over Being Wealthy to most people when cornered into answering one over the other. however no one can not deny the fact that having some wealth is essential to be able to survive and be happy when you have good health.
I am then working on a model to be able to combine these into one in one way for a common man approach for us to follow in real life.
I will elaborate in my next blog.
Meanwhile i have not forgotten to follow up my other blog on traffic and speed awareness!
Warm Regards
Chockalingam
Monday, May 2, 2011
Traffic awareness and Speed awareness
This is a subject quite close to my heart. Trauma is called an accident in India often meaning this was unexpected. this gives a implication that one can feel sorry for the event and the persons involved in the accident. This is quite the opposite to what is true. most trauma incidents and if not all can be predicted and preventable. the western countries have worked on this so well that most accidents are prevented.
the problem in a country like India had always been traffic awareness or the lack of it. however the present scenario of lack of speed awarenss complicates in a significant way. the same lack of traffic awareness with low speed and high speed have different implications with the resultant severity of injury quite high.
this is recognised in a country like UK where the stress on speed awareness is given a huge thrust on public education even when the traffic awareness is high
I will continue in my next blog and elaborate
the problem in a country like India had always been traffic awareness or the lack of it. however the present scenario of lack of speed awarenss complicates in a significant way. the same lack of traffic awareness with low speed and high speed have different implications with the resultant severity of injury quite high.
this is recognised in a country like UK where the stress on speed awareness is given a huge thrust on public education even when the traffic awareness is high
I will continue in my next blog and elaborate
Dental Camp at our school at Sreenivasapuram, Lalgudi
The Sugam Charity organised a dental camp with the help of Dr Iyyappan Shankar and his team from Dencity at KMC Speciality hospital and Dr Navarasu Dental Surgeon from Poovalur. The supporting volunteers were C Rajamanickam, Mrs Maragatham,chockalingam, Rajamanickam friend and his family. there was a hiccup with tamil nadu electricity board supply with unexpected stoppage of electricity. Generator was organised by Gandhimathinathan with his friend and the camp presentation started. there was a presentation by the dentists on how to care for the teeth to the children and their parents. dental check up was done for over ninety children, most of them underprivileged. a comprehensive assessment and advice was given. it was nice to see young dentists enjoying themselves in this cause of health education and awareness. please note that i am not calling this as service as i do not think it as a free service, rather it is the duty of everyone.
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