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Monday, December 21, 2015

Surgery all papers

Surgery was an altogether different experience
This is Surgery (general) paper, part 1
This is orthopaedics paper
And this is Surgery part 2 which was the ultimate cram-test

General Medicine Paper 2

Everything went by so fast and I have no idea how. Heart failure, again!

Tuesday, December 15, 2015

General Medicine Paper 1; final year, final exam, finally!

That's the question paper, folks. Except the 10 markers, everything was random.
Finally, after years of apparent toil, the final exam starts. I was cramming yesterday and today morning (exam was from 2-5 pm).

Heart failure was taught by Dr Srinivas in those 7 day extra classes.
Pneumonia, I read today morning. So was NASH and Sjogren's.
Secondary hypertension, I wrote from what I remembered Dr LakshmeGowda telling when I diagnosed Vinay with hypertension.
Pancytopenia, BMT, Megaloblastic anemia, all the same answers.
Vildagliptins lucky guess as hypoglycemic agent.
Ptosis, thanks to learning opthalmology twice.
Tension headache, I'd no idea, but compared it with cluster and migraine.
Neurogenic Bladder, straight from Dr LakshmeGowda's mouth from the extra classes.
Scabies - I had remembered the organism that caused it, Zigu telling it while we were having lunch.
ARB, I confused with ACE inhibitors (and wrote Enalapril, etc.), but I've drawn the diagram of RAS.

Everything here and there knowledge over the past life translated into black ink.

Monday, October 5, 2015

Onaghosham 2015

I reached Mysore at 8 in the morning from Mozilla Kerala community meet-up and Zigu and Harinath had just dressed up to leave for the badminton court where 2k13 were organizing the Onam this year.

I had a quick shower, changed immediately to the mundu I got as Onakkodi this year and the kurta that was dad's; and left for the badminton court walking (my bicycle was being serviced).

As soon as I reached I had sweet appam and chicken curry and then started working on cutting the orange jamanthis with Sanjana and Harinath. Zigu was drawing the pookkalam. We had our usual spot right next to the entrance to the badminton court. It was 2k14 batch right next to us, 2k12 then, 2k15 and Interns+PGs and 2k13 at the other end.

While everyone was still laying the kalam, Aparna, Fahad, Gautam, and me represented our batch in the General quiz which was happening in the yard outside. Most of the questions were about Kollam (where the quiz master appears to be from) and we were leading till the last round. The last round was about kusruthi chodyangal (riddles) and we couldn't figure out which dance form was associated with vehicles. So we ended up third.

Back at the pookkalam we were almost done and I now was stripping vadarmalli petals for the extra finish. At 11.15 I went around to see how others were doing. 2k14 were just like ours. 2k12 hadn't put 50% of their kalam. 2k15 had put all kinds of vegetables in. Interns were just re-doing what they did 3 years back when they won. And 2k13 just put some flowers in between a lawn of grass. After ensuring success I returned to our kalam to take selfies with everyone.

After photographs vadam vali  started. I was trying to sit down with Terese when Gautam called me to be part of the team. Fortunately we had to pull just interns before reaching final. But Gautam got injured in the last pull and couldn't particpate in the final. Naturally, we lost in the final to 2k12. They eat too much chicken. Even the girls. They won too.

It was balloon bursting after that. And Arun almost won this time too. But only Fahad and Fayaz remained when Arun got out and it was Fahad who won.

Then we had lunch. I, as usual, wasn't interested in food.

Post lunch there were many more games. Musambi in the bucket - where you put your head inside a bucket filled with water and bite a musambi out, Uriyadi, musambi eating, etc.

In between the 2k15 juniors introduced themselves. Nice lot. Also, this year, for a change, PV had come for Onam. Took a selfie with her too.

For tea there was, excellent according to others, dosa straight from the pan.

Everyone came and the formal function was very nice. CFTRI administrator was the chief guest. Dr Shekar, Dr Dakshayani, et al with their Malayali love. Karun was Maveli.

After the regular Thiruvathira there was three more group dances - an oppana, a thematic dance; and then a very nice cinematic dance.

And a couple of songs. Dr Dikshitha made me melt.

2k10 got mementos for leaving us. And we took so many photos. And everyone took one photo. And then we left.

Number of people who broke their legs: 2 (Dr Ashitha whom Fayaz threw a stump on, and Josna who sprained her ankle falling from stage and ending up in our own Ortho OPD today morning)

Tuesday, June 9, 2015

Standing up to be Happy

Woke up to a dream today, like the last few days. Ran to surgery ward where we discussed deep vein thrombosis - Virchow's triad and more. Try this question:
A very young girl (13 or 15 year old), comes to emergency room with acute abdomenal pain in the right iliac fossa. What do you do/ask/investigate?
After rounds, where we saw dramatic improvement in a thromboangiitis obliterans case after lumbar sympathetectomy - his left leg which was colder than the normal right limb has suddenly became warmer, Anie, who just landed in India last day, gave us chocolates and the best cake on Earth which her mother made.

Later had fruit salad with ice cream with Trees (who's leaving for home today), Sweety, and Maggie, followed by butter fruit juice and heard about the amazing fight over closed toilet doors in LH. Speaking of going home, Hari is also going home after having handed over Terrorist to a mess worker two days back.

My order for rechargable batteries and there charger was delivered by Amazon/BlueDart in the evening. So, while that's charging, I set up my standing desk again.

My standing desk. The zig-zag aluminium laptop stand was originally meant for using on the bed, but it is very versatile. The wireless keyboard and mouse you see on the table is not used while standing, but rather when it becomes sitting/sleeping desk.
Just as I finished setting it up, I discovered this #100HappyDays challenge and decided I'd enroll. The standing desk and the fruit salad would be happy day #1.

BTW, for that young girl, if you take her to operating theatre, you might not find acute appendix like you wished for. You ask for last menstrual period and rule out Mittelschmerz - which occurs at the middle of the cycle and presents with pain. It'd be a good idea to rule out pregnancy too.

Sunday, June 7, 2015

Turns out there's a reason why people love Surgery

Reading someone else's blog is a great motivator to write one's own blog. I just went through some of the very first posts in Lamya's blog. And the idea of documenting one's day/week in excruciating details still fills me with enthusiasm.

The reader deserves to know. They can't be left hanging off the cliff. Every story needs to be completed, or continued. If you do not plan on finishing a story, do not begin writing one (at least, do not invite readers).

Surgery is what I wasn't sure of. And it is the only thing I am sure of, now. More than my love of learning, it is Balu sir's love for teaching that keeps me hooked. Nothing is complicated. Surgery is like plumbing. Conceptually very simple, but when you get down on your knees and reach out to the corner to fix a leak on the pipe, it is a tug-war between your perseverance and the graveness of the leak. If you become lazy and do a quick hack, you'll pay for it in terms of complications soon.

Sometimes in the operation theatre I come up with ideas of building robotic hands that can go inside the peritoneum and hold that structure just the way the surgeon wants. If you watch the struggle to get the gall bladder into a plastic bag in laproscopic cholecystectomy, you'll definitely come up with such ideas. It is all about reaching into that space, why should it be so difficult? If only you could put your hands inside the body like Neo does in Matrix 2.

Fact is, that is what surgeons do. When a giant cyst is trapped inside your body, pressing on your nerves and causing you unbearable pain, all you want is someone to reach inside and take it out - something that no amount of medicine can do. That desperation is the license for surgeons to be daring. It is what lets them cut tissue knowing for sure that it is irreplacable. Surgeons live the Nike slogan - they just do it.

The results are usually immediate and dramatic. Here is a patient who's crying and dying, and minutes later he's smiling and dreaming again.

I am that patient. Hopeless and desperate before going in, and within days of surgery posting I've regained my confidence in what I can do.

Thursday, April 30, 2015


Today evening viswa found a kitten outside in the drain. He brought it to hostel and I thought I'd adopt it.

Later Hari went for a tea at lemon tea and found two of its siblings also. We went back to fetch them, but the auto drivers there had thrown them inside the hostel walls itself to protect from dogs.

So we found them in the backyard and put it with the first one.

Three kittens are sleeping in that peacefully now.

Friday, April 10, 2015

Defending Net Neutrality

I truly believe that the Internet and the Open Web has played and will continue to play a massive role in my learning. That's why I had started MMC MedFox Club - to spread the Internet love to more medical students.

Today that Internet is about to be saved from being damaged by TRAI and Telecom companies. And the following letter to Mysore MP Pratap Simha is one of my contributions to the effort.

Sub: Please come out in support of the Open Web and #NetNeutrality

I'm a final year MBBS student of Mysore Medical College.

As a student, the Internet has vastly improved my life - learning from books not even available in India, talking to alumni who are mentoring me from abroad, communicating with professors, friends, taking open courses from foreign universities, watching disease symptoms, operations, examination, etc on YouTube, etc.

Recently TRAI has announced a consultation paper on regulating Over The Top services which will include YouTube, Gmail, and other such services which I mentioned above.

I have gone through the 118 page document myself and I find it heavily biased, insensitive towards Internet users like me, and blind towards the founding principles of the Internet. Reading between the lines makes me suspect an immoral association between TRAI and Telecom operators, for the paper is more concerned about protecting the profit margin of TSPs rather than defending the rights of the consumer.

With your experience in investigative journalism, you must be able to judge this situation better than me.

I urge you to come out in public support of net neutrality as a democratic representative. Also, if possible you should use all your reach and influence to make other MPs aware of this issue, and make journalists cover the same.

Attaching some links for your reference.

Expectant young social citizen,
Akshay S Dinesh


* TRAI consultation paper: http://trai.gov.in/Content/ConDis/10743_23.aspx
* The Hindu editorial "The importance of net neutrality" : http://www.thehindu.com/opinion/editorial/the-importance-of-net-neutrality/article7065661.ece 

* Odisha MP ​Tathagata Satpathy​'s open letter to TRAI http://ibnlive.in.com/news/odisha-mp-earns-internet-points-by-writing-a-letter-to-the-trai-chairman-in-support-of-net-neutrality/538497-79.html

Thursday, April 2, 2015

Cochlear Herniation of Brain

Today is a holiday. Tomorrow Kreida'15 starts. The batch organizing it seems to be enthusiastic enough to write 2k12 on every T-shirt, even that of people from other batches.

Sobotta atlas of anatomy is a brilliant textbook for anatomy. I had discovered it under the caption of an image in Gray's anatomy. Used that to learn about the position of cochlea, semi circular canals, etc. 

Later read about radical behaviourism (Skinner's works).

Sleep kept crawling in, as usual.

Finished a few more pages of Nireeswaran.

And read Bailey and Love for the first time. Hernia is explained beautifully in that. 

Pirate Praveen and I were discussing Telegram vs TextSecure. As usual, I lost. Will probably be running a textsecure server on our own.

Kreida chess is full on. Watching Zigu play.

Tuesday, March 31, 2015

Bharat Ratna Dr APJ Abdul Kalam

On account of graduation day of 2k9 batch, the former president is speaking inside PJA right now.

"What can I give?" seems to be the message.

More on his website.

Friday, March 13, 2015

Something I was waiting for

Today the third year result was announced. As expected I failed in ophthalmology. Also otorhinolaryngology. But contrary to what I've been thinking about how it'd feel, I'm having an odd sensation of freedom. 

Now this is not a rationalization of the situation. But I'm feeling this way because I no longer have the pressure of maintaining a pattern to worry about. 

So I'll hopefully be more actively updating this blog in the coming days with stuff I'm doing and steps I'm taking to end up with a better scorecard eventually.

For now I'm home on my table and reading 

Thursday, March 5, 2015


Of late my likeness for neuroscience has resurfaced. Could be because of the urgency in deciding what to do after MBBS.

Anyhow, I've been having email conversations with people in IISc Bangalore and I'll be visiting the place in April. Got loads to prepare by then.

Found a nice set of courses in brain and cognitive science on MIT OCW. There is a lot of content there. Yet.

Final Year

OBG posting ended with an internal on 2nd March. We were supposed to do partograms.

Skin posting started the day after. But the cubicles are filled with so many of us

Friday, February 13, 2015

How many hours of sleep do you actually need?

OBG OPD on Thursday. Suddenly those people whom nobody wanted are doing per speculum examination. Ah, that's what final year fetches you. Luckily, we removed a copper T, saw androgen insensitivity syndrome, pubertal menorrhagia, etc.

After days of procrastinating, had to spend a whole night on writing down MAA project report. Luckily my study isn't so big.

Surgery conference in JK grounds. Apparently filled with robotic surgery demonstration from remote location. Sounds complicated, probably useless. Also followed in the night by step up style dance competition between MMC & JSS.

Should go to Firefox Student Ambassador Bootcamp tomorrow.

Oh, and, a blog is coming up for student association. It's been coming for a long time now though.

Friday, January 9, 2015

Third year theory question papers RGUHS phase 3 part 1 December 2014

Ent, community medicine, ophthalmology question papers.

Nobody knows if I'm passing ophthalmology and ent