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Tuesday, March 29, 2005A team of Australian surgeons yesterday reattached both hands and one foot to 10-year-old Perth boy, Terry Vo, after a brick wall which collapsed during a game of basketball fell on him, severing the limbs. The wall gave way while Terry performed a slam-dunk, during a game at a friend’s birthday party.

The boy was today awake and smiling, still in some pain but in good spirits and expected to make a full recovery, according to plastic surgeon, Mr Robert Love.

“What we have is parts that are very much alive so the reattached limbs are certainly pink, well perfused and are indeed moving,” Mr Love told reporters today.

“The fact that he is moving his fingers, and of course when he wakes up he will move both fingers and toes, is not a surprise,” Mr Love had said yesterday.

“The question is more the sensory return that he will get in the hand itself and the fine movements he will have in the fingers and the toes, and that will come with time, hopefully. We will assess that over the next 18 months to two years.

“I’m sure that he’ll enjoy a game of basketball in the future.”

The weight and force of the collapse, and the sharp brick edges, resulted in the three limbs being cut through about 7cm above the wrists and ankle.

Terry’s father Tan said of his only child, the injuries were terrible, “I was scared to look at him, a horrible thing.”

The hands and foot were placed in an ice-filled Esky and rushed to hospital with the boy, where three teams of medical experts were assembled, and he was given a blood transfusion after experiencing massive blood loss. Eight hours of complex micro-surgery on Saturday night were followed by a further two hours of skin grafts yesterday.

“What he will lose because it was such a large zone of traumatised skin and muscle and so on, he will lose some of the skin so he’ll certainly require lots of further surgery regardless of whether the skin survives,” said Mr Love said today.

The boy was kept unconscious under anaesthetic between the two procedures. In an interview yesterday, Mr Love explained why:

“He could have actually been woken up the next day. Because we were intending to take him back to theatre for a second look, to look at the traumatised skin flaps, to close more of his wounds and to do split skin grafting, it was felt the best thing to do would be to keep him stable and to keep him anaesthetised.”

Professor Wayne Morrison, director of the respected Bernard O’Brien Institute of Microsurgery and head of plastic and hand surgery at Melbourne’s St Vincent’s Hospital, said he believed the operation to be a world first.

Sunday, August 21, 2005

A robotic system at Stanford Medical Center was used to perform a laparoscopic gastric bypass surgery successfully with a theoretically similar rate of complications to that seen in standard operations. However, as there were only 10 people in the experimental group (and another 10 in the control group), this is not a statistically significant sample.

If this surgical procedure is as successful in large-scale studies, it may lead the way for the use of robotic surgery in even more delicate procedures, such as heart surgery. Note that this is not a fully automated system, as a human doctor controls the operation via remote control. Laparoscopic gastric bypass surgery is a treatment for obesity.

There were concerns that doctors, in the future, might only be trained in the remote control procedure. Ronald G. Latimer, M.D., of Santa Barbara, CA, warned “The fact that surgeons may have to open the patient or might actually need to revert to standard laparoscopic techniques demands that this basic training be a requirement before a robot is purchased. Robots do malfunction, so a backup system is imperative. We should not be seduced to buy this instrument to train surgeons if they are not able to do the primary operations themselves.”

There are precedents for just such a problem occurring. A previous “new technology”, the electrocardiogram (ECG), has lead to a lack of basic education on the older technology, the stethoscope. As a result, many heart conditions now go undiagnosed, especially in children and others who rarely undergo an ECG procedure.

Sunday, July 1, 2018

On Friday, the police of the Indian state of Kerala registered a case against Catholic} bishop Frank Mullakkal of the Syro-Malabar church in Jalandhar for allegedly raping a nun at least thirteen times.

According to the complaint, the bishop from Kerala assaulted the nun starting in 2014. Police superintendent Hari Shankar said the complaint was lodged at the Kuravilangad police station. The nun said she was first sexually assaulted in Kuravilangad. Bishop Frank Mullakkal was appointed the bishop of Jalandhar’s church in 2013.

The nun’s complaint was registered just days after the accused bishop lodged a complaint reportedly against the nun’s family for blackmailing him about the alleged sexual assault. The nun said she had complained to church authorities about the assaults but she was dismissed from her official position.

Police superintendent Hari Shankar said, “The bishop has given a complaint against the nun, saying that she has threatened him. Police have registered two cases based on the complaints”.

Sunday, August 21, 2005

A robotic system at Stanford Medical Center was used to perform a laparoscopic gastric bypass surgery successfully with a theoretically similar rate of complications to that seen in standard operations. However, as there were only 10 people in the experimental group (and another 10 in the control group), this is not a statistically significant sample.

If this surgical procedure is as successful in large-scale studies, it may lead the way for the use of robotic surgery in even more delicate procedures, such as heart surgery. Note that this is not a fully automated system, as a human doctor controls the operation via remote control. Laparoscopic gastric bypass surgery is a treatment for obesity.

There were concerns that doctors, in the future, might only be trained in the remote control procedure. Ronald G. Latimer, M.D., of Santa Barbara, CA, warned “The fact that surgeons may have to open the patient or might actually need to revert to standard laparoscopic techniques demands that this basic training be a requirement before a robot is purchased. Robots do malfunction, so a backup system is imperative. We should not be seduced to buy this instrument to train surgeons if they are not able to do the primary operations themselves.”

There are precedents for just such a problem occurring. A previous “new technology”, the electrocardiogram (ECG), has lead to a lack of basic education on the older technology, the stethoscope. As a result, many heart conditions now go undiagnosed, especially in children and others who rarely undergo an ECG procedure.

Tuesday, May 4, 2010

The United States National Transportation Safety Board (NTSB) has completed its investigation into the ditching of US Airways Flight 1549 into New York’s Hudson River. The fifteen-month probe began after the Airbus A320 performed a water landing when bird strikes damaged both engines in a move dubbed the “Miracle on the Hudson” by the media. Nobody was killed.

The NTSB’s final report, adopted after a board meeting today, concluded that a combination of safety equipment better than the mandatory minimums and good reactions by the crew were the main reasons the 150 passengers and five crew survived. The board stated that the aircraft’s equipment met the standards required for “extended overwater operations”, equipment that was not needed for the January 2009 flight.

The aircraft was equiped with escape slides that doubled as water rafts at the front and aft emergency exits, but the aft ones were rendered unavailable. Airbus assumed when designing the aircraft that only one engine would be inoperative during an emergency ditching, and current emergency checklists assume plenty of prior warning for dual-engine failure since the aircraft would be at a high altitude. The A320 was at just 2,700 feet when the incident occurred, having just taken off when it collided with a flock of Canada geese, almost completely removing the engines’ ability to generate thrust.

The final report has blamed a number of factors for extensive fuselage damage caused in the impact, which cracked a rear bulkhead and caused the aircraft to flood, as well as taking the rear slides out of action. The board said standards aircraft should meet in ditchings — set by the Federal Aviation Authority (FAA) — were inadequate, training in industry was not sufficient for ditchings and the high level of tasks the crew had to focus on made it difficult for the pilot to maintain his airspeed. The pilot’s decision to ditch was credited as being the best possible solution to the emergency.

The NTSB noted that while the rear rafts failed, 64 people climbed into the forward rafts, and said many of these people would have been immersed in the frigid river. The board claimed that this could induce “cold shock”, which can lead to drowning within minutes.

The report found that the good visibility, calm water, nearby ferries which provided rescues within twenty minutes and good cockpit resource management, allowing the crew to maintain control, were further factors that contributed to the survival of those on board. However, it also found that “more creative and effective methods of conveying safety information to passengers” are required after learning that most passengers had not paid attention to the in-flight safety announcement. It also noted that many passengers had difficulty putting on the life vests supplied under the seats.

The report further stated that the accident was hard to predict due to the fact that bird strikes tend to occur much lower, usually below 500 feet. It considered the possibilities of fitting engine screens or redesigning engines to mitigate bird strike risk, but these proposals were rejected after consideration since they were deemed unfeasable.

NTSB Chairman Deborah A.P. Hersman described the circumstances as “a great example of the professionalism of the crewmembers, air traffic controllers and emergency responders who all played a role in preserving the safety of everyone aboard.” She further discussed the safety recommendations the report will contain when it is released. “I believe the safety recommendations that have come out of this investigation have an extraordinary origin – a very serious accident in which everyone survived. Even in an accident where everyone survives, there are lessons learned and areas that could use improvement. Our report today takes these lessons learned so that, if our recommendations are implemented, every passenger and crewmember may have the opportunity to benefit from the advances in safety.” A total of 35 recommendations have been made seeking improved checklists for emergencies, better certification standards for aircraft and their engines, advances in crew training, better safety equipment and improved safety briefings to passengers.

One result of these findings is that the board will likely ask the FAA to require emergency equipment for water landings on all commercial aircraft. The FAA has until now held that such a move would place a disproportionately high cost on airlines.

Tuesday, August 8, 2006

New Delhi authorities hope a fierce looking primate will solve the problem of mischievous monkeys infilitratring the city’s subway system. The Hindustan Times reports that langurs will be used to scare away their smaller cousins. A langur-wallah (or handler) is being paid 6,900 rupees (US$ 167) a month as a retainer and “will be called in whenever there is a monkey problem” says Anuj Dayal of the Delhi Metro Rail Corporation. “There are too many monkeys” said Mr. Dayal.

In June, a monkey reportedly crawled through some pipes and into a subway car jumping around and making faces at passengers who were evacuated to another car while staff chased the creature.

Delhi is known to suffer from trouble brought on by monkeys. The animals are reported to invade homes, schools and government offices in the city. Scores of animals have moved in as the city expands into surrounding forests. In an effort to control the problem, the Delhi administration captured about 500 monkeys and took them to the outskirts of the city last year.