OUR oldest colleague passes away in California MS Mathew RIP

Tom Bose <ktbose@gmail.com>	6:46 PM (3 minutes ago)
to Kuriakose, Mohan, Shakuntala, Sany, Kurian, dr, Binoy, bcc: me, bcc: Maxwell, bcc: vinod, bcc: Tessy

Dr Mathew the eldest brother of MS Sebastian and perhaps THE OLDEST AMONG  Graduates that practiced in  USA, died last night peacefully at his home with his son wife and family by his side.

His practice spanned over 45 years, after graduating from Calcutta Medical Collge.

He was a physician in Qatar, treating the Royal family.   

He availed of an opportunity offered by the State of Missouri, which granted him a green card along with residency in psychiatry, and a job.

His wife practiced Ob/ Gyn in MO for over forty years, while most of his practice of psychiatry was near Indianapolis.

Recently he moved to a town in N California near his son Allen. Allen and wife are also physicians.

Dr Mathews youngest brother MS Sebastian and wife enjoy excellent heath and live in Nova Scotia.

rIOTS AND kERALEEYAR

 THERE OUGHT TO BE MORE PUBLIC SERVANTS, WHO ARE ELECTED TO serve  PEOPLE 

 WHAT WE HAVE IS ANARCHY. My APPAN AND 8 OF HIS RELATIVES SPENT TIME IN JAIL S

TO GAIN FREEDOM WHICH IS BEING DESTROYED BY A MINORITY ODD SELFISH RIOTERS , AND CRIMINALS.

  IT IS A SHAME VIEWING FROM ABROAD, THE IRRESPONSIBLE BEHAVIOR OF POLITICIANS INCLUDING SOME MINISTERS, ENCOURAGING AND NOT CONTROLLING CHAOS ACROSS THIS WONDERFUL STATE.

IS THIS A GOOD EXAMPLE FOR OUR CHILDREN TO GROW IN?

THE GOVT SHOULD allow freedom  TO DEMONSTRATE, IN ASSIGNED PLACES IN PLACES THESE HOOLIGANS GATHER.

FREE MOVEMENT OF VEHICLES, AND PEOPLE OUGHT TO BE EASED.

STUDENTS SHOULD NOT BE ALLOWED TO DEMONSTRATE , BUT ATTEND CLASSES, TO LEARN THE WONDERFUL ANCIENT AND MODERN HISTORY.

THE STRUGGLES FOR OVER 100 YEARS OUR    LEADERS FOUGHT TO HAVE FREEDOM.IF THE PRESENT GOVT CANNOT MAINTAIN ,ORDER A CENTRAL MILITARY AUTHORITY OUGHT BE GIVEN CHARGE FOR FIVE YEARS.

IT SEEMS, THE PARTIES THAT LOST A DEMOCRATIC ELECTION, START RE ELECTIONEERING, WITHOUT GIVING, A CHANCE TO THE NEW  CABINET.

ONLY WELL QUALIFIED MLA S AND IAS OFFICIALS SHOULD BE ALLOWED IN THE CABINET.

SPECIAL BONUSES MAY BE SET UP FOR DOING A GREAT JOB.

WE ARE SUPPOSEDLY AN EDUCATED STATE. MR ALPHONSE Played a wonderful role in eduction in KOTTAYAM DT

PEOPLE OF KERALA LET US UNITE AS A CIVILIZED, SOCIETY FOR THE GOOD OF  OUR OWN FUTURE.

ANY ONE READING THIS PLEASE TRANSLATE AND CIRCULATE 

K THOMAS BOSE

KARIPPAPARMPIL

From K T BOSE, class of 196-69  Trivandrum.

These facts may be new to some and interesting to all.
Drunks and alcoholism is ubiquitous in Kerala , more these days with lifting of prohibition. Many have seen them in their own homes an on the roads.

Cirrhosis means simply fibrosis of the soft pliable liver into a hard poorly functioning mass  with many side effects leading to death.
Many people get Type A hepatitis a mild form of viral infection due to poor sanitation, transmitted through in their childhood. It is not uncommon the way the disease spreads among many siblings in each family during summer months in school.

Many of us do not worry about and usually never even suffer sequences as with other forms of hepatitis which may be fatal.

In our first classes in Pathology we learn about fatty liver. This is a condition, for various reasons fat accumulates in the liver, often with drinking of alcohol. If stopped drinking and take nutritional food this may completely recover.
Non ALCOHOLIC, cirrhosis is a  condition often poorly understood where fat then fibrous tissue accumulate in the liver., also known as nonalcoholic steatorrea.
 The liver becomes firm bilirubin increases in blood an patient suffers malaise loss of appetite and weight along with enlarged liver ans ascites.
.Treatment is difficult as the real causative factor may vary from poisons ingested, medicines taken Diabetes,and various yet to be found reasons. Danger of developing cancer, multiple melanoma other immune deficiency diseases become cause for worry.
To be contd.

KNOW OUR NEW MINISTER, support him!

https://youtu.be/6QqccbJHv2E

Subject to ponder!

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Original Investigation

October 11, 2017

Long-term Outcomes of Multiple Arterial Coronary Artery Bypass GraftingA Population-Based Study of Patients in British Columbia, Canada

Aihua Pu, MSc¹; Lillian Ding, MSc¹; Jungwon Shin, MSc¹; et alJoel Price, MD, MPH^2,3; Peter Skarsgard, MD^2,3; Daniel R. Wong, MD, MPH^3,4; John Bozinovski, MD, MSc^3,5; Guy Fradet, MD, MSc^3,6; James G. Abel, MD, MSc^3,7

Author Affiliations

JAMA Cardiol. Published online October 11, 2017. doi:10.1001/jamacardio.2017.3705

FullText

Key Points

Question  Does multiple arterial grafting provide long-term clinical benefits without safety concerns among patients who are undergoing coronary artery bypass grafting?

Findings  In this population-based study of 20 076 consecutive patients with triple-vessel or left-main disease, multiple arterial grafting was associated with significant reductions in long-term mortality and repeated revascularization without increased perioperative risks. Similar reductions in either mortality or repeated revascularization rates were observed among all subgroups of patients except for those with severely impaired ejection fraction.

Meaning  Multiple arterial grafting can be safely extended to a broader spectrum of patients to maximize the long-term benefit of coronary artery bypass grafting among patients with multivessel disease.

Abstract

Importance  Although the long-term survival advantage of multiple arterial grafting (MAG) vs the standard use of left internal thoracic artery (LITA) supplemented by saphenous vein grafts (LITA+SVG) has been demonstrated in several observational studies, to our knowledge its safety and other long-term clinical benefits in a large, population-based cohort are unknown.

Objective  To compare the safety and long-term outcomes of MAG vs LITA+SVG among overall and selected subgroups of patients.

Design, Setting, and Participants  In this population-based observational study, we included 20 076 adult patients with triple-vessel or left-main disease who underwent primary isolated coronary artery bypass grafting (MAG, n = 5580; LITA+SVG, n = 14 496) in the province of British Columbia, Canada, from January 2000 to December 2014, with follow-up to December 2015. We performed propensity-score analyses by weighting and matching and multivariable Cox regression to minimize treatment selection bias.

Exposures  Multiple arterial grafting or LITA+SVG.

Main Outcomes and Measures  Mortality, repeated revascularization, myocardial infarction, heart failure, and stroke.

Results  Of 5580 participants who underwent MAG, 586 (11%) were women and the mean (SD) age was 60 (8.7) years. Of 14 496 participants who underwent LITA+SVG, 2803 (19%) were women and the mean (SD) age was 68 (8.9) years. The median (interquartile range) follow-up time was 9.1 (5.1-12.6) years and 8.1 (4.5-11.7) years for the groups receiving MAG and LITA+SVG, respectively. Compared with LITA+SVG, MAG was associated with reduced mortality rates (hazard ratio [HR], 0.79; 95% CI, 0.72-0.87) and repeated revascularization rates (HR, 0.74; 95% CI, 0.66-0.84) in 15-year follow-up and reduced incidences of myocardial infarction (HR, 0.63; 95% CI, 0.47-0.85) and heart failure (HR, 0.79; 95% CI, 0.64-0.98) in 7-year follow-up. The long-term benefits were coherent by all 3 statistical methods and persisted among patient subgroups with diabetes, obesity, moderately impaired ejection fraction, chronic obstructive pulmonary disease, peripheral vascular disease, or renal disease. Multiple arterial grafting was not associated with increased morbidity or mortality rates at 30 days overall or within patient subgroups.

Conclusions and Relevance  Compared with LITA+SVG, MAG is associated with reduced mortality, repeated revascularization, myocardial infarction, and heart failure among patients with multivessel disease who are undergoing coronary artery bypass grafting without increased mortality or other adverse events at 30 days. The long-term benefits consistently observed across multiple outcomes and subgroups support the consideration of MAG for a broader spectrum of patients who are undergoing coronary artery bypass grafting in routine practice.

Full Text

Read Mor

Ignorant selfish Congressmen, putting down our New Minister Alphons

 It is disappointing that so many Congressmen here, insult our only Minister. Most are ignorant. You do not have to be a congressman, Mani group, or a Hindu to be a patriot and work for our State.

Give him a chance. 

Let us see how he does his job. How from New Delhi, surrounded by Hinduvatha, people he accomplishes great things. Modi is not a bad person as some depicts him here. He certainty has more admirers among world leaders, compared to the Rahul crowd.

music and dancing dames!

https://youtu.be/TiG6x378smk