Dr. Michael E. DeBakey

I came across his name while studying, Classification of Dissections of the Aorta - DeBakey I, DeBakey II, DeBakey III and just got curious to know more about him and found some interesting facts. Here, they are:

Michael Ellis DeBakey (born as Michel Dabaghi) September 7, 1908 is a world renowned surgeon, innovator, medical educator, and international medical statesman. DeBakey is currently chancellor emeritus of Baylor College of Medicine in Houston, Texas, and director of The DeBakey Heart Center of Baylor and the Methodist Hospital.

Michael Ellis DeBakey was born in Lake Charles, Louisiana, to Lebanese-American immigrants Shaker and Raheeja DeBakey.

On May 28, 1965, Time Magazine featured Dr. DeBakey on its cover for his pioneering work and innovations in cardiovascular surgery and the artificial heart. His achievements have also been cited in Time Books’ Great Events of the Twentieth Century (1999) and many other prestigious national and international volumes of outstanding contributors to society.

Both the DeBakey High School for Health Professions and the Michael E. DeBakey Veterans Affairs Medical Center in Houston in the Texas Medical Center in Houston are named after him. Several atraumatic vascular surgical clamps and forceps that he introduced also bear his name.

DeBakey still practices medicine to this day. In 2008, Michael DeBakey will be 100 years old. His contributions to the field of medicine will have spanned the better part of 75 years. He's a Health Care Hall of Famer and a Lasker Luminary. He's a recipient of The United Nations Lifetime Achievement Award, the Presidential Medal of Freedom with Distinction and The National Medal of Science. He was given the Lifetime Achievement Award of the Foundation for Biomedical Research and in 2000 was cited as a "Living Legend" by the Library of Congress. On 23rd April, 2008 he received the Congressional Gold Medal from President George W. Bush.

On December 31, 2005, at age 97, DeBakey suffered an aortic dissection, the very condition that his pioneering procedure was designed to treat. He was hospitalized at The Methodist Hospital in Houston. Dr. DeBakey initially resisted the surgical option, but as his health deteriorated, the Houston Methodist Hospital Ethics Committee approved the operation; on February 9–February 10 he became the oldest patient ever to undergo the surgery for which he was responsible. The operation lasted seven hours. After a complicated postoperative course that required eight months in the hospital, at a cost of over one million dollars, Dr. DeBakey was released in September 2006 and has returned to good health. He was present at Baylor College of Medicine for the groundbreaking opening of the new Michael E. DeBakey Library and Museum on October 18, 2006.

Ursula Andress - The First Bond Girl -Honey Ryder

Swiss actress and a major sex symbol of the 1960s

Andress' in her iconic Dr. No scene.

Olga Kurylenko - The Latest Bond girl

She has some Soviet connection. She is a Ukrainian model and actress and was discovered by a female model scout while on vacation in Moscow at the age of thirteen.

The Big Four

The Big Four are the venomous snake species considered to be India's and Pakistan's most dangerous, as together they account for nearly all Indian and Pakistani snakebite fatalities.

The Big Four are:

1. Indian cobra
2. Common krait
3. Russell's viper
4. Saw-scaled viper

The members of the Big Four are all quite common and bite readily. They are often found in proximity to human habitation, as they are attracted to the associated rodent populations on which they feed. These species are all primarily nocturnal and most victims are bitten at night when walking barefoot and accidentally stepping on them.

Polyvalent serum has been developed in India specifically for treatment of snake bite by any of the Big Four cases.

Common Cobra (Naja naja)


The cobra is the most common poisonous snake in the India.

The venom of cobras is highly neurotoxic and dangerous. Early symptoms of a bite include ptosis, diplopia , dysphagia, and dizziness, followed by progress ive respiratory muscle weakness, ultimately requiring endotracheal intubation. Cobra venom is a postsynaptic neurotoxin. It works by stopping the acetylcholine molecules in the diaphragm muscle from interacting. Without treatment death from respiratory failure may occur as early as 30 minutes after being bitten.

Standard treatment involves the use of antivenin. Additionally, it is possible to support bite victims via mechanical ventilation, using equipment of the type generally available at hospitals. If too far away from a hospital, doctors prefer the "suck and spit" formation. Such support should be provided until the venom is metabolised and the victim can breathe unaided. If death occurs it takes place approximately 6 to 12 hours after the cobra bite. Cause of death is respiratory failure or suffocation caused by complete paralysis of the diaphragm.

Russell's Viper (Daboia russelli)
Tamil - retha aunali, kannadi virian or kannadi viriyan
It is a thick set, ground dwelling snake, with a small conical head and large nostrils. Dorsum brown, with three rows of spots along the body, the belly is cream in colour. It lives in grasslands or scrub forests. They are aggressive once threatened or disturbed. The smaller ones are much more aggressive than adults. Once agitated, they produce a high pitched hissing sound which is audible from even a few meters away.

It should be noted, however, that D. russelii does not associate as closely with human habitation as Naja and Bungarus (cobras and kraits).

Envenomation symptoms begin with pain at the site of the bite, immediately followed by swelling of the affected extremity. Bleeding is a common symptom, especially from the gums, and sputum may show signs of blood within 20 minutes post-bite. There is a drop in blood pressure and the heart rate falls. Blistering occurs at the site of the bite, developing along the affected limb in severe cases. Necrosis is usually superficial and limited to the muscles near the bite, but may be severe in extreme cases. Vomiting and facial swelling occurs in about one-third of all cases.

Severe pain may last for 2-4 weeks. Locally, it may persist depending on the level of tissue damage. Often, local swelling peaks within 48-72 hours, involving both the affected limb and the trunk. If swelling up to the trunk occurs within 1-2 hours, massive envenomation is likely. Discoloration may occur throughout the swollen area as red blood cells and plasma leak into muscle tissue. Death from septicaemia, respiratory or cardiac failure may occur 1 to 14 days post-bite or even later.

Saw scaled Viper (Echis carinatus)
Tamil - surattai pambu.viriyan pamboo, surutai vireyan

A small viper which is distributed across the Indian sub-continent. Even the slightest disturbance will make this snake react aggressively. The snake makes noise by rubbing its scales together. Its venom is hemo-toxic.

Its inconspicuousness nature, the speed of its strike, and its readiness to bite at the smallest provocation make this one of the most dangerous reptiles of India.

Of the more dangerous systemic symptoms, hemorrhage and coagulation defects are the most striking. Hematemesis, melena, hemoptysis, hematuria and epistaxis also occur and may lead to hypovolemic shock. Almost all patients develop oliguria or anuria within a few hours to as late as 6 days post bite. In some cases, kidney dialysis is necessary due to acute renal failure (ARF), but this is not often caused by hypotension. It is more often the result of intravascular hemolysis, which occurs in about half of all cases. In other cases, ARF is often caused by disseminated intravascular coagulation.

In any case, antivenin therapy and intravenous hydration within hours of the bite are vital for survival.At least eight different polyvalent and monovalent antivenins are available against bites from this species.

Common Krait (Bungarus caeruleus)
Tamil - Kattu viriyan, Yennai viriyan, Yettadi viriyan.

The krait is largely nocturnal in nature. While it stays hidden & dormant during the day, it becomes very alert at night. Its body is glossy black with paired bands on the body. Widely spread over the Indian subcontinent . Studies indicate the venom is more toxic than that of a cobra. The snake often enters people’s houses in its quest to find a cool place. People get bitten when they step on the snake accidentally.

Krait found in the Shoes

This was a news item from Times of India 27 June 08 , Chennai edition.

Karthikeyan, a resident of Selvavinayagar Koil Street in West Mogappair, Chennai had a brush with death on Wednesday night when he reached out to pick up a shoe in his house. To his shock, he found a snake popping its head out. He called up the Velachery animal rescue and rehabilitation centre which rushed its personnel to the house. What they recovered was a 3.5-feet-long female adult krait (Bungarus fasciatus), the most poisonous land snake found in India.

Let us look at more detail about the Krait, the most venomous snake of the Indian Subcontinent:

Common name in Tamil - Kattu viriyan, Yennai viriyan, Yettadi viriyan.

Behavior
All kraits are nocturnal. The snake is more docile during the daylight hours, becoming more aggressive during the night. However, they are rather timid and will often hide their heads within their coiled bodies for protection.

Venom
Bungarus species contain neurotoxic venom that is 16 times more potent than cobra venom. Krait venom is extremely powerful and quickly induces muscle paralysis. Clinically, their venom contains mostly pre-synaptic neurotoxins. These affect the ability of nerve endings to properly release the chemical that sends the message to the next nerve. Following envenomation with bungarotoxins, transmitter release is initially blocked (leading to a brief paralysis), followed by a period of massive overexcitation (cramps, tremors, spasms), which finally tails off to paralysis. Not all these phases may be seen in all parts of the body at the same time.
Note that there is frequently little or no pain at the site of a krait bite and this can provide false reassurance to the victim. Typically, victims start to complain later of severe abdominal cramps accompanied by progressive muscular paralysis, frequently starting with ptosis. As there are no local symptoms, a patient should be carefully observed for tell-tale signs of paralysis (eg the onset of ptosis, diplopia and dysphagia) and treated urgently with antivenom. Before antivenom was developed, there was an 85% mortality rate among bite victims.

Treatment:
Once at a healthcare facility such support should be provided until the venom is metabolised and the victim can breathe unaided especially if there is no species-specific antivenom available. Given that the toxins alter acetylcholine transmission which causes the paralysis, some patients have been successfully treated with cholinesterase inhibitors such as physostigmine or neostigmine, but success is variable and may be species dependent as well. If death occurs it typically takes place approximately 6 to 12 hours after the krait bite, but can be significantly delayed. Cause of death is often respiratory failure ie suffocation via complete paralysis of the diaphragm. Even if patients make it to a hospital subsequent permanent coma and even brain death from hypoxia may occur given potentially long transport times to get medical care.

Historical fact:
In 2001, herpetologist Dr. Joe Slowinski was bitten by a juvenile krait (B. multicinctus) while doing field research in Myanmar. He was unable to reach medical assistance and subsequently died from the effects of the bite.

Winter Palace Square in St. Petersburg

Located between the Palace Embankment and the Palace Square, the Winter Palace or Zimniy Dvorets (Russian: Зимний дворец) in Saint Petersburg, Russia was built between 1754 and 1762 as the winter residence of the Russian tsars.

Designed by Bartolomeo Rastrelli, the Rococo-style, green-and-white palace has 1,786 doors and 1,945 windows. Catherine the Great was its first imperial occupant.

The Palace is now part of a complex of buildings known as the State Hermitage Museum, which holds one of the world's greatest collections of art. As part of the Museum, many of the Winter Palace's 1,057 halls and rooms are open to the public. The Military Gallery, opened in 1826, accommodates 332 portraits of military leaders of the Russian army during Napoleon's invasion of Russia.

After the February Revolution in Russia, the Winter Palace was the headquarters of the Russian Provisional Government.

The assault of the Winter Palace by Bolshevik forces was the official milestone of the October Revolution.

Nevsky Prospect in St.Petersburg

Nevsky Prospect
Nevsky Prospect or the Nevsky Avenue, is the main street in the city of St Petersburg. Planned by Peter the Great as beginning the road to Novgorod and Moscow, the avenue runs from the Admiralty to the Moscow Railway Station and, after making a turn at Vosstaniya Square, to the Alexander Nevsky Lavra.

India's best soldier battles for life

Former Indian Army Chief Field Marshal Sam Manekshaw is seriously ill and is undergoing treatment for a lung disease, military hospital sources said on Thursday.

Ninety four-year-old Manekshaw, who had led India to victory in the 1971 Indo-Pak war, has developed ''acute broncho pneumonia'' with associated complications and his condition has been serious for the past four days.

He is being provided with best medical support at the intensive care unit of the military hospital, sources said, adding the team of doctors treating him was being assisted by a pulmonologist who has come from the Army Hospital in New Delhi.

A medical bulletin issued by Commanding Officer, Wellington, E J Kochekan, read, ''it is hoped that the Field Marshal will respond positively to the treatment''.

During this Indo-Pakistani War of 1971, Manekshaw showed uncommon ability to motivate the forces, coupling it with a mature war strategy. The war ended with Pakistan's unconditional surrender, and the formation of Bangladesh. More than 45,000 Pakistani soldiers and 45,000 civilian personnel were taken as POWs. He masterminded the rout of the Pakistan Army in one of the quickest victories in the recent military history. This led to the Shimla Agreement which opened the door to the creation of the nation of Bangladesh as separate from Pakistan.

St.Petersburg in aerial view

Few pictures of the second important city of Russia, St. Petersburg. I post here only some of them taken from a helicopter by a great photographer and the credits go to him. Tourists can go on ride in a helicopter and see the city in a bird's view.
It is Russia's second largest and Europe's fourth largest city (by city limit) after Moscow, London and Paris.
I am proud to say that I have spent some time of my life here and enjoyed the beauty of the city. Even now when I see the pictures I go into nostalgia.