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He will keep you

Posted by: Philip Alex | Posted on: June 26th, 2009 | 0 Comments

Difficult circumstances. Trying times. Uncertain futures. Painful experiences. 

Through all of them, the words from Isaiah 26:3 holds out hope. Hope with a promise. That He will keep you in perfect peace. However, this is a three part promise. The promise of peace, and being kept in it is linked to two aspects of our being. Our mind being stayed in Him, and our trust in Him. 

Trusting anyone is not easy. The older we get, the more difficult it is to trust. Our past experiences condition us with memories of trust betrayed. This fuels distrust which can become a stronghold in itself. The ability to trust however, is the secret of keeping our mind stayed in Him, and the key to appropriating the promise of peace. 

The engine in this cycle is the ability to trust. Rarely will we give our trust away. However, once given, it becomes easy to trust those we love. The key to this trust is knowing the person we trust in. 

Let us place our trust in HIm, and our restless minds harried with cares and doubts will be stilled with that peace He promised. 

THE PATTERN OF HYDATID DISEASE

Posted by: Philip Alex | Posted on: March 22nd, 2009 | 0 Comments

Abstract

Background

Hydatid disease is a common but seldom reported disease in Himachal Pradesh, India. This paper reports Hydatid disease presenting to a remote hospital in the foothills of the Himalayas.

Methods

Records of 115 patients presenting with Hydatid disease to the Lady Willingdon Hospital, Manali , from April 1996 to March 2007 were reviewed. Site, sex distribution, presentation, scolicidal agent and surgical technique used were recorded. Outcome measures were mortality and morbidity.

Results

70 patients were female and 46 were male. (One female patient was operated on twice). 78% (n=90) of the occurrences were hepatic. Extrahepatic sites were spleen, lesser sac, ovaries (n=2), retroperitoneum, broad ligament, mesocolon, renal (n=2), and mesentery. There were fourteen pulmonary hydatids, 10 in the right lobe and 4 in the left. All patients underwent surgical cystectomy. Thirty two patients after March 2003 underwent scolicidal deactivation using an intraoperative modification of the

Delayed thrombolysis in acute frostbite- a modality of worth?

Posted by: Philip Alex | Posted on: March 22nd, 2009 | 0 Comments

Abstract

Acute frostbite is increasingly becoming a civilian problem. Increased mobility and access to extreme environments [i] bring patients to the remotely practicising general physician [ii] . We present the late presentation of a computer engineer to our hospital with severe bilateral frostbite of all the fingers while trekking in the Indian Himalaya. He was thrombolysed with informed consent. Tissue perfusion improved at 24 and 48 hours. Follow up at three months demonstrated considerable tissue salvage. The left hand was entirely spared except the tips of the third and fourth fingers. The right hand demarcated at the terminal phalanges of the second, third and fourth fingers. Though immediate thrombolysis has been beneficial in acute frostbite19, this report suggests its role in delayed tissue salvage.



[i] Edlich RF, Chang DE, Birk KA, Morgan RF, Tafel JA. Cold injuries. Compr Ther. 1989;15:13

Management of Shock

Posted by: Philip Alex | Posted on: September 6th, 2008 | 0 Comments

Presented at the Northern Chapter of the Association of Surgeons of India at Sarabai on the 5th September 2008.

Basic concepts on the management of shock together with recent thinking on hypovelemic shock and trauma.

Multitasking in a Mission set up

Posted by: Philip Alex | Posted on: January 27th, 2008 | 2 Comments

MULTITASKING IN A MISSION SET UP

Drudgery or devotion?- from “My Utmost for His Highest”, June 15th

Posted by: Philip Alex | Posted on: June 14th, 2006 | 0 Comments

GET A MOVE ON

"And beside this . . . add . ." 2 Peter 1:5

You have inherited the Divine nature, says Peter (v.4), now screw your attention down and form habits, give diligence, concentrate. "Add" means all that character means. No man is born either naturally or supernaturally with character, he has to make character. Nor are we born with habits; we have to form habits on the basis of the new life God has put into us. We are not meant to be illuminated versions, but the common stuff of ordinary life exhibiting the marvel of the grace of God. Drudgery is the touchstone of character. The great hindrance in spiritual life is that we will look for big things to do. "Jesus took a towel . . . and began to wash the disciples’ feet."

There are times when there is no illumination and no thrill, but just the daily round, the common task. Routine is God’s way of saving us between our times of inspiration. Do not expect God always to give you His thrilling minutes, but learn to live in the domain of drudgery by the power of God.

It is the "adding" that is difficult. We say we do not expect God to carry us to heaven on flowery beds of ease, and yet we act as if we did! The tiniest detail in which I obey has all the omnipotent power of the grace of God behind it. If I do my duty, not for duty’s sake, but because I believe God is engineering my circumstances, then at the very point of my obedience the whole superb grace of God is mine through the Atonement.

Embryonal rhabdomyosarcoma of the prostate in a 19 year old

Posted by: Philip Alex | Posted on: May 27th, 2006 | 0 Comments

A 19 year old boy presented to us with edema, difficulty in passing urine and a pelvic mass extending till the umbilicus. He had this for the past six months, and had been to Lucknow once to be treated with little benefit. He apparently had received two cycles of chemotherapy there with again, little benefit.

A per rectal exam revealed a hard mass anteriorly pushing the rectum backwards. A CT scan revealed bilateral hydronephrosis with a large mass in the prostatic region invading the bladder and pushing the rectum back. The large mass was the bladder.

A prostatic biopsy revealed embryonal rhabdomyosarcoma prostate.

His preop creatinine was 3.2mg%. He underwent a trocar suprapubic cystostomy to drain and decompress his obstructed system. After his creatinine had decreased to 1.7mg% he underwent exploration, total cystectomy, prostatectomy, pelvic node dissection, and bilateral ureteric reimplantation into an ileal conduit.

By the grace of God he is now doing well postoperatively and will be scheduled for post op chemotherapy.

Ascariasis causing intestinal obstruction

Posted by: Philip Alex | Posted on: May 22nd, 2006 | 0 Comments

A four year old boy presented with history of not passing stool or flatus for three days and vomiting a worm.

On examination he was dehydrated, and had abdominal distension with features of intestinal obstruction.

A plain x

Easter – the day before

Posted by: Philip Alex | Posted on: April 15th, 2006 | 0 Comments

Imagine the day after Good Friday. The disciples would have seen Jesus on the cross and watched him die. They would have also watched their hopes and dreams die. Memories of their times together, the way He made their hearts burn. He had

Torted Para- uterine leiomyoma

Posted by: Philip Alex | Posted on: August 2nd, 2005 | 0 Comments

A 58 year old lady presented with the history of excruciating abdominal pain for two days. She had no pain before that and was not aware of a mass in her abdomen.

On examination she was well nourished, not pale, and not febrile. She had a huge mass arising from the pelvis upto her umbilicus, filling the lower abdomen. It was firm, not tender and non mobile. It appeared continuous with the uterus.

An ultrasound showed a mass from the pelvis, adjacent to the uterus, separate from the ovaries, with cystic degenaration.

She was taken up for a laparotomy when a torted para uterine leiomyoma was found with cystic degenaration. She did well post operatively.