Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

World Clubfoot Day @ Kerala


It’s #WorldClubfootDay in two days… June 3rd

In years previous to the #COVID pandemic we at Palakkad Cooperative Hospital used this day and weeks around it to raise awareness, plan fundraising via MITRA Trust and re-dedicate ourselves tot he cause of Clubfoot care. Unfortunately there has been a hiatus in our activities for over 2 years.

Clubfoot Care Team at Palakkad District Cooperative Hospital, Palakkad, Kerala, India
Clubfoot Care Team at Palakkad District Cooperative Hospital, Palakkad, Kerala, India

This year we are re-starting everything.

What is Clubfoot ?

#Clubfoot is a #congenital#deformity of the foot which can be fully treated in most cases. The children lead a normal life after a successful treatment course.

Events

We will be oraganising events this year after a hiatus of two years to mark this day and re-dedicate our team at #Cooperative#Hospital#Palakkad to cost effective, accessible, state of the art and evidence based #Clubfoot #Care .

We are planning :

  1. Medical camps
  2. Training for staff
  3. Subsidised / Free Foot Abduction Brace provision

Venues

  1. Rajiv Gandhi Co-Operative Hospital
  2. Palakkad District Cooperative Hospital, Palakkad, Kerala

#cooperativehospital#palakkad#kerala

Palakkad District Cooperative Hospital Clubfoot Clinic, Palakkad, Kerala
Categories
Cerebral-palsy Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

Combined Pediatric Neurology and Pediatric Orthopaedic Medical Camp for Children


We are restarting our yearly free combined #PediatricNeurology and #PediatricOrthopaedic #MedicalCamp for #CerebralPalsy, #autism, #orthopedic #Diseases in #children this May at #Palakkad, #Kerala.


The children can consult a Pediatric Neurologist Dr. Velmurugan and Pediatric Orthopaedic Surgeon Dr. Easwar TR and also get counselling from Psychologist Mr. Toji Joseph and Physiotherapy consult from Mr. Biju Bhasker

The Medical camp is being organised as usual by the wonderful people at #Sevabharathi , #palakkad and also #LifeCarePhysiotherapyClinic, Palakkad
Registration is free : 9495888879, 6238256073, 8891294916

Do share widely so that the news reaches the beneficiaries.
Thank you
Dr. Easwar TR
Pediatric Orthopaedic Surgeon

Categories
Art and Paintings Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

Cerebral Palsy – Detect Early, Intervene Early


This is my #NFT #Art to raise awareness on #Disability caused by #CerebralPalsy .

Importance of detecting it early and early intervention is stressed. Quite often we find that children are not referred early and treated. This results in very bad deformities that are difficult to mend.

This is part of the #ArztForACause effort by doctors to improve disease awareness among public via 🎨#Art #paintings #nftart https://t.co/OzZUu9FJCh

This will be available as #NFT on https://opensea.io/dreaswar shortly.

Major part of the sale proceed will go towards treatment of these children with #Deformity, #Disability and #cerebralpalsy .

The link to my NFT in the bio.

🌍https://linktr.ee/dreaswar

Early Intervention is the key

#WorldDisabilityDay

Categories
Art and Paintings Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

#ArztForACause : Mother leading a Cerebral Palsy Child…


Cerebral Palsy is such a drastic turn of fortune for any family. The poorer the family, the more challenging. With her back to the closed door, symbolising all the lost life oppurtunities, a mother steadfastly leads her child along the well lit path of medical care with darkness of either side.

This tale repeats with so many children I see in my clinic. It is mind wrenching. Promise of quick cure lures any number of parents from that narrow path to dark streets of quackery and extorsion rackets who promise magical cures.

This is my tribute to so many parents who lead their child along the narrow lit path

Mother Leading a Cerebral Palsy Child

Even when treatment of cerebral palsy is widely available, it is not uncommon to see severe deformities due to improper or delayed referral to a treating centre, lack of awareness of simply neglect. Quite often patients live in far flung villages with poor access to healthcare or broken families compounding the difficulties.

Advanced deformity of the hand in Cerebral Palsy

I have seen that through these storms invariably the mother stands and guides the child unwavering.

This art is in dedication to that spirit. Available as #NFT here : https://opensea.io/assets/matic/0x2953399124f0cbb46d2cbacd8a89cf0599974963/75139301128692202745789003873188758042217057528859930189796240456315928838145/ on #opensea

Categories
Art and Paintings Deformity Correction and Limb lengthening Pediatric Orthopedics

#ArztForACause Art on World Disability Day


As part of our #ArztForACause effort to raise awareness of #PediatricOrthopaedic #Diseases and upcoming #WorldDisabilityDay I have made this #Art on #FibularHemimelia

fibular-hemimelia-art
Limb Deformity and Limb Deficiency #Art #NFT


Know more about the disease : https://dreaswar.wordpress.com/2021/11/13/fibular-hemimelia/

The NFT/#Art at:#opensea

https://opensea.io/assets/matic/0x2953399124f0cbb46d2cbacd8a89cf0599974963/75139301128692202745789003873188758042217057528859930189796240473908114882570/

#NFTCommunity

Categories
Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

Tone Inhibiting Casts in Cerebral Palsy


Cerebral Palsy is a tough problem in Paediatric Orthopaedics. The children have spasm, contracture and variety of coordination issues , balancing issues, seizures and other symptoms like tremor, dystonia which makes treatment quite a challenge. This is more so in the younger children where we would like to have a tool that is non invasive and still helps relieve spasm.

Tone Inhibiting casts offer an invaluable tool to control spasm in a very young child that you would want to avoid surgery.

The dosage of surgery in cerebral palsy has to carefully titrated as muscle are inherently weak and over-lengthening can be disastrous.

We try to avoid overzealous initial surgery and but time when possible with plaster casting to reduce muscle spasm.

Tone Inhibiting Casts are a vanishing tool these days in medical professionals’ armamentarium but find it a great tool. In India with cost of Botox injections to relieve being very high and in the class of patients I treat many of who are from poorest strata this is a godsend.

Cast application is done under general anaesthesia so that adequate muscle relaxation is obtained and we take great care for a close , bespoke type fit with good pressure relief over bony prominences. Prevention of pressure sores is very important and technique of cast application – the fit, padding, tightness, joint position, strength of cast all play a role in the final result.

We keep child on physiotherapy all through the time child is on cast to keep up muscle strength and also aid stretching. A cast usually is kept for 6 weeks. Sometimes in severe spasm we have staged application of casts to progressively apply it lesser flexion of joints as the muscle tone decreases.

Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

Fibular Hemimelia


Categories
Pediatric Orthopedics Spina Bifida Spine & Scoliosis Surgery

Paediatric & Adult Spine Clinic


Happy to announce that the Spine Clinic for Children and Adults will be functioning on all days except Thursday at Palakkad District Cooperative Hospital & Research Centre, Palakkad, Kerala.

This will cater to all variety of Spine diseases in Children and Adults.

Common diseases like Disc Problems, Infections of Spine ( Septic Spondylitis ) , Tuberculous Spondylitis, Scoliosis, Spina Bifida are treated here.

I am available for consultation on all days except Thursday from 10am to 4:30 pm. Please contact Palakkad District Cooperative Hospital for details and appointment.

Please find the location of the Hospital here

Paediatric and Adult Spine Clinic, Palakkad, Kerala
Categories
Orthopedics Pediatric Orthopedics

Children’s Fracture Clinic


My Clinic restart has been delayed due to Covid situation and we have noted that children with fractures are having difficulty getting consult for emergencies.

A speciality Fracture clinic for Children run by Dr. Easwar TR is operating at Malabar Hospital Palakkad.

Treatment is provided for all types of children’s bone problems, sports injuries and fractures. The service is available around the clock in association with Orthopedic doctors at Malabar Hospital, Palakkad.

For Emergencies and Appointments please contact Malabar Hospital for appointments.

Phone 📞 :  0491 252 8200,
                    0491 252 8201,
                    +91 99952 33666

Children’s fracture clinic for bone and joint problems, fractures, sports injuries at Malabar Hospital Palakkad Kerala by Children’s Bone Specialist Dr Easwar TR

The COVID19 Challenge ~ MedTatva Apps


To help with ongoing #COVID2019 #Pandemic crisis we at https://medtatva.com have launched 2 apps 1) https://bit.ly/3dPx1Kx for #CoronaVirus Symptom checker to allay public fear and 2) #COVID19 #AI #Chest #Xray analyser for #healthcareprofessionals https://bit.ly/39Kvx0T

You will need a free account to get started. Registering is simple and free. Get yours at https://medtatva.com/signup. Remember to read the Terms and Conditions, Privacy and Disclaimers before using the App and the website. Kindly keep in mind that Privacy policy when uploading data / personally identifiable X-ray on the website.

Categories
General Linux Open Source & Programming Others Python

MedTatva : Tool to screen for #COVID19


We are all going through a tough time with #COVID19 #Epidemic. It has been a testing time for doctors, public and administrators alike. The poor have been hit badly and are under threat as the epidemic is still spreading in various countries as we speak. Access to healthcare, paying capacity, travel are all issues that the citizens of various demographics have to confront.

We at MedTatva [ https://medtatva.com ], have been trying to solve accessibility to healthcare and diagnostic tools by using technology.

Past few days we have put together the best recommendations from CDC and WHO to build a symptom checker that is simple and which could be completed in less than a minute by a non-medical person.

Please find the screening tool here : https://medtatva.com/coronavirus/home

Categories
Art and Paintings Cerebral-palsy Open Source & Programming Orthopedics Pediatric Orthopedics

Tribute to the Eternal Mother ❤️ – Digital #Art of Cerebral Palsy


Cerebral Palsy is such a difficult disease to handle and treat for the health care professionals.

The treatment process needs to take the parents and family members along so that these children get optimal care. It’s important to reinforce on the parents and lift their morale throughout the course of long and arduous treatment.

I routinely arrange seminars and medical camps and arrange public events in association with groups serving these children to help them and keep caregiver morale high. It’s a fight, a relentless fight against Cerebral Palsy.

It never ceases to amaze and move me that the mother , however humble or rich , illiterate or well educated, they may be cares for the child and stays with child through thick and thin.

Wacom One CTL and MyPaint on Linux works like it’s a match made in heaven.

My Digital Art on a mother caring for her child with Cerebral Palsy – Drawn using Wacom One CTL 472 and MyPaint Open Source Software.

This painting is part of the #ArztForACause fundraiser for children with Cerebral Palsy , Autism and Movement Disorders

She literally is the guiding light of the treatment, showing the way and proving that she’s the true representative of the all giving , ever loving Divine Mother

Cerebral Palsy - Digital Art
A Mother leading and lighting the way of care for her child with Cerebral Palsy – Digital #Art
Categories
Arthroscopy, Knee Surgery Orthopedics Pediatric Orthopedics Sports Injury

Story of Anuiruddhan – Junior National level Roller Skater


Anirudhan V, Roller Skater National Junior Champion prospect ~ an inspiration !

Anirudhan V, Roller Skater National Junior Champion prospect ~ an inspiration !

Am writing below the inspiring story of Anirudhan V, studying in the 6th class at Bhavans Vidya Mandir, Chithali, Palakkad, Kerala.

Am writing below the inspiring story of Anirudhan V, studying in the 6th class at Bhavans Vidya Mandir, Chithali, Palakkad, Kerala.

He is the son of Advocate S. Vinod and Advocate M. Deepa of Kuzhalmannam, a sub-urb of Palakkad in Kerala State.

He is the son of Advocate S. Vinod and Advocate M. Deepa of Kuzhalmannam, a sub-urb of Palakkad in Kerala State.

 Aniruddhan with his father. His latest fracture a minor blow in his quest

 Aniruddhan with his father. His latest fracture a minor blow in his quest

 

Aniruddhan with his father. His latest fracture a minor blow in his quest

How I met Aniruddhan and his father He came in to my Outpatient Paediatric Orthopedic Clinic at Palak kad, Kerala, brought by a common friend who’s son is also a roller skater. Aniruddhan suffered a fall while practicing and had fractured his right wrist. With a competitive sports time away from tracks and practice is time somebody else could spend to improve and get ahead of you. I advised his father that since the fracture could be immobilised in a cast with artificial material giving it some strength that a regular plaster of paris would, he could get back to practice with his cast on the same day. We could always do weekly check-ups to see whether the cast is becoming loose or if the fracture is moving and alter treatment plans accordingly. Aniruddhan’s dedication is so much that he jumped at the idea. His father, who has been encouraging him also advised him to do the same.   This simple act of dedication and ability to tolerate an adverse event inspired me to ask more about him. What I heard from his father about him merited a small story. I cannot divulge many of his early struggles because of patient confidentiality, but what ever his father found non-sensitive I am sharing with the world to inspire other kids (and parents) who dream. Hopefully it would make them dream bigger and reach higher.   

His story, a simple inspiration

His story of how he overcame hurdles in his early education and learning difficulty by complete dedication to his sports and earned peer recognition is wonderful to hear. Not only did it help him achieve laurels in sports it also helped him overcome his difficulty in learning and progress there too. I suppose sports does that to people. With intense training in balance, coordination, fitness, struggle against odds, facing the exhilaration of success and depths of failure character builds. 

Doubtlessly.

 

Tough Life of practice, dedication to sports and educationAniruddhan is now 11 years, in 6th class has been religiously getting up at 3 am every morning for the past 4 years. His father accompanies him to Coimbatore, a nearby town about one and half hour by road, where there are facilities for roller skating practice. After practicing for 2 hours he returns at 8 am and then does his full days school and then in the evening does his road practice on Roller Skates.  It is no wonder then that Anirrudh is a National Level Skater and deserves every bit of encouragement he can get. He sustained an unfortunate accident and fractured his wrist last week. Aniruddhan has a cast on him now, but his spirit has not been dampened. I have recommended to practice roller skating with his cast on !Aniruddhan’s story has just begun. He is at the Junior National level now with mile of hard training struggle ahead of him to get ahead of the tough competition. However, if what I have seen is the attitude he keeps then his success is sure, in time. He has now moved to inline skates and is entering the world of elder children with some tough competition ahead of him. I am sure that with his dedication to the sport and will to practice in spite of odds he will shine through and bring laurels to his loved ones and country !The story of Aniruddhan is one among the many who have come out of all odds and made it to the top. Watch this space for more inspiring stories of child athletes, their battle against sports injuries towards victory.

How I met Aniruddhan and his father He came in to my Outpatient Paediatric Orthopedic Clinic at Palak kad, Kerala, brought by a common friend who’s son is also a roller skater. Aniruddhan suffered a fall while practicing and had fractured his right wrist. With a competitive sports time away from tracks and practice is time somebody else could spend to improve and get ahead of you. I advised his father that since the fracture could be immobilised in a cast with artificial material giving it some strength that a regular plaster of paris would, he could get back to practice with his cast on the same day. We could always do weekly check-ups to see whether the cast is becoming loose or if the fracture is moving and alter treatment plans accordingly. Aniruddhan’s dedication is so much that he jumped at the idea. His father, who has been encouraging him also advised him to do the same.   This simple act of dedication and ability to tolerate an adverse event inspired me to ask more about him. What I heard from his father about him merited a small story. I cannot divulge many of his early struggles because of patient confidentiality, but what ever his father found non-sensitive I am sharing with the world to inspire other kids (and parents) who dream. Hopefully it would make them dream bigger and reach higher.   

His story, a simple inspiration

His story of how he overcame hurdles in his early education and learning difficulty by complete dedication to his sports and earned peer recognition is wonderful to hear. Not only did it help him achieve laurels in sports it also helped him overcome his difficulty in learning and progress there too. I suppose sports does that to people. With intense training in balance, coordination, fitness, struggle against odds, facing the exhilaration of success and depths of failure character builds. 

Doubtlessly.

 

Tough Life of practice, dedication to sports and educationAniruddhan is now 11 years, in 6th class has been religiously getting up at 3 am every morning for the past 4 years. His father accompanies him to Coimbatore, a nearby town about one and half hour by road, where there are facilities for roller skating practice. After practicing for 2 hours he returns at 8 am and then does his full days school and then in the evening does his road practice on Roller Skates.  It is no wonder then that Anirrudh is a National Level Skater and deserves every bit of encouragement he can get. He sustained an unfortunate accident and fractured his wrist last week. Aniruddhan has a cast on him now, but his spirit has not been dampened. I have recommended to practice roller skating with his cast on !Aniruddhan’s story has just begun. He is at the Junior National level now with mile of hard training struggle ahead of him to get ahead of the tough competition. However, if what I have seen is the attitude he keeps then his success is sure, in time. He has now moved to inline skates and is entering the world of elder children with some tough competition ahead of him. I am sure that with his dedication to the sport and will to practice in spite of odds he will shine through and bring laurels to his loved ones and country !The story of Aniruddhan is one among the many who have come out of all odds and made it to the top. Watch this space for more inspiring stories of child athletes, their battle against sports injuries towards victory.

How I met Aniruddhan and his father

 

He came in to my Outpatient Paediatric Orthopedic Clinic at Palak kar, Kerala, brought by a common friend who’s son is also a roller skater. Aniruddhan suffered a fall while practicing and had fractured his right wrist. With a competitive sports time away from tracks and practice is time somebody else could spend to improve and get ahead of you. I advised his father that since the fracture could be immobilised in a cast with artificial material giving it some strength that a regular plaster of paris would, he could get back to practice with his cast on the same day. We could always do weekly check-ups to see whether the cast is becoming loose or if the fracture is moving and alter treatment plans accordingly. Aniruddhan’s dedication is so much that he jumped at the idea. His father, who has been encouraging him also advised him to do the same. 

  This simple act of dedication and ability to tolerate an adverse event inspired me to ask more about him. What I heard from his father about him merited a small story. I cannot divulge many of his early struggles because of patient confidentiality, but what ever his father found non-sensitive I am sharing with the world to inspire other kids (and parents) who dream. Hopefully it would make them dream bigger and reach higher.   

His story, a simple inspiration

His story of how he overcame hurdles in his early education and learning difficulty by complete dedication to his sports and earned peer recognition is wonderful to hear. Not only did it help him achieve laurels in sports it also helped him overcome his difficulty in learning and progress there too. I suppose sports does that to people. With intense training in balance, coordination, fitness, struggle against odds, facing the exhilaration of success and depths of failure character builds. 

Doubtlessly.

 

Tough Life of practice, dedication to sports and education

Aniruddhan is now 11 years, in 6th class has been religiously getting up at 3 am every morning for the past 4 years. His father accompanies him to Coimbatore, a nearby town about one and half hour by road, where there are facilities for roller skating practice. After practicing for 2 hours he returns at 8 am and then does his full days school and then in the evening does his road practice on Roller Skates.

 

 

It is no wonder then that Anirrudh is a National Level Skater and deserves every bit of encouragement he can get. He sustained an unfortunate accident and fractured his wrist last week. Aniruddhan has a cast on him now, but his spirit has not been dampened. I have recommended to practice roller skating with his cast on !

Aniruddhan’s story has just begun. He is at the Junior National level now with mile of hard training struggle ahead of him to get ahead of the tough competition. However, if what I have seen is the attitude he keeps then his success is sure, in time.

 

He has now moved to inline skates and is entering the world of elder children with some tough competition ahead of him. I am sure that with his dedication to the sport and will to practice in spite of odds he will shine through and bring laurels to his loved ones and country !

The story of Aniruddhan is one among the many who have come out of all odds and made it to the top. Watch this space for more inspiring stories of child athletes, their battle against sports injuries towards victory.

 

 


Aniruddhan V , on Roller Skates

Aniruddhan V , on Roller Skates

Categories
Cerebral-palsy Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

World #CerebralPalsy Day – October 6, 2018


#WorldCerebralPalsyDay is afoot. Like last year, I am planning to conduct month long events across Palakkad and Shoranur to raise parental awareness on treatment of #CerebralPalsy.

Most of the parents who come for care of their children come late, unfortunately with joint contractures, hip subluxations, alteration in knee mechanics and foot deformities. Aside from these the problems these children have with upper limbs, hands and doing activities.

Many of these children have uncontrolled seizures, terrible difficulties communicating, speaking out their issues apart from ambulation.  Ambulation may in fact be least of their issues. This sad fact goes to show how important early referral is and how important it is to enroll the child under a care of a Pediatric Neurologist, Pediatric Physiotherapist who can then co-ordinate care with their colleagues in Pediatric Orthopedics, Pediatric Medicine, Occupational Therapy, Speech Pathology, Audiology etc ..

Cerebral Palsy care is a great team effort. No part of the team is greater than other, but the role of the General Practitioner / Pediatric Medicine Doctor, Pediatric Physiotherapist is central, at least in India. They determine the sole referral entity, a person with whom the parents spend their maximum time and trust with. They are the ones in whom they confide most of their issues with.

World Cerebral Palsy Day is a wonderful concept to reinforce these simple care giving principles. Parent education and empowerment being central to the cause of care of these children. Like 2017, we are organising activities across the district of Palakkad – in Palakkad town and neaby rural areas and Shoranur town to educate parents and also conduct early detection and intervention camps to identify children who need care.

World Cerebral Palsy Day - at Palakkad and Shoranur, 2018
World Cerebral Palsy Day – at Palakkad and Shoranur, 2018

Activities planned :

  • Free medical camps for underpriviliged children
  • Special clinics with Gait Analysis
  • Funded Orthotic programme for poor children
  • Pediatric Physiotherapy advice
  • Custom made Wheel Chair fitting
  • Parent awareness of Cerebral Palsy – lectures and symposias in rural areas
  • Notices and public handouts to improve general awareness
  • Involvement of other NGOs , social service organisations to improve public outreach

These activities would be done throughout Ocotober 2018 under aegis of the Cerebral Palsy Clinic at Rajiv Gandhi Cooperative Hospital & Research Centre and ICCONS, Shoranur

Contact Numbers for Clinic bookings  and more information:

  1. Rajiv Gandhi Cooperative Hospital, Kallekkad, Palakkad : 0491-250-9000
  2. ICCONS, Shoranur, Palakkad                                                   : 0466-222-4869
  3. Contact me                                                                                  : EMAIL

 

Categories
General Linux Open Source & Programming Pediatric Orthopedics

Making Media rich Medical Presentations using Emacs, Org-mode and Reveal.js – Part 1


Scenario

As a practicing Paediatric Orthopaedic Surgeon, I am called to meeting to present my work. This involves presenting to peers, co-workers, patients and parents of children I care for. Each of these presentations will be with a different focus on a particular topic. 

While this is not an uncommon scenario, the solution to create a reusable presentation slides using #OpenSourceSoftware tailored to individual audience is. Most doctors are not familiar with programming environment  and shy away from anything that is not WYSIWYG. They rely on good old #PowerPoint / #Keynote to save them. At the most some of them may try and use the clunkly #LibreOffice or #OpenOffice if they want to stick to OpenSource. Recently with advent of tools like Prezi, media heavy interactive presentations have become popular. The popular presentation softwares of KeyNote, PowerPoint have also spruced up their animations and transitions to enable them to look more attractive. Still the WYSIWYG nature of these and point-and-click makes them very slow. We could achieve better, faster and more attractive results with using #FOSS tools. 

 

What I use now

For the past few years I’ve been using a combo of 

  1. #LaTeX via #beamer class 
  2. #RevealJS ,
  3. #Emacs, Org-Mode, org-reveal
  4. #HTML5 and #CSS3
  5. FOSS Image and Video editing softwares as required to arrange the media. I mainly use GIMP, InkScape, KdenLive, OpenShot, HandBrake to arrange my media and encode them. 

My choice depends on the demands of the presentation. 

For media heavy, especially video heavy presentations I use RevealJS. For presentations that are more of less static with few videos I tend to use Beamer / LaTeX. What I note below are my experiences as I tried to create a smooth workflow that could replace PowerPoint ( or KeyNote / LibreOffice ) as a tool to create #Medical Presentations. 

Overtime I have refined my workflow and now I find that I am far more productive and my slides can pack much more information than a power point slide. While the more advanced interactions would require some knowledge of JavaScript, and therefore would turn off most doctors, most of what follows require minimal programming use. 

I will detail my workflow to create simple fast layout using Emacs and RevealJS without handcoding of JS and HTML. We will be relying on the RevealJS, Emacs, Org-Mode and ox-reveal package to do the lifting. 

 

Disclaimer : Even though it doesn’t need programming knowledge, ability to use Emacs is a must for this workflow. It is preferable that one is on a Linux OS as the attempt is to go all #FOSS here. 

 

so, here goes ….

 

Aim

To create an visually impressive medical presentation using non Power Point open source (FOSS) softwares.

Tools

  1. Emacs (24.3 or greater)
  2. org-mode
  3. org-reveal
  4. Reveal.js
  5. Chrome Browser
  6. Open source video codecs on the system

Why this and not PowerPoint ?

Over the years Medical Conference presentations have got mature and old tools have got boring. Varied audiences, topics, media content , interactivity required, transitions and animations to keep audiences interested have all changed.

PowerPoint with it’s traditional set of tools is boring to say the least. The point and click interface is slow by comparison to plain text typing. This seems counter intuitive to PowerPoint pandits but I’ve found that once the media is arranged and readied, once can create more far more attractive presentations with the tools mentioned above. 

As far as medical presentations go, the video presentations embedded PowerPoint / LibreOffice have a habit of breaking on stage. I have seen numerous instances of this happening.

And, of course PowerPoint costs 💰💰

It is also Closed Source making it difficult to edit and reproduce when you are with a system where it is not installed.

 

Okay, but why Emacs, why indeed ?

Emacs is Open Source

Emacs is stable

Emacs is good

Emacs is better than #Vim

Emacs has un-paralleled number of extensions and programming support

Emacs has Org-mode… 

 

Okay, So why org-mode, what has that got to do with presentations ?

org-mode is cool

org-mode is simple text

org-mode can be manipulated anywhere with text-editor

Its FOSS

It can be extended with other tools like org-reveal

 

Hm, Okay, but why Reveal.js ?

An actively developed FOSS Tool with a community

Allows 2D stacking of slides permitting nesting

Plugins and all the JS/CSS/HTML5 goodies can be integrated

Very good slider-presenter notes

PDF export option for handouts

Very nice transitions and animations

Good builtin themes and literally infinite customisation options as per CSS

Works very well with slide-projectors and remote tools to advance slides

 

Okay, but why use org-mode / org-reveal with Reveal.js ?

Org-mode is cool, easy, transparent text typing

org-mode is structured and nested just like a regular presentations would be

One can easily do a text-only sketch of a presentations by typing out a few lines of text in org–mode formatting and out put a neatly animated stacked presentation in Reveal.js

If one were to code HTML and JS with Reveal.js, it would be considerably opaque, with HTML markup and JS obscuring the structural details of the presentation.

By integrating org-mode, org-reveal and reveal.js we are integrating all that is good in respective tools while sticking to what the non-programmer user ( an average medical professional ) would like to do – type text and structure the presentation.

 

So, How to go about making one ?

Part 1 : Preparing the ground

Step 1 :

Install GNU-Emacs > 24.3

 

Step 2 :

Update package-archives and use Melpa archive.

Update org-mode.

 

Step 3 :

Install ox-reveal package

 

Step 4 :

‘require(ox-reveal) in your .emacs file

 

Step 5 :

Download and keep the Reveal.js file in a folder.

Note down the path to the folder relative to the folder where the presentation will live.

If you have Bower installed you can just do bower install revealjs

 

Step 6 :

Create a folder where your presentation will live. 

Inside the folder create subfolders for Images, Videos, Scripts, CSS styles and other documents which may be needed for the presentation. 

Now we can create the main file of the presentation – the Org-mode file using Emacs.  Org-mode file is a simple text file which can be opened using any other text-editor. It has the extension of  “.org”

While using Emacs and Org-Mode, however, it provides lot of goodies. Org-Mode in Emacs has lot of extensions one can install that extends it functionality. One can for example use the same org-mode file to output HTML, LaTeX, and PDF. 

So let us create the main presentation file. I title my presentations the following way, giving it context, separated by underscores : <topic>_<audience>_<date>_<venue> . For example if I am giving a public talk on Cerebral Palsy at my home town of Palakkad, on July 30th,2019 , I would title my presentation like this : “CerebralPalsy_PublicTalk_Palakkad_30072019.org”

This allows me to keep separate org-mode files for different audience and keep using the same images, videos etc.. Therefore I am fully portable and self-contained when I have to whip up a presentation tailored to any particular audience – technical or non-technical. 

C-x C-f  in Emacs  to the file you want to create with .org extension.

C-C C-# to insert Template for a Reveal.JS presentation.

If you have ‘ox-reveal loaded it should be available as a choice.

Once chosen it will list some options at the top of the org-mode file.

We will need to provide the path to the REVEAL_ROOT directory to the place we have stored the reveal.js library. This path is relative to the folder where the file for presentation lives. 

Once these are done, It is important to get the images, videos ready. They have to be edited using FOSS tools for editing photos and videos. Once edited they’ve to be named properly so that we can reference them in our presentations. 

 

This completes the ground work required to start writing the presentation. While this may seem a lot of work, one must remember this is one time effort.

We will deal with the actual creation of  org-mode file, the options while using Reveal.JS in the next part ….

Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

DDH – Its June !! It’s Dysplasia Awareness Month


DDH otherwise called Developmental Dysplasia of Hip is a condition where the ‘ball-and-socket-joint’ of the hip is not formed well at birth. It used to be called Congenital Dislocation of Hip.

The child is born with a slightly misfitting hip joint where the ball is slightly shifted out of cup or a hip joint where the ball is completely outside the cup and cup is also very shallow. This can occur on one side or both sides.

Developmental Dysplasia of Hip - Left hip is dislocated
Developmental Dysplasia of Hip – Left hip is dislocated

Why does it happen ?

Most times its ‘Idiopathic’ , a medical term which means – cause is not known. In many other patients, the child will be having one of the syndromes (a group of clinical features and disorders in other organs systems and external appearance) or neurological issues in the spine (like meningomyelocele) that also causes this. This second group is sometimes medically referred to as Teratogenic DDH and is much more difficult to treat.

We will discuss below the aspects as related to Idiopathic DDH. They don’t apply to Teratogenic or Neurological DDH.

How do we know the child has DDH ?

Most newborn screening procedures at the hospitals have doctors checking to see if the new born child has clinical signs of DDH. It is easiest to detect and treat it at that early stage.

Once a clinical suspicion of DDH is there the Neonatologist usually refers the child to a Pediatric Orthopedic Surgeon. In addition to establishing the clinical diagnosis by physical examination, the doctor will order an x-ray and an Ultrasound Scan of the Hips to check the dislocated hips. Several measurements need to be taken and ease of dislocation need to be established under Ultrasound scan by a procedure called Dynamic -Ultrasound. The treatment starts after these are done.

In many children, the initial diagnosis may not be made in the immediate post-delivery period. Children may be brought to the OPD by parents with complaints that the thigh skin fold dont look symmetrical and the hips don’t open out fully for parents to change diapers.

In older children parents may notice a limp when the child walks or a limb length difference may also be noted with the dislocated side being shorter.

Limb Length Difference in DDH
Limb Lengths may be noted to be different in DDH when child is older and walking. The limb with the dislocated hip will appear shorter.

How soon should the treatment start ?

As described in previous section, treatment should ideally start in neonatal period once the problem has been detected. After clinical examination and Ultrasound examination, your doctor will suggest usually a belt type device called Pavlik Harness to be applied on the child to keep the hip reduced inside the cup. This harness is to be worn full time. Parents are counselled on how this is applied and how the straps are tightened.

Ultrasound exam for a child with Hip and Knee dislocation
Ultrasound exam for a child with Hip and Knee dislocation

Once this harness has been applied, the hips are scanned with Ultrasound every 2 weeks to check for improvements. Ideally this has to be kept for about 3 months and taken off after the hip stabilizes inside the socket. A slow weaning period is there before the child can be fully taken off the Pavlik Harness. This is to ensure that the Ball ( head of femur ) stabilizes inside the socket (Acetabulum of Pelvis) and the hip is stable. The tissues around the hip also has to shrink and adapt to the new location of Head of Femur. Otherwise re-dislocation or partial slip (medically called subluxation) is a possibility.

In many cases the parents may not be willing for a device to be applied on the child full time post-delivery or the DDH itself may go undetected. This child eventually may be brought later in life by the parents with complaints necessitating surgical procedures.

What is the treatment options for DDH?

As previously described if the newborn is detected to have DDH the treatment is to apply Pavlik harness on the child after Ultrasound exam proves hip is reducible and stable in what is called a safe zone. Safe Zone is a zone where the position in which the harness has to be applied to the child does not compromise the blood supply the head of femur. This is very important decision to make.

Pavlik Harness for DDH hip needs to be fitted properly
Pavlik Harness for DDH hip needs to be fitted properly

Hip Spica Plaster in child with DDH
Hip Spica Plaster in child with DDH

Application of Hip Spica under anesthesia in DDH
Application of Hip Spica under anesthesia in DDH

If the child is brought later in life, before 1 year, the hip has to be checked for reducibility as the tissues around the hip would have become contracted and sometimes it is difficult to reduce the hip back into the socket. Usually anaesthesia would be required and the hip once reduced back into the socket is held there by application of the plaster of paris or POP called Hip Spica. This is kept for approximately 3 months until the hip has stabilised inside. A CT scan to verify whether the hip is reduced should be done while child is in POP as slippage of the hip socket is also seen when POP cast becomes loose with time.

Surgery is the only option in older children with DDH. These range from relatively simple procedures to complex hip reconstruction procedures depending on age of the child, slope of cup, angle of rotation of the neck of the thigh bone and shape of the head. These are best evaluated as per the needs of the child.

Arthrogram for DDH
Arthrogram for DDH

Generally these surgical procedures can be grouped into a few types :

  • Open Reduction of Hip and Capsulorraphy (medical term meaning stitching up of capsule or the covering around the joint)
    • This is basic necessity. Here the hip is reduced back into the socket and the covering, the capsule, which is loose is tightened with several sutures
  • Femur Derotation Osteotomy with shortening
    • This would involve a slight shortening of the hip bone and turning it around. The bone would then be stabilied with a metal plate and screws
    • The need for your child to have this done depends on the age of the child and the angle of the ‘neck of the femur’, something medically known as Anteversion. This procedure essentially de-rotates the femur neck and allows the head of femur (the Ball) to deeply sit inside the Acetabulum (the socket). A slight shortening of the thigh bone may be needed as the child , if old enough, would have developed tightness of the tissues and hip should be sitting inside the socket slightly loose than in tension.
  • Acetabular Osteotomy
    • In many children, when they present to the clinic their Acetabulum would be shallow and not deep enough to receive the Head of Femur. In such children deepening of the Acetabulum by a surgical procedure called Osteotomy (a type called Salter Osteotomy being the most popular) may be done.

The above procedures may be combined along with Open Reduction as the surgeon sees fit after evaulating the child. These options and its pros-and-cons would be discussed with the parents before the surgery.

What happens if we don’t treat DDH promptly ?

Best time to treat the child is in the newborn period. With time the tissues around the hip gets tighter and the bone structure of thigh bone and pelvis alters since the normal growth with moulding of the ball being inside the cup doesn’t happen.

This lack of moulding results in a shallow cup. Additionally the thigh bone’s upper end would be twisted out of shape and the ball also would be misshapen since it has not been moulded by the acetabulum.

All these result in a much more complex procedure to try and restore the hip.

Left untreated DDH causes osteoarthritis or the Hip joint and Hip pain in early adulthood often requiring complex reconstructive procedures.

It is best if the treatment is not postponed and done at the earliest.

Hip Dysplasia Awareness Month – June !!

The Hip Dysplasia Awareness Month of June is to educate parents on Hip Dysplasia and its treatment methods. We hope that parents would bring children to care centers at the earliest if suspicion of hip dysplasia is there.

For more information please visit : http://livingwithhipdysplasia.com/june/ or consult your Pediatric Orthopedic Surgeon.

Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

Cerebral Palsy Medical Camp at Shoranur, Kerala


A free medical camp for underpriviliged children suffering from Cerebral Palsy and Pediatric Orthopaedic disorders was organised by Dr. Easwar T.R and the administrative team at ICCONS, Shoranur, Kerala on 24th, May,2018.

A gamut of problems commonly seen in children with Cerebral Palsy was observed in OPD. While some parents had the good fortune of seeking medical care and intervention early in course of disease and others were not so fortunate. Lack of parental knowledge, distance / accessible care, financial cruch, normal siblings to care for and single parent challenges were the most important issues observed on casual data collection.

The medical camp was followed by an awareness class for parents, therapists and other care givers by Dr. Easwar T.R on the various aspects of Cerebral Palsy.

Custom wheel chair and mobility solutions for needy patients was discussed with Physiotherapists and low cost solutions for the same identified. Mobility solutions continue to be a major challenge for children in rural areas with poor roads, small homes with narrow doors and steps inside homes especially with outdoor toilets.

Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

World Clubfoot Day on June 3rd


This 2018, on June 3rd, we at Palakkad District Co-operative Hospital and Research Centre are celebrating the World Clubfoot Day.

We are planning special Outpatient Clinics for children with Clubfoot disorder in and around Palakkad, Kerala.

Please find below the Malayalam Poster for the #ClubFoot Day

Screenshot from 2018-05-25 16-07-28.png

 

Categories
Art and Paintings Deformity Correction and Limb lengthening Pediatric Orthopedics

Knock Knees or Genu Valgum in Children


Categories
Cerebral-palsy Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

Using #STEM teaching as a rehabilitation tool in Disability – Karunya, Palakkad


Excited and so happy to be part of this attempt at @Karunyamvrc to teach #children with #disability #STEM #Electronics as a mean of #rehabilitation

More details at : https://t.co/nCvQ7ahUX1

Inauguration

Today I will be speaking at the inaugural function of this new effort by Karunya MVRC at Palakkad Kerala.

Last year the team at Karunya broke ground and made a sensor driven, no touch hand sanitizer dispenser. This was made by differently abled students.

Unfortunately COVID pandemic raging again meant that all events and celebrations had to be toned down and postponed.

Will post again on updates in a while …

Last year these specially abled children designed and built a sensor driven sanitiser dispenser.

Will post more pictures later today after the event.

Categories
Deformity Correction and Limb lengthening Orthopedics Pediatric Orthopedics

October 6 Painting To raise awareness..a memory


Memories of a more pleasant year in 2019. Before the pandemic struck and wrought drastic stop to treatment of children with cerebral palsy. That October we hosted a live painting workshop at ICCONS to raise awareness about Cerebral Palsy

Memories of a more pleasant year in 2019.

Before the pandemic struck and wrought drastic stop to treatment of children with cerebral palsy.

Two years have passed and we hobble back to restart our work and pick up pieces. Many children have lost the improvements that they had attained as they lost out of treatment due to lack of money, travel restrictions and physiotherapy.

This is October 2019 we hosted a live painting workshop at ICCONS to raise awareness about Cerebral Palsy.

We wish we can do a better job in 2022.

Categories
Art and Paintings Pediatric Orthopedics

Spilled Coffee 🎨 Painting NFT


https://bit.ly/2YDBbSS Spilled Coffee..
#Art
#NFT

Tired day at waiting room. Overslept. Drowsy. A hurriedly drunk coffee with spills in morning before the day’s at doctors’ office starts.

I see so many parents who wait and wait… The general conditions for stay and wait in most of the hospitals is below par, especially for the poor.

Most Pediatric Orthopedic Deformities need long drawn out care. It’s tough. Waiting makes it tougher.

Categories
Art and Paintings Cerebral-palsy Deformity Correction and Limb lengthening Pediatric Orthopedics

#Saksham. Hold your strength. Let’s be with them as they wait for healing..


Waiting Room Medicine is tough. Treatment slow, arduous. I feel for those who wait patiently in crowded poorly appointed waiting rooms, corridors in India's hospital for the poor. They spend their days here by the loved ones side.

Medicine is tough. Treatment slow, arduous. I feel for those who wait patiently in crowded poorly appointed waiting rooms, corridors in India’s hospital for the poor. They spend their days here by the loved ones

https://opensea.io/assets/matic/0x2953399124f0cbb46d2cbacd8a89cf0599974963/75139301128692202745789003873188758042217057528859930189796240465112021860353/

Categories
Art and Paintings Cerebral-palsy General

#ArztForACause – Art for health awareness


#ArztForACause a project by doctor to raise awareness on #PediatricOrthopedic Deformities, #CerebralPalsy 
#Art
#Ethereum
#NFTCommunity
 https://t.co/JElnnkqhfq via @opensea

ArztForACause a project by doctor to raise awareness on #PediatricOrthopedic Deformities, #CerebralPalsy

Art

Ethereum

NFTCommunity

https://t.co/JElnnkqhfq via @opensea

Categories
Art and Paintings General

My Art, Paintings and NFT have a home


See my 🎨 Art and NFT at 
https://opensea.io/dreaswar
Categories
General Poems

Guru Poornima


A poem to the Guru, the eternal teacher who’s soul reincarnate who pervades all and guides the wandering seafarer home. Without fail. Everytime. Until the last one.

Winds are getting rough, 
The sea churns,
Sharks jump unforeseen,
Vultures circle for prey afloat,
Path is dark, no stars above,
My boat leaks, filling slowly,
The three sandbags of gold,
Hang anchoring me to churn,
From far away land a twinkle,
Catches my eye, amongst mist,
Swirling and spray amidst the clash,
Hope springs anew, there's land ahoy !
Desparate I turn and whirl the wheel,
With all my might, to keep it in view,
The dim yellow light , my pole star,
Light gets brighter but my sandbags,
Stall and fill my boat, tossing more,
The final stretch alas, run aground,
I hurl myself in shallow water,
To swim to the sandy beach and race,
Ahead to meet the light house that,
Guided me home, standing tall,
Unshaken, uncaring, unyielding,
On the rocks, amidst crashing sea,
I join my brethren on the beach before,
Me as they welcome and we join chorus,
Of praise to the lighthouse, as full moon,
And stars are all there again.

~Dr. Easwar TR
The lighthouse
Categories
Art and Paintings Others

A #COVID Warrior 🪖 Tribute


COVID warrior.

#Art #Ballpen on #paper. 🙏

A tribute to those who’ve laid down their lives risking self and family for others.

COVID19 WARRIOR 🪖

Tiruppavail of Saint Andaal – Pasuram 6


Long time, year after year, I resolve to translate one Song ( Paasuram ) a day from the Thiruppaavai, written by Saint Andaal ( the only female Viashnava Saint among the 12 Alwars ) . This year, after missing first 5 days I made an effort finally.

Find it below.

A humble offering at the feet of Saint Andaal .

புள்ளும் சிலம்பினகாண் புள்ளரையன் கோயிலில்
வெள்ளை விளிசங்கின் பேரரவம் கேட்டிலயோ
பிள்ளாய் எழுந்திராய் பேய்முலை நஞ்சுண்டு
கள்ளச் சகடம் கலக்கழியக் காலோச்சி
வெள்ளத் தரவில் துயிலமர்ந்த வித்தினை
உள்ளத்துக் கொண்டு முனிவர்களும் யோகிகளும்
மெள்ள எழுந்(து) அரியென்ற பேரரவம்
உள்ளம் புகுந்து குளிர்ந்தேலோ ரெம்பாவாய்.

puLLum silambina kaaN
puLLaraiyan kOyilil
veLLai viLisangin pEraravam kEttilaiyO
piLLaay ezhundhiraay

pEy mulai nancundu
kaLLac cakatam kalakkazhiyak kaalOcci
veLLaththaravil thuyilamarndha viththinai
uLLaththuk kondu munivargaLum yOgigaLum
meLLa ezhundhu
“ari” enRa pEraravam
uLLam pugundhu
kuLindhElOr embaavaay.

Look ! The temple birds preach sweet !
Hear ! White conch blows forth primeval !
From inner sanctum of Holy Bird’s Lord !
Don’t you hear any ? Up my child !

Lord who drank from poisoned breasts,
Lord who kicked off monstrous killer carts,
Lord who reposes on waters atop serpent,
Lord the cause seed of the Universe,
Lord the image Yogis, Munis keep in,

To Him, do chanting ‘Hari’ in happy chorus,
To Him, do in-turned our hearts cool, abide,
To Him, Prayer mine, awake my dears you too !

Tiruppavai – 6 by Saint Andal

Categories
Cerebral-palsy Orthopedics Pediatric Orthopedics Sports Injury

Adaptive Sports in Cerebral Palsy


On #WorldCPDay this year, amid the pandemic, we’ve managed to launch a new rehabilitation facility in association with Karunya MVRC, Palakkad, Kerala, India ( @Karunyamvrc on Twitter )

Kerala State loves Sports, and specially loves Football. We married care for children with Cerebral Palsy and Sports, to setup a one of a kind Adaptive Sports Environment where children would be trained with Physiotherapist’s support by well known Sports Coaches.

Paediatric Orthopaedic Surgeon’s service is also available to assess these children and triage then into various categories from where they can be rehabilitated.

Our Cerebral Palsy Adaptive Sports Team

Ms. Valarmathi- Physiotherapist


Mrs. Valarmathi- Senior Special Educator

Mr. Ravindran – Retd SI and Kerala, Police state and national team Football coach


Ms. Dhanya Ravi- Change Maker, mentor, PwD, National Award winner in the Role Model Category under Empowerment of People with Disability


Mr. Anudarsan – Director , Karunya Medical and Vocational Rehabilitation Center


Dr. Easwar TR Paediatric Orthopedic Surgeon

Karunya MVRC Contact Details


Websitewww.kmvrc.in

Address: Karunya, Chenkol, Karingarapully, Palakkad 678551
Phone – 9061000101 /8590667698

What is Adaptive Sports ?

Adaptive Sports is a special type of Sports training given to children with special needs by adapting the requirements of sports to the specific difficulty the child faces.

This would often involve some change in rules, some Assistive device support, fall prevention and a completely tailored coaching system to enable the child to play effectively.

Why Adaptive Sports ?

Well known rehabilitation method for Cerebral Palsy is Physiotherapy. Often times children find repeated therapy sessions boring, painful at times and many fall out of care. We’ve seen this happen over the years.

Also, there are several limitations to traditional physiotherapy approach when given as a single rehabilitation modality.

Sports training allows much the same benefits of improved strength, coordination and improvement in function that we get out of Physiotherapy but also improves the quality of Physiotherapy session as the child is a willing participant because of the interest in sports.

What are the special challenges in setting up Adaptive Sports in India ?

Coaching for Adaptive Sports is a patient art and the skill is much in dearth. The Sports coach has to tailor his or her expectation to the unique medical issues of the child and training method is customised accordingly.

Often these children have profound muscle weakness, spasticity ( unusual tightness of the muscles ), contracture, ataxia ( issues with body balance ) and inability to selectively more a body part. These result in delayed improvement a ability to perform in Sports activity. These children need care and support of their team to get ahead.

The coach has to be understanding of all these aspects and train the child.

What have we launched in Palakkad ?

Details about our effort to train children in Adaptive Sports here :