Doctors operated on three-day old Sam Esquibel after finding what looked like a microscopic tumour on an MRI scan.

But while removing the growth, they also found a nearly perfect foot and the partial formation of another foot, a hand and a thigh.

The growth may have been a case of “foetus in foetu” in which a twin begins to form within its sibling.

However, the team at Memorial Hospital for Children in Colorado Springs said such cases very rarely occur in the brain.

It may also have been a type of congenital brain tumour.

But such growths are usually less complex than a foot or hand, the doctors added.

Unique

Dr Paul Grabb, a paediatric neurosurgeon, said Sam was otherwise healthy when he underwent the procedure in October.

“It looked like the breech delivery of a baby, coming out of the brain,” he said.

“To find a perfectly formed structure (like this) is extremely unique, unusual, borderline unheard of.”

Sam’s parents, Tiffnie and Manuel Esquibel, say their son is at home now but faces monthly blood tests to check for signs of cancer or regrowth, along with physical therapy to improve the use of his neck.

But they say he has mostly recovered from the operation.

“You’d never know if he didn’t have a scar there,” his mother said.

Mr Dominic Thompson, a consultant paediatric neurosurgeon at London’s Great Ormond Street Hospital, said there were probably less than 100 recorded cases of foetus in foetu in the medical literature.

He said another possibility was that the tumour was of a type called a teratoma, which can include tissue such as muscle and fat, and more rarely bone and teeth.

However, he said the available details from the US case suggested that foetus in foetu was the most likely explanation, as the tissue was so exceptionally well formed.

Trevor Lawson, of the charity Brain Tumour UK, said: “Even with modern imaging techniques, surgeons can’t be entirely sure of what they’ll find when they go into the skull.

“Even so, this is an exceptionally rare event.

“It’s good to know that baby Sam is recovering well. Brain tumours now kill more children than any other solid cancer and it’s essential that more research is undertaken to identify what causes them.

“Where appropriate consent is gained, rare events like these can sometimes provide invaluable genetic material that gives an insight into the origins of these traumatic tumours.”

source

Here are some of my favorites ( i know it sounds mean, but i cant help myself )

Aeschylus, Greek playwright, was killed when an eagle dropped a live tortoise on him

Chrysippus, a Greek stoic philosopher, is believed to have died of laughter

An insect flew into the Roman emperor Titus’s nose and picked at his brain for seven years

Humphrey de Bohun, 4th Earl of Hereford was fatally speared through the anus by a pikeman hidden under the bridge during the Battle of Boroughbridge

George Herbert, 5th Earl of Carnarvon became the first to die from the alleged King Tut’s Curse after a mosquito bite on his face became seriously infected.

Janet Parker, a British medical photographer, died of smallpox in 1978, ten months after the disease was eradicated in the wild, when a researcher at the laboratory Parker worked at accidentally released some virus into the air of the building. She is believed to be the last smallpox fatality in history

In Congo, a soccer game ended when every player on the visiting team was struck by a fork bolt of lightning, killing them all instantly

28-year-old South Korean, Lee Seung Seop, collapsed of fatigue and died after playing StarCraft for almost 50 consecutive hours in an Internet cafe.

But this has to be the funniest of them all:

Arius, the heretical priest who precipitated the Council of Nicea, passed wind and evacuated his internal organs

Here’s the link, http://en.wikipedia.org/wiki/List_of_unusual_deaths

Enjoy

A study published on Thursday by the Dutch Centre for Insurance Statistics (CVS) showed that fewer accidents and reports of fire and theft occur when the 13th of the month falls on a Friday than on other Fridays.

“I find it hard to believe that it is because people are preventatively more careful or just stay home, but statistically speaking, driving is a little bit safer on Friday 13th,” CVS statistician Alex Hoen told the Verzekerd insurance magazine.

In the last two years, Dutch insurers received reports of an average 7,800 traffic accidents each Friday, the CVS study said. But the average figure when the 13th fell on a Friday was just 7,500.

There were also fewer incidents of fire and theft, although the average value of losses on Fridays 13th was slightly higher.

(Reporting by Tineke van der Struik; Editing by Catherine Evans)

I’ll leave you with the article

On March 31, an important advisory statement on “hands-only” (compression-only) CPR was published in Circulation. This statement clarifies the 2005 AHA Guidelines for CPR and ECC, which included the recommendation that laypersons – or bystanders – should perform hands-only CPR if they are unable or unwilling to provide rescue breaths.

Hands-Only CPR Consumer Web Site to find out more about this lifesaving initiative.

In my Neurosurgery rotation i got the privilege of observing a surgery done by Dr. Shurbaji, it was for a CP-angle meningioma, it was quite an experience. i remember the patient was a woman from Yemen that came all the way to Jordan to do this operation. Needless to mention that the operation was a total success.

Well here’s the source for the BMj article on Karak Syndrome

enjoy

http://jmg.bmj.com/cgi/content/full/40/7/543

I was wondering what would anyone think if they saw this creature?! it sure isn’t the cutest you’d see ?!

Well it may not be the cutest, but it sure is one of the most famous, this is the Asian Palm Civet (Paradoxurus hermaphroditus), also known as the Toddy Cat, and it’s the origin of Kopi Luwak, the most expensive coffee in the world, selling for between $120 and $600 USD per pound.

Kopi Luwak is made from coffee berries which have been eaten by and passed through the digestive tract of the Asian Palm Civet . The civets eat the berries, but the beans inside pass through their system undigested. This process takes place on the islands of Sumatra, Java and Sulawesi in the Indonesian Archipelago, and in the Philippines (where the product is called Kape Alamid). Vietnam has a similar type of coffee, called weasel coffee, which are coffee berries which have been defecated by local weasels. In actuality the “weasel” is just the local version of the Asian Palm Civet.

Kopi is the Indonesian word for coffee, and luwak is a local name of the Asian Palm Civet. The raw, red coffee berries are part of its normal diet, along with insects, small mammals, small reptiles, eggs and nestlings of birds, and other fruit. The inner bean of the berry is not digested, but it has been proposed that enzymes in the stomach of the civet add to the coffee’s flavor by breaking down the proteins that give coffee its bitter taste. The beans are excreted still covered in some inner layers of the berry. The beans are washed, and given only a light roast so as to not destroy the complex flavors that develop through the process. Some sources claim that the beans may be regurgitated instead of defecated.

Severe Acute Respiratory Syndrome (SARS) scare led to thousands of these civets in China being exterminated, but the demand for the coffee was not affected.

We may not have this coffee in Jordan, but i’m sure all coffee lovers like myself are dying to get a taste of Kopi Luwak.

I looked this up after watching the movie “Bucket List”, where Jack Nickelson always insisted on taking his Kopi Luwak machine wherever he went, even when he stayed in hospital with a few months to live..

Enjoy

A Chinese man has had surgery to remove part of a 22lb (10kg) tumour from his face.

The surgery was the second operation for 32-year-old Huang Chuncai, who had part of his original 55.7lb (23kg) tumour reduced last year.

Surgeons at the hospital in Guangzhou removed a further 9.9lb (4.5kg) of the growths this week.

The tumours are caused by the condition Neurofibromatosis, a genetic disorder causing soft, non-cancerous growths to appear on nerve tissues.

In the UK, around one in avery 25000 babies born are affected by the condition.

Huang, who comes from a remote village in China’s southern province of Hunan, said he was relieved following his first operation in July last year.

The tumour first became visible when Huang was four years old, and has since blocked his left eye, knocked out his teeth and deformed his backbone.

Last month the Telegraph reported the story of Jose Mestre, a Jehovah’s Witness who refused all surgery on his facial disfigurement.

A tumour that began on his lip during adolescence now obliterates most of his face, measuring 15 inches long and weighing 12lb.

Following a consultation in London with Dr Iain Hutchison of St Bartholomew’s, it was hoped Mr Mestre may be able to have surgery without a the blood transfusion banned by his religion.

So i’m going to post a few of the most common ways, starting with the four-in-hand knot

1. Begin with the wide end on your right and extending about a foot below the narrow end of your tie.

2. Bring the wide end of the tie over the narrow (right side to left side).

3. Bring the wide end underneath the narrow end (left side to right side).

4. Bring the wide end of the tie over the narrow again (right side to left side).

5. Bring the wide end of the tie through the back of the loop (left side to center).

6. Hold the front of the knot loose with your index finger; pass the wide end down through the loop (created in step 4) in front.

7. Remove your finger and tighten the knot.

8. Hold the narrow end of the tie and slide the knot up to the collar.

This is the most common tie, so i thought it should be posted first, the rest will follow soon

عمان – حافظت حكومة المهندس نادر الذهبي على شعبيتها رغم قرار رفع الدعم عن أسعار المحروقات، بحسب نتائج استطلاع مستقل للرأي العام أعلنت أمس وأظهرت أن 62% من الأردنيين ما يزالون يعتقدون بقدرة الحكومة على تحمل مسؤولياتها بعد مرور مائة يوم على تشكيلها.

بيد أن الباحث ومسؤول وحدة الاستطلاعات في مركز الدراسات الاستراتيجية في الجامعة الأردنية، الذي أجرى الاستطلاع، الدكتور محمد المصري اعتبر أن النتائج تعكس “رغبة المواطنين في إعطاء فرصة للحكومة”، لافتا إلى أن “شعبية الحكومة قد تنهار لاحقا في حال فشلها في معالجة قضايا تفصيلية رأى الأردنيون أن فشلت في مواجهتها”، وتحديدا قضايا ارتفاع الأسعار والحد من الفقر والبطالة.

وأظهر الاستطلاع الذي أجراه المركز بين الرابع والعاشر من الشهر الحالي، أن أولويات المواطنين هي “أولويات اقتصادية”، خصوصا وأن مشكلة ارتفاع الأسعار وغلاء المعيشة سجلت كأهم المشاكل التي تواجه البلاد، وأن 48.8% من المستطلعة آراؤهم قالت إن على الحكومة معالجة هذه المشاكل، وتلى ذلك مشكلة ارتفاع الأسعار ثم ظاهرة البطالة والفقر,

وفيما يتعلق بقدرة الحكومة على تحمل مسؤولياتها، كشف الاستطلاع أن النتائج كانت متطابقة مع توقعات المستجيبين في الاستطلاع الحالي واستطلاع سابق أجراه المركز عند تشكيل الحكومة في كانون الأول (ديسمبر) الماضي، إذ بلغت في كلا الاستطلاعين 62%.

وأرجع المصري ثبات شعبية الحكومة إلى عدة محاور أساسية أبرزها أن الحكومة “لم تدخل منذ تشكيلها في أي أزمة سياسية مع طرف سواء السلطة التشريعية أو الأحزاب او النقابات أو الصحافة”.

وإلى جانب ذلك، ساهمت فترة الحوار الطويلة التي سبقت رفع الأسعار، والتي امتدت لنحو ثمانية أشهر، أي منذ عهد الحكومة السابقة، “على ما يبدو” في إقناع المواطنين بأن تحرير المحروقات خطوة لا بد منها في ضوء توالي ارتفاع الأسعار عالميا، وخصوصا أسعار النفط، بحسب المصري.

وجاءت كذلك، مقابلة ارتفاع الأسعار بزيادة الرواتب لتساهم في الحفاظ على شعبية الحكومة، “إذ أنه وللمرة الأولى يجري رفع الأسعار بالتوازي مع زيادة الرواتب”، وفق المصري.

وقال المصري لـ”الغد” إن “المواطنين على ما يبدو ما يزالون يأملون في أن تقدم الحكومة على خطوات أخرى للتخفيف من وطأة الغلاء عليهم”

http://alghad.jo/?news=315439

That’s a lot of medical students! And as much as I would like to believe that all of the students are stellar in knowledge, dedication, and attitude, I know it is not true.

I would venture to guess that most of the medical students reading this entry have been told by a resident or attending at some point that they are “good” students, or that their work has been “excellent”, or their write-ups “outstanding”. It’s easy to praise someone to their face. It’s not as easy to tell them they’re doing a bad job. Therefore, if you’re a “bad” medical student, you may not know it until you get your evaluations back. And at that point, it’s too late to change.

(At this point you may be asking yourself, “If I’ve never received any true positive feedback face-to-face, does that mean the residents have only negative feedback for me, and that I’m a ‘bad’ medical student?” Hmmmm….)

I’ve asked a few residents to give me a few tips, and I’ve compiled a list of things that make a medical student “bad”:

-#1 overall = BAD ATTITUDE. If you balk when your intern asks you to write the note on your patient for that day, or if you repeatedly say no to scrubbing in on late afternoon OR cases, you may be a bad medical student.

-Disappearing for extended periods, multiple times per day, to read or nap or goof around. I’m not saying you need to be married to your team, but make them aware you’re available and willing to help.

-Not appearing interested. Even if you detest surgery, or if you’d rather poke yourself with a MRSA-flavored fork than interview a manic patient, try to make a conscious effort to look engrossed. This may be as simple as altering your resting facial expression.

-Correcting your resident on rounds, or its extreme variant, “The Reverse Pimp”. Some medical students get so bent out of shape over being asked difficult “pimp” questions that they decide to try the “taste of your own medicine” routine. If you ask your resident or attending a question that is fact-based, a picky detail, or something that you’d find in a long paragraph of your basic science book, and you don’t ask it in a curious “I’m asking because I don’t know” manner, you may be a Reverse Pimper. Steer clear.

The above are just a few characteristics of “bad” medical students; there are countless others. Take a glance at the column “How May I Help You?” and think of the opposite.

My last point is this: even if you’re not the smartest 3rd year ever to don a short white coat, never fear. Not knowing answers does not make you a bad medical student. Attitude and work ethic count for a lot!

(Disclaimer: In no way am I claiming to be the polar opposite of a “bad” medical student, that is, a “perfect” medical student. Just sharing observations and solicited advice )