Bilateral anterior cerebral artery infarction following viper bite.

The viper is one of India’s most commonly encountered poisonous snakes and envenomation following viper bite usually leads to consumption coagulopathy. Clinical manifestations most frequently include external and internal bleeding. In the setting of viper envenomation, large-vessel thrombosis is a very rare occurrence. Also, bilateral anterior cerebral artery infarction, when unrelated to anatomical abnormalities, subarachnoid haemorrhage, surgery or trauma, itself is an exceedingly rare event. We report a case of a 24-year-old previously healthy man who presented with bilateral anterior cerebral artery infarction following a viper bite. We also present hypotheses that may explain this unusual occurrence. ©

Spine revisited: principles and parlance redefined.

A revised appreciation of the evolution and the nature of bone in general and of vertebrae in particular, allows revisiting the human spine to usher in some new principles and more rational parlance, that embody spine's phylogeny, ontogeny, anatomy and physiology. Such an approach accords primacy to spine's soft-tissues, and relegates to its bones a secondary place.

Non-pathology: the bedrock of pathology.

Pathology, also called morbid anatomy, is macroscopically, microscopically, and molecularly so manifest an array of phenomena that it has compelled medical men to closely link it up with disease, dis-ease, and death. But there is more than meets the eye of the morbid anatomists, microscopists, and the molecular biologists. The obvious science of pathology is governed by numerous abstract, subtle, non-pathological factors. A pathological phenomenon is subservient to cosmic noumenon. Such a sea-change allows a newer perspective that cures modern medicine of many of its dogmas and provides epistemologically valid directions to research methodologies on the one hand and clinical practices on the other.

Cause of death--so-called designed event acclimaxing timed happenings.

Cause-of-death as an established global medical institution faces its greatest challenge in the commonplace observation that the healthy do not necessarily survive and the diseased do not necessarily die. A logical analysis of the assumed relationships between disease and death provides some insights that allow questioning the taken-for-granted relationship between defined disease/s and the final common parameter of death. Causalism as a paradigm has taken leave of all advanced sciences. In medicine, it is lingering on for anthropocentric reasons. Natural death does not come to pass because of some (replaceable) missing element, but because the evolution of the individual from womb to tomb has arrived at its final destination. To accept death as a physiologic event is to advance thanatology and to disburden medical colleges and hospitals of a lot of avoidable thinking and doing.

TRAS principles blight arterial bypass and plasty.

A new concept--Tissue Requisitions (Principle I)/Relinquishes (Principle II) Arterial Supply--of TRAS principles is introduced to help appreciate the failures/successes of modern medicine's attempts at restoring arterial flow in luminally compromised coronary/carotid fields, an invasive branch rightly called vascular ReRheology, which comprises diagnosing/treating arterial blocks. The technical wizardry of arterial reconstruction (bypass) or lumen--restoration (plasty) has to reckon with the TRAS principles all the time.