Thursday, November 30, 2017

Je ne c'est quoi ? This Advent –“finite humans in the universe and an Infinite Creator God”

Je ne c'est quoi ? This Advent –“finite humans in the universe and an Infinite Creator God”

What kind of world are we all living in? Today, we are dealing with a total plurality of belief systems. We should not just open the bible and expect people to fall on their knees and believe in Jesus.
Things to consider when we share our precious Christian faith:
1.       Look at the root of man’s problems
2.       Share what the bible has to say
3.       Gently persuade people to accept the truth in Christ Jesus
Our faith is constantly challenged in several ways:
1.       Direct opposition to Christians
2.       Indifference to the Christian truth
We can either get discouraged or defensive and say,” I believe in it anyway; Jesus is in my heart and so do not bother me with arguments”. On the flip side, we ourselves lose hope and begin to doubt in our hearts, and some are even crippled with doubts that build up over years of opposition and indifference by those around.
At times, some of us feel threatened and retreat into our own shells and become unapproachable and confrontational, seeing a “demon behind every bush!” .This leads us to blast the so called “non-believers” or weaker Christians with judgment and condemnation. This unwholesome mindset soon becomes part of our distorted worldview and so we put people we “disapprove of” into our own petty, preconceived “basket of rotten eggs”. Little do we realise that this is not from God but from our own depraved human nature. I love the conversation the Indian humourist, Kushwant Singh had with some friends who were criticising the decadent west, judging their entire race as “filthy, depraved and full of dirty, sinful lifestyles”. Kushwant Singh replied,” Yes, yes. They are doing dirty things and watching all those terrible, dirty things. We are not like them. We do it only in our minds!”
Some Christians prefer to take a very low profile, not sticking their necks out. Others unconsciously compromise and dilute their faith. The bible reminds us again and again that there were many prophets in the Old Testament who were zealous for the Lord and never let untruth go unchallenged.
Someone once said,” the best way for evil people to succeed is for good people to do nothing”.

The Challenges facing us today: What are we facing in society today?
The world has not changed much . We all live in a pluralistic society where there are no absolutes. Everything is relative.
When a pastor shares about the exclusiveness of Jesus in John 14:6,” I am the Way, the Truth and the Life. No one comes to the Father but by me”, what are some of the expected responses from the secular world to such a message?
1.       Immediate confrontation – we are soon labelled as ethnocentric and intolerant for claiming that Jesus is the Only Way, The Truth and the Life. For many, this verse is one of the most confrontational verses in the bible.
2.       Not exposed to the views of others. We are accused of absolutizing our own private experience and not ready to compromise with their version of reality.
3.       Dubbed intolerant and arrogant people, who are self-centred. Christians are often portrayed by the secular world as people who are psychologically imbalanced, with a need to control others and impose only their own views. The biggest challenge then is, “How can you say that only Jesus is the Way, the Truth and the Life?” That is a preposterous claim.

Faced with this mountain of unbelief and indifference before us, how does one reconcile truth with day to day reality? Understanding this challenge from scriptures, the Bible tells us that –
1.       We were made in God’s image Gen 1, 2 “making man in the image of God”. God is a personal, loving Creator who made us, and everything that exists
2.       In Gen 3:5  the serpent said,” You will be like God” and both Adam and Eve believed it.From that moment, they could make up their own minds and do what they thought best, without acknowledging their Creator.  In Isa 14 Satan said,” I will make myself as the most high. Run the whole thing myself”. This was the exact same, false promise offered to Adam and Eve that you can be like God! You do not need God because you can be God. In the moral area,” you can be like God, knowing good and evil”. This is one of the most popular worldviews in our world today because it means we are not accountable to our God. Man has become God over good and evil, becoming like God determining good and evil, being sovereign determiners of the very character of good and evil. As a result, man sets himself up as a rival to God. God no longer has any authority over him.
All of us are living under this influence, trying to live without God and becoming autonomous – no one above me, I will set the rules and laws.
The greatest aim of man is to become a cosmic hero- a self-made project, “self-made leader, pastor, worker...” without any dependence on anyone.

Thought: “if there is no God, what is man? Man without God is the highest thing there is- self-determining, self-judging, self-governing”

But there are limitations to this! Humans find themselves trying to make a better world, playing for change. The buzz word in today’s war troubled world is “change, change we need. Get us out this MESS we have created”.  We are all limited by death, disease, pain- the limitations of the world cutting across our intentions and plans. At the end of the day, all of us are exhausted playing God. It just does not work.

This brings us to a logical conclusion that we are humans in the universe, after all. We are not God and He is not man. We are human beings and He is God! In psalm 9: 20 the psalmist says, “let the nations know that they are but men” The world nations do not realise that they are “but men, made by God in His image ,dependent on Him for their very breath and existence”. They think they are gods somehow, trying to decide what is real and saying that they do now want or need God”. Look at what is happening in nations today where other nations drop bombs to maim and kill people and later desperately plead with the world for “ immediate aid to feed the now famine ravished land”. What a mess. This is the reality of our humans in the world.

Some doctors entice patients with false promises,” we will give you a face, a body that God could not give you!” The psalmist in psalm 49:20 says, “Like beasts that perish”. What an insult to man made in the image of God, distinct from the animals. Now he is like the beasts that perish and left to rot. Such is the state of man, says God. What a fall from the grandeur that he had been in.

Could it be that we need to reconsider our ways and seek God again? We humans in the universe need to be reconciled to our Creator.

What is at the core of “modern thought process”?

A huge content of our modern day talking and thinking is in the denial of sin. There is no such thing as sin. It is all a state of mind. When a person does not believe in sin, the whole relevance of the Christian faith falls to the ground. That is because sin is the diagnosis that needs a solution through Christian thought and action to bring back the alienated human mind back to the Bible. Back to the Creator.

Some self-help schemes:
1.       I am getting better every day-fact is, I am stuck and trying to survive and make sense of this mess called life
2.       I am better than that bloke down the street- I am still a mess anyway
3.       It is not my fault that I am not good-I blame events and circumstances that made me this way!
 Stop, look and listen! For God has spoken in the Bible like he did a long time ago.  God shows us His great love through creation itself. He cares deeply about our lives, about our hurts and pains and about our whole life. Psalm 19 tells us, the heavens declare the glory of God.  The whole of creation speaks of God... all heaven declares... the trees, the mountains... all declare the glory of God!
Except for humans in the universe! Romans 1: 18-21 tells us that the revelation of God is clear, His invisible nature, His eternal power and deity have been clearly perceived in the things that are made. But human beings have grasped the truth in unrighteousness. The unregenerate mind has to grasp the truth of God through nature in unrighteousness and twist it to keep from being challenged by it, to keep from having the message of God challenge his or her autonomy.
In Romans 2, God is showing us what we are like. All of us are guilty, not just before God’s standards but our own standards of other people. We set moral standards for others but fall into potholes ourselves! We are all without excuse.
Here is an analogy about the state we are in. A tape recorder is tied around our necks that clicks on when we make moral judgments and record it. God will use that exact same tape recorder, rewind it and play it back to us and say, “Now where do you stand?”
God reveals us to ourselves when we read His word. He shows us our areas of need. We fall short of our own standards, let alone God’s.
When we have that revelation of ourselves to ourselves, we may be confronting a world where the TRUTH has been twisted. Romans 1: 18...not just non-Christians, but believers as well.
Once God speaks to us about our area of need-the truth is so close that we cannot ignore it. It is wiser to listen and grasp His truth and be free.
For instance, Psalm 19 tells us that creation declares the glory of God. We can hold that in unrighteousness by worshipping created things rather than God the Creator Himself. Or we can argue that we should live moral lives, minus God – we do our duties to the world, to society and fulfil some expectations of society. But then we miss the moral compass totally. We have missed the target God set for us. All of us have to come to this realisation that without Him we are helpless and hopeless-like a ship without a sail. Apart from God’s grace and favours, we are nothing.
But the sad reality is that, all said and done, at the end of the day, folks AVOID this ultimate moral challenge from the Bible.
CS Lewis described it as, “man’s sincere search for God, is like the mouse who searched for the cat”. The mouse wants to know exactly where the cat is, to say,” Well away, well out of reach”.

As we see the principle of self-law,or autonomy at work in our own lives and in the world around us, God continues to remind us that He is God the Creator and He is ready to help us know Him so that we can be free and fulfilled humans of His universe.
“ All heavens declare,the glory of the Risen Christ” amen.

Wednesday, November 22, 2017

Some handcrafted aesthetic skincare items at smilemakernyc

Some of my handcrafted, made to order skincare stuff for friends who use our products -enjoy!

colhibin inhibits metalloproteinases which destroy collagen when you are exposed to the sun; it helps protect your skin;use as a day care lotion,once a day

the ultra pigment lite has several pigment lighteners like licorice root extract, kojic acid,fission white arbutin, oils,allantoin,stearic acid, optiphen plus,willow bark extract,fruit extract
Apply on face and neck, morning and evening. Ensures healthy and clear skin over a few months use.

a limited edition face and hand scrub with aluminium oxide microcrystals, and pigment lighteners kojic,arbutin,licorice,willow bark,optiphen plus,allantoin, honey soap base. Great for your skin. Makes it soft and smooth.  Scrub face and hands for 3-4 minutes and wash off,leaving your skin smooth and clear.

Aloe gel with allantoin,extracts,glycerine,oils - good moisturizer for dry skin conditions,prevents TEWL and keeps skin well hydrated

Pre shampoo for dry hair and dandruff with oils, allantoin, fruit extract;i use a bit of ketaconazole for treating dandruff . Good for healthy hair growth. Suggested for dandruff and dry scalp.

The very gentle 3 minute peel with kojic acid lightener,lactic and salicylic acid,optiphen,fruit extract. Good for antiageing,acne comedones ,pigment and superficial scar reduction

Handcrafted kojic acid soaps for pigment lite

Ramblings of a global surgery outreach enthusiast :tips in thyroid surgery for large goitre

Large multinodular euthyroid goitres are still seen in some developing regions .

Today's OR demo was on hemithyroidectomy for a right sided euthyroid colloid goitre.
Use a sandbag between the scapula and a neck roll to extend the neck and a ring for the head support

Some tips:
1. My incision is a bit higher than usual because of the large size.I find this helps in surgery
2. Finger dissection is also a good idea in
avascular planes
3. Helps to divide strap muscles at least on the affected side: makes your work easier
4. Once you control the superior and inferior pedicles, the rest is straightforward
5. In very large multinodular goitres, the superior pole is shifted more towards the midline, so be aware of this
6. After dividing the middle thyroid vein, the inferior thyroid artery is ligated away from the gland in order to prevent injury to the recurrent laryngeal nerve. For the superior pole, ligated close to the gland to avoid the superior laryngeal nerve
7.  In a very large goitre I sometimes enucleate the gland; this ensures minimal chances of injury to the nerve and parathyroids
8. We always use a closed suction drain for 24-48 hours and close the platysma followed by cosmetic closure of the skin
Make sure you use a very light gauze dressing. Large padded dressings are contraindicated and can easily cause respiratory obstruction if a hematoma is missed.

Hope this is helpful for those in med mission outreach

Tuesday, November 14, 2017

Global surgery outreach missions : abdominal hysterectomy tips

In many mission hospitals, the surgeon is often requested by gynecologist friends to help with abdominal hysterectomy.
The patient in this case was a middle aged multi, with chronic DUB and a posterior adnexal fibroid close to the cervix.

I share some useful tips during mission hospital demo sessions:

1. In this case the preferred incision was vertical
2. I always like to mobilise the uterus by dividing and ligating  the round ligaments first
3. The ureters are identified in the medial leaves of the broad ligaments and displaced laterally with wet gauze
4. The uterus is devascularized from the broad ligaments to isthmus
5. Uterine vessels are divided by using a Heany clamp at right angles to the longitudinal axis of the uterine body; stay close to the uterus.the ureters are behind the vessels at about a cm distance - they are displaced laterally by a wet gauze.
6. Divide and suture the cardinal ligaments,with clamps almost parallel to the body of uterus ,after dividing the uterine arteries
7. The bladder is always dissected away from the uterus in the initial steps.
8. To prevent vault prolapse, the cardinal ligaments are fixed to utero sacral ligaments
9. Hemostatic transfixion sutures like the heany stitch or tailor stitch are reliable and prevent blood loss.

Following these tips make your procedure relatively easier and blood loss will also be negligible.

For our friends and well wishers @ smilemakernyc

Thanks to all our friends and well wishers who use our products.  Here is some good news for you all.
There will be an introductory offer  for the products in north east India, Nagaland by December 2017.

Saturday, November 11, 2017

This seasons aesthetic handcrafted skincare @

This season, we will be launching some new handcrafted aesthetics for our aesthetic collection.

Using a perfect blend of hi end ingredients from FDA lab suppliers in the USA with

exotic organic ingredients from India, we hope our clients will enjoy the great experience.

For the present, the items will be mostly available in  Nagaland, India  for all our friends and well wishers.

This limited edition aesthetic range is for pigment correction, healthy hair growth and  organic facial scrub.

Saturday, November 4, 2017

Medical Missions Revisited: safety issues and checklists

Surgical safety checklists are absolutely necessary in all medical mission endeavours. The risks are greatly minimized by following a few simple rules and doing regular checklists on every procedure.

What you require in a recovery room/ ICU:  Checklist

A. First Line Drugs in a medicine tray -these are what you call the essential and life saving drugs in any emergency
1. Adrenaline ampoules
2. Atropine
3. Lidocaine
4.dexamethasone vials
5.hydrocortisone vials
6.dopamine ampoules
7.Deriphylline ampoules
8.Aminophylline ampoules
9.50 % dextrose vials
10. IV fluids. Dextrose saline, 5 % dextrose, Ringer Lactate
11.sodium bicarbonate vials
12. Calcium gluconate/chloride vials
13. Lasix ampoules
14. Morphine vial
15.Manintol bottle
16.Diazepam ampoules
17 Phenobarbital ampoules

18. Metroprolol injection(2 ampoules)

B.  An Electrocardiogram machine and a defibrillator; multiparameter monitor, a finger pulse Oximeters for the nurse on duty in the room

C. A ventilator, suction unit and at least 2-3 oxygen cylinders with all connector masks, an IV fluid warmer, warm blankets for children,

D. An Ambu bag resuscitation kit for adults and child/ keep a bed pan and also some plastic bins in case patient vomits

E. Plastic disposable airways , laryngeal masks, suction catheters different sizes, Foleys catheters child and adult with urine bags, disposable gowns,masks,and caps, disposable syringes 3cc, 5cc and 10cc,naso gastric tubes different sizes

F. Headlights for emergency (LED - 800-1000 YR only)/ one portable light source

G. Nursing station with table, chair and records for ready reference

H. Laryngoscopes adult and child, Maegel forceps, dressing trays, sterile gauze in a drum, plaster, cutting scissors, rubbish bins 2
This would be enough for a very good recovery and ICU room

Keep one duty nurse there at all times.. Different shifts

In Yemen Arabia our mission team always kept a booklet of safety measures for every surgery to make sure there were no problems during procedures. It worked well , and we were happy that we had a checklist to follow at all times.

Cleft Craft / Basic music theory n guitar as a hobby

Digital downloads are now here on for
1. cleft craft techniques
2. basic guitar techniques,order:ascending,stats:true

Basic theory and method for beginners in guitar
A good way of relaxing in between busy work schedules­čśŐ