Merry Christmas from the Aetas

I was stuck in Avenida traffic when suddenly this pretty Aeta girl popped in front of my car's side window, singing an out-of-tune Christmas Carol. I searched for some coins in my pocket but found none. She waited patiently, hoping that I can give her some money. I found a 50 bill, but I told her that she should give me a smile and pose in front of my camera in exchange for my money. She agreed to the business deal and gave me the most charming smile which made my day. I took my shot and she took my money. A great deal that made us both happy! She walked away happily, proudly telling her fellow Aetas that she got 50.

Then suddenly her fellow Aetas were rushing towards me, also hoping to be given some money. One father and child made it first base, and I gave them another 50.

The other Aetas were also coming forward (I'm not sure if after the photo or the money ;), but alas, the traffic had moved on, and I had to drive my car immediately, as the driver behind me was already honking his horn mad. The Aetas immediately retreated lest the rushing vehicles hit them. I promised to myself, though that I will come back to them on Christmas to distribute foods and some of my unused clothings.

During Christmas season, Aetas come down from the mountains of Zambales, literally walking hundreds of miles all the way to Manila. They rely on donations of food and clothings from people on various towns they are passing by. Once in Manila, they usually camp under bridges or side streets. They wait for their benefactors to give them gifts of food and clothings. While waiting, they ask for some donations from pedestrians and car owners.

The good thing about these Aetas is that they are a solid group, and all the donations are divided equally among the tribe members. They usually walk back to the Zambales mountains after the first week of January.

Christmas in the Philippines:Misa de Gallo

Minor Basilica of the Black Nazarene, known simply as
Quiapo Church (Manila, Philippines)

Misa de Gallo is a Spanish phrase that literally means “Mass of the Rooster”. The first crow of the rooster during the early morning of December 16 marks the beginning of the yearly observance of the Misa de Gallo, popularly known to Filipinos as the Simbang Gabi. These masses are the most important of all Filipino Christmas traditions because they signify the coming birth of the Messiah. It is a fusion of Filipino folk rites and indigenous customs with religious devotion deeply embedded by Spanish colonizers.

These nine dawn Masses, usually starting at four o'clock in the morning, are considered a novena by the Catholic and Aglipayan faithfuls. Going to mass this early for nine consecutive days is meant to show the churchgoer's devotion to his faith and to heighten anticipation for the Nativity of the Lord. A traditional Filipino belief, however, is that those who complete the novena will have a special wish or favor granted by God.

After the mass, it is traditional for Filipinos to have a breakfast of bibingka (rice cakes), puto bumbong(purple sticky rice sprinkled with grated coconut) suman (sticky rice steamed in coconut leaves), and hot chocolate, coffee, or salabat (ginger tea). All of these delicacies can be found at makeshift kiosks found near the church.

(All pictures and images in my blog are copyrighted. Please ask permission first before reproducing in other websites or publications)

Our Lady of Perpetual Help


Depicting Jesus Christ's Crucifixion


The Senyor Nazareno




The burning of candles for special wishes or prayers


Bibingka

Retinal hemorrhage in non accident trauma

Findings

Figure 1: T2*GRE axial image through the globe demonstrates nodular low signal in both retinas representing bloom artifacts from blood products suggesting retinal hemorrhage.
Figure 2: T2*GRE axial image shows low signal in the posterior parietal subdural space suggesting subdural hemorrhage.
Figure 3: Axial T1 image shows left frontal subdural fluid collection similar to CSF signal suggesting subdural hygroma.


Diagnosis: Retinal hemorrhage in non accident trauma


Child physical abuse is an unfortunately common occurrence that may manifest as any pattern of injury. Some patterns of injury (metaphyseal fractures, posterior rib fractures, subdural hemorrhages, retinal hemorrhages) are more suggestive and specific than others. Child abuse is often misdiagnosed and under-recognized by physicians and caregivers.

Non-accidental head injury (NAHI) or shaken baby syndrome (SBS), (some authors prefer the term shaken-impact syndrome), occurs in 12% of the physically abused children and is a major cause of neurological disability and death during infancy. Radiological imaging plays a crucial role in evaluating cranial injury, both for guiding medical management and the forensic aspects of abusive trauma. The neurologic injuries are more devastating than other injuries. NAHI is the leading cause of morbidity and mortality in abused children. MRI is the test of choice over CT for detecting different ages of intracranial hemorrhages, shearing injuries, and retinal hemorrhages.

Subdural hemorrhage is the most common intracranial lesion in shaken baby syndrome. Other findings are cerebral edema, subarachnoid hemorrhage, intraparenchymal hemorrhage, intraventricular hemorrhage, diffuse axonal injury, shearing injury, ischemia and brain herniation. Retinal hemorrhages may be found in 50%-100% of shaken infants, the prevalence of retinal hemorrhages in victims who die approaches 100%. Retinal hemorrhage is a characteristic and diagnostic feature of SBS. The severity of retinal hemorrhage is strongly correlated with intracranial injury in SBS. It is therefore very important to recognize retinal hemorrhage on neuroimaging.

Scenes from the Fire: Aftermath

It's hard not to feel saddened by the loss of so many homes during the fire, especially now that Christmas is only a few days away. No doubt, many of the affected families will spend Christmas and New year on makeshift shelters, with no proper beddings and toilets. Many of these families now rely on the helping hands of other people for donations of clothings and food. It's so sad even to just imagine a Christmas without a home, what more if it's already a reality.

A man looks resignedly at his destroyed house








Charred bananas--what was left of a Sari-sari store


Taking the opportunity to bath in the open fire hydrant


Saving the precious electric wires

They are homeless now


Firemen successfully controlled and snuffed out the blaze

Multiple Arachnoid Cysts-CT

Arachnoid cysts are CSF-filled intraarachnoidal collections. They are most commonly located in the middle cranial fossa followed by suprasellar and quadrigeminal cisterns, posterior fossa, cerebral convexities, and interhemispheric fissure. This is an exceptional case with the coexistence of multiple arachnoid cysts in three different locations.

Primary Choledocholithiasis-MRCP

"Up to 85% of CBD stones are secondary from GB. Primary CBD stones are caused by conditions leading to bile stasis and chronic bactibilia. Up to 90% of patients with brown pigment CBD stones have bile culture results positive for bacteria. Primary duct stones are usually brown pigment stones. Brown stones differ from black pigment stones by having a higher content of cholesterol . In Western population Biliary stasis is secondary to factors such as sphincter of Oddi dysfunction, benign biliary strictures, sclerosing cholangitis, and cystic dilatation of the bile ducts. Bile stasis promotes growth of bacteria, which produce phospholipase A1, thus releasing fatty acids from biliary phospholipids. The duct epithelium and/or bacteria (eg, Escherichia coli) produce beta-glucuronidase in amounts sufficient to deconjugate bilirubin diglucuronide. The presence of free fatty acids, deconjugated bilirubin, and bile acids leads to the formation of insoluble calcium bilirubinate particles. With the loss of bile acids, cholesterol becomes insoluble, resulting in the formation of biliary sludge. The sludge also contains mucin and bacterial cytoskeletons, which further aid in stone formation. In Asian populations, infestation with A lumbricoides and C sinensis may promote stasis by either blocking the biliary ducts or by damaging the duct walls, resulting in stricture formation. Bactibilia is also common in these instances, probably secondary to episodic portal bacteremia. Some authors have suggested that the stones are formed because of the bactibilia alone and that the parasites' presence is just a coincidence. "

Case By Dr MGK Murthy, Sr Consultant Radiologist

Bunky

(March 16, 1922 - November 22, 2008)

Today we laid to rest a man who was a vital part of my life. John William "Bunky" Connolly was a man whose love for his country was only surpassed by the love for his family. With a smile that could brighten a room, Bunky was a warm spirit that was able to strike up a conversation with anyone, whether you were someone who had known him his entire life or the new cashier at Costco selling him a bunch of bananas (did you know that the savings on bananas alone will more than make up for the cost of the membership?).

Bunky lived a life of service to the United States of America, including time as a federal fire chief in Spain to time as a decorated United States Marine, earning two Purple Hearts during World War II after being shot twice.

There was no mistaking when Bunky entered a room. He would make everyone smile with his rhymes and jokes. And whether he knew you or not, the instant he met you, you felt like part of his family.

The ceremony was beautiful and full of tears. After tearful remembrance speeches from his children, we left to the cemetery to bury his ashes. After a solemn version of "Taps", there was an emotional delivery of the flag to Bertha by the United States Marines.

Even though these unfortunate circumstances brought the family together, many of us were there, and that's what Bunky loved most, our family spending time together.

To a fantastic father, grandfather and friend, we will miss you very much Bunky. I love you.