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June 29, 2009

Errors, terrors, statistics and a confession

Past three months have been a bit too hectic for me. I had to finish the whole 3-year-course of physiology during that period, since by nature, I am a late starter. Now that the results are out and I passed my MD, I can breathe more freely.

During those periods of forced 'bibliomania', I did not write any article for my blog, though I checked mails and sometimes I checked Sitemeter stats for my blog. I do this sometimes to see where my visitors were coming from, what they look for and for how long and so on. Almost everyone does it. It gives me pleasure when I see people from many different countries and educational institutions visit my blog. I noticed how the visits per day dropped from about 70 to below 35 during the period. I also noticed some errors in some of my pages, I'll rectify them as early as possible. Meanwhile, please point out errors so that I may correct them.

I was in for surprise when I found a US military site (.mil domain) as one of my hallowed visitors. What on earth have I done? I clicked on the landing page; it was "Show me the enemy and I'll take action". The reason was now obvious, it was just some kind of 'code sequence identification algorithm' (pattern recognition) giving a 'false positive'. One puzzle I am yet to crack is what my friend from Ljubljana, Slovenia find so interesting in "cerebellum, electronically speaking". He (she?) visits my site at least 3-4 times per day. I guess, he has configured his browser this way so that this was the opening page each time he started the browser. Anyway amigos, have a good day and do visit.

While I did commit some inadvertent errors in some of my pages (of my blog); the mistake I committed on the examination (viva part) eve was unpardonable and was least expected of a medical person, to be very honest. After finishing a summary of my thesis work, I sat down to prepare a powerpoint presentation on "water reabsorption in the kidneys". After finishing the two, the clock ticked 4 AM. I took 5 mg of Valium (diazepam) orally. (Diazepam, a member of benzodiazepines family interacts with the GABAa receptor-chloride channel macromolecular ionophore complex and help us to get sleep.) Then I went on to burn them onto a CD. But sleep wasn't really coming. I took another 5mg of valium, this time chewing the bitter drug and keeping it inside my oral cavity (this route would bypass the portal circulation) for about 5 minutes [THIS ROUTE FOR DIAZEPAM IS NOT RECOMMENDED IN ANY TEXTBOOK I KNOW]. I increased the buccal pressure (for better absorption) by blowing my mouth, while keeping my mouth shut (resembles Valsalva maneuver) during this time. Then I took a cup of hot tea to facilitate its entry across the mucosa (also hoping it would induce diuresis so that I would have less amount of of the drug next time I voided urine). It was 5:30 AM when I finally went to sleep, and I were to wake up at 7:00 AM!

Thus you see how many mistakes I committed at one go: sleep deprivation, intake of a drug for sleep that causes psychomotor slowing and impaired cognitive performance, being fully oblivious of its half-life of 20-80 hours! It takes 4-5 half-lives for a drug to be 'considered' eliminated from the body. Next, if a person was aroused from REM sleep while on diazepam, he could become irritable and anxious. Moreover, there is the specter of anterograde amnesia (inability to remember lessons learnt during the drugs' duration of action). (I should have taken Alprazolam/xanax or Zolpidem instead, for they have less half life and are quicker acting. Even better would be to take nothing at all, sleep or no sleep!)

Given those, you can well imagine the difficulty I had when I faced the examiners. Thought processing, information retrieval and even articulation was not at their peaks. Despite all odds, things luckily went well, as I was able to answer some key questions well and I got through. One should take lessons from it: have adequate sleep and completely abstain from benzos the night before their exams. Hope you learn from my mistakes.

1 comment:

Pranab Chatterjee said...

Congratulations on having done it!!!!