EDITORIAL

Learn from us

The knowledge that Pakistan is eventually wary of glorification of terrorists as heroes will give many of us a sort of vicarious pleasure. It proves that the wearer alone knows where the shoe pinches. One may find easy to ride the tiger of the terror and spread mayhem but one can’t but become aware of one’s own vulnerability while trying to get off it. Nevertheless, the remedy proposed by Pakistan Information Minister Sheikh Rashid to stop the veneration of the killers is worse than the disease. According to a newspaper report, he has held out a warning to his country’s print and electronic media against perpetuating the cult of the worship of the terrorists and threatened to take ...........more

Jammu Press Club

The Jammu Press Club has added a feather in its cap by organising an extremely warm and highly successful reception during the recent visit of the Pakistan journalists. It has splendidly risen to the big occasion. As the only elected body of media persons from all regions of the State, the Club no doubt holds a unique position, which nobody can and should ignore. Its location on the bank of the Tawi also gives it a distinctive look. At a time when such institutions are unfortunately threatening to become merely waterholes in at least some places in the country it is a matter of immense satisfaction that our Press Club has shown the capability to be outstandingly different. It should keep up its good work by actively involving its members......more

SAFMA's face to face with realisation
Men, Matters & Memories

By M L Kotru

Interesting indeed it was for me to be able to attend some of the sessions of the South Asian Free Media Association (SAFMA) over the week-end. The three-day session spilled over to Monday. The most remarkable thing was to see journalists from India, Pakistan, Bangladesh, Nepal and Sri Lanka, each in .......more

Odd solution and evened men! ……
Yours Randomly,

By Dr. R. L. Bhat

A tale is told of a blind man walking of a dark night, with a lighted lamp in hand. A ‘wise’ one laughed at his folly and asked, "Night and day are all the same to you. What do you need this lamp for?" The blind man replied earnestly, "It is not for me; it is for thee lest you stumble against me". It is instructive to remember this tale when talking of the visit of Pak journos and its after math. It may be that the visiting .......more

Resuscitation of trauma

Brig. (Dr.) Yudhvir Suri, VSM

Trauma is considered the disease of the 21st century with revolutionary industrialization and time save high speed transport system. It is the leading cause of morbidity and mortality in India today, more so, in the younger population, leaving many families financially ....more

EDITORIAL

Learn from us

The knowledge that Pakistan is eventually wary of glorification of terrorists as heroes will give many of us a sort of vicarious pleasure. It proves that the wearer alone knows where the shoe pinches. One may find easy to ride the tiger of the terror and spread mayhem but one can’t but become aware of one’s own vulnerability while trying to get off it. Nevertheless, the remedy proposed by Pakistan Information Minister Sheikh Rashid to stop the veneration of the killers is worse than the disease. According to a newspaper report, he has held out a warning to his country’s print and electronic media against perpetuating the cult of the worship of the terrorists and threatened to take action against them if they failed to fall in line. To quote his exact advice to the media: ‘Don’t present terrorists as heroes, we warn you. Terrorists want to live by the media. Don’t play into their hands’. He has left no doubt that if his plea is not heeded ‘then we’ll see what we can do’. In tune with this thinking, the Pakistan Government has reiterated in a statement that it would not be averse to using the Anti-terrorism Amendment ordinance of 2001against those not following its suggestion. What appear to have offended the official machinery in the neighbouring country are the interviews of al-Qaeda sympathisers carried out by certain private television channels. In the government parlance it obviously means an attempt to ‘praise the terrorists and criminals’. As is the case with the governments in these instances, one in Pakistan also wants the help of the media in exorcising the land of the evil. It is presently in the thick of a battle against the militancy and, therefore, is confronted with a situation in which it regards a spokesman of the terrorists groups as also a terrorist and any publicity of their activities as anti-national. It is not surprising that the Pakistan Government regrets having ‘garlanded’ the terrorists in the past which as Mr Rashid has stated now ‘was a wrong decision’.

If Mr Rashid’s words have a familiar ring it is because we in this country have gone through the worst form of the terrorism sponsored and patronised, ironically, by Pakistan first in Punjab and then in our State. The people in the authority would time and again advise us not to eulogise the destroyers of peace. At times they would go to the extent of verbally telling us to completely shut all information about the militant outfits. An interview with one militant leader or the other would cause them sleepless nights. However, they were by and large helpless in dictating their terms to the media because of the enormous freedom we enjoy under our Constitution. How can the newspapers or television channels ignore one section of players in the field when there are only two of them at a given point of time? Of course, responsible media persons would never laud or publicise the acts of violence. To the contrary they would condemn them straightway as many have done it in this country boldly and bravely making a supreme sacrifice in the process. Applying the same logic as in the case of the terrorists quite a few newspaper commentators have expressed their strong disapproval of the Kuka Parray cult encouraged at one time by the official machinery in the Valley in particular. On several occasions, the terror at its peak had virtually gagged many newspapers and their editors and publishers. One has seen this dastardly occurrence both in Punjab and on the home turf. Its practitioners would dictate what is fit to print even though it may have been totally untrue and unpalatable to reason. There are examples of the editors sitting at home and their newspapers being printed in their absence carrying the information that they would have normally spiked. They have suffered the pain and anguish of their names in print lines being disgustingly misused and at the same time not being allowed to close their shop.

This is not to say that there were no newspapers simply cheering the militants all the way. Indeed, some of them had been helpful in building the larger-than-life images of those holding guns in their hands. What has been their fate? If one were spared the trauma of naming them, one would find that they are eating their words. They are not able to retain the circulation they had built in the immediate aftermath of the eruption of the terrorism. Their heroes, if they have survived, have themselves fallen by the wayside. These newspapers have also immensely lost their credibility. All this happens in an open society because the ordinary citizens who are the arbiters in such situations can always distinguish the right from the wrong even though they are too helpless to speak in the face of a vicious tussle of the gun. People understand everything. The experience in our State as well as Punjab has shown that they react silently withdrawing their patronage to newspapers and television channels they are convinced are out of touch with reality. Therefore, the Pakistan Government will do well to learn from what has happened in this country. Ban on newspapers or the imposition of restrictions does not help. In real life it has the tendency to boomerang on the administrative system itself. For the Pakistan Government the best choice will be to ensure that there is no let-up in its well-intended and overdue fight against the terrorism. It must go ahead with its spirited battle to restore sanity and order. Its key functionaries should not waste their time and energy by picking up frivolous controversies. They can rest assured that the demons don’t become gods just because their pictures are published or televised too often. If they pursue their mission with single-mindedness they will find that they are the deserving recipients of the applause of one and all in the end.

Jammu Press Club

The Jammu Press Club has added a feather in its cap by organising an extremely warm and highly successful reception during the recent visit of the Pakistan journalists. It has splendidly risen to the big occasion. As the only elected body of media persons from all regions of the State, the Club no doubt holds a unique position, which nobody can and should ignore. Its location on the bank of the Tawi also gives it a distinctive look. At a time when such institutions are unfortunately threatening to become merely waterholes in at least some places in the country it is a matter of immense satisfaction that our Press Club has shown the capability to be outstandingly different. It should keep up its good work by actively involving its members from the Kashmir region. Of course, the Club’s young leaders and members are well aware of their responsibilities. They have proved beyond any shadow of doubt that they can live up to the toughest of challenges and can carry out their job efficiently and effectively. This augurs well for journalism in this city in particular and the State as a whole. There can hardly be any doubt about this.

SAFMA's face to face with realisation
Men, Matters & Memories

By M L Kotru

Interesting indeed it was for me to be able to attend some of the sessions of the South Asian Free Media Association (SAFMA) over the week-end. The three-day session spilled over to Monday. The most remarkable thing was to see journalists from India, Pakistan, Bangladesh, Nepal and Sri Lanka, each in his own way, trying to act as a bridge builder in an area riven by disputes.

SAFMA by itself is an innovative phenomenon which provides a platform for journalists from the region to discuss issues face to face. It is obvious the success or failure of the nascent institution will depend on how straight and honest the participants are in stating their positions and also on how strong is their commitment to the cause of building permanent bridges.

During the discussions in New Delhi one was glad to notice the seriousness which a majority of participants tried to bring to their discussions. It is a pity though that the discussions for the most part remained unreported by the capitals's media, bar one or two exceptions and with at least one paper deciding to yield a few inches of space to the deliberations for two days. A reflection perhaps of the fact, as stated at one of the sessions by Arun Shourie, that Indian papers, unlike in the past, are now known by the name of their owners and not, as in the past, by the names of their Editors. If this be the case in India, it should not be difficult to imagine the media scene in the neighbourhood. Yet, one does not have to go whole hog with Shourie. The journalist community can still influence decision-making in a manner that no prorietor or proprietor's body can.

Polemcis aside, the most interesting aspect of the SAFMA regional conference was that it enabled the large Pakistani contingent to score a first as it were after 1947. It made them the first Pak journalists to visit Jammu and Kashmir after the partition. This by itself was a significant achievement, one that needs to be persisted with on both sides of the border. The Pakistani scribes returned to Delhi a happier and somewhat sober lot, to end their visit with three days of speechifying at New Delhi's Ashoka Hotel.

For one thing, they were face to face with the realization that most Kashmiri Muslims they interacted with were not particularly in favour of acceding to Pakistan. Almost everyone, except hardened separatists like Syed Ali Shah Geelani and his ilk, wanted to join Pakistan. There were some tough encounters as well, one at least that witnessed a bizarre display of bad manners by the host at their meeting with the irascible JKLF leader, Yaseen Malik in Srinagar. This man has over the years come to think of himself as the ultimate martyr to the cause of Kashmiri Muslims' emancipation. Characteristically he chose to question the Pakistani's integrity ''and their indifference to the sufferings of Kashmiri Muslims''. A woman member of the Pak delegation ticked him off for his insolence and the JKLF leader was also reminded of the opulence he was surrounded by.

Bar this incident and another on their visit to the Kashmir University, the visiting journalists obviously had a professionally rewarding experience. Apart from the overwhelming support for 'Azadi' which the visitors ''discovered'', the only major pro-India presentation was the one made by the National Conference and, of course, by the Congress Party.

An ''eye-opener'', one which obviously did not open all Pakistani eyes, was the presentation made on behalf of the Kashmiri Pandit migrants in Jammu. A senior Pakistani journalist told me later that he was totally unaware of this aspect of the problem. The very articulate and persistent Dr Ajay Chrangoo of Panun Kashmir, insisted on the visitors having a session with migrants; he later joined the journalists in New Delhi where he once again took up the cudgles on behalf of the displaced Pandits. Not that there were many takers for his views among the Pakistanis but that never deterred him.

Talking to another Pak journalist on the last day of the conference I was astonished when he told me that Kashmir was essentially a Muslim problem. Pakistan was not concerned about demographics it just wanted that all Muslim majority areas come to it. Which brings one to the point raised in another conversation on the sidelines. Why wasn't Pakistan addressing the problem of cross-border terrorism? Why did it allow training camps, run by seemingly banned fundamentalist outfits, to operate in areas under its control ? Wouldn't CBMs, like the proposed opening of the Srinagar-Muzaffarabad or Jammu-Sialkot roads, be rendered pointless in a situation wherein Pakistan is unwilling to call the militants to order ?

The most ''positive'' response one heard was that ''having seen with my eyes, and having heard with my own ears, Pakistani intervention in an 'Azad' Valley may not at all be necessary; an 'azad' valley will work out its own future.'' Which in other words represents the view endorsed by some track-twoers that the solution lies in Pakistan keeping what it has, India retaining Jammu and Ladakh and the valley getting independence. Another Pak visitor whispered 'azadi' is what all Muslims leaders seemed to want. ''You know'', he confideds, ''even the odd leader from the National Conference and the PDP, whom we met, favoured independence.. but that was said strictly on a 'between - you- and me' basis''.

This longing for freedom from both India and Pakistan, he admitted, was a revelation. It changes the whole perspective and the people of Pakistan must be informed of it, he said. If only for the sake of this part of the revelation having got across, the Pak journalists' visit to Kashmir may have been worth their while.

There was no point in expecting them to seriously consider the possible consequences of a ''Muslim Kashmir'' seceding from the Indian Union for the future of the world's second largest Muslim population living in India. Salman Khurshid, the Congress leader, raised the question in the open session of the conference. It went unanswered except for some protests by a few Pakistanis. Which reminds me of the answer provided to the same question many years ago by Gen Ziaul Haq's Foreign Minister, Gen. Yaqub Ali Khan at a background briefing at the Pakistan High Commissioner's house in New Delhi. Said he : ''I have great confidence in the magnanimity of the great Indian people. They surely won't dump the Muslim population into the Arabian Sea''. Have the cake, will eat it too.

Odd solution and evened men! ……
Yours Randomly,

By Dr. R. L. Bhat

A tale is told of a blind man walking of a dark night, with a lighted lamp in hand. A ‘wise’ one laughed at his folly and asked, "Night and day are all the same to you. What do you need this lamp for?" The blind man replied earnestly, "It is not for me; it is for thee lest you stumble against me". It is instructive to remember this tale when talking of the visit of Pak journos and its after math. It may be that the visiting team did take back some impressions. They may even have chanced upon an eye-opener or two. But the great question is whether the ‘wise-ones’ on this side have seen some light from the lamps that shone all along. Many people have asked how many of our journalists would have the gumption to tell to the face of the ‘elected’ government installed in PoK that it was an illegal entity, that they did not recognize as the leader of the visiting delegation told the deputy chief minister after he had gone to great lengths welcoming them and swearing peace and amity.

Nor did the people attending the ‘welcomes’ miss the tell-tale docility of the many ‘fire-brand’ ideologues who quietly chanted the bhai-bhai mantra when in the ‘august presence’ of the Pak journos. To say that they were looking for visas, visits and invites is to stoop to petty levels. They as well as others know that the visas and visits are arranged not gotten; they also know which wires to pull for that purpose. For, they are doing it all the time! So why do the firebrands go mum when necessary corrections are to be put in place? That is one odd question that would never be answered straight away. The other question could well be what Geelani meant by calling his ‘only’ solution ‘one odd’ solution. Did he realize that his Pak-solution evoked odd looks in the Pak establishment, or that he was the odd man in the jungle of Kashmir politics where all opinions flourished evenly? There Omar paid put to all points of fundamentalist Geelani saying that they promoted only his own cause. But that does not tell what ‘all Kashmiris’ supported in 1990-94 when Kashmir had been flooded with terrorists of all hues. It was not the third option, the second but the first thing that Geelani has been saying all these years.

Probably, it is not what impression the Pak journos took back with them but what lessons the Indian journos have learnt from it all. Onkar Singh of the Kashmir Bar may be an odd man, yet it would be important to reckon how many odd men and women around keep prattling principles and theories that have nothing to do with realities of the case or solving the problem or anything. They are pushing forth personal cause, promoting private interests and making useful noises all around. Sometimes they support the good sense; at other times they make the strategic points to make a more effective pitch. All these are at variance with what is mouthed privately in the security of bars and chambers. Rarely are the public posture and the private position reconciled. Often they are not even asked to be reconciled. The powers and promoters are content to project lines suited to the occasion without caring what that ultimately means in the long term. In the long term, as Keynes said in an economic context, all are dead. But nations live and are condemned to carry the burden of these indiscretions. Centuries are punished for the wrongs of moments in consequences and corollaries. Indeterminate masses pay for the definite gains of individuals and persons. And, often go unredeemed.

It was left to the displaced of Kashmir living in the camps around Jammu to connect the salient support and approval of the Pak media men to the turmoil and turbulence in the valley and the state. It was the representative of the Pak refugees to reiterate that the Pak occupation of parts of the state since independence is what the dispute in Kashmir is all about. Neither the rebuffed deputy chief minister nor the committed ideologues raised one voice that would have irked the smooth conduct of the ‘tour’. The Indian point, the Indian case was conspicuously given the slip by the people who represented this nation and people. It is would not be amiss to recall that historic hand-shake between Rajiv and Farooq in the city Parade Ground in the winter of 1987. Farooq took Rajiv’s hand and announced that he the Muslaman of Kashmir joined hands with the Hindu of India to seal a solution of Kashmir. Rajiv gave him his reluctant hand but muttered that he was not a Hindu of India. Few Indians are ready to acknowledge in exchanges of this sort that they are Indians or that they stand for Indian case and cause.

Politicos fight shy of saying that they support the stand of their nation; editors get visibly irritated at the mention of Indian case and analysts are at pains to show that they are more concerned with understanding the other side than putting forth their position. A Laloo posits Jinnah as an icon of Indian nation and compares the Bombay blast criminals with the accused of the ephemeral Jinnah murder case. Of course, others have been doing it for more viciously. Indian establishment has un-written Iqbal’s address to Allahabad session of Muslim League, where he had demanded a separate Muslim nation for the first time, out of the history books and public memory. Had Pakistan done so, it would have been understandable. No nation wants to carry such a crass blemish. Yet she is at pains to emphasize it while Indians want, not to forget it but, to un-write it, denying that it ever happened. Indians also want to un-write Pak aggression, Pak occupation, Pak position and posturing. It is left to the people who have suffered pointed wrongs - like Pandits exiled from Kashmir, like Refugees ousted from the PoK - to reiterate these positions and raise the prickly points. Often, they go unheard as the all-seeing, all-wise keep stumbling against the blind post. Knowingly. Willingly. Pray, why?

Resuscitation of trauma

Brig. (Dr.) Yudhvir Suri, VSM

Trauma is considered the disease of the 21st century with revolutionary industrialization and time save high speed transport system. It is the leading cause of morbidity and mortality in India today, more so, in the younger population, leaving many families financially and emotionally crippled. In Jammu and Kashmir State, besides increased motor vehicle accidents, civil society is badly affected with social criminal violence and militancy of low intensity war from across the border.

In India, pre-hospital medical care is almost non-existent, even, Armed Forces failed to provide basic life support resuscitation at the site of militant attacks and evolved the concept of "Scoop and Run" to the nearest hospital. It is suggested pre-hospital medical care to trauma victims, particularly in the rural areas, can be provided by the medical manpower and volunteers of the primary health care system with the availability of ambulance and network system. It should be attached with large Government hospitals for administrative and financial support linked with other services such as police and fire departments. Highway road system should have integrated trauma hospitals to provide life saving resuscitation at the shortest possible time based on "Golden Hour" concept of trauma resuscitation management.

Trauma victims suffer from shock due to variable degree of blood loss. This causes insufficient oxygen delivery to sustain the energy metabolism in vital cells of essential organs of the body. Blood supply in the tissues decreases to produce tissue hypoxia. Heart may be depressed as indicated by decrease in blood pressure, rapid low volume pulse and oxygen saturation of the blood, lungs fails to supply sufficient oxygen to the blood because blood circulation to the lungs decreases to come in contact with the air in the alveoli, so called, mismatch of ventilation - perfusion in the lungs. Kidneys produce less urine because of decrease of blood supply to the kidneys. Brain hypoxia causes altered sensorium or loss of consciousness. Body metabolism is affected by lack of oxygen to accumulate acids in the blood. The survival of the patient depends on the degree of blood loss, haemorrhagic shock, and its secondary effects on the various body systems.

The most common situation is usually seen at the Accident Emergency Department of the Hospital, that a trauma victim may be conscious, spontaneously breathing with intact airway reflexes, but showing restlessness, agitation and low oxygen saturation in the blood (SPO2<90%). Head and chest injury is ruled out patient will improve with reassurance, oxygenation with face mask, conscious sedation, analgesic and intravenous fluids. In average normal adult 3.0 - 5.0 lit.O2/min. will provide 30-40 percent and 6.0 - 8.0 lit. O2/min. 45-60 percent O2 with air. Sedation analgesic needs to be tailored to individualized patient without compromising consciousness, respiration, haemodynaemics (cardiac function and circulation) and protective reflexes.

First priority in trauma resuscitation management is oxygenation in spontaneously breathing patients with intact airway otherwise airway management with compromised airway and oxygenation takes over the priority. There is need to balance the increased oxygen demands of the body, so called shock induced oxygen debt, with the oxygen supply and delivery to the cells of the vital organs of the body. If this balance is not maintained during the sublethal reversible phase of injury, hypoxia and ischaemia will produce irreversible necrotic phase of anoxic injury with mortality. Oxygen can be administered by face mask connected with the oxygen cylinder, delivered directly to the lungs through an endotracheal tube in the trachea connected with the oxygen source on a mechanical ventilator for artificial respiration, or oxygen may be delivered under high pressure when the patient is laced in the "hyperbaric chamber" oxygen delivered to the patient can be monitored by "Pulse Oximeter" a non-invasive device to monitor to the patient can be monitored by "Pulse Oximeter" a non-invasive device to monitor the heart rate and arterial xoy-haemoglobin saturation (SPO2). Morbidity and mortality of the trauma victim can be predicted by estimating the blood gases (oxygen and carbon dioxide) and acid-base status with the help of arterial blood gas machine. These facilities are available in Medical College, Jammu, Srinagar, Skims (Kashmir) and ASC Medical College, Jammu.

All trauma patients should be assessed for adequacy of ventilation immediately upon arrival at the emergency room of the hospital to determine the urgency of intervention. The upper airway consisting of the nose, the mouth, the nasal, oral and laryngeal portion of the pharynx (inner back part of mouth) and the larynx is particularly vulnerable to obstruction. The obstruction of the upper airway may be due to secretions, blood, dentures, fall back of the tongue in unconscious patients and swelling of the soft tissues of the mouth. Trauma victim may regurgitate the stomach contents with the oral cavity to obstruct the upper airway. Suction of the oropharynx will be life saving to the patient.

The other simple menoeuvers may be 1.) Chin Lift - which is performed by placing the fingers on one hand under the anterior base of the mandible (Chin Portion) while gently lifting upward to move the chin forward. 2) Jaw Thrust - by securing the angles of the mandible bilaterally to displace it forward and lower lip to be displaced downward to open the mouth. These procedures should be done gently to protect the cervical spine which might had sustained injury.

The initial airway control and adequate oxygenation of the trauma patient needs highest priority. Further, inadequate ventilation should be corrected with a bag-valve mask (Ambu-bag) ventilation. Majority of the patients will improve their saturated oxyhaemoglobin levels, however, if frank desaturation persists, orotracheal incubation should be performed to deliver 100 percent oxygenation and artificial ventilation by mechanical ventilator. Laryngeal mask (LMA) and oropharyngotracheal double lumen tubes (combitube) are the alternatives of orotracheal intubation in difficult situations and lack of expertise. Surgical airway such as Tracheostomy and cricothyroidectomy may be required whenever, there is direct trauma to the upper airway. The difficult situations to maintain upper airways may be maxillofacial injuries, missile injuries of the next, cut throat injuries, temporomandibular joint and bimandibular fractures. Majority of the trauma patients die of uncorrected loss of blood, so called, haemorrhagic hypovolaemic shock, secondary to visceral injuries, extensive fractures and soft tissue injuries. Sometimes, fluid loss remains under estimated due to the collection in the body cavities, extensive swelling of the soft tissues because of injury, swelling of the tissues as after effect of the blunt trauma, penetrating injuries of the retroperitoneum (back portion of inside abdomen) this is called "Third Space" or the "Hidden" loss of extra cellular space.

The acute loss of blood decreases the blood volume with the circulatory system, less blood will be available to the heart for pumping (venous -return), less blood will be pumped out from the heart into the circulation (cardiac output) which initiate the vicious cycle of haemorrhagic shock. Acute blood loss upto 20 per cent can be tolerated in healthy adult individuals by compensatory defense mechanism of the body called Compensatory Haemorrhagic shock. More than 15-20 percent of the blood loss needs replacement of fluid volume or blood to prevent progressive haemorrhagic shock (30 - 40 percent blood loss) or irreversible haemorrhagic shock (>40 percent blood loss).

Emergency doctors usually adopt a practical approach to treat shock resuscitation with rapid intravenous infusion of 1-2 litres of lactated ringers solution for all trauma victims. This is modified according to the patient's injury later on. However, isotonic nature of normal saline make it the ideal fluid of choice in patients with head trauma. The patient with head injury will need less intravenous fluids to prevent further swelling of the brain. Similarly caution is exercised in pre-existing heart disease, diabetes and extremes of age who sustain trauma. Three volumes of crystalloids or 2 volumes of colloids (starch solutions) for one volume of blood loss is recommended for initial resuscitation. This is called "Haemodilution Concept" of fluid replacement without blood transfusion even in polytrauma resuscitation management. No adverse effect have been seen with this method. Author of this article has managed more than 3,000 missile injuries patients in low intensity war successfully with haemodilution technique of fluid resuscitation from 1991-1993 at Base Hospital Srinagar, Kashmir.

We recommend that early resuscitation, early surgery is as important as monitoring the successful resuscitation of the polytrauma patient in the intensive care unit, clinical parameters, central venous pressure, urine output, arterial blood gases and oxygen delivery and consumption indices should be monitored to prevent mortality.

(The author is former president International Trauma Anaesthesia and Critical Care Society.)

 
 



|
home | state | national | business | editorial | advertisement | sports |
|
international | weather | mailbag | suggestions | search |
subscribe | send mail |