I read the word "bullshitted" today and it got me thinking about whether or not it's a transitive verb, and what the correct past participle would be.  UK English has the past tense and past participle of shit as shat, but in Americanese it's shit in the past tense/participle as well.  Bullshit as past tense and past participle just doesn't sound good, so Americanese is out.  Bullshat ... doesn't sound good either.  But, as far as I can recall, there are no, or few, English words ending with "t" that have their past tense ending in "ed", so I think this needs to be made a formal exception to the rule, and bullshitted recognised as the correct spelling.

Actually it seems to be - see the Wiktionary entries for bullshitted and bullshit.  However, Google also lists 86000 hits for bullshat, and only 34000 for bullshitted, indicating that the former is more popular.  Quite possibly because the Internet may have more sites written in or influenced by Americanese.

What is the difference between "quality assurance" and "quality control"?

Good question.

The answer is, in English, nothing.  The two are synonymous phrases.  They have, however, been appropriated by bureaucrats to mean two different things in bureaucrat jargon that has infected countless poor individuals around the world for decades.

The terms also lack an important element - a real adjective.  Good quality?  Bad quality?  There are plenty of organisations who do their best to maintain bad quality in their services.

See http://tinyurl.com/Quality-crapspeak for more on the bureaucrat usage.

The latest ProMed reports a case of a Brazilian boy who survived rabies.  Like all previous survivors except one, he received vaccine as prophylaxis, but prophylaxis was incompletely administered (no immunoglobulin.)  Apparently unlike the previous survivors, the virus was isolated from the patient.  He was treated with the Milwaukee protocol first tried on the non-vaccinated girl in Wisconsin who survived.  To what extent this is a result of the protocol is unclear - rabies after failed prophylaxis appears to have a higher survival rate, especially for bat rabies.
 
The ProMed report [22 Nov 2008] - Rabies, human survival, bat - Brazil (02)
 
Milwaukee Protocol 2.1 with its checklist can be obtained at the Children's Hospital of Milwaukee Rabies Registry page.

A few articles referenced in the protocol or the ProMed article or discussing the protocol:
 

cave canem? cave etiam vespertilionem!

These are a few of the crapspeak words/phrases that irritate me the most:

Learners - they are really pupils
Strategic - my arse (for Americans who don't speak English, "ass" refers to a donkey)
Value-added - like a tax
Quality - is a "quality item" of good or bad quality???
Service delivery - an excuse for bad service
Niche market - a market in a corner
Drill down - for oil???
Comprehensive - full of it
Project manager - he manages projects
Fixed-dose - I have never prescribed a variable-dose tablet!
Grass roots - where we find garbage, snails, and other crap
Culture - the culture of crapspeak is a niche market that adds value to strategic learners

Useful items to include in a game of Bullshit Bingo in your next meeting.

For those who don't know what Bullshit Bingo is, it's a form of Bingo where you have a card with words or phrases instead of numbers, and then wait for those words/phrases to be used in meetings or speeches.  When you hear them, you cross them off.  Once you have a full line (across, down, or diagonal) crossed off, you shout "Bullshit!" and you've won.

Here's an example of a Bullshit Bingo card:


You can make such cards (each person should get a slightly different card, so not everyone has the exact same words in the same positions) and distribute them at your next meeting.

A few problems with the recently released 2007 National HIV and Syphilis Prevalence Survey [PDF] aka Antenatal Survey.

It appears that the new stats have been produced using a new methodology to work out its conclusions.

Two people who know what they're talking about when it comes to these stats wrote a letter to the SAMJ, which can be found here [PDF].

Rob Dorrington, David Bourne. Has HIV prevalence peaked in South Africa? – Can the report on the latest antenatal survey be trusted to answer this question?  SAMJ October 2008, Vol. 98, No. 10

Reported here by IRIN:

Reported here by the Treatment Action Campaign.

A note on the correct use of the terms "method" and "methodology" which do NOT mean the same thing:

Politix.

Over at PLoS Medicine, there is an article entitled "Ethical Implications of Modifying Lethal Injection Protocols"


Harm?  Isn't death "serious harm"?


We no longer have the death penalty in South Africa.  And when we did, it was never the electric chair.  Imagine load shedding during an execution?


BTW, the myth that if someone fails to die during an execution he/she gets freed is just that - a myth.

A few months back, smut was killing the sugarcane in Australia.  Now bacteria are killing the crappies near Ashby, MN, USA.

Most crappies were small, "but 10- to 15-inch crappie were also observed."

It's not all bad news:

"Assuming good numbers of adult crappie remain, they'll be very successful in producing lots of young crappie in 2008 to fill the void ..." - ProMED-mail, 15 Sept 2007

Headless Snake Bites Hapless Man


So says Scientific American, which also refers to the NEJM article:

Dead rattlesnakes can bite? Mayo Clin Health Lett 1999;17:4.
PubMed

Suchard JR, LoVecchio F. Envenomations by rattlesnakes thought to be dead. N Engl J Med 1999;340:1930.
PubMed
Excerpt at NEJM

So be careful.  Don't be bitis.

Skillie might have a new friend, if I can persuade Wolfgang to adopt.

Yesterday, a baby puff adder was found in Jeevs' garden.  Very cute, and about 25cm long (an estimate - he didn't stretch himself out for us.)  Species name: Bitis arietans - you have to be careful because they bitis!  Apparently quite common in Mthatha.

He was very cold, and hiding under a box, safely stowed away in the back of a bakkie.  We put him in a smaller box, and took him inside.  He took a liking to one of the pieces of the box he could hide in - maybe just because we were inspecting him and he didn't like that.

Luckily he wasn't in the mood for biting, although we didn't touch him while he was able to get a nip in.

Here is is getting into his little corner:


More:


A close up:


Even more:


All the way in:


People here are terrified of snakes ... this one is sweet, though, and well behaved.  He's quite safe to look at if you're careful - snakes don't carry viruses that can transmit to humans.

Driving in Umtata is quite amusing, and quite dangerous at times.  Probably a collection of the worst drivers in South Africa, probably excellent drivers compared to the rest of Africa.

I think a very high percentage of drivers here either have no licence, or they bought it.  If you're a government official, or work for one, the rules of the road don't apply to you, as the newspapers recently pointed out.  But they don't apply to anyone else either.

The yellow lane is a passing lane for taxis in many parts of the country; here, that holds true, but the oncoming lane is also a passing lane for taxis here.  As soon as it's dark, and you can no longer see the lines on the road, they become irrelevant, as I discovered in yesterday's power failure (almost as common as roads here in Umtata.)

When I had nearly reached my destination, driving in the middle lane of two, with cars passing me in the parking spaces on my left, I luckily didn't know whether I needed to turn left or right, so I turned left and parked.  Had I tried turning right, I'd have ended up in the funniest traffic jam I've seen.

In normal society, if the traffic lights don't work, they should be treated as a 4-way stop.  In Umtata, you just don't stop.  Other traffic has to wait for you.  It's a bit better at real 4-way stops.  There you just have to push your way into the intersection.  If you're second in line, you can get through without waiting your turn simply by going through on the tail of the car in front of you.  Generally, the unwritten rule here is that if the car entering the intersection hasn't yet obstructed your path, you can still enter and go.

The traffic jam was a perfect example of how rush hour traffic in Africa works.  Everyone has the right of way, everyone can go first, so everyone does.  And by refusing to allow anyone else right of way, it ends up as a huge mess.  Nobody can move.  Eventually the police arrived and I assume they sorted it out, after solving a dispute between a car and a Fidelity Guard van whose noses were almost touching, each refusing to move for the other one.  I left after getting a few photos - not ideal ones, in the dark - with my cell phone's camera.


A bit blurred, but you can make out the green van with Fidelity on the side.



Some cars had opened their doors.  The drivers had to explain to those who didn't have right of way how they should drive.

Will Africa ever learn?

Taken from HIV treatment in a conflict setting: outcomes and experiences from Bukavu, Democratic Republic of the Congo, by Heather Culbert et al in PLoS Medicine, 2007 May;4(5):e129
PubMed link
Article on PubMed Central
Article on PLoS Medicine

Patient 1
Followed in the clinic since 2002, on ART since December 2003. Lives in Rwanda.


Patient 2
Followed in the clinic since May 2003, and on ART since December 2003.


Sad, very sad.

Smut?  Australia?  Yes, they have smut in their sugarcane.  Particularly in the Bundaberg/Isis, Mackay, and Ingham districts in Queensland.

And no, it has nothing to do with sheep.

Pictures of this smut can be seen here and here.

The full report is on ProMED-mail.

As you know, I am a medical virologist.  Which means I deal with the biological type of virus, and their consequences.  But sometimes computer viruses can be interesting too, and I amuse myself at times with technovirology - computer viruses.

Jeevs' son, Reshlan, had a project for medical school on a flashdisk, and every time it was plugged into a PC with antivirus software, that file got deleted.  The file was a Word document.  The virus had inserted executable code in the beginning of the file, and renamed it with the extension SCR.  SCR files are usually screensavers.

The logical person to ask for help is ... the virologist.

The virus was W32.Rungbu, as named by Norton.

Here I describe how I chopped the virus out of the file, and got back the original Word document.

PLEASE NOTE: this is not for the faint hearted, or for anyone who, like me, doesn't really know what he's doing.  You risk your computer becoming infected, and losing data.  What I describe below is not something you should try at home.

First, I backed up my registry, and turned off System Restore, and then inactivated my antivirus software.

I copied the infected file.scr onto my hard drive.  Then I renamed the infected file so it had a TXT extension, and opened it in Notepad.  It looked like this:


Lower down, some of the text contained in the Word document was visible.  I didn't know what to do ... so I tried various things, none of which worked.  Forcing the file.scr to open in Word or Wordpad didn't work - it had non-Word header information that Word couldn't interpret.  I tried chopping off the top part of the document, including everything between the start of the document and the end of the code inserted by the virus.  I tried chopping out the part of the document that was clearly Word, and placing it into a document from which I removed that document's section from that position onwards.  For this I was using Notepad, and was probably saving it in some way I shouldn't have saved it - or maybe I shouldn't have been saving it at all in Notepad.  None of the final products opened in Word.

In the process I followed above, I discovered that all the Word documents I checked began the same way.  I already knew that this was the case with GIF, JPEG, PDF, RAR, and ZIP files, so I was expecting that.  The following three images show how three different Word files began:




I've highlighted the sequence common to all the files.

But, as I said above, deleting everything before that sequence and saving the result using Notepad produced a file that Word couldn't open.

Then I thought of using a hex editor to delete the infected section.  I used a fairly simple programme called 1Fh Binary+Hex Editor 1.07.

By searching for the specific sequence that the other Word documents began with, I found out that the first 46592 bytes of the file were something else.  This is what it looked like:


The B600 is the hexadecimal version of 46592, which I could have calculated by hand, but was too lazy, so I used HexDecBin 1.0 to do it for me:


I decided that using 1Fh to space over the extra 46592 bytes would simply take too long.  So I thought that maybe splitting the file into pieces, in such a way that the extra piece would be separated from the rest, might allow me to piece the file back together without that extra piece.

For this I used GSplit 2.0.  I simply split the file into pieces 46592 bytes in size - so that the first piece would be the the entirety of the extra piece, presumably the virus, and not contain any authentic piece of the original Word document.  I also set GSplit to omit headers to the pieces that it split the file into, to not create an executable file that would piece them back together again, and, in case it affected anything, deleted the code set to give the pieces a unique ID.


Then I split the file - 35 files resulted, namely disk1.gsd, disk2.gsd, ... disk35.gsd.

I checked disk2.gsd, and, not surprisingly, it began with the sequence that started all the other Word files.


I then ran a batch file to unite all the pieces except the first.  It looked like this:

copy /b disk2.gsd+disk3.gsd cow.gsd
copy /b cow.gsd+disk4.gsd cow.gsd
copy /b cow.gsd+disk5.gsd cow.gsd
...
copy /b cow.gsd+disk35.gsd cow.gsd

The /b was simply because I expected it to be a binary file and not an ASCII file like a text document.  (Probably something to do with Notepad saving it in a way that Word couldn't interpret as a Word file.)

I then renamed cow.gsd to cow.doc ... and tried to open it in Word.  And there was the original, opening fine as a normal Word document.  (It had another error in it, and wouldn't show page 48, but that I converted to a PDF and the PDF back into Word, and recovered the text that way.)

And that is amateur technovirology in action, as performed by a clinical virologist.  Viruses are indeed fun!

I am a fan of George Romero's Dead movies:

Night of the Living Dead [1968]
Dawn of the Dead [1978]
Day of the Dead [1985]
Land of the Dead [2005]

Diary of the Dead, for release in 2007, is a 5th, but not a sequel to Land of the Dead, as it takes place at the during the initial outbreak of the zombies that occurred in Night of the Living Dead.

Remakes of these movies by other directors:

Night of the Living Dead [1990]
Dawn of the Dead [2004]
Night of the Living Dead 3D [2006]
Day of the Dead [2007]

And then of course there's Shaun of the Dead [2004], a spoof of the above, not by George Romero.  See also Night of the Living Bread [1990].

Wikipedia has a good explanation of which are Romero movies, which are Russo movies, and which are non-Romero "sequels" and related and unrelated movies, such as unofficial non-Romero non-Russo sequels Day of the Dead 2: Contagium and Zombi 2.

The original Night of the Living Dead was co-written by George Romero and John Russo.  Romero sequels are "Dead" movies and Russo sequels are "Living Dead" movies.

I haven't a clue what this means:


Probably something to do with Άννα Βισση coming to Sun City in May.

They linked to me ... so here's the Anna Vissi blogspot.

I have a reputation, and am living up to it.  I think this is quite a good way to use a box, but it needs a table cloth - when I get round to getting one.


This is some sort of crate packing support device that I have turned into a shelf for my DVDs and CDs, and maybe a few books when I get more of those unpacked.


Very fashionable.

I trained as a medical virologist at Stellenbosch University, Tygerberg Medical Campus, and, prior to the current head of department, Prof Estrelita Janse van Rensburg was the head there, so I spent the first few years of my training under her.  Now she's head of the virology department at Pretoria University, where I did my undergraduate medical training.

On 28 March, she was awarded an Exceptional Achievers Award.

The Pretoria News (which we don't get in Umtata - my mom e-mailed me the article) said:


The article can be read here.

I also know Prof Louis Nel, Prof Brenda Wingfield, and Prof Mike Wingfield.

Congratulations!

Mycobacterium tuberculosis and related bacteria are bacteria, NOT viruses.

The following are also not viruses:

• malaria
• typhoid
• tick bite fever
• syphilis
• gonorrhoea
• cats and dogs

"More hospitals to treat TB virus" published on 14 March 2007 in The Mercury (a newspaper) should have a better headline.

Some snippets:


I am sure they are ... it's quite a problem.  The local stats sound quite scary.


Hmmm ... do they mean that MDR and XDR TB in a patient result from that patient's treatment failure?  MDR often yes, and I'm not an expert on the genetics (I'm a virologist, and TB is NOT a virus) but I think the jury is still out on XDR TB, and there is some evidence that XDR infections are usually caused by an XDR strain infecting the person.


We definitely need more money to fight HIV and TB in this country.

We've all seen the photos of power cuts in Johannesburg and Cape Town.  Now I am providing some from Umtata.

Here the power doesn't go out because too much is being used.  It goes out because it rains.  And sometimes just for fun.  It's very frustrating, because I take a lot of work home with me, and I'd like to be able to use my computer to do that work.  I've thought about a generator with a UPS to stabilise the current, but maybe I should go to bed early sometimes.  Power failures are usually at night, the most impractical time.

Here's the photo of Umtata at night with no electricity.


If you click on the picture, a larger version will load.

More on rabies vaccination ar the Journal of Travel Medicine, March/April 2007.

Gautret P, Parola P, Shaw M, Torresi J. Rabies preexposure vaccination in travelers. J Travel Med 2007; 14: 136. PubMed abstract

Probably worth reading ... I can't get at it, though.  I'll try other ways.  All my usual ones are exhausted.

In the February Weekly Epidemiological Record, put out by the World Health Organisation, there is an update on rabies vaccination.

I've previously commented on rabies and post-exposure prophylaxis on one of my other blogs.  I've had my pre-exposure prophylaxis.

Virologists have good taste in music.  Άννα Βίσση, or Anna Vissi, is one of the most popular modern music artists amongst virologists in South Africa, and probably worldwide.  Those virologists who haven't heard her music should listen ASAP.  They'll be hooked.

Anna is a Cypriot Greek with an incredible voice.  She was born in 1957, so she turns 50 this year ... but she looks like she's in her 20's or 30's, at least in concert and on her CD covers and in her music videos.  Her husband, Nikos Karvelas, is 6 years older than she is, and he looks his age.

She took part in the Eurovision contest for the first time in 1980, and most recently in 2006 - her 2006 song was Everything, which was played a fair bit on the radio here in South Africa around the time of the contest.  The last time I looked it could be heard on her official site.  There are apparently music videos available on YouTube and MetaCafe.

Another Anna Vissi site worth visiting.  It has downloadable music and tour info.

Wikipedia has a detailed discography.

Dodeka (Δωδεκα) is one of her very popular songs ... it seems to be part of many of her concerts.  Listening to it explains why.  It means Midnight in English (dodeka = do + deka = 2+10).

Anna Vissi lyrics

Dodeka is one of the first Anna Vissi songs I heard back in high school.  You can scroll up and down with the various buttons on the flash thingie - the pause is on the right of the scrolling lyrics (from lyricsdownload.com - move your mouse out of the scrolling lyrics to pause.

I still need to get used to the new camera - it has nearly as many settings as my PC.  But here are some photos.

This is Walter Sisulu University, previously University of the Transkei (Unitra), by day and by night:

The hills seen from the townhouse I stay in:

Umtata Dam after the rain, seen from where I stay:

The driveway and garages in the place where my townhouse is:

From my balcony looking onto the nearby nature reserve in a misty day:

The Anglican Cathedral, which looks very much like a Catholic one from the outside.  I must still find the Catholic Cathedral here.

Welcome to Umtata!

That is Skillie's other name.  She's now eating well, and her health has improved a lot.

You can read all about Skillie and her relatives here:

Angulate tortoise
Angulate tortoise care

Okay ... this blog isn't only about Skillie and elevators lifts ... so I'll put a post on with some photos of the Eastern Cape and Umtata.

This is a photo of Jeevamoney Govender (Jeevs), the currently acting business manager of the Umtata NHLS laboratory - NMTL, or Nelson Mandela Tertiary Laboratory.  There's always a cup of coffee waiting in her office for you ... except during power failures.

This is Jeevs with her secretary, Mardi Nolands.

They're in Jeevs' office.

The laboratory is connected to the academic hospital, and is partly on the 2nd floor (level with the ground) and partly on the 3rd floor (one up from the 2nd floor.)  The lift has buttons for floors 2, 3, and 4.  The first thing I thought odd was that there were no stairs near the lifts.  If you want to go up or down, the lifts are the only option.  If you really need to take the stairs, you can go to the other side of the building, which isn't far, and on that side there are no lifts.

I feel quite silly going up one floor in a lift instead of taking the stairs, and even worse going down one floor, but everyone does it.  Eventually I'll have my bearings better and know instinctively which way the stairs are - most things I need downstairs are on the side of the building with the stairs.

The highly unusual thing about these lifts is that, due to their distance from the stairs, they remain functional.  I've only been here for two weeks now, but they have always worked, they stop on all floors, and their buttons don't turn on and off by themselves.

At the Tygerberg Medical Campus of Stellenbosch University one of the places I worked before, the lifts are controlled very ingeniously by a team of experts whose job it is to provide a new puzzle every day for lift users.  On some days, certain buttons remain on all day (that had nothing to do with infection control during the Namibian polio outbreak, which was first identified by my old lab at the top of these lifts); sometimes you cannot call the lift from certain floors; sometimes the experts want people to guess which floor they need to run to in order to catch the lift ... and they are sneaky!  When you reach that floor, sensors detect that you're approaching, and the lift closes and goes up to another floor (usually the 4th), waits there a while, and then comes down slowly, opening on each level for the invisible person who didn't press any buttons.

At that place still fresh in my memory, the same experts are training people for the special olympics - they have a special electric door for people in wheelchairs, and the door is specially fitted with a device that senses when someone is in the doorway, and then it closes on them.  Only the fastest get through in time.  My advice: if you're already injured, in a wheelchair, blind, or use a walking stick, climb over the turnstiles and go up the stairs - it's safer!

None of that excitement at my new lab.  Here there are only 2 relevant floors for the lab staff - they wouldn't get away with it even if they wanted to.

These are the lifts from the outside:

And from the inside:

These are the stairs, looking up from the ground (i.e. 2nd) floor:

These are the stairs from the outside of the building:

I suppose not many blogs have an entire post dedicated to a discussion of the lifts the blog writers use.  I promise to have more virology in future posts, but this is also about my new life, and therefore functioning rural elevators are topical.  In the places I've worked in, functioning elevators are topical, rural or not.

Maybe in a future post I'll go into the fascinating aspects of the buttons in these lifts ...

Key word for the day:

English: lift; plural lifts
Americanese translation: elevator; plural elevators

I arrived in Umtata on the evening of 27 January, and my belongings arrived the following day.

This is a photo of Umtata at night, taken from the Garden Court hotel along the N2 highway as it passes through Umtata, where it is known as Nelson Mandela Drive.  A larger picture will load if you click on it.

Some scenic photos of the area later ... but after doing some of my unpacking, I started work on 1 February.  At first I felt a bit lost, and although the lab is in somewhat of a rectangle with passages going right around, it was a bit confusing in the beginning.  I still have to think about which way the lifts are, and which way the stairs are - they're on opposite ends of the lab.

I am the new pathologist for the diagnostic virology laboratory.  At the moment they do HIV DNA PCRs on blood and dried blood spots, and HIV viral loads.  Serology for HIV, Hepatitides A, B, and C, Rubella, and Cytomegalovirus get done in the Chemical Pathology laboratory, and don't fall under the Virology section, which is dedicated to supporting the antiretroviral rollout in the Eastern Cape.  We have place to expand, and the section will eventually do a lot of other viral diagnostics, and incorporate the serology as well.

These are the people working in the Virology laboratory:

Tobeka Gibson (Toto) is the laboratory manager.  Here you can see her preparing samples for HIV PCRs.

Nandipha Tinzi (Nandi) is sorting specimens that will get viral load testing later.

Nokwanda Busakwe (Skwash) is preparing plasma samples for RNA extraction prior to viral load testing.

Masixole Nkanyuza (Masi) is the youngest; he's preparing the reagents for the detection step of the viral load assay.

More soon.

There are wedding plans for Skillie, for when she's better.

This is her future stepdaughter.

Her future stepdaughter likes apples, and prefers to eat them out of her adoptive mother's hand.

She thinks she can climb stairs.  Not very well, it seems.

Skillie's babies will fortunately have four legs.

My current head of department, Wolfgang, and his fiancée were recently in the Eastern Cape, and came across a tortoise that had been hit by a car.  They rescued her, and she has been to hospital.  Unfortunately she had to have her foot amputated, and gets daily antibiotic injections, which she doesn't like at all.

It's unlikely that she will be able to be released back into the wild, so she's getting a new home, all legal with the right permits.

Her name is Skillie.

This is her being told she's going to get her medicine.  When she realises this, she goes into her shell fast.  The vet taught Wolfgang how to give her her injections.

She wouldn't come out, so I took her, and I was new to her, so she came out to look.  That gave us a chance to get hold of her leg.  Here she is getting her injection.

This is Wolfgang with Skillie after her injection.

This is me with Skillie.  Her shell had cracked underneath, and her one back leg broken.  The foot has been amputated and bandaged.

Skillie doesn't bite.

A close up of Skillie.

Skillie had been to the toilet before the injection.

Hopefully she'll recover well.

Welcome to my new blog, about medical virology, rural medicine, and the Eastern Cape in South Africa.

In 2005, I qualified as a medical virologist, FCPathSA(Virol), and in 2006 I finished my MMed in virology at Stellenbosch University.

As from February 2007, I will be working in Umtata, as the only medical virologist in the Eastern Cape province, with plans to build up the virology service there, and to consult on laboratory, diagnostic, and clinical virology in the Eastern Cape.

On this blog, I plan to document my journey in rural medicine, and let people know more about the life of a virologist, and about the Eastern Cape.

Please join me on this journey.