Chelsea1-Man Utd1

The hotly anticipated match has been played and stalemated.There was no shortage of fireworks and overheated fuses.Majority of my readers probably watched the game or have already read reports on BBC,Eurosport or Skysports online.So I will not bore you with the minute details.
Man Utd probably did themselves a huge favor by scoring first in this game,otherwise it could have been a whitewash.They were outplayed and looked like they constantly gasped for air under the cush from their "boring-boring" rivals.

Any Man Utd fan who after watching today's game does not recognize that chelsea now has much more than their team can muster under stretch is living in a fools' paradise.The most ardent of those fans would probably inundate anyone who cares to listen with complaints on how Terry's red was reversed and how Vidic's absence weakened their defence today.That would do stand-in defender Johny Evans loads of injustice because quite honestly,he got his team out of jail several times in this game.

Ronaldo was on the bench,but so was Drogba.Deco picked up an injury just before kick-off,so this was by no means Scolari's choice starting eleven.Essien is a long time absentee.
Nothing could be stranger than Mike Riley's decision to blow the final whistle before chelsea had had a chance to take a last minute free kick after Ferdinand bundled Drogba over at the edge of the box. I remain convinced that the heavy presence of Man Utd and Arsenal influences in the rank and file of the FA will continue to ensure bias in favor of those 2 teams.Decisions go their way even on away grounds..like that stone cold penalty after Edwin Van Der Saar brought down Anelka.He was off the field because of injury...but he should have been sent off really.

Arsenal fans who may be singing "look who's top of the table now" need to check their fixture list again.They still haven't played anyone in the so called top four and have already lost to Fulham(!) this season.Arsenal flatter to deceive.They've done that for the last 5 seasons.Frankly,I don't envy Arsenal fans...I don't know how they keep doing this to themselves.You must be a masochist to remain an Arsenal fan these days.This team has no staying power...and the league has been won in the past 5 seasons only by teams with some staying power.Arsenal will fizzle after January.The premiership remains a marathon,not a sprint.

My biggest worry for Arsenal is the Dubai led renaissance in the blue half of Manchester.Seriously,there is a genuine possiblity Arsenal may not finish in Champions league places at the end of the season...especially if Man City sustain the form they displayed against Pompey today and Al Fahim spends some of those billions in January.I presume that the Keane-Torres partnership will come good for the Kop soon in making that assessment.

Finally,I appreciate good honest football analysis.Last year,I acknowledged Man Utd's superiority ahead of the pack despite being a Chelsea supporter.This year,only a blind man will not agree that Chelsea is stronger than the rest of the pack.

Your comments are welcome.Keep them clean and respectful.

OMC.

St. Malachi and the rest of us.

Memento mori is a Latin phrase that may be translated as "Remember that you are mortal," "Remember you will die," "Remember that you must die," or "Remember your death". It names a genre of artistic creations that vary widely from one another, but which all share the same purpose, which is to remind people of their own mortality.

In ancient Rome, the phrase is said to have been used on the occasions when a Roman general was parading through the streets of Rome during the victory celebration known as a triumph. Standing behind the victorious general was a slave, and he had the task of reminding the general that, though he was up on the peak today, tomorrow was another day. The servant did this by telling the general that he should remember that he was mortal: "Memento mori." It is also possible that the servant said, rather, "Respice post te! Hominem te esse memento!": "Look behind you! Remember that you are but a man!", as noted in Tertullian in his Apologeticus.

As I drove down Carnegie with Florin,one of my batch mates with whom I was on the palliative care service,I could not stop wondering how everyday issues really distract physicians especially from the harsh reality of man's ultimate mortality and the issues contingent on that.
At this moment,I also allowed myself the luxury of feasting on the beautiful Cleveland downtown skyline and soak in the ambience of this kind summer afternoon.

Everyday,each physician has had some brush with mortality,whether providing some end-of-life care or certifying a patient that just expired.This fact however often gets lost in the semi-automated fashion most physicians go about their daily routine.The expressionless demeanor of many a physician while delivering the verdict of death to patient's relatives may sometimes send the wrong signal to those family members that their doctor does not feel that human connection.
The truth may however be closer to the fact that most doctors are trained not to be emotionally attached to their patient.There is a good reason why doctors are discouraged ethically from treating their own ailing family members.

On this trip,Florin and I sought to see first hand how Malachi House worked.

Malachi house is a place which everyone on the palliative care rotation hears about so many times especially when the discharge of hospice patients is being planned.
The location of the house is symbolic.On the near end of the west of downtown,as we negotiated W28th street en route Clinton Avenue,one could not but note that the houses in this neighbourhood probably date back to the founding of Cleveland itself.

When St Malachi church received a donation of 4 row houses in the mid 80s,the mission that had existed merely as an idea in human service gradually started to add flesh.By the time the house opened in 1988,more than 100,000 volunteer hours and massive trade union support had renovated this old property and turned it into a very functional and supremely conducive facility for the dying.

As soon as we were parked outside 2810 Clinton Avenue,the peace and tranquility was palpable even in an area of Cleveland not usually associated with those traits.The warmth and friendly atmosphere were personified by our contact lady Alice,the volunteer co-ordinator.

Alice is the absolute Miss Malachi House.She exhibits all the values of care and sacrifice that inspired this mission.Alice calls every resident by their first names and has a special connection with each of them.She gave us a crash course in the history and tradition of the house.I was particularly touched by the little tradition of laying a red rose on the bed when a resident just expired.

Residents have stayed anywhere from just a few minutes to up to 4 years until expiring.Residents do need to have been accepted into hospice care with a reassessment every 6 months.

The house boasts a full coverage by registered nurses but cannot function as a regular nursing home.Hence,no regular hospital care is routinely delivered.Only oral medications are permitted and agitated residents may not be accepted.The way to see Malachi house is as a substitute home for the less priviledged dying patient with no family or whose family can not take care of them for some reason.
An extensive tour of the facility can only best be conveyed in images which I have posted in this article.

We were informed that the mission accepts no payments from residents or their family members.Malachi house is supported exclusively by donations from philanthropists foundations and corporations.No dollar from the government.
My readers who may wish to donate to this noble cause can visit
http://www.malachihouse.org/index.htm

OMC

Giggle

A white missionary is sent into deepest darkest depths of Africa to live with a tribe.

He spends years with the people, teaching them to read, write and good Christian values. One thing he particularly stresses is the evil of sexual sin.
Thou must not commit adultery or fornication!

One day the wife of one of the Tribes noblemen gives birth to a white baby.The village is shocked and the chief is sent by his people to talk with the missionary.

"You teach us evils of sexual sin, today black woman has white child. You only white man in village. what u say ???

"The missionary replies, "No, no, my good man. You are mistaken. What you have here is a natural occurrence - what is called an albino"

Chief says: " No mistake here, What nature ? what albino ?

"The pastor trying a simpler approach goes, "Look to thy yonder field. See a field of white sheep, and yet amongst them is one black one"

The chief pauses for a moment then says......, Ok Ok ; you no tell and i no tell !!!

If you don't get the joke,you need a brain transplant.LOL!

Niger Delta Ministry

The new Niger Delta Ministry
By Reuben Abati

The creation of a Niger Delta Ministry, which can focus exclusively on the needs and challenges of this troubled, and much neglected, but oil-rich part of Nigeria had been recommended before now both by restive militants and groups in civil society, as one way of indicating official seriousness about the Niger Delta Question, and the political will to make a difference. As recently as Friday, August 1, 2008, The Guardian made the same case in an editorial titled: "A Ministry for the Niger Delta". Wrote the newspaper: '...we believe the creation of a Ministry of the Niger Delta is imperative".

By taking the bold step to set up the Ministry, the Federal Government seems to be sending a strong message to Niger Delta stakeholders that it really intends to address their fears and expectations. This is coming however, as part of a series of attempts by the Yar'Adua administration since May 2007 to come to grips with the issues and many of these attempts have been poorly conceived.
They include the inclusion of the Niger Delta in the President's seven-point agenda, meetings with Niger Delta stakeholders which came across as an insincere attempt to keep the people talking, the proposed Niger Delta Summit which died a-borning on the altar of controversy. There was also the setting up of a 40-man committee to deliberate on the Niger Delta, within a rather curious time-frame of 10 days! It was certain that the Federal Government really needed to do something urgently about the Niger Delta situation.

It is a notorious fact that the area had become ungovernable. Escalating violence in the region had turned it into one of the major hotspots in the world; and the country's economy is the worst hit. Oil exploration companies have had to scale down their scope of operations in the Niger Delta, and the country's oil production, the main source of national wealth had been reduced by 30 per cent. With output down and still threatened, Nigeria faced a serious crisis, even if the looming tragedy was mediated by the rising cost of crude oil in the spot market. Were oil prices to crash dramatically and output still low, the Niger Delta crisis would have fully exposed the nakedness of the Nigerian empire.

It should not be surprising then, that the creation of the Niger Delta Ministry would result in considerable excitement in the Niger Delta. It is a re-affirmation of the strategic importance of the region and a confidence-booster for the activists who have since resolved that Nigeria should either negotiate with the Niger Delta, or face the consequences of organized and sustained protest and sabotage. Twice now, in the last 16 months, the people of the Niger Delta have shown great resolve; first, by rejecting the proposed Niger Delta Summit and the appointment of Professor Ibrahim Gambari as head of the steering committee of that Summit, and second, by getting the Yar'Adua government to establish a Ministry of the Niger Delta.
But creating a special Ministry for the Niger Delta is not enough. It is important that the Ministry hits the ground running and that it does not become yet another piece of bureaucracy.

The ultimate test of the Ministry would lie in how quickly it begins to make a difference in the lives of the people. Here is a Ministry that is 51 years behind time. It carries an enormous burden - social and historical - and faces an uphill task in mobilizing all possible energies for practical and measurable intervention. In announcing the Ministry, the Secretary to the Government of the Federation had indicated that it will be headed by two Ministers, each focusing on a strategic assignment. The substantive Minister will deal with the provision of needed infrastructure in the Niger Delta: roads, transportation, electricity etc, while the Minister of State will address the issue of youth development and empowerment. Both tasks are critical.

Considering the historical and strategic value of the Ministry, it has to be well-funded. And the heads of the Ministry when eventually appointed, need not be reminded that they would be taking on a major responsibility. In its editorial of August 1, The Guardian had advised as follows: "To be effective, it must not be just another Ministry guided and bogged down by red tape and other bureaucratic ills.
Such a Ministry should ordinarily be located in the Niger Delta region itself, with liaison offices in the Federal Capital Territory and in the states that make up the Niger Delta. The Ministry should have a special budget which in our view should be a fixed percentage derived from the total allocation to the Federal Government. The Vice President who has a keen interest in the Niger Delta, not least because be comes from the region, could be made to head the proposed Ministry".

The Guardian's recommendations are worth considering, especially as the Federal Government is setting up a Committee to determine the structure and nature of the Federal Ministries. In retrospect though, the suggestion that the Vice President should head the Niger Delta Ministry may be controverted. The new Ministry would require persons who can focus on the assignment without distractions. In appointing the Ministers of the Niger Delta, the President must ensure that the persons so appointed understand the issues involved and the urgency of the assignment. They must not be party loyalists seeking a job or the opportunity to be relevant. They must not be mentally tired dodderers either, but development experts with the energy to absorb pressures and deliver results. Needless to add that the President himself must personally treat the Niger Delta as a priority, and not simply hand it over to the bureaucracy of a Ministry. There are Constitutional issues that will need to be addressed, particularly s. 162. There is need also to keep a proper perspective. Hopefully, there will be no mischievous demands, from any quarter, for the creation of Ministries of Yoruba, Igbo and Arewa affairs!.

The creation of the Niger Delta Ministry is significantly part of a general restructuring of the Federal bureaucracy, resulting in the creation of 28 ministries, with 42 Ministers. This exercise had been on the cards for about two months. But it must now be seen in the light of President Yar'Adua asserting his authority and putting a personal stamp on the government that he heads. The structure he has now set aside was hurriedly announced and imposed on Nigerians in January 2007 by the Obasanjo administration. Former President Obasanjo's restructuring of the Federal Ministries at the time was generally criticized as mischievous. Why restructure the Ministries at the eleventh hour? Why hand over to a new government that was due in 128 days a structure that it may choose not to work with?

At the time, the Federal Government had come up with 19 ministries and three federal agencies. It was an untidy structure. The government's explanation that its intention was to reduce big government made no sense whatsoever. Why reduce the size of government eight years after the fact? In addition, there were Constitutional issues involved. The Constitution suggests literally, in upholding the idea of Federal Character, that each state of the Federation shall have a Minister in the Federal Cabinet (cf. s. 147(3) and 14(3). President Obasanjo tried to address this by appointing 22 substantive Ministers and 14 Ministers of State, but this only served the purpose of generating complaints about the unequal treatment of states.

With its restructuring of the Federal Ministries this week, the Yar'Adua government has taken care of the mischief in the January 2007 exercise. What is surprising is why President Yar'Adua had to wait this long, before setting up a government machinery that appears to reflect his own priorities. The new emphasis we are told is on "greater flexibility, direction and focus while addressing the issues of equity and affirmative action". For a government that has been playing possum since May 2007, its sudden reveille is good news.

Other notable highlights in the new structure include the re-establishment of a Ministry of Petroleum Resources and the proper identification of task-oriented Ministries - Aviation, Transport, Housing and Urban Development, Water Resources, Agriculture and Rural Development, Power, Tourism, Police affairs, Culture and National Orientation etc. In the arrangement that Obasanjo imposed on the Yar'Adua administration, functions were not so clear-cut, certain Ministries had up to three Ministers, creating such confusion that ensured inefficiency. There is now a new clarity. The establishment of a Ministry of Petroleum Resources is particularly instructive.

For close to eight years, President Obasanjo chose to be his own Minister of Petroleum Resources and when in January 2007, he appointed Dr. Edmund Daukoru as Minister of Petroleum and Energy, he chose to retain the portfolio of Chairman of the Nigerian National Petroleum Corporation (NNPC). The issues in the petroleum sector are just as central as those in the Niger Delta: a substantive Minister running a properly focused Ministry would be in a better position to deal with the issues at stake including transparency in the extractive industry, gas flaring, refining capacity, domestic prices of petroleum products and the inefficiency of the NNPC.

The restructuring that has been announced is to be followed naturally by an inevitable change in the composition and complexion of the Federal cabinet. So far, there has been general dissatisfaction with the quality and the output of President Yar'Adua's team. When he announced his cabinet in 2007, after an exasperating two-month delay, the hesitation and incoherence that were advertised were traced to the fact that the President had set up a cabinet principally to settle his political IOUs; and he had many.

The former President, Governors, and party chieftains reportedly chose his team for him, and in 16 months, he has confirmed this with his inability to run a government that inspires. For example, his appointment of Alhaji Baba Gana Kingibe as Secretary to the Government of the Federation was most shocking when it was made; his dismissal of the man this week has been greeted with relief in equal size. The present expectation is that President Yar'Adua will now choose his own team, in line with his seven-point agenda. Public expectations are high.

The timing of President Yar'Adua's current moves would seem to be related to affirmations, speculations and arguments in the past three weeks that he is an ailing President, in urgent need of a kidney transplant. He was even declared dead, and then resurrected. He finally returned to the country during the weekend.

Since then, the President has been acting with such great bursts of energy and uncommon dynamism. He decorated the military service chiefs; he set up the Niger Delta committee, he has restructured the Federal Ministries. On Wednesday, he chaired a Federal Executive Council meeting which lasted for eight hours (!), he has also been receiving a steady stream of visitors from the states, Cameroun and elsewhere. This President has never been this busy publicly within the space of one week. It is a new-found dynamism that Nigerians would like to see sustained.

Reuben Abati is editor of the Nigerian Daily:The Guardian.

Syndrome of the week

Glanzmann's thrombasthenia is an extremely rare disorder of the blood, in which the platelets lack glycoprotein IIb/IIIa. Hence, no fibrinogen bridging can occur, and bleeding time is significantly prolonged.

The GpIIb/IIIa is an adhesion receptor and is expressed in thrombocytes. This receptor is activated when the thrombocyte is stimulated by ADP, epinephrine, collagen and thrombin. The GpIIb/IIIa integrin is essential to the blood coagulation since it has the ability to bind fibrinogen, the von Willebrand factor, fibronectin and vitronectin. This enables the platelet to be activated by contact with the collagen-von Willebrand-complex that is exposed when the endothelial blood vessel lining is damaged and then aggregate with other thrombocytes via fibrinogen.

Patients suffering from Glanzmann's thrombasthenia thus have platelets less able to adhere to each other and to the underlying tissue of damaged blood vessels.
The understanding of its pathophysiology led to the development of GpIIb/IIIa inhibitors, a class of powerful antiplatelet agents.
Glanzmann's thrombasthenia can be inherited in an autosomal recessive manner or acquired as an autoimmune disorder.

Characteristically, there is increased mucosal bleeding:
epistaxis
menorrhagia
increased bleeding post-operatively.

The bleeding tendency is variable but may be severe.
Patients present with moderate bleeding and normal platelet morphology. Aggregation of platelets occurs in response to ristocetin, but not to other agonists such as ADP, thrombin, collagen or epinephrine.

It is named for Eduard Glanzmann.