Kerala ENT Conference (KENTCON) 2014

I presented a Case report at KENTCON 2014, Perinthalmanna



Onam celebration at ENT Department, SGMC

Review – Losing its footing in the e-commerce sector?

Update: See below for an Update posted on September 14, 2014 used to be a market leader in the e-retailing industry. Once upon a time Flipkart used to be synonymous with quality service and trust. However in recent months, Flipkart seems to have become a commercial venture which has lost track of quality service and has dwindled distribution nodes. At least that seems to be the conclusion drawn from its lack of distribution nodes in major cities of South India.

For the past few months, Flipkart has been notable by the absence of distribution partners for mobile phones and other electronic equipment in major cities in South India. Cities like Thiruvananthapuram, the capital city of Kerala; Cochin, which is called the commercial capital of Kerala are places where Flipkart does not deliver electronic goods to. The situation is similiar in other cities of South India, except perhaps Chennai and a handful of other metropolitan cities. This has prompted customers to comment whether this once giant in the e-commerce industry is on the verge of decline, since reducing distribution outlets in major cities is often the first sign of cost cutting and reduced profits.


That this has occurred in recent weeks when Flipkart has tried to market its “Flipkart First” subscription service which guarantees “same day” delivery to multiple cities of India is ironic. One wonders whether Flipkart has the logistical infrastructure to undertake this venture, the first step of which should have been securing a dense distribution infrastructure, at least within major cities of South India. Flipkart’s move may perhaps be a cost cutting exercise in the segment it was once renowned for, and it may be a sign of it concentrating more on the clothing segment, as suggested by its recent acquisition of

Flipkart also seems to lack the hardware infrastructure to handle large number of transactions. On May 23, when Moto E was restocked,’s server became offline for hours at a stretch and the mobile app became unresponsive.

Flipkart has been the sole delivery channel of Motorola in India. Motorola has enjoyed a massive support from userbase in India for its recent launches, the Motorola E and Motorola G. These launches have so far been a novelty unavailable across major parts of South India, thanks to Flipkart’s lack of a delivery network in this region.

When contacted, Flipkart’s Farheen M. from customer support responded that Flipkart does not have any immediate plans to consolidate its delivery channel in South India. He responded by saying, “Kindly note that the availability of service in a locality is based on several factors like the products, the coverage of us for this servcourier partners used by ice and the policies of the respective sellers. Unfortunately, at this point of time, the mobiles cannot be delivered to the pin code ..(all cities in Kerala) .. by any of our sellers. We are unable to provide an approximate time frame on the availability of service in your location for the mentioned product.”

It makes one wonder whether Motorola should have chosen a better partner for distributing its mobile phones, an e-retailer with a more diverse and solid infrastructure. However in the e-commerce sector, companies rise and fall, and may well be replaced by globally acclaimed brands like (

Already companies like are proving to be a staunch competition to the homespun and customers have already started moving away from even in their once secure stronghold-online book sales. Flipkart used to provide books at a competitive rate, excellent delivery and post delivery service via its Easy returns policy. Unfortunately for Flipkart, now matches prices and in many cases undercuts Flipkart’s pricing for books, and delivers books and other goods even on the same day. It’s easy to predict that Flipkart is going to see a massive decline in user base over the coming months, given their lack of a solid delivery infrastructure.

Update on September 14, 2014:

It was perhaps a bit too premature to put the blame on Flipkart. The real issue was a standoff with the Commercial Taxes Department of Kerala. According to newspaper reports that came in over the next few days, stopping transactions with customers in Kerala was due to the Commercial Taxes department starting to charge VAT on products delivered to Kerala. Since the items had already been taxed at the source of shipment this amounted to double taxation and non-viable for online stores. The Government also prohibited Cash on Delivery orders stating that these shipments had not paid taxes.

Online shopping is a huge boon to citizens. Since it does away with profits by middlemen, and to a large extent does away with mass media marketing, stores are able to price items at a fraction of the amount at which it is available at retail outlets. As a mechanism of transferring profits to the enduser, it should be considered as a boon, and not as yet another golden goose slaughtered before its time.

As of today, products sold directly by Flipkart (WS Retail) are the only items that can be shipped to India by Flipkart. Jabong and are other sellers which have completely stopped shipping to Kerala. as of now redirects purchases to Jabong (buyout?), and hence that’s another option gone. Myntra was bought out by Flipkart and along with are some of the few remaining sellers who ship to Kerala. Around three quarters of sellers on have stopped shipping to Kerala while a few still do.


Indian railway tatkal booking

The Tatkal scheme of Indian railways is an option which allows customers to book a ticket a day before the actual journey, buy paying a premium price, after normal seats are exhausted. Previously Tatkal booking online used to be possible from 8am three days prior to journey. But recently Tatkal booking has been changed to allow booking only on the eve of the journey, and only after 10 a.m. What this implies is that Tatkal booking from the comfort of your homes is no longer a viable option when tickets are a scarcity. It is quite likely that tickets are exhausted by the time booking opens online.

It is not uncommon to see long queues of people outside railway booking counters even as early as 5 a.m. Scenes like below are quite common:


Unfortunately, Indian railways are not helping remedy the situation by enforcing restrictions on Tatkal booking online.



Tomorrow, it’s general elections in Kerala. Since our college had decided not to grant a public holiday, I’ll have to exercise my fundamental right late evening tomorrow.



It’s been a while since I posted on my blog. Life’s been busy. Joining for DLO has been a difficult choice, but when looked upon retrospectively, has been a sane and unregretted decision. A private medical college and a diploma had been far from my aspirations post MBBS, but it was necessary to break the cycle of studying for postgraduate entrance and the pitfalls of gloomy poring on the aftermath. At some point, one needs to take a break from the mundanity. And that’s why I chose to opt for a subject which wasnt among my top choices for a postgraduate career.

The college itself is good, the department full of topnotch faculty, and my confrères quite tolerable. There is the frequent altercations regarding work but such instances occur in any workplace. Each setting has its share of trouble. If you’re in a private hospital, there are the occasional run-ins with management, and needing to toe the line regarding their unethical policies. A private medical college run by a multibillionaire has its own share of issues. Our department has been without an operating microscope and an endoscope for months, and the management seem hardly bothered by a need to provide these essentials.

Two years seem hardly enough time to learn a trade, and it’s likely that the better part of experience is yet to come, from actually practising what one learns.


Cast iron system

I have to admit that the work at the dispensary is growing on me. Maybe it has to do with outlook. I used to travel to the dispensary with the feeling that I somehow had to be here for a few years, till I could go back to my city, at the next due General transfer. But nowadays, the journey is easier, made pleasant by the recognition that people bestow upon me.

At college, one of the questions put to us as students in first year during impromptu sessions was the question, “Why did you become a doctor”. The hated cliche, was to answer that it was to serve humanity. That always brought out the boos. I never felt that this was the reason for choosing the medical profession. As for me, I never even considered joining a medical college, till the first year of engineering college. Yea, that’s as good a tale as any, but we’ll save that for later. It was the most sought after profession, and a different experience when Information Technology was the in thing. Anyway, now I’m beginning to understand the service aspect of it, and welcoming my role in it.

Though the junior most doctor in the dispensary, thanks to the seniors here, Dr Devarajan and Dr Muhammed Riaz, I’ve never felt looked down upon. It may have been partly the experience of being a Casualty medical officer at X Hospital, Trivandrum. I had my share of proud moments, some of the more memorable ones being when I rightly diagnosed a patient misdiagnosed by the senior consultants at the private hospital. A particular incident jumps to my memory. A patient had got himself admitted in the care of Dr Name Redacted, a physician at Jubilee the previous week. Part of my job as the Resident Medical Officer, was to take rounds in the wards. I came across the case due to some trivial complaint made by the patient. However after a summary history taking and brief examination, it became apparent that the patient was not having a simple case of “Generalized tiredness”. In fact, I got a history of weakness in his feet, and a sensory impairment in his legs. I heard the warning bells go off in my mind. Some finer examination made me make a provisional diagnosis of Guillain Barre syndrome. I informed the consultant as was my duty. However, Dr Name Redacted, is, well, let’s just say that he has his own style of clinical approach. But he redeemed himself by referring the patient to a neurologist.

Unfortunately the neurologist either missed my notes, or didn’t pay much attention to them (After all, who trusts a doctor with just an MBBS, right?). He gave more attention to the low blood sodium values in the patient, and his advice was to add more salt in the diet. Dr Name Redacted called me up and explained to me in no uncertain terms, how I had been wrong in diagnosing the patient as a case of GBS. I didn’t argue. I probably should have done so for the patient, but I didnt think it would make a difference. In an altercation between a junior doctor and a consultant, the consultant who is a valuable asset to the institution always has his way. I didnt see the patient until 4 days later, when on another night duty, I was asked to write a referral note for a patient. It was the same patient, and I was disheartened to see that now he was paralysed from the neck down. He had not fully developed motor weakness when I’d first seen him, and could have gone home that week if started on some anti-inflammatory medicines early on. Instead, he was made a cripple. I can’t blame Dr Name Redacted for his approach. He did his due, and referred him to a neurologist. However it is still saddening that a case which a junior doctor diagnosed just after spending a few minutes did not receive the proper attention from a consultant just because the junior doctor did not have a list of post graduate degrees following his name.

In such cases, what can you do? Fight the system? Go head on against the senior arguing for what you think right? I did make my argument. I clearly outlined my examination and history findings, as well as any neurologist does. Thankfully, my alma mater and my extracurricular reading had bestowed me with those skills. But when you’re ignored, and just a part of the system, and not the decision making part, at that, you often have to resign yourself-bite the bullet and accept fate. Right?


Hotel review – UG Grand – Travelguru

Among all the hotels that I’ve ever booked, this is the worst service that I’ve ever had to endure. I have booked the hotel through and am angry that they could enlist such a hotel in their service. Read on to learn about my experience.


Hotel UG Grand is just a brisk 10 minute walk from the Majestic (Kempe Gowda) bus terminus. Having found the location on my smartphone’s Google Maps, I decided to take a walk instead of hiring an auto in an unknown city and succumbing to their exploitation. After a few intersections, you can see the sign which points to the UG Grand Hotel.


It doesn’t have any sheds for parking. There’s a small open area parking that can accommodate around 10 cars at most.


As mentioned, it is close to the hub of Bangalore city, the Majestic bus stand and the Bangalore City railway station. Hence it is easy to visit anywhere in Bangalore, since the Majestic bus stand has buses to everywhere.


The staff were unhelpful even to the point of being distinctly hostile. When I reached the front desk, they were sending away another guest who had reached there after being shunted from another of their hotels nearby, and had pre-booked his reservation from ‘’. Apparently they had no idea about the number of rooms already paid for via online bookings, and had already filled the rooms to other people who had no bookings.

I had to argue with them for 15 minutes to make them understand that I had already paid for the rooms online, and that they already had my money with me. Finally they had to acquiesce. I had to wait for 45 minutes in the lobby for their manager, before I was accommodated.

The Room

I have stayed at this hotel in the past and the previous stay was in a cosy room. However this time, they accommodated me in a room with tattered walls, unkempt sheets and to add fuel to the fire, one whose electrical wiring was shoddy so much so that the socket where you insert your key to power on electicity was hanging loose from the wall. It took half an hour for an electrician to fix it, before I could switch on the fans in the place.

The bed sheets I was provided were torn (See photo).

The pillow covers were dirty.

The mirror was stained and useless (See photo),

and the paint on the walls was falling apart in places (See photo).

The room itself was in corner of the building, and had no view. If you open the windows, you can peer into another room through its windows. However you’d be advised to close the windows shut since there are a lot of pigeons rollicking about in the spaces between the rooms.

Even though the hotel is close to the roads, it is very quiet within the rooms, and you can hear the bustle and noise of the city only if you listen intently. It is a good choice if you need to take a good nap.

General cleanliness and facilities

There is nothing much to praise about this hotel. When I was shown into my room, the pillows were missing covers and there weren’t any blankets. They took around an hour to bring fresh pillow covers and even these were stained. They provided just one blanket. They did not provide towels or soaps, which are provided by almost every budget hotel.

Dining facilities

Since the hotel did not have a restaurant, I didn’t order from room service, and instead took a walk to a nearby diner and ordered tasty South Indian dosai and curry. Mind you, there are NO good restaurants nearby. The diner I used resembled a fast food joint, and may not be for everyone’s taste.


I cannot recommend this hotel for families. If you’re staying for just a couple of days and absolutely need an economical hotel, this one is fine if you can put up with the unkempt rooms, and aren’t claustrophobic. I’d still advise you to keep phoning up the hotel reception at least a couple of times to make sure they hold your reserved room. On the overall, a very pitiable service. The only advantage is the closeness to Majestic.

I have never received such a poor and shoddy service in a hotel booked through I have complained to the online booking service and asked them to refund my booking at least partially. When one uses an online service of good repute like, they have a responsibility to ensure that hotels they’ve enlisted provide a minimum standard of service to their guests. When the hotel has no clue that an online booking exists for the date, something stinks somwhere, and maybe it’s time to switch the online provider and use another service like or

I’ll keep this post updated with details of any feedback from Travelguru. As of now, their only response was that they will talk to the hotel’s management and ask them to improve their facilities, which seems a pretty dismal response. What about the consumer who had to endure the shoddy service due to their lapse?

Other Photos


I’d complained to today morning and also contacted them through their social media portals. I just received a reply from them (after around 5 hours), so that’s pretty fast for customer service.

Response from

Dear Mr.Mathew.

Greetings from Travelguru.

With reference to your e-mail, we sincerely apologise for the inconvenience caused to you and would like to express our deepest regret for the disappointment caused to you during your recent booking with Travelguru.

We would be closely monitoring the hotel and would upload your feedback on our website which shall also lead to a decline in the hotel rating. We would also like to inform you that in future if we continue to receive any more complaints we shall blacklist the hotel on our website.

You deserved better – a lot better – from us with each transaction you do with Travelguru, and this time we have let you down. Nothing is more important than regaining your trust and as a goodwill gesture we are providing you Rs 500/- gift voucher which you can use for your future reservation.

So that seems pretty decent of them. It doesnt take away the difficulties I faced, but mitigates it.


ESI Dispensary, Mynagapally

Work at an ESI dispensary is far more relaxing than that in a similiar hospital of the Health service department. Our clientele comprises cashew workers employed in shelling, segregating, and weighing cashewnuts in a host of factories located in and around Karunagapally and Sasthankotta. Most of their chief complaints are similiar. The main ailments include Low backache, shoulder stiffness, allergic wheezing, which can be crudely classified as Occupational diseases.

We rarely have emergency cases. There are two shifts from 8am-1pm and 1pm-6pm, with poor turnout for the afternoon shift.

Getting to the hospital by train is easy. If one needs to reach the hospital before 8am, one can board the Nagercoil-Mangalore Parasuram express (alias “Day express”) which starts from Trivandrum Central railway station at 6am. If one needs to go just a little bit later, one can board the Sabari express which runs from Trivandrum central to Hyderabad, which starts out from Trivandrum at 07:15. Then there is the 08:05 Kanyakumari-Mumbai CST (Jayanthi express) which starts departs Trivandrum at 08:05. The latter two do not have a stop at Sasthancotta, and I make do by alighting at Kollam junction and then boarding either the 08:45 or 10:05 MEMU (Mainline Electrical Multiple Units) train which run from Kollam to Ernakulam (Cochin), via Alappey  and Kottayam.


How to process salary for a Self drawing gazetted officer via SPARK

I submitted my first salary bill to the treasury today. The procedure to be followed is this:

First, I had to give an RTC form along with a copy of the posting order to the treasury. They then provided a Specimen signature card, in which I had to make three different signatures in front of another gazetted officer drawing salary from the same treaury (Karunagapally treasury in my case)-I got it attested from the Tahsildar. Once I submitted the Specimen signature card, they opened a Saving Bank (SB) account for me and provided the Account number. They also provided the SDO code (Self drawing officer code), which I then entered into the Service and Payroll Repository of Kerala (SPARK). Once I did that, my Spark account and AG payslip were linked to the Treasury.

Today, I submitted a request in paper, asking for cheque book and passbook, and had to fill another specimen signature card, this time for the Savings Bank account. Within 15 minutes, I received my cheque book and passbook. For submitting the Bill, I had to login to Spark.

The Spark procedure to generate and print a Salary bill is detailed below:

Generating a Salary Bill

If this is not the first salary, you have to first “Update encashment details” of last month’s salary before you can process the current month’s salary.

Salary>SDO Salary>Update encashment details

You can see the processed last month’s salary. Select it, then enter the date when you got the money transferred to your Treasury account or got it as cash. And select proceed.

Note that it won’t give a prompt for confirmation. However the data will be logged in system. Now, y0u can proceed to process the current month’s salary.

Salary>SDO Salary>Salary processing.

Choose the month and year.

Choose Pay among ‘Pay’ and ‘Leave Salary’.

Choose ‘Proceed’.



and submit the job for processing after verifying amount and deductions. Then, one can see the job completion status. Once the estimated time is over, login again to print the bills.

Printing Salary Bill and Schedules

Then, Salary>SDO Salary>Salary Bill and Schedules>Choose the month.

Click on the “Select” link next to the month. The site pops up a box saying “This may take some time”. Ignore the warning. You’re just going to view the generated bill and not process it again.

You’re now able to view a set of new links, like “Outer Bill”, “PF Schedule”, “LIC Schedule”, “Group Insurance Scheme”. Each of this links lead to downloading of the respective bills (Salary statement) as a PDF file. The outer bill is the main salary bill. I had to print both Salary bill and Group insurance scheme schedule.

Once everything was generated, I had to take a print of the salary slip and schedule for GIS (which I had to subscribe to in September), stick a Re 1 Court fee stamp on the printout of salary slip, near the first signature coloumn, sign on the stamp and the paper and also adjacent to the stamp in a signature coloumn, sign on the reverse near the HRA statement. I had to attach the AG’s slip in original, the salary bill and the schedule for GIS, along with a maroon coloured Challan, tie all three with a twine and submit it to one of the officers. It was immediately taken up for processing and I could then leave. The entire process took an hour.

Scanned Salary Bills:

Below, I have scanned and annotated a typical salary bill and the Treasury challan. These have to be tagged together and submitted to the treasury.




After these were done, I had to return to the Treasury after the second working day to collect my cash via Treasury cheque.