before_sent:  He started his practice under government service at Madras Medical College where he helped establish the department of vascular surgery in 1978 and served as its founder head till his superannuation in 1993.
before_sent_with_intent: <fluency>  He started his practice under government service at Madras Medical College where he helped establish the department of vascular surgery in 1978 and served as its founder head till his superannuation in 1993.
after_sent:  He started his practice under government service at Madras Medical College where he helped establish the department of vascular surgery in 1978 and served as its founder head until his superannuation in 1993.