BOOKS AND BANGALORE

Showing posts with label Health First. Show all posts
Showing posts with label Health First. Show all posts

Sunday, October 2, 2016

The Scavengers




"Everyone must be his own scavenger"


-Mohandas Karamchand Gandhi-

My two cents to Baapu today, the only thing he can do is this, leap out of this beautiful street art and do the needful. I have been commuting through Bannerghatta Road of Bangalore for the past two years; and I must say that once upon a time this place looked a tad bit better. This is somewhere on the five hundred metre stretch from Shopper’s Stop to the Jeddimara junction, right on the main road, travelling on this road is as good as getting a breath holding test done to check your cardiopulmonary reserve. I stopped by and clicked a picture today for it is something which perfectly defines our defiance amidst all the celebrations. People have thrown enough garbage for Gandhi to do his part, to be his own scavenger! 

Today on the birth anniversary of Gandhiji and Shastrji our Prime Minister and our government with all the ‘Swachh Bharat Abhiyan’ wants us to make this unfathomable dream of a clean India come true. Before we catch hold of a broom and pose for a photograph and send it across as requested, well there is a lot of introspection to do.

Every time I pass by this place, I think of the Samaritan who drew this on the wall, I think of his or her effort and of all the people who may see it. I wonder how many of us can figure out the intention behind this art. It is to create a new mindset and to educate people but look at all the garbage around! Ironically ‘Shramdaan’ happens only on days such as today and constructing ’Shouchalyas’ remain only as winsome advices from film stars. A while before I clicked this picture a man was happily taking a leak and a few others were tip toeing around awaiting their turn. Nature calls in the wee hours of morning you see. Civility demanded I turn around and look at the other side, that's the most I could do!

Normally it is impossible to walk on this stretch of the road, with children defecating on the footpath, garbage and filth piled at every twenty feet of distance and the Bruhat Bengaluru Mahanagara Palike workers half willingly cleaning and scavenging the area. And mind you this is all on one of the busiest roads of the Garden City and Silicon Valley of India, the situation elsewhere in Bengaluru I bet isn’t any different. I wish the Palike of our city and the people of this locality looked into this matter, at least today. Look at our Baapu smiling on the wall despite what he has been offered! Before we think on what is the best tribute we pay our leaders and country, we as citizens are duty bound to sustain what we have already been provided with, knowledge or amenities. Somehow in India, this never seems to happen. Lakhs of villages and hundreds of cities are now declared Open Defecation Free. Bless the data and statistics, let us include them in our bag of achievements. All the advertisements and campaigns in fact are nothing but a veil of development; our Indianness is here to stay for a long time to come. 

So what am I complaining about? Well I could have gone ahead with an enthusiastic team today [of which there is no dearth especially on such occasions!] to clean this place and sent a picture to Modiji, put it up on social media and all. You know with the masks and caps and tees and boots and brooms in hand but which fellow Indian can assure me that after a couple of months this place will not bear the brunt again? I cannot wait till the next Gandhi Jayanthi or any other Jayanthi for that matter to go ahead and clean my Bengaluru. I am writing this with a larger issue in mind, of personal hygiene and a sense of personal health. One cannot expect one’s neighbour to come and scoop up what one throws on the road. Unless every individual realizes that his own cleanliness comes before his own happiness and somebody else's too, all community efforts are futile. Let godliness stay where it wants, to each his own. When it comes to cleanliness, nobody can better our lives. We have to do it ourselves, it's a responsibility which is strictly personal, just like one's belief.

-R. 



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Saturday, November 14, 2015

For The Sweet People



“Daktre nange sugar ide!”

This is something I get to hear from every fourth person I meet. ”Doctor, I have sugar!” With India being the diabetes capital of the world, a spacious home to about 60 million people living with this disorder there is a lot more that needs to be done in this regard. As a  doctor I would like to share a few thoughts today on World Diabetes Day. 'Healthy Living And Diabetes' is the theme for the period 2014-2016.



Diabetes has no longer remained a problem of the rich. A day ago one of the house keeping staff of my laboratory came to me.

“Madam! 279 Madam! Is it because of the Diwali sweets?”

I gave him some serious advice. I told him to go for a check up, for some more laboratory tests and for a dietitian consultation, but the indifference with which he responded only made me realize that this diabetes problem is a tough one to deal with in this country. It requires a multifaceted approach. Do visit the Diabetes Foundation Of India to know more on what is being done in India.

 My concern is that there are innumerable myths around this non-communicable disease. I would like to throw some light on the most popular.   


  • SUGAR is synonymous with DIABETES.
Picture Courtesy

 
 No. Diabetes has reached such magnitude that we need to be a tad serious about it. Sugar does not mean diabetes, let us get more rational and scientific. 


  • INSULIN is worse than TABLETS. 
No. Treatment has to be monitored by a diabetologist. Do visit one before getting into self medications. What works for one patient may not work for the other. 

  • I only have to STOP EATING SWEETS.
No. Diabetics require a diet. There is nothing like no sweets. We all are born with a sweet tooth, aren’t we? And that too with so many festivals that have to be celebrated every fortnight! But yes, we need to watch what we eat, when we eat and how much we eat!  

  • My PARENTS DON’T HAVE DIABETES, So I WON’T GET IT

No. Although there is familial predisposition there is no science behind this baseless thought. Diabetes is a lifestyle disorder, mind you it is a DISORDER and not a disease.  

Picture Courtesy


  • I HAVE 'ONLY' DIABETES.  

NO. This is a major misconception among diabetics. You know that constant feeling of self assurance 'Nothing is wrong, it is only diabetes' The first step towards living with and solving a problem is accepting it followed by gaining knowledge about it. Diabetes can lead to multiple health issues, if I were to list it as a risk factor for the number of other diseases I can begin and end a major medicine textbook.



 Some diabetics do good and live with it like they have no problem at all, what I see in them is the difference in attitude - diet, exercise, medicines, health updates and most importantly 'HAPPINESS'- Hakunamatata! :-)




My mother is someone who believes not in fighting with diabetes, but in living smart with it :-D

She was the one who reminded me this morning.

 “Aren’t you going to wish me today?” she asked.

“Why?” I questioned in reply looking at her adorable smile.

“Today is World Diabetes Day, it is kind of my day” she said.

And we laughed.





We had gorged on this last week. Haha! :-)

-R.


Wednesday, September 2, 2015

B or P- Issues Raising Blood Pressure

"There are some atypical cells probably" said the pathologist.

The doctor was worried, it was his wife's PAP* smear report after all. After a brief discussion they both decided to go for a Human Papilloma Virus detection just to ensure that the picture does not turn out to be bad. He walked to another section and spoke with the Microbiologist regarding the case, the investigation would be outsourced from there to another laboratory which carries out molecular diagnostics.

A couple of minutes later.

"What sample is required for HPV-PCR** pa?" he called the microbiology laboratory and asked.

"EDTA-sample Sir" a technician replied.

The doctor billed for a HPV-PCR test from the billing section and sent the sample from the sample collection centre as told.

 The EDTA vacutainer reached the laboratory through the house-keeping. Another technician received it and took a printout of the worksheet and kept everything ready for the test to be outsourced.

Now one may wonder what this is all about and what happened after that.Let me tell you what the final report was:

Hepatitis B Virus- Not Detected

Human Papilloma Virus
Eh? B or P, what is in a letter? Definitely a great raise in Blood Pressure! I did fall of the chair when I heard this. Everything is pretty much kicked to Pluto if there is a miss or a change, especially in a health care setting when this happens it is not at all pardonable. I am sharing this because it is a necessary learning, unfortunately I wasn't around when this happened. I heard various versions from the technicians regarding this matter, what I understood was the kind of miscommunication that happen over telephonic conversations. The doctor called asking for HPV, the technician heard it as HBV and advised him to send a EDTA vacutainer, but in reality it is either a cervical swab or cytology fluid that needs to be sent. Well even after that with the mismatch in the bill, nobody really bothered to cross check. The outsourced test was for HBV-PCR since it was an EDTA vacutainer. The realization dawned only when the doctor called asking for the HPV-PCR report after two days. HPV is a virus associated with cervical cancer and HBV is a virus associated with hepatitis and liver cancer, two different clinical presentations and diagnoses. The matter is getting sorted out, and we hope not to have such disastrous events again.

  

Hepatitis B Virus
What bothers me is the mechanical nature of work that happens in most of the hospitals. This happened with a hospital staff, a doctor, I cannot imagine the scenario if it was a patient. It does happen nevertheless. Nobody talks about it, the matter is hushed up or sorted out by us doctors or dealt by the patient relations section. I am talking about it because this kind of maleficence is something we all need to be aware of, as doctors and as patients. We need to always ensure that abbreviations or short forms are not used for drugs or tests during diagnosis and treatment. After all it is a matter of someone's life or death. There is a thin line, a very thin one. Thankfully this incident was something that could be handled, if it was something else I couldn't have forgiven myself for being a part of such a work team! It sends a shiver down my spine, every time I think of it. "Do No Harm" is sometimes easier said than done.

*PAP Smear- The Pap smear is a screening test for cervical cancer. Cells scraped from the opening of the cervix are examined under a microscope. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina.

**PCR- The polymerase chain reaction (PCR) is a technology in molecular biology used to amplify a single copy or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence.

-R. 



Saturday, July 25, 2015

Dengue Season Lessons


http://blog.blogadda.com/2015/07/25/spicy-saturday-picks-25th-july-2015





“Hello, calling from emergency, can you tell us the dengue report of…”a resident doctor asks from the other end.





“Positive for NS1 and IgM…”says our laboratory technician.



Seconds later.           



“Hello, calling from the ICU, SDP* needed for….are they ready?” asks a staff nurse.



“Ready, you can send someone right now” replies a blood bank technician.



At the same time.



“Hello Ma’am, calling from reception, can you please verify the dengue report of…”a data entry operator from the other end.



“We will do it in a couple of minutes…” I reply.



Seconds later.



“Hello, calling from the ward can you run a Dengue IgM ELISA for my patient with the previous sample, his platelet counts are low, I strongly suspect Dengue…”a clinician from the other end.



“No problem Ma’am, we will add it to the run today” one of us reply and agree to do it.



This diagnostic and treatment process runs in the various departments of every other hospital in India twenty four seven these days. All thanks to the ‘Dengue Season’ like we choose to call it. At this point of time, as you are reading this I bet there is at least one person you know who has had dengue this year. The emergency and outpatient department is busy with cases of fever, the doctors with every third patient coming with signs and symptoms of dengue, the blood bank is worked up with platelet transfusions and the laboratory with monitoring platelet counts and serological tests.



Dengue is a serious public health concern, like many other diseases and disorders it turns into a red alert when mortality rate surges. Remember the H1N1 a couple of months ago? Keep that for memory, there could be is always a next. I initially thought of writing a post on the ‘dos and donts’ to avoid the transmission of dengue thinking that would be helpful, and then it occurred to me that most of us know about the Aedes mosquito, water stagnation, sanitation, coils, nets, electric bats, repellents, papaya juice and what not. It is not the lack of this knowledge that causes the dengue outbreak every year in a tropical country like ours. There is more to the picture.



 What bothers me as a laboratory physician is our failure at many levels of health care to handle such a situation. There is a great lack of responsibility from all sides- hospitals, doctors and patients alike. The extreme variability in the standard and costs of testing and treatment has recently grabbed attention in Karnataka. Read this to know more-Government Fixes Dengue Test Rate for Pvt Hospitals. Such measures although put the government in a Samaritan position, the real problem is something else. None of us is bothered about any preventive measures or a long term solution to such vector borne diseases. ‘Odomos’, ‘Good Knight’ and 'Mortein’ can think of new advertisements. Doctors, laboratories and blood bank can think of their work load and price revision. And the government can think of regulating them. Until the same time next year! 

Ek machar kaafi hai, par ek soch nahi :-P

Picture Courtesy

Do share your opinions and experience.

*SDP-Single donor platelets

-R.