Thursday, January 29, 2015

The Preventable

A major scourge of healthcare in India is the presence of preventable diseases. The incidence of malaria has definitely been on the decrease. However, I’ve few friends who believe that there is not much of a decrease in incidence, rather, it is a failure of reporting that has sort of given across the message that the incidence has decreased.

At Kachhwa, we see quite a few cases of malaria every week. Most of them are Plasmodium Vivax cases. 

Yesterday, we had a very interesting patient. A young man working in a town in North Bihar, he had come with fever of quite a long duration – almost couple of months. We had seen him about a month back and had treated him as Enteric Fever. And he had responded well to treatment.

However, he came back within couple of weeks of stopping treatment. We did a malaria smear and this is what we got.


The smear was full of gametocytes. In fact, almost every field had at least one gametocyte and surprisingly we could not find any ring forms. It is not very common that we got a field with 3 gametocytes.

The scenario of having Falciparum Malaria cases in the community is frightening. It exposes the population to a chance of morbidity and mortality from severe forms of malaria. And it is a harsh reminder of the infantile public health scenario of the country. 

5 sisters

Over the last 2 weeks, we were treated to a visual delight in the flowers in Barsati's garden. However, there was a special rose plant which had 5 flowers and it was quite special. Snaps of the same . . .









Wednesday, January 28, 2015

Menace

As most of us, tuberculosis is a major problem all over the country. 

One of the major issues in tuberculosis management is over the counter medications. Almost all anti-tuberculosis medicines are available very easily. 

Yesterday, in OPD, there was a boy who came with a peculiar skin lesion. We did a biopsy of the lesion. However, the boy also had a prescription written by someone on a piece of paper. He was told that this medicine is quite strong and should clear out the disease. 


He was smart to have not taken the prescribed treatment and opted to have it checked with a doctor. 

Unless, we can rein in such prescriptions, we are inviting avenues for emergence of Drug Resistant Tuberculosis. Of course, another cause of DRT is sub-optimal prescription doses of anti-tuberculosis medicines. 

The question is about any of us being serious about this issue.