Wednesday,
August 26, 1998
|
|
Consequences of vehicular
accidents Let’s
decide what is health plus welfare Who
is afraid of cataract? Simple
way to save a life on golf course Intricacies
of acupressure Easy
cure for constipation |
Consequences of vehicular accidents INJURIES present a much greater problem than what is seen in the emergency setting of a hospital. These are by far the commonest cause of death and serious disabilities especially in young people. Vehicular crashes account for a significant portion. Crashes involving drinking and driving, speeding, or failure to wear safety devices are not accidental at all. They are man-made situations and there is a place where opportunity lies for correcting them. I wish to quote from an article published in 1997 titled “A princess dies, a surgeon reflects”. “Diana’s death should force us to reconsider what actually happened. If Princess Diana had never entered a car with a driver who had been drinking, had refused to allow the driver to speed, and had worn her safety belt, she would have probably made it to home — to her beloved children. Her death should force us to reconsider what actually happened. Ironically, this could be her greatest gift to humanity.” There is an urgent need to develop locally applicable injury-prevention or treatment strategies. Road safety and other injury-prevention efforts have lowered the mortality rate from motor vehicle crashes in developed countries. Doctors have a very important role as advocates of accident-prevention and we should seriously consider this aspect of our profession. Counselling by physicians can be the most cost-effective approach to prevention. Injuries cannot be totally eliminated by prevention strategies, but their incidence and severity can be significantly reduced. Educational programmes require no advanced skills. Society as a whole must recognise the importance and utility of these programmes. Traffic control, reducing alcohol-impaired driving and public education programmes are likely to reduce the number of vehicular death and the extent of disability. Vehicular restraint systems and the use of various safety devices are extremely important preventive measures. Alcohol contributes to the frequency, severity, mortality and disability of injury. It is associated with a higher incidence of death from crashes and a greater incidence of post-injury complications. In countries where real effort has been made to reduce driving while impaired, a significant reduction in vehicular injury, especially death, has been achieved. We have to redouble our efforts in this direction. Many deaths occur at the site of accidents. An improvement in pre-hospital capabilities is likely to be more effective than expensive hospital-based interventions. Communication has always been one of the big blocks to improve trauma-care. There is need for the development of practice guidelines for the care of the injured. In rural areas the trauma victim may not be able to receive advanced trauma-care, particularly resuscitative surgery for a prolonged period. During that time cardiac arrest must be prevented. Efforts should be made to maintain pulse-oxygen administration. The prevention of hypothermia can be initiated at the site. Hypothermia is bad for trauma patients and contributes significantly to mortality. We ought to continue our efforts regarding the persistent problem of resuscitation, transportation and communication. There is an urgent need for a trauma system which provides an opportunity for development. There has to be a drive to improve the quality of the care of trauma victims. Injury is a unique problem. Each death on the road should force us to reconsider what actually happens countless times every year in the community we serve. Our own experience should remind us that the cost of death and disability from an injury on a personal basis is incalculable. We have all seen the profound anguish on the faces of members of families after the death of the loved ones from an injury. A child or a young adult, who dies in an accident, makes us sad for long. Imagine the enormous economic loss from premature mortality and disability. If each one of us refuses to enter a vehicle with a driver who has been drinking, does not allow the driver to speed, and wears safety gadgets, we would probably make it to our homes — to our beloved families and children. The incalculable benefit of preventing death and disability of our loved ones is not imaginable. We, the doctors, represent not only those involved in dedication to the treatment of those in need of the most urgent care. Our commitment to the prevention of such injuries and a marked improvement in the care of those who have been injured are part of our creed. The public and those responsible for implementing the traffic regulations should make a real contribution towards the unavoidable commitment to the prevention of man-made injuries. —Dr
Wig is an eminent surgeon and a distinguished teacher at
the PGI, Chandigarh. |
| H |
Let’s decide what is health plus welfare INDIA is the second largest country in the world, next only to China, in terms of population. Nearly 15 per cent of the total world population, 2.4 per cent of the world area and a population growth rate which is now second to none is a source of tremendous anxiety amongst the country’s planners and decision-makers. They foresee ever-increasing numbers over-shadowing the achievements that the country makes on the economic front. Overpopulation is assumed without question to be the main cause of every problem, from the growth of slums to unemployment, famine, pollution, liberation wars and striker. Futurologists take perverse delight in painting a hopelessly pessimistic picture of the world in the 21st century, especially in the third world. Universal family, planning is accepted by economist, planners and other experts, mostly in the developed countries from whom their Indian counterparts draw inspirations, to be the miracle cure of the problem of population explosion. The protagonists of this line of thought argue that the small family norm is desirable because it enables people to live a prosperous life. By curbing the population, there would be goods in plenty to meet the material demands of the people. But this is not so, especially when viewed in the perspective of the economic status of the family. When the family lives a subhuman level of subsistence, having fewer children does not perceptibly elevated their standard of living. Hunger and starvation still have to be combated. More children mean an additional pair of hands which can contribute something to the family kitty. In any case, deficits and debts preclude the possibility of savings and subsequent elevation of lifestyles. And how many would survive the first five years of life is a moot question. It is only when a family is assured a steady income that having more children becomes a liability. A small family norm is a middle-class value and to force the poor to submit to this without improving their economic and social conditions is unjust. It is ironical that a development process to ameliorate the lot of the teeming poverty-stricken millions is sought to be generated by merely reducing it. It deprives the individual, the future beneficiary, of the dignity and freedom to decide how many children he or she wishes to have. In a pratiarchal social order, more than men it is the women who face the major brunt of this insensitive assault on human dignity. The methods, attitudes and subsequent after-effects further undermine their fertility and position in the socio-economic hierarchy. Another aspect of the problem, hitherto undebated, is the psychological implications of a small family. Is the “one child family” norm really desirable? Its effect on child development, social relationships and structures in the Indian situation have not been discussed in entirety. Though not yet overtly propagated, the mass media is now seeking to idealise the “no child” family as a symbol of desirable economic values. Release or resources through population control is possible only when resources are universally available and uniformly distributed. The inequalities in access to even basic services such as health care become apparent through the fact that though 80 per cent of the Indian population is rural, less than half of the total health budget is allocated to this section. To make matters worse, public health personnel are so overburdened with family planning targets that primary health care becomes synonymous with birth control for the rural population. The present socio-economic structure of society does not guarantee fair distribution of the released sources. The existing resources are concentrated in the hands of a few, a fact deliberately ignored by the major donor agencies. Very few are prepared to support developmental activities without population control being the frontal strategy of approach to solve problems of poverty and unemployment. For instance, maternal and child health (MCH) programmes find favour with the funding agencies because it is closely linked to fertility. With the deterioration of India’s economic condition, foreign aid has come to acquire a crucial role in shaping India’s policies and family planning is an indispensable part of the aid package. Population control is pleaded with such intense fervour that it cannot even wait for improvements in the economic and social fields. Population growth aggravates poverty, undernutrition and illiteracy; and these in turn create a situation which favours unregulated population growth. The quantitative and qualitative dimensions of the population problem which are mutually reinforcing must be addressed for family planning programmes to succeed. The use of pressure tactics, the bureaucracy and panchayats at the village and taluka levels, as well as monetary incentives are accepted inducements to motivate people to accept family planning. If population control is seen independent of development, then motivation and incentives are perceived to be independent of the individual’s social existence. Family planning is much easier to implement than major advances in the areas of education or the economy. And, although it has been repeatedly stated that family planning is part of the package of development, it has been more a substitute for development and structural change. Decline in death rates in the western countries was achieved not through aggressive and deliberate promotion of contraceptive technology or through national family planning programmes, but through changes in lifestyles and value systems brought about through socio-economic development. There are no short-cuts and instant solutions which even the latest advances in contraceptive technology can offer. Family planning can only be meaningful as a by-product of overall prosperity; not when it is used as a means to chase a mirage. (Source:
The Voluntary Health Association of India) |
Who is afraid of cataract? PATIALA: A 60-year-old woman walks into the operation theatre for a cataract operation. She is given counselling and mentally prepared for an operation without any injection, any stitch or any bandage. Within the next 15 minutes the operation is done and the woman is free to resume her normal activities. A demonstration of this unique surgery called phaco surgery was given by Dr Harbans Lal, 43, a consultant eye surgeon at the Sir Ganga Ram Hospital in New Delhi to delegates of the 12th annual conference of the North Zone Ophthalmological Society here the other day. Demonstrating to around 100 delegates at Government Medical College, the patient was made to lie down at the table after receiving counselling that this was an operation in which no injection would be given and she need not have any fear. The patient’s eye was cleaned and anaesthetic drops were put into the eye following this a 3mm incision was made with the help of a special instrument and the lens broken and sucked out. This left a thin membrane to support the intraocular lens. A foldable lens which opened immediately after being put from the 3mm incision was put inside. Following the operation, the woman was able to get up on her own and her vision was restored. The delegates broke into cheers as the patient walked out unaided. Talking to TNS, Dr Harbans Lal said this new technique of surgery removed earlier obstacles faced by physicians as well as the risk factor undergone by patients when an injection was administered in the eye before surgery. He said in convential surgery there were chances of bleeding from the eyes. Besides, the patient had to be careful not to exert himself for at least a month. Dr Harbans Lal said in the lens implant surgery there was restriction of activity for four to six weeks and it took 10 to 12 weeks for the vision to stabilise but in phaco surgery the vision was stabilised in two weeks. Dr Harbans Lal, who is one of the few surgeons practising this technique and is always on the move demonstrating the technique all over the country, said the number of patients opting for phaco surgery was increasing as it was more convenient. No follow up was required. He said steps should be
taken to ensure that more doctors got training in this
technique so that patients could avail themselves of the
new eye operation technique. |
Simple way to save a life on golf course PEOPLE die on golf courses for two major reasons. They have heart attacks or are struck by lightning. The unfortunate part is that not all these people have to die; at least 50% would survive if fellow golfers know how to apply simple life-support techniques of cardiopulmonary resuscitation known as CPR. CPR is the ability to use your hands and mouth to help someone start breathing or restore the pulse beat until he can be given professional emergency medical assistance. Anyone 13 years old or older is capable of doing CPR. If a fellow golfer on the scene can do CPR during the first crucial moments (5 to 10 minutes) of an accident, there is a good chance of survival. So CPR (cardiopulmonary resuscitation) is resuscitation of the heart by chest compression and resuscitation of lungs by mouth to mouth breathing. Mouth to mouth
breathing Chest compression CPR is not only useful at golf courses. It is helpful in drowning, choking, shock, electrocution and people suffering from respiratory problem. — Dr G.S. Kochhar
|
Intricacies of acupressure Traditional Chinese medicine (TCM) teaches that channels of energy flowing throughout the body may be manipulated by pressure. Acupressure involves pressing points on the body with fingers and to alter the internal flow of a vital force or energy called ‘chi’, strengthening it, calming it, or removing a blockage of the flow. This system of healthcare originated in China thousands of years ago and it is still widely practised in Asian countries. Acupressure is a drugless way of healing. It is simple, without any side effects and the cost factor is very small. It is said, “Acupressure treatment is so simple, easy and effective that any layman, even a child of 12 years, can learn and practise it. This therapy is especially known to cure chronic ailments like arthritis, spondylosis, sciatica, asthma, paralysis, migraine, high blood pressure, sinusitis and diabetes.” According to TCM, acupressure points are aligned along 14 bodily meridians, or pathways. Twelve of the meridians are bilateral; that is, identical versions of them (with the same set points) exist on both sides of the body. The other two are unilateral, running along the midline of the body. The 14 meridians do not correspond to any known physiological processes or anatomical structures in the body, such as nerves or blood vessels. Nevertheless, some studies have suggested that acupressure can be effective for a number of health problems, including nausea, pain, and stroke-related weakness. A single point may be pressed for relief from a particular symptom or condition; or to promote overall well-being of the body, a series of points can be worked on in a specific order. Acupressure can be administered by someone trained in the technique or it may be practised at home. The force used on different points varies, but in general, most points call for a steady, downward pressure lasting one to two minutes. The risk of acupressure are minimal, provided certain cautions are observed. During pregnancy, the points designated for spleen (six) and large intestine (four) should never be used; avoid the abdominal area entirely, if possible. Never apply pressure to open wounds, varicose veins, tumours, inflamed or infected skin, sites of recent surgery, or areas where a broken bone is suspected. But remember! Acupressure is not a substitute for a physician’s medical advice. —
IJCP Medinews |
Easy cure for constipation Do you have difficulty in emptying your bowels? If you do, then you are suffering from constipation. Well, nothing alarming, constipation is a very common symptom. Most of us suffer from constipation at some or the other point of time in our life. A list of drugs is available in Allopathy to relieve constipation but most of them are habit-forming and do not provide permanent relief, says a write-up in IJCP’s Medinews. Definition Causes
Treatment
Diet recommended Wheat or rice with bran,
vegetables, fruits, especially citrus fruit, old rice,
green gram, garlic, banana, bathua leaves, parmal, lemon
and papaya. |
| . |  |
