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| HEALTH TRIBUNE | Wednesday, August 15, 2001, Chandigarh, India |
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Time to
donate your eyes Why be
afraid of radiotherapy? HEALTH BULLETIN On to
cashless hospitalisation THE HUSHING UP DEAL BY
FAMILIES Questions & Answers |
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Time to donate your eyes THE diseases of the cornea rank very high in contributing to the perfectly curable causes of blindness in our country. Against a colossal demand of seven million donor eyes required to effect cure for the huge pending mass of patients, only 18,000 could be collected in the country! To focus attention on this great magnitude of calamity, an Eye Bank Association-led fortnight is being observed all over the country from August 25 to September 8. The focus of this special campaign will be on the rampant practice of burying or burning the eyes with the deceased rather than donating them to bring light to a fellow citizen. Other countries have done wonders in educating the population and enacted appropriate laws, keeping in view the pressing need of those living in darkness and desperation. Beginning this year during the fortnight on eye donation, the Government of India has convened 10 workshops to train eye bankers in the methodologies to practise grief counselling to promote eye donation. Trained grief counsellors will be catalytic agents in interacting professionally with the families of the deceased and convincing them of the need to donate the eyes rather than destroying them. Such efforts have been successful in many parts of the world. Additionally, a change in the law is on the anvil mandating the hospital staff to request for eye donation in the case of death. The fortnight will also have a major meeting of experts in Delhi in the first week of September to address the question of the lack of quality in the operation of eye banks. It is hoped that the quality of the operation will enthuse and attract the participation of a large number of organisations. States are in the process of setting up "Accreditation Authorities" to oversee the implementation of the national guidelines. The enormous gap in providing services to the blind population is encouraging malpractice and
breeding ominous frustration. We need to pool and collate our efforts and work for visions to eradicate corneal blindness. It is simple: Do not burn, do not bury; donate eyes after death. Once we understand this, it becomes simple to contribute to a cause as gigantic as collecting seven million eyes instead of 18000 only. Let us say: We can do it! Dr Saini is the President of the Eye Bank Association of India. He is based at the PGI, Chandigarh.
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Why be afraid of radiotherapy? What is radiotherapy? How does radiation therapy work? What are the ways in which this treatment is given? Brachy therapy:
there is a short distance between the radiation source and the target tissue, when the source of radiation is kept near the tumor. Insterstitial:
It is a type of brachytherapy and involves implanting radioactive isotopes into tumour tissue, resulting in the delivery of high intensity radiation within the volume. Radioisotope comes in several forms -- seeds, needles, wires and ribbons. Is admission to a hospital necessary? What about skin changes and how to look after it? Are the skin changes permanent? What are the early side-effects of radiotherapy? Are there any late effects? Conclusion Dr Wig, the renowned surgeon, is based at the PGI, Chandigarh. |
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HEALTH BULLETIN Dr R Vatsyayan, Ayurvedacharya THE medicinal properties of neem have been known to Indians since time immemorial. The earliest ayurvedic literature refers to the benefits of all parts of this majestic tree — fruit, leaf, bark, flower and root. Its scientific name, azadirachta
indica, has been derived from the Persian word azadiracht-e-hind which means a freely growing tree of India. Due to its immense utility to mankind, today the saga of neem has spread to the far corners of the globe. Ayurvedic texts describe neem as tikta and kashaya ( bitter and astringent) in taste and laghu and sheet a ( light and cold) in effect. It allays kapha and pitta but aggravates
vata. Modern studies have resulted in finding various alkaloids, volatile oils, tannin and traces of calcium, potassium and iron in it. Neem seeds yield a non-volatile oil which is of high medicinal
value. Bhava Mishra, the ancient ayurvedic scholar, has attributed different properties to the various parts of the neem tree. While , in general, neem has been described as an anti-pyretic, an anthelmenthic and a blood purifier, its bark is cool, astringent and the healer of
wounds. Neem leaves are carminative, anti-bacterial and anti-diabetic. Its fruits are bitter and have purgative,
anti-haemorrhodal and anthelmenthic properties whereas the flowers and seeds are an antacid and a blood purifier respectively. The use of neem oil is indicated in a wide range of skin
disorders. Neem has also fascinated the exponents of modern medicine and it has become a subject of scientific research in many parts of the world. Although it has proved to be an excellent upkeeper of the environment, an effective pesticide and a useful element in veterinary medicine, modern studies have come close to the findings of ayurvedic seers regarding its benefits for human health. The use of neem is indicated in a number of diseases ranging from fever, skin troubles, acidity, piles and liver diseases to conjunctivitis, alopecia and certain fungal and viral afflictions. Since neem also has spermicidal properties, experiments are being carried out to use it as dependable
contraceptive. Neem has been an indispensable part of our home remedies for ages. Here are some simple ways to use it in everyday life. Boil neem leaves in water and add it to the bathing water along with rose water for relief for itching, excessive perspiration etc. Use pure neem oil mixed with coconut and sandalwood oil for treating
hairfall, premature greying, lice infestation, dandruff and other scalp infections. For acne, pimples and skin infections, apply neem leaf powder mixed with water to the affected area. Chewing four or five neem leaves regularly helps in cases of hyperacidity and diabetes. In jaundice, taking on an empty stomach 10 to 20 ml of juice of neem leaves along with one teaspoonful of honey for seven days is beneficial. While in the sophisticated market the use of the active principles and extracts of neem in soaps, shampoos and tooth pastes is not new, one can see persons regularly using simple neem twigs living a very healthy life. Classical ayurvedic literature mentions a large number of neem formulations. Apart from the famous Nimbadi
Churna, there is another formulation known as Panchnimb Churna which contains all the five parts of the tree. Dr Vatsayayan is based at Sanjivani Ayurvedic Centre, Ludhiana. ( Phones: 423500 and 431500;
Email: sanjivni@satyam.net.in |
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On to cashless hospitalisation WHEN Mr B.K. Modi, a senior executive in a large corporation, left home early in the morning to catch the Shatabdi for Delhi, he had a return ticket for the same day and his wife, Unmesh, had already planned the dinner with her in-laws. Little did she know that her efforts to make her in-laws happy would be wasted. While driving through the congested roads of Connaught Place, B.K. felt a choking sensation with pain radiating to the left arm. Sensing trouble, he rushed to a famous hospital in the neighbourhood, flashed his membership card and was taken up for emergency treatment with no payment asked to be made. B.K. stayed for three days in the ICU and was subsequently discharged, to be followed up in another network hospital in his hometown. B.K.’s stay in the hospital did not cost him a penny. His signature on the bill was enough.
Merchant Navy Captain Satnam Singh’s wife and his two daughters have got used to living without the only male member of the family for long periods. However, the captain is not financially worried about the health of his dear ones. He has enrolled his family with a leading health planner. Mrs Satnam Singh knows precisely whom to contact in a medical emergency. She is aware that she can call for an ambulance, anytime during day or night, seek medical advice and get priority treatment — all this without having to pay anything! This concept of managed care, prevalent in developed countries, is now being promoted in India through Third-Party Administrators (TPA) such as the Family Health Plan (an Apollo group company), Sedgwick Parekh (an associate of the Sedgwick Group plc, UK), Emmed Life (a Dabur group company) etc. The process is simple: * TPA arranges for a medical policy through an insurance company. * The client pays the premium directly to the insurance company. * The client avails himself of the services of a network of leading hospitals without making any payment. * Hospitals forward bills to TPA or the insurance company for reimbursement The advantages are many: *Assurance of emergency and qualitative medical care — nationwide. * Affordable and fixed cost. *No upfront payment or reimbursement of bills. *Pre-existing diseases and maternity covered. *Value-added services like free ambulance, health workshops, etc. Managed care is ideal for small to large enterprises in the public or private sector. INSCOL in Chandigarh, which is on The Tribune’s list of approved hospitals, is a member of the network of hospitals of almost all TPAs. Other member-hospitals (a total of more than 300 nationwide) include: Delhi: Apollo, Rajiv Gandhi Cancer Hospital, Escorts, Batra, etc. Mumbai: Breach Candy, Jaslok, P.D. Hinduja, Lilavati, etc. Chennai: Apollo, Malar, Vijaya, etc. Kolkata: B.M. Birla, Woodlands, Wockhardt, etc. The writer is a healthcare manager with vast experience. He is the Director of INSCOL, a tertiary care hospital in Chandigarh.
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THE HUSHING UP DEAL BY FAMILIES Dr Rajeev Gupta GENES have been blamed by many workers for suicidal behaviour. Some scientists strongly feel that those who commit suicide have defective genes which in turn lead to dysfunction in the neurotransmitter system in the brain and thus lead to suicidal behaviour. Can a complex and intricate behaviour like suicide be caused by biochemical disturbances in the brain? This is still open to debate. But there is strong evidence to show that the incidence of suicide is more in biological relatives of adopters who suffered from depression than in other adopted relatives. It has also been observed that biological and adopted relatives of non-depressed adapted controls had fewer frequencies of suicide than biological relatives of adapters who are depressed. There is obviously a genetic component in suicide. In a symposium on "Healthy cities, healthy mind" at an annual conference of the Indian Psychiatric Society in Kanpur a few years back, Dr R.S.Murthy, then Professor of Psychiatry at the National Institute of Mental Health and Neurosciences, Bangalore, said: "The largest number of suicides are taking place in the mega cities with the most rapid social changes". According to Dr Murthy, suicide— a manifestation of growing urban health problems— has not attracted adequate attention of the psychiatrists in the country. We in India are not aware of the magnitude of the problem because of the under-reporting of suicide. Whenever a suicide attempt is made, all possible ways are tried by the family to hush up the matter. Because of the fear of the law or social ridicule, many suicidal attempts or suicides are shown as accidents. Families become non-corporative and don't provide accurate information. There are no figures about the extent of under-reporting but it is generally felt that it is at least 10 to 15 times of the reported suicide. The fear of the law makes many families delay their contact with medical agencies and very precious time is wasted in this process. A completely traumatised family has to bear the burden of police enquiry and action. Most of these try to avoid police probe or contact.
(To be concluded) The article on vitiligo by Dr Gurinderjit Singh and the views of Dr
G. R. Verma on endoscopic surgery will be published next week.
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Questions & Answers Q My mother has been found to have tuberculosis of the lungs. How should we manage her? A The management of tuberculosis involves: the administration of drugs (the patient requires treatment with a number of drugs for a considerable period; the drugs used and the organs involved are the determining factors:) the general care of the patient to improve nutrition, to cure anaemia and to deal with the environment; the prevention of infection to other people who come in contact with the patient; the rehabilitation of the patient to ensure that he or she does not become a burden on the family or society. Q Why are four drugs prescribed simultaneously for the treatment of tuberculosis? A The four-drug or three-drug regimen is used for a short period initially in view of the increased prevalence of drug-resistance. A multi-rug approach is usually successful. Q What is drug-resistance and how can it be prevented? A Drug-resistance means that the bacteria are not affected by the medicine that is prescribed to the patient. It is possible that the bacteria which have infected the patient may have already become resistant to the drugs or these may subsequently become resistant because of the improper and inadequate treatment. Q I have tuberculosis. What measures should I take to prevent the spread of infection? A First of all, you must find out whether you are sputum-positive or not by getting your sputum examined on three consecutive occasions. Only sputum-positive or open patients can spread the infection. The precautions that must be taken are given below: * All the inhabitants of the house must be examined for tuberculosis and treated if necessary. * Children and new-born babies should be appropriately vaccinated and kept away from the patient. * Spitting is prohibited except in a container. The sputum should be disposed of carefully. * The patient should cover the mouth and the nostrils while coughing or talking. * Persons taking care of sputum-positive patients should get a TB test done. If they test negative, the BCG vaccination should be given to them. Q Does a patient require frequent visits by the doctor? A Yes. A patient of tuberculosis, and for that matter of any disease, requires a close and regular follow-up to find out whether he or she is responding to treatment or not and also to know if the drugs have produced any toxic reaction. Drugs used against tuberculosis in some cases can give rise to jaundice. The offending medicine has to be stopped and replaced by another drug. In certain cases — in the tuberculosis of the intestine, the brain, the bones or the joints — the patient may require surgical intervention. Q The doctor has advised my mother to take all the four drugs early in the morning on an empty stomach. Why? A The drugs taken on an empty stomach get rapidly absorbed. If all the tablets are taken together at a fixed time, the patient does not miss his or her daily dose. The B.C. Roy Award-winner surgeon organises the question-answer column for the benefit of the Tribune readers. He is based at the PGI, Chandigarh.
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