The Tribune, Chandigarh, India

HEALTH

Wrong diagnosis by labs a common feature
Our Correspondent

Ludhiana, July 13
“The whole family was very happy as I was going to have my first baby. My in-laws were excited and so was Ashwani, my husband. During my second trimester, I started running low grade fever and my in-laws took me to a doctor for a check up. I was sent for various blood tests and after going through my reports, the doctor said I was suffering from tuberculosis. He made us buy medicines for at least six months and advised me to remain isolated so that others were not infected” said Sania (name changed).

Then the couple went to a laboratory in Delhi where the tests proved negative. The family heaved a sigh of relief. One error by the diagnostic clinic had created hell for the family. But such faulty diagnosis are common creating problems for many. Thus mushrooming of laboratories has instead of leading to correct diagnosis, have worsened the matter. Geeta Jain (name changed) was advised to get her cholesterol tested. On the same day she gave her blood for testing to a prestigious lab and a hospital and she discovered a difference of 50mg in the two readings. What the patient can do in such circumstances. They just go by the results of the tests and hardly go by clinical symptoms.

No degree or licence is required to start a diagnostic laboratory and technicians after working for some time in a hospital or private clinic, start their own laboratories. Ideally a diagnostic lab should have an MD in biochemistry, pathology and microbiology under one roof. But do all the laboratories have all three? Most of them have one MD in one of the disciplines and the other tests are done by the technicians. Though many laboratories have auto analysers and the tests are done by computers, certain tests like that of enterric fever have to be done manually.

There are hundreds of patients who suffer from wrong diagnosis as in the case of Sushms whose bloodsugar results by one laboratory showed that she was a diabetic. The doctor gave her anti-diabetic medicines. She went into coma and was rushed to the hospital. Who will pay for the agony of the patient and her family?

“Since the tests have become so vital for the treatment of diseases, laws should be made by the Health Department and the medical fraternity should exert pressure on the government and ask for strict control over the pathological labs, said a city resident.

Dr Gursharan Singh, president of the Indian Medical Association, has urged the government to exercise control on the working of these laboratories.

How to avoid cholera and gastroenteritis

Prevention is better than cure in the case of cholera and gastroenteritis. Cholera is an acute infection which spreads in water contaminated by human faeces. Today, it usually occurs only in areas where hygiene and sanitary conditions are poor. Cholera is an extremely serious, highly infectious and often fatal bacterial infection of the intestines. This infection of the intestines caused by germ V brio choleae. In the endemic areas children below five years are its easy victims, while during an epidemic outbreak the disease has no age restriction. Cholera is contracted through the mouth by eating infected food or drinking water. The cholera germ does nor survive long in clean water and is very easily killed by heat.

Enteritis is inflammation of the small intestines. Many factors are responsible for the onset of the disease. The most common factors are — overeating or eating spoiled food; poisoned mushrooms; medicines; industrial poisons; salmonellae, staphylococci, cholera vibrio, etc. and all allergy-some food or medicines.

The first signs and symptoms of cholera are loose stools which appear like rice water. In few hours the process of loose stools continues in quick succession. Vomiting generally follows loose stools. The whole body becomes ice cold and despite feeling so, the patient cannot tolerate any sheet or cover on his body. Both the stools and vomit of the patient contain a large amount of the cholera germs. Due to the loss of a large amount of fluid from the body, the eyes are shrunken and skin all over the body loses its normal elasticity and looks as if tightly stretched over the underlying tissues; the bones of the face become very prominent. The mouth and the tongue are dry and there will be extreme thirst. The voice becomes husky. Diarrhoea is the main symptom of acute enteritis. Bowel movements are frequent. The patient complaints of poor appetite, nausea, vomiting, abdominal pain and flatulence. The body temperature rises and the arterial pressure falls in severe cases.

Precautions

*Bed rest is recommended in cholera and gastroenteritis. Water for drinking should always be boiled.

*Cleanliness is the most important and preventive factor. Everyday living and dietary habits must be clean and hygienic. Keep all food items and drinking water well covered.

*Deposit of water should not be allowed. Special attention should be given for cleaning toilets and bathrooms.

*In the rural areas water from the open ponds, canals and dirty wells should not be used.

*Wash your hands and utensils before preparing other food. Cut your nails and your children’s.

*Raw vegetables should not be eaten unless they have been soaked in salt water for at least fifteen minutes before cooking.

*Water and tea are recommended during the first two days. A sparing diet is prescribed for third and fifth days; rusks, vegetables and dal soup, rice water, ripe bananas. They should be eaten six to eight times a day in small portions.

*Dehydration is managed through ORS (oral rehydration solution).

*Use fresh lime water, including salt, few drops of honey every one hour an hour till the virulence of the diseases subsides.

*For gastroenteritis patients, food should be highly caloric and rich in proteins and vitamins.

*In cholera the initial medicine is Amritdhara in small doses of two to three drops every thirty minutes.

*Care should be taken to restrict the dosage because larger quantities of those preparations might lead to stoppage of urine which would create complications.

*Exposed fruits and food exposed to flies must never be taken; nor should you take cold drink and ice candy sold on the streets.

*Avoid salads, over-ripe or unripe fruits, outside eating, spicy food, alcohol, coffee and dairy products for few days.

*Use appropriate chemicals to ward of flies and mosquitoes.

— Dr Anil Dheer

Admn urged to implement High Court’s order
Tribune News Service

Ludhiana, July 13
The Indian Crime Prevention Society, Punjab, has demanded to implement the orders of the Punjab and Haryana High Court against illegal, unauthorised and unqualified quacks practising in the city. In a memorandum submitted by the president of the society to the Secretary, Health, Chief Secretary and Director General of Police the society has urged them to initiate legal action against persons.

Though the Civil Surgeon, Dr Rajinder Kaur, has forwarded a list of 43 such quacks to the SSP, Ludhiana for necessary action, yet he has expressed his ignorance about any such letter from the office of the Civil Surgeon, a communique by the society said here today.

The Civil Surgeon, Ludhiana, has written to the SSP, Ludhiana, vide his letter No. Drugs/22001/1940 dated 30/5/2001 regarding some quacks and had said that the District Family Welfare Officer had checked the clinics and added that many of them did not possess valid registration for practising.

Such war of wits between quacks and administration is going on and as a result the patients were becoming victims at the hands of such quacks. Mr Naveen Sharma, president of the society, has also threatened to the district administration, Civil Surgeon and the SSP to organise large-scale demonstration. If legal action is not initiated against such quacks, contempt petition will be filed before the High Court for necessary action, he threatened.