Showing posts with label Member of parliament. Show all posts
Showing posts with label Member of parliament. Show all posts

Monday, January 11, 2016

Medical Encounters: True stories of patients – Memoirs of a Physician By Dr. S. K. Jindal




Jindal Clinics is proud to announce the release of the latest book by Dr. S. K. Jindal - the medical director of the institute and ex head, Department of Pulmonary Medicine, PGI Chandigarh.

The book, meant for general reading chronicles the stories of some of the patients seen by the author during a career of about half a century. It provides glimpses of the trials and tribulations faced by patients and their doctors in their heroic struggles against disease and death. It also tends to project the physician’s handling of the myths and dilemmas about disease management and treatment modalities faced by different patients. 

The pen portraits reflected in this fascinating book encompass the lives of Prime Ministers, Governors, Chief Ministers, Judges, highly placed officials, army-men, police officers, newly married couples, precocious teen agers, wealthy men and farm labourers. It is a captivating story of life and living process. Full with vignettes from history, classical civilization, epics and mythology, it is enjoyable to read and meaningful for the doctors, the patients and the care-givers into disease management. A brief synopsis of its contents follows:
 
Foreword

Prologue

1.      The Childhood Adventures: Life in a community riddled with superstitions about health in a haunted house during 1950s in small towns of Punjab. Medical practice was rather scarce and simple maladies were often handled in medieval fashions.  

2.      Dissection Hall: Vivid scenes from the ‘dissection hall’ of the medical college (Government Medical College, Patiala) during the author’s first year of MBBS in 1966-67. Does the virtual dissection now provide the same attachment with human body?

3.      Patient with Scalded Palms: Lessons during bed-side case demonstration in the Skin Out-patient department. Was the reason of scalded palms in an otherwise healthy young man?

4.      Labour Ward: Melodrama in the busy ‘labour-room’ of the hospital while witnessing the first delivery by the author during the final year MBBS. 

5.      Bhag Singh: A former army soldier who used to brag about fighting with enemy forces and cockroach sized mosquitoes was admitted with cancer. Both he and the doctor were quite afraid of catheterization at night for urinary obstruction. 

6.      Emergency Ward: Facing the first death in the over-crowded Emergency of the Postgraduate Institute of Medical Education & Research, Chandigarh in 1972. 

7.      JP – The quintessential Leader or 1975: Story of Jai Prakash Narain during the period of Emergency in India when he was interned in the hospital at Chandigarh. His care was a real challenge for which the author along with senior doctors faced political reverberations.

8.      Sherlock Holmes: A senior police officer who suffered from a relatively uncommon respiratory disease, was quite reluctant. It was Sherlock Holmes who helped in treatment.

9.      The two oustees: Struggles and superstitions of two village folks who suffered from chronic respiratory disease, both were displaced from the land where Chandigarh was built as the state capital of Punjab after Indian partition.

10.   Culture Shock: A young man from Denmark developed illness while visiting as a tourist. Both he and his friend had a tough time in the hospital in the beginning; both got adjusted very soon. On the other hand, Griffth who suffered from chronic obstructive pulmonary disease was evading law because of drug abuse and trafficking.

11.   ‘Morrie’ of Punjab: A senior Professor had a chronic muscle disease; his life was almost a replica of the Morrie immortalized by Mitch Albom (see ‘Tuesdays with Morrie’).

12.  The American Dream: Handling of a friend with asthma in Seattle during Fellowship in USA in 1982-83. He was a tough nut to crack - willfully avoiding treatment for his problem.

13.  Pickwick Papers: Obese patients with respiratory sleep disorders. The main character like the fat Joe of Pickwick Papers was blissfully unaware of his illness.

14.  God’s own People: Patients with respiratory problems belonging to ‘below poverty-line’ category faced multiple hardships. Their innocence was often overwhelming and over-bearing.

15.  Perseverance: A resolute youth was determined to cure disabling emphysema of his grand-father. His misdirected treatment proved disastrous.

16.  Mr Prime Minister: Visit to Nepal for a medical consultation. The Prime Minister had an exceptional medical knowledge.

17.  Mountain out of a mole hill: Pleasure of curing small problems which looked threatening to others. But one needs to know the problem!

18.  Corporate Honchos: Treatment of the rich and the mighty. One of them who suffered from a respiratory sleep disorder was quite secretive about his visit to the doctor.

19.  ‘If a man’s lungs pant with his work’: Problems of handling two senior judges who suffered from brittle asthma! The severe and almost near-fatal attacks used to develop with an electrifying speed. 

20.  Erythrocyte Sedimentation Rate: Misconceptions about and misinterpretations of non-specific medical tests! The test report was a good excuse for the two patients to repeatedly visit the hospital.

21.  Teenage Hiccups: Abrupt and angry outbursts of sick teenagers who needed tender care.

22.   Weakness of the Powerful: The powerful politicians including Chief-ministers and Governors who suffered from asthma or other respiratory diseases were as weak as the ordinary folks. Inhalation therapy was particularly difficult to teach and gullibility was the greatest weakness.

23.   Marital Woes: Sickness as a stigma for ‘soon to marry’ girls and boys. One young lady who suffered from asthma defied medical advice with serious consequences.

24.   The Stigma of Inderjeet: Isolation of young Inderjeet for her tuberculosis. She conquered her illness with courage and bravery.

25.  University Dons: Teachers at the University were generally difficult to convince. Professor Ahuja used to underplay his illness, while several others were over concerned, sometimes about hypothetical illnesses.

26.  Swami Anand: A pious and spiritual man who imbibed the greatest human values! 

27.  The Devilish Test: Misinterpretation of a simple medical test brought an engagement almost to a break-point. It was the medical counselling which helped.

28.  Yasin Mohammad: A bear performer who suffered from asthma was quite magnanimous. Petty favours by unrecognizable patients proved to be pleasant, sometimes even embarrassing.

29.  Barriers: It was difficult to communicate with an old man with hearing impairment. Yet the old man was quite satisfied!

30.  The Big League: The VIP attitudes of a few senior officers often interfered with good medical management. It was always better to shed the mask of bigness while seeking treatment.

31.   Holy Water – The Last Wish: A holy priest was afraid of admission in the hospital for the fear that his last wish may not be fulfilled. The medical personnel and the facilities need to respect the wishes of patients with terminal illnesses.

32.   One More world to go: ‘Not to be defeated’ attitude of a terminally sick patient.

33.  Dilemma of Critical Care:  The real question is ‘When to opt for assisted respiratory support?’ 

34.  Knowledge – Explosion: 21st century – the era of lung transplantation, advanced life-prolonging treatments and internet with a quagmire of information.





The book is available for purchase at: 

 Partridge India    000 008 10062 62



www.nobleandbarne.com



Saturday, April 18, 2015

Smoking

The Indian Evidence on Tobacco Hazards
“Absence of evidence is not an evidence of absence” is a dictum which any rational individual always need to keep in mind. Presumably therefore, the absence of Indian evidence against tobacco hazards does not imply that the Indians are likely to behave differently than people anywhere in the world. We all know that the colour of blood of all human beings is red irrespective of their being blacks or white, or for that matter, Indians or Americans. Similarities aside, the fact remains that there is no dearth of Indian evidence on tobacco related harms. Obviously, the recent Parliamentary Committee Report on the subject is an act of short sightedness.
It seems that the Committee has conveniently decided to overlook the bulk of reports and research publications on the subject which have accumulated in the last few decades. The writer of this article himself has been engaged in clinical work on tobacco related disease since 1970s. One of my first paper which was published in 1982 in the international journal Thorax clearly showed relationship of lung cancer with tobacco smoking. The relative risk for smoking was reported as about three times more than in non-smokers. Similarly, higher risks were reported in the publications from Mumbai for several different types of cancers.
Cancer Registry Reports from India have regularly appeared which clearly show a significant relationship of cancers with both cigarettes and bidis. Most significant are the important Reports published by the Ministry of Health and Family welfare, Government of India which summarize the Indian evidence. A 2008 Report “Bidi Smoking and Public Health” was entirely devoted to bidi smoking. Only god can help if we continue to harp on the “lack of evidence’.
It is important here to understand that the cause and effect relationship in medicine is established on basis of multiple studies which are necessarily not possible to undertake in experimental laboratories. It is different from the experiments conducted in basic science laboratories. For causal relationship of diseases, one has to rely heavily on clinical and epidemiological data. Factually, these two types of studies constitute the core of medical research which represents factual relationships. From public-health view-point, it is more important to demonstrate clinical and epidemiological relationships with risk-factors than the experimental relationships. In any case, there are enough analytical studies and biochemical laboratories to show the presence of a large number of cancer-producing chemical in tobacco and their cancer-producing effects on experimental animals.
While Indian evidence on tobacco hazards including the cancers is substantial, there is far greater evidence from the American and the European continents. I must lay stress on the fact that factual information on disease causation is quite universal. It is quite true that there may be small differences in disease relationship in different countries. Some of the clinical risks and disease manifestations may vary depending upon local cultural, socio political and economic factors. But the basis facts in science remain the same. Why only cancer? This is also true for other diseases like asthma, hypertension,  diabetes and everything else. Factually speaking scientific research is universal in its application. We must not trivialize the issues by limiting the scope of research findings to a particular region on a country. We must also remember that we heavily rely on the Western data for most of cancer related research including on its diagnosis and treatment. It is irrelevant that the International companies have their own motives. That they have. But we also need to keep the health interests of the Indian people in our minds.
Cancer is not just one disease- it is a general terms for a large number of different diseases with similar a characteristic of relentless progression to early death. Cancers of lung, blood and brain have different rates of progression than cancers of tongue, mouth and jaws. Nonetheless, all forms of cancers will result in permanent disfigurement and disability. Interestingly, the only other commonality between most cancers is the relationship to tobacco which remains as the root cause. Undoubtedly, tobacco is the strongest cancer providing consumer product. There can be no greater truth than what was said by the WHO Director General, Dr Gro Brundtland:  “A cigarette is the only consumer product which when used as directed kills its consumer.”
The same sentiment was truthfully  echoed by Anne Edwards by Philip Morris, the major multi-national tobacco company:  "What I think is clear is if someone came to us with a cigarette today and said, hey, here is a new product, I'm going to bring it to market.  Would it be allowed in the market anywhere? No, it would not. It is a very harmful product" (on Sex, Lies and Cigarettes)

Tobacco is also responsible for a large number of non-cancer diseases. It can be easily listed as the number one cause for a majority of heart attacks, strokes, chronic respiratory diseases and general ill health.  In women of child bearing age, tobacco is responsible for infertility, prematurity and low birth weight of new born babies, and abortions.
Smoking is not just injurious for a smoker. It damages the health of non-smokers who live in the company of smokers. This is a type of second hand or passive smoking which is directly related to cancers and other diseases. Such relationship which was first shown amongst non-smoker wives of smokers from Japan, has been also reported from a large number of other countries.
The only valid argument which the Committee has put forwards is related to the loss of jobs for b­­idi workers and tobacco farmers. A large number of studies are now available which show that the overall economic loss from tobacco related hazards is far more than the revenue loss from tobacco. A number of remedies including alternate crops have been suggested in several reports to compensate for the losses of farmers. Undoubtedly, the health is the most crucial issue and tobacco-control forms the core for National Disease Control Programmes of Government of India. One cannot lose sight of the fact that the Government of India is signatory to the International Frame Work Convention on Tobacco Control. The country is committed to undertake several mandatory steps to reduce consumption and production of tobacco.

_____________________________________________
Dr Surinder K. Jindal, MD, FCCP, FAMS, FNCCP
(Ex-Professor & Head, Department of Pulmonary Medicine
Postgrad Instt of Med Edu & Res, Chandigarh, India)

Medical Director, Jindal Clinics, SCO 21, Dakshin Marg, Sector 20 D,
Near Guru Ravi Das Bhawan, Chandigarh, India 160020.
Website: jindalchest.com
Ph.  Clincis: +91 172 4911000,  Res.  +91 172 2712030/ 31

Wednesday, November 19, 2014

Free Camps

Jindal Clinics is proud to announce its participation in two health camps. The first one was held by the Joshi foundation in Sec 15, Chandigarh and involved the checkup of over 2000 patients. The participants were honored by Mrs. Kiron Kher, member of parliament from Chandigarh  and the Home Secretary of Chandigarh, Mr. Anil Kumar.









The other camp was held in the town of Dhuri on 16-11-14, where over 125 patients were examined free of cost by Dr. Aditya Jindal.