WHY DOCTOR’S DAY? Dr. Gangadhar Sahoo Dean, IMS & SUM Hospital, Bhubaneswar
In India the Doctors Day is celebrated on the 1st July every year to honor the legendary physician, second chief minister of West Bengal & the Bharatratna Dr. Vidhan Chandra Roy, who was born on 1st July, 1882 & died on the same date & same day in 1962. What a great coincidence.
Dr.Roy was born on Patna. His father Prakash Ch. Roy was on Excise inspector & mother Aghorkamine Devi a housewife. His mother died when he was only 14 years old. He graduated from a medical school in Kolkata. He then shield to England for higher study. He completed his MRCP & FRCS & returned to India to join as a faculty in Calcutta Medical College.
He believed that that “Swarj” would be possible if people of India have a strong mind & body. With that idea he established the Jadavpor TB Hospital, ChittaranjanSevaSadan, R.G Kar Medical College, Kamala Neheru hospital & many more. He had a strong faith in the youth of India. His belief was that the youth must not take part in any form of strikes, fast & demonstrations rather they should study & committee themselves to social work. At a convocation address on 15th December, 1956 at the university of Lucknow he said, “ My young friends ! You are shoulders in the battle of freedom, i.e freedom from want, fear, ignorance, frustration & helplessness. By a dint of hard work for the country, rendered in a spirit of selfless service, may you march ahead with hope & courage”.
He entered politics in 1925 & because of his honesty, integrity & perseverance he took the office of the chief minister of Bengal on 23rd January, 1948. It was a rare honor for a physician. Bengal at that time was in a chaotic state because of creation of East Pakistan. Within 3 years the law & order returned to Bengal.
“We have the ability & if, with faith in our future, we exert ourselves with determination, nothing, I am sure, no obstacle, however formidable or in surmountable they may appear at present, can stop progress……….. if all of us work unitedly, keeping our vision clear & with a farm grasp of our problems”. The nation honored him “Bharatratna” on 4th Feb, 1961. On 1st July, 1962 after treating his morning patients & discharging affairs of the state he took a copy of “ BrahmoGeet” & sang a piece from it. Eleven hours later he died. In his honor the “Doctor’s Day” in India is being celebrated, the 1st being in 1991.
Objectives of Doctor’s Day :
To honor & remember Dr. B.C Roy. To have confidence in every physician that a physician can be a chief minister, Bharatratna& a role model. To spread a strong message that what Dr. B.C Roy had done, we the physicians can do if we stand united without compromising our professional dignity. To spread the message loud & clear the contributions of physicians to every sphere of the society. To keep of the dignity & position of the physicians in the society.
Quotes from a POEM written by RajkumarZindal, Chandigarh
Doctors ‘profession is godly & noble helping mankind. Angels in spotless white coat, in none others we find.. Inherent smile, hope, courteous listening and fast walk, Psychological touch, empathy& patient customized talk. Baby is born to a mother and brought up by parents, But only a doctor can diagnose and cure its ailments. Her or his care, commitment, precision and expertise, Ought to be praised and acknowledged by all the wise. A sight of a person wearing in her neck a stethoscope, Gives patients and relatives in wards, a life, new hope Working up to 40 hours at a stretch during his internship, Is possible as his attitude elevates work to love& worship With current Indian patient doctor ratio of about1700 to one.. Nothing rapidly better for all patients’ care can really be done Opting strenuous medical stream & not thinking of brain drain, Grace of God, blessings of patients and mental health they gain. The Day is an opportunity to appreciate entire Medical profession, For doctors’ duty, grace, integrity ,latest knowledge & compassion. The Poem was like a baby, easy to conceive but hard to deliver-‘send,’ Gestation- 1st July 08, to pay tribute to Dr..BCRoy’ Gandhiji‘s friend
Think Before You Judge
A doctor entered the hospital in hurry after being called in for an urgent surgery. He changed his clothes and went directly to the theater. He found the boy’s father pacing in the hall waiting for the doctor. On seeing him, the father yelled, “Why did you take all this time to come? Don’t you know that my son’s life is in danger? Don’t you have any sense of responsibility?” The doctor smiled and said, “I am sorry, I wasn’t in the hospital and I came as fast as I could after receiving the call and now, I wish you’d calm down so that I can do my work”. “Calm down?! What if your son was in this room right now, would you calm down? If your own son dies while waiting for doctor than what will you do??” said the father angrily. The doctor smiled again and replied, “We will do our best by God’s grace and you should also pray for your son’s healthy life”. “Giving advises when we’re not concerned is so easy” Murmured the father. The surgery took some hours after which the doctor went out happy, “Thank goodness! your son is saved!” And without waiting for the father’s reply he carried on his way running by saying, “If you have any questions, ask the nurse”. “Why is he so arrogant? He couldn’t wait some minutes so that I ask about my son’s state” Commented the father when seeing the nurse minutes after the doctor left. The nurse answered, tears coming down her face, “His son died yesterday in a road accident, he was at the burial when we called him for your son’s surgery. And now that he saved your son’s life, he left running to finish his son’s burial.” Medical Profession is the Noble Profession, the Profession with highest dignity and solemnity. Doctor’s day is celebrated in the memory of Dr. Bidhan Chandra Roy in order to pay honor to the entire medical profession. This observance fulfills a need to show the doctors and physicians in our lives how important they are to us and how invaluable their treatments are that cure us. The celebrations are indicative of the respect that they command in the lives of their patients and thus obligate them to fulfill their responsibilities as well. There have been instances of public violence and protests against doctors, many a times the doctor is not in fault, not done anything wrong. The Profession is slowly losing its glory and nobility. It is in Doctors hand, must not let the profession go down, take it to a great height to define dedication and medical care.
Dr. Manoj K Sahu Dept of Gastroenterology & Hepatobiliary Sciences IMS & SUM Hospital, Bhubaneswar
TEEN AGE CONTRACEPTION
Dr. Susanta Kumar Mahapatra Retired Professor, O & G Bhubaneswar
The present Society and culture are changing very fast beyond our imagination. Developing nations are imitating the culture of the developed countries not in Toto, but in the areas which are easy to adopt and peruse. Some of the worst areas are drug abuse, cruelty towards fellow beings, racialism, teen age sex, disrespect for the society etc.. These are in the present scenario, accepted as modernity or development, whatever you prefer. Present generation is calling the previous generation old fashioned, conservative, narrow-minded and so on. Most of the time they are landing in a point of no return.
Everybody is aware of teen age sex. News papers and news channels are supersaturated with these. Everybody know the serious problems like AIDS, teen age pregnancy, serious complications of MTP etc..associated with this ; but at the same time the society is almost helpless. Different organizations are trying their level best to solve some of the problems. One of them is “teen age contraception”.
Intrauterine devices and contraceptive implants, with their very low pregnancy rates and high rates of patient satisfaction, are the best method to prevent unintended pregnancy in adolescent girls, according to new guidelines issued by the American College of Obstetricians and Gynecologists. The latest guidelines, from the Committee on Adolescent Health Care Long-Acting Reversible Contraceptive Working Group, were published in the October issue of in Obstetrics & Gynecology. Long-acting reversible contraception (LARC) such as intrauterine devices (IUDs) and levonorgestrel-releasing intrauterine devices (LNG-IUDs) have lower pregnancy rates than the short-acting birth control methods teenagers are more likely to use. Unintended pregnancy rates for short-acting contraceptives such as condoms, oral contraceptives, contraceptive patches, vaginal rings, and depot medroxyprogesterone acetate (DMPA) injections were 22 times higher than rates for LARC. The pregnancy rate among women using LARC is less than 1% per year. Furthermore, women younger than 21 years who were using short-acting contraceptives were twice as likely to have an unintended pregnancy as older women, according to a study published in May in the New England Journal of Medicine. With LARC, the pregnancy risk was equal for both age groups. Short-acting contraceptives have far lower continuation rates than LARC methods among teenagers. In a study of women aged 15 to 24 years using short-acting hormonal birth control methods, few were using the same birth control method a year later. Sixteen percent of those using DMPA injections still relied on them a year later, and 11% of those using the patch remained with that method a year later. The continuation rate was higher for vaginal rings and oral contraceptives, both at 30%. LARC continuation rates are often well above 70% among teenagers, other studies show. A 2011 study in girls and women aged 14 to 45 years showed an 86% continuation rate for LARC after 1 year compared with a 55% rate for short-acting contraceptives. Although that study combined data from teenagers and adults, a study that compared LNG-IUD continuation rates for women younger than 20 years with the rates for older women showed similar rates across age groups: 85% of the younger group were using a LNG-IUD a year later, as were 80% of the older women. Copper IUD continuation rates were slightly lower for teenagers than older women, but the 72% continuation rate in teenagers was still far higher than shown in other studies for short-term contraception. LARC methods are becoming more popular, although they are still in the shadow of short-term birth control. In 2002, 2.4% of women in the United States using contraception relied on a LARC method. By 2009, 8.5% did. Among teenagers aged 15 through 19 years who were using contraceptives, 4.5% use LARC, according to a study published online July 16 in Fertility and Sterility. "When choosing contraceptive methods, adolescents should be encouraged to consider LARC methods, Intrauterine devices and contraceptive implant are the best reversible methods for preventing unintended pregnancy, rapid repeat pregnancy, and abortion in young women."
A committee report says complications from IUD use are infrequent. Research shows young women using IUDs have no increased risk for pelvic inflammatory disease (PID), nor are they at an increased risk for infertility.Complications among IUD users are "rare and differ little between adolescents and older women." Relative risk for PID is increased in the first 20 days after insertion and then returns to baseline, studies show, and absolute risk is low. PID risk with IUD placement is between 0% and 2% when there is no cervical infection, and 0% to 5% when there is an undetected infection. If there is infection, the cause is most likely to be bacterial contamination, and not the IUD itself. A positive chlamydia test after IUD insertion will not increase the likelihood of PID if it is treated promptly. LNG-IUDs may actually decrease risk by thickening cervical mucus and thinning the endometrium, the authors write. Women aged 15 to 19 years have the second-highest chlamydia infection rate and the highest rates for gonorrhoea, according to a 2010 surveillance report by the Centers for Disease Control and Prevention, so the report advises testing for sexually transmitted infections, noting that they can be treated with the IUD in place. "Increasing adolescent access to LARC is a clinical and public health opportunity for obstetrician–gynecologists.With top-tier effectiveness, high rates of satisfaction and continuation, and no need for daily adherence, LARC methods should be first-line recommendations for all women and adolescents."(Obstet Gynecol. 2012;120:983-988. ) In concluding it is better to advice LARC to susceptible teen agers than exposing them to the hazards of “teen age pregnancy” in terms mental, physical, social and financial BURDEN.
SLEEP DISORDER :A MULTIDECIPLINARY PROBLEM . Dr. ELLORA DEVI PROFESSOR DEPARTMENT OF PHYSIOLOGY
India is a vast country with diverse climate and culture. The population is crossing 1.25 billion. Sleep is the biggest luxury provided by the nature with enormous unknown benefits. Have you ever noticed how it affects you, if you are deprived of sleep for a day or two?The consequences of not sleeping well and on time are scientifically well documented. But the modern society has started abusing it by staying awake more and disturbing normal physiology. We need minimum 6- 8 hours of sleep /day. A good night's sleep has the power to restore the body and enlighten the mind.We have to bring the importance of sleep and sleep disorders to general public to build a healthy India. Pulmology –Sleep in chronic obstructive pulmonary disease (COPD) is commonly associated with oxygen desaturation. The mechanisms of desaturation include hypoventilation and ventilation to perfusion mismatching. The consequences of this desaturation include cardiac arrhythmias, pulmonary hypertension and nocturnal death, especially during acute exacerbations. Coexistence of COPD and obstructive sleep apnoea (OSA), referred to as an overlap syndrome. Overlap patients have worse sleep-related hypoxaemia and hypercapnia than patients with COPD or OSA alone. OSA has a similar prevalence in COPD as in a general population of similar age, but oxygen desaturation during sleep is more pronounced when the two conditions coexist. Treatment with continuous positive airway pressure alleviates hypoxaemia, reduces hospitalisation and pulmonary hypertension, and improves survival. ENT- Snoring may be a sign of a serious condition in obstructive sleep apnea (OSA). OSA is characterized by multiple episodes of breathing pauses greater than 10 seconds at a time, due to upper airway narrowing or collapse.Untreated obstructive sleep apnoea increases the risk of developing heart attacks, strokes, diabetes, and many other medical problems. A sleep study in a laboratory may be necessary to determine if snoring is due to OSA. Gastroenterology – Commonly Patients with Gastro Esophageal Reflux Disorder experience night time heartburn, which is more bothersome. According to 2001 NSF Sleep in America poll, adults who experience night time heartburn are more likely to report having symptoms of sleep problems/disorders such as insomnia, sleep apnoea, daytime sleepiness and restless legs syndrome. Dental –One of the causes of bruxism is snoring in sleep apnoea with dryness of mouth. Paediatrics - Consequences of untreated paediatric sleep disordered breathing are, Social problems : Loud snoring. Behaviour and learning: may become moody, inattentiveand disruptive both at home and at school. Acts as contributing factor to attention deficit disorders in some children. Enuresis: Bedwetting. Growth: may not produce enough growth hormone resulting in abnormally slow growth and development. Cardiology: OSA can be associated with an increased risk of high blood pressure, stroke or arrthymia . Neurology - There is a close association between sleep and epilepsy. In some epilepsy syndromes, seizures occur predominantly (or even exclusively) during sleep . Endocrine : Obesity leads to increased resistance to insulin or daytime fatigue with decrease in physical activity. Along with metabolic disorder person may suffer from OSA leading to further complications . Most sleep problems can be eliminated, improved or controlled if treated.Good sleep is a reachable dream .
Be a Man first Then a Doctor
By: DEAN Prof. Gangadhar Sahoo One day a teacher asked the primary school students “My dear students! What do you want to be in future?” Majority of the students went in favour of becoming a doctor. Their explanation was, “Service to the mankind is service to God.” Then the teacher told them three stories and wanted to know what they learnt from these stories? One day a “Bai Chadhei” saw a monkey sitting on the palm tree, totally drenched in the heavy rain. Then the bird politely told to the monkey, “Dear brother ! Why are you suffering like this? Why can’t you make your own home? You are too strong. You can arrange materials and build your home and stay away from the rain. You see; we are small creatures. We can make our nest and live happily during rain, storm, sun & bad weather.” The monkey got annoyed and suddenly jumped to the tree where the bird’s nest was built and tore the nests into pieces. The teacher asked the students what did they learn from this story? One student said, “Monkey’s reaction was abnormal. He should have listened to the advice of the bird.” The second student said, “The monkey does not deserve such beautiful advice.” The third student said, “Monkey is intolerant to the bird.” The teacher summarized the things and told “My dear students you all are right. We learn four things from this story: One should listen to the advice or suggestion of somebody irrespective of whether one is small or great. One should give up anger and should not do harm to others as the monkey did by destroying the beautiful nest of the bird. One should be tolerant and learn from others. One should shed ego. These are a few qualities a person should acquire to become a man and then a doctor. Another day the teacher called his students and told the second story. The story was about “The Thirsty Crow”. In a hot summer a crow was very thirsty. He searched for water in the nearby places but could not find any trace of water. At last he could locate an earthen pot deserted under a tree. Luckily there was some water inside. The crow tried to put his beak into the pot but in vain. He thought of a plan. He collected small pebbles from the nearby places and dropped one after another into the pot. The water level rose. The crow could quench his thirst and happily flew away. The teacher asked the students what lesson did they learn from that story? One student replied, “Presence of mind of the crow is the most vital thing.” Another student told, “In difficult situations one should not be panic and lose one’s patience.”
FEW WORDS ON A DOCTOR… BY DR. IVY SAI INTERN Doctor, this word brings in the mind of an individual; the image of such a person who can heal his/her ailments. The word itself is a synonym of faith & trust. To acknowledge the commitment & dedication of the medical fraternity towards society, DOCTOR’S DAY is observed in India on JULY 1st to honor the legendary physician DR.B. C. ROY whose birth & death anniversary happen to fall on the same day. Its a significant day for doctors also to remind themselves of the ethics of medicine. India is unique in the sense that patients, their family members & the whole society trust the doctors to such an extent that they equate them with God who cures them of all their ailments & distress. Doctor is trusted upon the most whom a patient confides in & is comfortable to reveal everything about himself which he may not do so with his family or friends. However, due to unethical practice by a small percentage of doctors, faith in the medical profession which once was considered noblest of all is on decline. This has resulted in patients struggling around in search of a ‘good doctor’ making it a business like issue & unfortunately in doing so they land up in wrong hands. So it is imperative for both society & doctors to work together on re-establishing the lost trust, & there could be no better day than Doctors’ day to reinforce the unique doctor-patient relationship with harmony. On this very occasion I would like to remind myself & whole of the medical fraternity of an important component of the Hippocratic Oath i.e. “KEEP THE GOOD OF THE PATIENT AS MY HIGHEST PRIORITY”.