God saved me number of times (more than thirty times) till date. Now I am giving the real account about one very extraordinary event that occurred recently. Details are as follows: I retired from the state government service, working in the medical and health department, as medical officer. By the grace of God, I was again given posting to work as medical officer, on contract basis, in a primary health (Medicare) centre, in a remote area. (Previously this type of system was not there). Doing Tubectomy (Female sterilization) surgeries is one of my duties as per the job chart and I did a number of tubectomies. 1. August 20, 2004: I did four tubectomies on that day and all the cases were all right and were discharged in the evening of the same day and they left for their respective native places. There is one female health nurse to give follow up, post operatively for seven days, to every Tubectomy case. Now I am giving details of one case of the four Tubectomy cases. She is about 26 year old and having three children, at the time of surgery. Her native village is 20 km away from my headquarters (PHC). The patient was without any complications for the next two days, i.e.; on 21st and22nd August. 2. August 23, 2004: The patient developed spotting (slight blood discharge) at 2 pm. But the female health nurse did not visit the case for these three days (negligence on her part). There are other health personnel (supervisory category) also, who also not visited that operated case. The parents of the woman patient approached a rural practitioner (a quack) and brought 3-4 tablets to arrest the bleeding and gave them to the case. But the little discharge of bleeding was still continuing, even on August 24. 3. August 25, … [Read more...]
Injection in rural health care
This incident was happened in 1987 in a tribal area (Rajavommangi) in Andhra Pradesh, where I worked as a medical officer. A female patient about 26 years old was brought to the hospital by her husband at about 2 PM. Complaint: Severe pain in the abdomen. The time is an odd hour as hospital was remain closed from 12-30 PM to 4-00 PM. Only one staff member was with me at that time. I gave her anti spasmodic drug in the IV (intra venous) form in anticipation for quick relief. The injection was bought by the patient relative from a near by drug store as the hospital store was closed. Immediately, the lady developed sweating and pulse became weak. I immediately gave her required treatment for the reaction in the form of Dexamethasone injection. She recovered within 10 minutes. But, I LEARNT A BIG LESSON. Lesson: Never give injection in Intravenous route when you are working in rural areas unless it is necessary or it is the only possible route for that drug. Please comment on this article. … [Read more...]
Medical Caes: Dog bite and Rabies
This I a real story happened in 1974 in Maharashtra, India, where I worked as medical officer in a primary care centre in Apatapa, Akola District. I was called upon to examine a female patient aged about 28 years. She was complaining of pains all over the body, running temperature, headache and also feeling uneasiness. I have necessary medicine and rated it as a emergency case. In spite of good treatment, her signs and symptoms are recurring after a brief period of relief. After 4-6 hours, I enquired the patient about the complaints, whether it is the first time or any similar past history. Then, the relative of the patient informed me that there is no such past history. But, she earlier came to the PHC for dog bite treatment. Then, I recollected previous history of the patient. It is as follows: Two months back, this young lady came to the centre with a history of dog bite. I came to know that it was a street dog and suspected that it was a case of Rabies (also known as Hydrophobia). After giving first aid and Tetanus vaccine, I advised her to go to Government general hospital, Akola for taking Anti-Rabies vaccine as they are not available with us. In stead of going to main hospital, they went to local rural unauthorized doctor. He gave some injections and tablets and sent them to their village. Afterwards, she did not come to see me. She might not have developed signs and symptoms of Rabies. For most of infectious disease, there is an incubation period i.e. the time of getting infection and developing signs of symptoms. This patient developed signs and symptoms after 2 months. She died on the next day. I explained to the relatives … [Read more...]
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