Painful eating is the presenting symptom usually when a person gets ulcers in the mouth. This apparently casual condition can be extremely troublesome and painful in some when occurs recurrently.

Causative factors-

(1) The major cause behind recurrent aphthous ulcers bad oral hygiene. The patient usually says that he has these types of ulcers since long, may be since childhood. Dental caries may accompany.
(2) Nutritional deficiency can also be a very important cause in patients from underdeveloped areas. Also bad eating habits and lack of vitamin rich food are the reasons. Especially in children, these types of ulcers are found frequently due to their eating fads.
(3) Gastric upset is also regarded as one of the causes for recurrent stomatitis. The bloating, belching, and constipation contribute to the trouble, though direct relation has not been verified.
(4) High doses of antibiotics are often associated with mouth ulcers, unless coupled with B-complex vitamin supplementation.
(5) Allergic reaction to certain toothpastes, mouth washes, dentures, etc are also blamed.
(6) Emotional stress is often found to exaggerate the symptoms of aphthous ulcers. (psychosomatic)
(7) Some women have been typically seen to have excessive ulcers prior to their menses, when it may be considered as the part of PMS.
(8) Some conditions like ulcerative colitis, celiac disease, Crohn�s disease are also associated with mouth ulcers.

Treating mouth ulcers with Homeopathic Medicines�

Here, the foremost thing one should understand is that unless the causative factor is dealt with, no treatment is going to be of help. Therefore, steer clear of bad oral hygiene, dental problems, nutritional deficiencies, etc. There are certain innate tendencies also those need to be addressed while treating anyone homeopathically for mouth ulcers. Even one may have tendency to have mouth ulcers in families.

The homeopathic medicines act in 3 steps to cure the problem of recurrent mouth ulcers�

� Alleviate the pain and suffering
� Improve oral health
� Prevent recurrence in future

The major medicines useful for the problem of aphthous ulcers are Merc sol, Kali chlor, Belladona, Hepar sulph, Sulphur, Phos, Lachesis, Natrum mur, etc. Apart from these, any other medicine may be indicated depending upon the constitution of the patient and his totality of symptoms of aphthous ulcers. Especially for chronic cases, homeopathy renders amazing cures and the patient feels blessed to be free from this troubling problem!

Auxiliary Treatment�

This is of prime importance in any such case and the homeopathic physician must educate the patient about these points.

(1) Maintain good oral and dental hygiene.
(2) Do not neglect any eruptions in mouth and consult your physician immediately
(3) Have nutritious diet and include sprouts, legumes, green vegetables in the diet so that one gets natural supplement of all vitamins and minerals.
(4) Drink adequate quantity of water. (at least 10 glasses per day)
(5) Take care of your gastric health and steer clear of hyperacidity, flatulence, constipation by seeking apt expertise.
(6) Do not consume high doses of medicines haphazardly without doctor�s advice.
(7) Have positive mindset and exercise regularly!

DEFINITION & NOMENCLATURE:----
"Koro" is a Genital Retraction Syndrome where a person thinks that his/her external genitilia (Penis/Testicles or Vulva / nipple of Breast ) will shrink, retract and disappear with or without fear of Death.It occurs more in male than female patients.The earliest Chinese refrence is seen in'Yellow Emperor's classic of Internal Medicine' dated 300 BC,Western reference to the term koro is found in B.F. Matthes' Dictionary of Beginese Language (1874) of South Sulawesi ,Indinesia. The word is also used in Makassarese Language,meaning "to shrink"; the full dialect for it is garring koro. In Malaysian Language,keruk is the probable linguistic link of koro which means "to shrink". The term shuk yang or shook yong or suo yang (Chinese),Jinjina bemar (Assamese,India),Rok-joo(Thai) are coined for this diseas all in regional language, means "the shrinkage of penis".Actual word "KORO"originated from Malaysian word Tortoise (which is another name for "Penis" in slander language)as Tortoise has a habit of retracting their head resembling (like a PENIS)in to body,so people probably used that example to express this disease.
PSYCHOSOCIAL CLASSIFICATION
Koro has been described as"Culture Bound Syndrome"(which means it occurs in person with certain cultures where these cultural beliefs or myths generate and spread this classical form of disease,it is seen endemic with outbreaks or epidemics as in China,South East Asia, Malaysia, Indonesia (migrated people from China with classical )and certain part of Africa,Thailand,Singapore,India (non chinese local peoples as both classical and non cultural form ) and Western countries like Britain,America, France, Canada, Jordan (sporadic non cultural or secondary Koro where only shrinkage without any fear of death associatedwith CNS disorder,drug induced or under another psychiatric diorder) in mental disorder book and has been subgrouped as'Specific Culture-imposed nosophobia'or 'The genital retraction Taxon' or 'Cultural related beliefs as causes of occurrence'.
PREDISPOSING FACTORS & CAUSES
Psychosocial cultural belief which predispose "koro" a punishment of personal guilt of sex with other ladies/prostitutes(than Spouse/Wife),masturbation/Impotence or Sexual inadequacy (many such ancient folk stories are rampant in Chinese culture or theory of loss of yang humor (The Yan & Ying theory)or semen which is condsidered as vital energy,excess loss of this by frequent Ejaculation(depicted in Taosim which strongly inflence chinese medical thought) may lead to death.Witch Craft or evildoers or Fox spirit or ghost stories and folklore novels or KALA JADU (Assam & Bengal) are prevalent in China where it has been described that these spirits cause genitilia to retract in abdomen,making them physically and sexually weak and utimately dead.in South China and in south asian and Africa and even in India where this disease is prevalent,people have strong belief in such stories and play. Mass hysteria that Contaminated pork with swine fever cause epidemic of Koro in singapore in 1967.In Africa,Black magic was behind this and in Nigeria and ghana,there was panic that penis has disappeared by touch of a stranger.
But in isolated 03 cases in America, patients suffering from anxiety and worries about Penis suffered it after smoking Cannabis which may increase worries and anxiety as its side effect.In Britian and other western part it was due to depression resulting from psychological disorder,phobia for AIDS,brain tumor,schizophrenia etc.,but never a social or folk beliefs based on prevalent ancient stories and dramas.Ethnographic psychologist (who study different cultures) consider koro to be closely related to panic attacks caused by either social belief based on prevalent stories or myth or rumors of food poisioning or evil doers or as punishment to evil doing in form of self perceived or believed sexual offence resulting in retraction or shrinkage of genitialia with or without fear of death.Attacks of koro are often set off when men are in situations that would normally cause the male genitals to shrink slightly,such as emotional distress or cold temperatures.as Scrotum and penis more responds for shrinkage on exposure to mental stress and cold temperature they affect more than female.But tensed and psychological disturbed or introverted sexually freezed or tense female may suffer too complaining of retraction of Nipples and of vulva or disappearance of vulva under tight thighes under severe stress and strain.
SIGN & SYMPTOMS: Koro exist in two forms.Classical or True or Primary Koro where patients under a social belif or rumor or myth complains of shrinkage of Penis or testicles or both in Male and of Vulva or Nipples of breast / breast or both in female folowed by retraction of them in abdomen with physical and sexual weakness with or without fear of death.Mostly present as acute attack lasting for hours to maximum duration of 02 days.But some may show symptoms for years as chronic cases or recurrent cases ,some instead of shrinkage of genitilia complain genital shortening,alteration of penis size,loss of muscular strength,genital paraesthesia with no complain of retraction or breast mass in female with altered breast size and hidden or distorted nipples.Feature of sexual dissolution,loss of sexual or physical power,weakness,urinary obstruction,sterility may be seen.Psychologically Pateint suffer from anxiety neurosis may include fear of death,non specific physical danger,impending madness,spirit possession and feeling of being bewithched or under cover of black magic with feeling to sex change to eother female or vice versa or turning Enuch.
But in secondary or unclassical form of Koro as seen in western world only retraction of penis or loss of penile strength is coplained where person has got intense anxiety for penis with a strong psychosocial disease or under any organic brain disease or under influence of drug or intoxication.
While there are no substantiated reports of the condition itself resulting in any physical damage to the individual, many sufferers have unfortunately inflicted harm upon themselves or physical damage in frantic attempts to stretch the penis or Breast to prevent further shrinkage. It is not unusual for those with koro themselves or wthrough their family members and social sympathisers to resort to using devices such as clamps or weights or pegs or by aloop of string for retraction of penis as mechanical traction device.female either herself or ladies around her grab breast,pull nipples out or insert iron pins in nipple so that it cannot go inside.
Chanting of local religious songs and puja or religious celebration to please God/Goddess through local preachers and pandits or programmes for their blessing or correct any unknown mistake conducted in their past celebration or work out by local witch hunters by putting wood fire and smoking to remove bad blessing or evils or black witch from society or beating or killing of socalled wrong or evildoers suspected in society or villages is done.In North bengal people are putting lime water over both ears and nose ,keep Kush grass or pure water of a temple or river to keep these bad evils from them .some also cover their genitilia and breast so much under clothe as nothing happens to these organs.
DIAGNOSIS: it is easily done when epidemics occur as strong social belief or myth or rumor based on past prevalent stories and drama of witch hunt or as a punishment of some sexual wrong doing or intake of contaminated food or prsence of some diseases with typical full blown symptoms of penile/Testicle shrinkage or retraction in abdomen in patient of introversion suffering from anxiety or psychological disorder or under religiuos and social belifs and faith in myths or evil doers with or without sexual and physical weakness and fear of death.Injuries are secondary to measures taken by patients or relatives to prevent injuries.
TREATMENT:---
As the disease involves social beliefs and psychological insult so both Medical and Indigenous treatment should be given otherwise complete eradication may not be possible.As no defect is found in genitilia and breast to nothing is done for this if injuries inflicted by patient or relatives as mechanical manipulation to prevent retraction of genitilia or nipples then local injuries are dealt both surgically and medically.
in Cultural bound cases,lectures should be organised through healers of society by educating them with anatomy and physiology of Genitilia with audio visual or practical demonstration either as alone or to whole society utilising local media,radio /Tv/poster/leaflets and picturing small booklets,Individualy affect person psychosocial analysis is done and therapy for underlying disease is started.Inwestern type sexual conflict is identified and patient treated for any psychological or organic disease diagnosed.
indigenous medicines by local healers may be also advised to win the belief of people,praying to Gods and submitting to socalled social healers and witch hunters may be allowed to control epidemic spread but side to side strong counselling and health education should be provided individually ,by NGO or by Government health agency and social reforming departments.In china people hit gongs or bells to drive out witches .They use chinese a yang or yin augmenting medicine including herbs,animal penises (of tiger,deer,and fur seal )pilose anter(stag of deer) or deer tail.Pepper soup ,ginger soup,Louki or cucumber soup or liquor is also drunk to cure the diesease,in north Bengal people are using lime water application over both ears and nose and kush grass and holy water keeping to keep awya bad evils.
PROGNOSIS:prognosis is seen in patient having an acute attack with short history having uncomplicated sexual life,low freauency of attack with previous functional personality.
Dr.D.R.Nakipuria

09434143550
**Author is a naco trained HIV and sex specialist

Festive seasons are on,it is a common practice in our society to crack crackers and put fire to sound bombs emitting light or fire with sound ,often we forget how much our such activites will cause damage in form of fire and noise to others but we also forget that this noisy sound of high intensity may damge our precious ear for life time.Not only this,the way we live our life everyday we listen to Radio,TV ,Ipods,mobile phones,music system,High speed Rail engines,taking off of Airplanes,Helicopter or noisy vehicles on road or high speedy noisy making machines in factories or Automobile work shops ,announcements and open speeches or mike being displayed before our home or residence by political parties or different religious celebrations or puja or Dusshera or local cultural functions where loud sound comes to us involuntarily and such sound may damage our hearing as smoker in a public places spread damage to near by innocent persons.Hearing loss also occurs when we become old (Presbycusis) or when bony growth takes place at inner ear called Otosclerosis. Protection ,prevention is the best method to get over this donot submit ourself to this noisy sound if possible,donot crack noisy sound crackers,donot listen to radio,mobile phone,TV,Ipod Phones turnig volume very high and close to ears ,in avoidable circumstances either use ear plugs or drums or fingers in ear or cotton packs to prevent hearing loss,simple formula is to avoid listening too noisy or loud sound,tooclosely listening sound and to hear loud sound for some time or continuously.
Sound intensity is measured in the form of a unit called Decibels,sounds too loud or loud sound for aggod time may damage our hearing,sound above 85 decibels may cuase hearing loss even it may be music sound.if a sound of 85 decibels is listened for 8 hrs a day or for about 5 days in a week may damge or hearing,here if sound intensity is increased only upto 03 decibels,i.e.,88 decibels will damage same in half time and a sound of 120-150 decibles or more may damage our hearing in no time.For a sound measurement 10 decibels is considered as one unit ,increase in10 decibels increase sound intensity by double i.e.,this sound is two times loud on listening.Asound below 75 decibels donot damage our hearing evenlistened for much time ,Ipod listend at 60% volume doesnot damage but 100% intensity may damage and it also depends on make,type of sound emitting,how much time and close we are to these instruments .
For example ,Awishper produce 30 decibels,a rainy storm 50 decibels,a Normal conversation 55 decibels , TV 60 decibels,a noisy office 70 decibels,a busy traffic 80 decibels,Hair dryer 90 decibels,an IPOD full volume 110-130 decibels,and same for rock concrete,loud car or home stereo or inside modern cinema house or sitting close to high sound emitting music programmes,Firecrackes and arms upto 140 decibels and same true for a loud engines even at 25 meters.
A sound wave or energy traves from our Ear pinna and Ext auditory Meatus through Bony Ear canal and produce impact on ear drum and make it vibrated and this vibration is carried to inner ear through bones of middle ear MIS and in inner ear Cochlea which contains fluid and a Basilar Membrane on which hair cells are situated are allowed to vibrate and this sound wave is changed into electrical impulse which is carried by Auditory Nerves to Auditory centres in Brain ,all this is situated in a portion clalled Labriynth which also helps us to correct our positon and balacing so damage to internal ear aslo damge our balancing system and in our early childhood Hearing and understanding it also stimulate speeching so if no good hearing speech is also affected and in the last intellegence and learning is also affected.
such hearing loss is some time so slowly that we hardly take precautions in time,so for better undestanding the defect we should be cautions if following symptoms starts as follows:----------------Do I have a problem hearing over the telephone?
Do I have trouble following the conversation when two or more people are talking at the same time?
Do people complain that I turn the TV volume up too high?
Do I have to strain to understand conversation?
Do I have trouble hearing in a noisy background?
Do I find myself asking people to repeat themselves?
Do many people I talk to seem to mumble (or not speak clearly)?
Do I misunderstand what others are saying and respond inappropriately?
Do I have trouble understanding the speech of women and children?
Do people get annoyed because I misunderstand what they say?
so if we found our selves suffering from any thing like this,we should be precautioned and avoid listening close to Mobile Phones,Music System, TV, Ipods,Radio or any cultural or Political or cultural programme or cinema sitting close to loud sound emitting system or use ear plugs at railway or airports or during takeoff and grounding of flights or at factories or at traffic jams or putting fire to crackers or sound emitting crackers or bombs or fire arms.if we prevent it Loud noise hearing loss is completely avoidable.
Dr.D.R.Nakipuria

09434143550

RECENT ADVANCES IN TREATMENT OF HIV/AIDS PATIENTS
-----DR.D.R.NAKIPURIA
AIDS is acquired immunodeficiency syndrome comprises of many symptoms and signs (different complains of patients and many thing evaluated by Doctor on examination)of Patient suffering from HIV,Hunam Immunedeficiency Virus.AS THE NAME SUGGEST OUR DEFENCE SYSTEM or Immune system is paralysed or made less responsive(measured in this infection by determining CD4 Count from Blood examination as a type of Lymphocyte fighting with invasion of HIV in our Body) whenever any infection of Bacteria,Virus,Fungus or parasite invade our body as a result infection can occur in any part of our body and as primary resistance from our Body System is weak,infection spreads more and more resulting in further growth of invading microbes and this HIV virus too(measured by Viral Load as Copies of Virus in Blood and susceptibility to drugs by sensitivity test).Therefore development of Anti Retro Virus (as HIV is Retrovirus) medicines has developed which once started raise immune system CD4 count by checking further growth of HIV virus and prevent infection by other Microbes(Oppurtinistic Infections) but as we know more and more about these medicines and their side effects and different Oppurtinistic Infections,WHO put some best guidelines when to start these medicines in HIV patients as in Year 2006 ART was to be started if CD4 count is below or 200 but in 2010 it is upto 350 But Amercan Journal suggest it upto 500 when patient is symptomatic or in stage I and II as per WHO staging(Patients with less grade of infections)but in stageIII and Stage IV patients or patients with severe form of disease or seriously ill as suffering from TB,Meningitis,Kidney or Cardiomyopathy,Chest or GI tract infections does not require any estimation of CD4 count as this is presumed and fact that their CD4 count is below 350 or 200 and ART or Better called HAART Medicines immediately.In case of TB patients ATT should be started after start of ART generally within 2-8 wks to avoid IRIS or any adverse reaction,those on HAART developing TB ,ART should be started immediately(with efavirenz except children below 03 yrs of age and first trimester pregnancy).In case of Pregnant Patient same module is practised ,in patients suffering with Hepatitis B or C patients,like TB, ART should be started immediately without any staging or delay of 2-8 wks.In case of Childrens too now same strategy is applied but here CD4 count varies according to age groups,we can start ART immediately in stage III and IV in infant or children upto 12 yrs of age but in Infants and children up to 2yrs of age no need of checking CD4 count start ART if patient is sytomatic or is diagnosed as HIV patients,even in infants now ART may be started if we strongly clinically suspect HIV (As Mother strongly positive or both parents positive or breast fed positive mother children etc) but in early age from 2-5 yrs reduction of CD4 count up to 750 or % of CD4 count below 25 but above 05 yrs criteria is 350 for stage I and II . In Developed countries Art is being started CD4 count upto 500 or less above 05 yrs and adult.CD4 count was previously estimated every 06 months but now at every 03 months and if it is not raising considered as immunological failure and Viral load to be done before starting therapy and also at 3-6 months to see copies below 5000/ml it is raising then drug sensitivity test is done and if not possible then IInd Line drug is started,if IInd line drug started then now a days IIIrd line drug is started.In pregnancy either mother exposed to AER earlier or not ART started in first trimester(avoiding Efavirez) with drug regime and is continued life long unlike nevirapine during labor or Zidovudine regime only,Zidovudine and Nevirapine found good in CD4 count between 250-350.
Now HAART medicines has been slightly modified,Two NRTIs and one NNRTIs is still practised to check drug resistance by Virus mutation but instead of dT4(Stavudine 30 or 40 as per wt above or below 60kg causing severe lididolysis or peripheral neuropathy,pancreatitis ) now3TC(Lamivudine)+AZT/ZDV(Zadivudine causing severe anaemia or neutropenia ) or 3TC + TDF(Tedofil,causing nephropathy and calcinosis ) or TDF + FTC (Emcritabine),AZT+ FTC(causing hepatitis) so 3TC+ AZT+NVP(causing hepatitis and stevenson Zhonson syndrome) or 3TC+AZT+EFV (Efavirenz)or 3TC+TDF+NVP(Nevirapine) or EFV is preferred ,even Simple FTC+NVP or FTC+ EFV is preferred.here Abacavir (ABC) or Diadanosine (ddi) is also used as NRTIS but combination like Stavudine+Zaduvidine,3TC+FTC or AZT+TDF or dt4+Abacavir is not used . Incase of Tuberculosis patients,Efavirenz is given not NVP except when patient is child below 03 yrs or Ist trimester pregnant or under Psychotic condition or medicines.If possible and patient can afford Rifabutine may be started in ATT instead of Rifampcin but mostly if patient is not renal compromised or under hepatic pathology simple ATT is good.In Resistant cases(increase in viral load,less cd4 count or drug resistance)IInd line drug of 03 drugs combination is started here one protease inhibitor(Liponavir(LPV) / Squanavir(SQR)/ Indinavir(IDV) /Atazanavir(ATV) /Fosamprenavir(FPV) / Darunavir(DRV) /Etarvine(ETV) with boosted Ritonavir(r)or plain Ritonavir(RTV) is used and along with this in TB patients with Rifampcin dose of protease inhibitor like Lopinavir+ boosted ritonavir(LPV/r) or Squanavir +Boosted Ritonavir or Indinavir + boosted Ritonavir is increased but with Rifabutine no dose adjustment is done.Instead of using NRTIS used in past as for dt4 or 3TC ,AZT + TDF or TDF + FTC or simply replacing 3TC by TDF or FTC or ABC or ddi is done,if any drug produce complication or side effect as mentioned above it is also replaced.In case of Hepatitis B TDF +3TC is used with NNRTIS or Protease Inhibitor.Revebrine and Pregylated Interferon is used with ART in Hepatits C patients.If after IInd line treatment CD4 count is increased third line treatment using one NNRTIS ,one Protease inhibitor as newly added ATV,DRVor FPV with Integrase inhibitor Raltegravir(RAL) is used.
Cotrimoxazole is added to prophylaxis below 350 to prevent malaria,bacterial,PNeumocystis Jivorecii or Campylobacter Diarrhoea and Toxoplasmosis.STD clinic for any sexual inflicted persons like commercial or flying sex worker (counselling and promoting use of condom )and treatment and screening of suspected highly prone patients like IDUs,drug users,(not sharing needle)migratory labours,Truck drivers etc., at target Intervention clinic is backbone to control it and every suspect should be submitted for HIV screening ,Similiarly every TB patient and in ICTC every Blood donor and PTCT pregnant mother is screened for HIV.Proper counselling of these patients with advise and regular follow up of these persons at primary or semi primary or assisting ART centre is must by doing off and on viral load and CD4 count examination. Every oppurtunistic infection should be controlled and here medicines shold be contined for a long time to prevent recurrence and continuation of ART medicine of great importance.Adhrence,compliance and continued taking medicines with proper counselling during IRIS or any other drug reaction is most important of HIV treatment.

09434143550
Author is an HIV specialist Doctor

DOCTORS ARE ON STRIKE AT JODHPUR! WHOLE RAJASTHAN! AT SAFDARGANJ HOSPITAL! NOIDA!GAZIABAD! KOKATA! NORTH BENGAL MEDICAL COLLEGE! ----------SO MANY PATIENTS DIED! NO TREATMENT FOR POORS!PATIENTS ARE RETURNING HOME!MOVING TO PRIVATE CLINICS!GOVERNMENT HAS FAILED!-----THESE SLOGANS ARE COMMON ON ELECTRONIC MEDIA GIVING 24X7 NEWS AND PRINT MEDIA.EVEN AT ANY PLACE,HOME,OFFICE, CLUB,RESTURANTS,PARK,HOTELS,AMUSEMENT CENTRES OR LIBRARY ANY GENRAL PERSONS WILL BE OF VIEWS THAT MEDICAL IS A NOBLE PROFESSIONS,A PROFESSION TO SERVE THE HUMAN BEING ACCEPTING ALL SUFFERINGS TO THYSELF,SO DOCTORS AND ITS FAMILY MEMBERS LIKE NURSES,HOSPITAL STAFFS,PARAMEDICS, MEDICAL STUDENTS, TEACHERS, RESEARCH SCHOLARS,LAB ASSISTANTS, DIAGNOSTIC CENTRES ,HOSPITAL, PRIVATE CLINICS MEDICAL REPRESENTATIVES AND DRUG MANUFACTURERS AND RETAIL SELLERS SHOULD NEVER CALL FOR STRIKE CLOSING THEIR WORK COMPLETELY, ABSTAINING FROM EXAMINING,PRESCRIBING AND TREATING PATIENTS AT WHATEVER REASON AND WHATEVER COST OF PERSONAL OR COMMUNITY SUFFERINGS AS THEY ARE WORSHIPED LIKE GOD AND GENERAL PEOPLE SEE AN IMAGE OF GOD IN DOCTOR'S BODY.
SECONDLY FOR MAKING A GOVERNMENT DOCTOR,GOVERNMENT PAYS A HUGH MONEY COLLECTING FROM TAX PAYER'S POCKET SO DOCTORS HAVE NO RIGHT TO CEASE WORKS -MANY CHANNELS AND WRITERS ARE ADVISING GOVERNMENT TO BRING LAWS LIKE ASMA TO BAN DOCTOR'S STRIKE AND CEASEWORK AND PUNISH DOCTORS OPENLY FOR VIOLATION OF THEIR DUTY FOR PERSONAL OR COMMUNITY GAIN.
SUCH POPULISTIC AND GENERAL VIEWS ARE OFTEN SOUNDED BY LEADERS OF POLITICAL PARTIES AND SOCIAL WEFARE GROUPS WITHOUT GOING INTO DETAIL OF SUFFERINGS WHICH THE WHOLE MEDICAL WORLD UNDERGOES BEFORE SUBMITTING THEMSELVES TO THIS LAST PAINFUL WEAPON OF SUBMITTING THEMSELVES FOR STRIKE!OR CEASE WORK! EVEN DURING SUCH STRIKE MOSTLY DOCTORS KEEP OPENS EMERGENCY SERVICE BUT NUMBER OF PATIENTS IN GOVERNMENT AND SEMI GOVERNMENT CENTRES ARE SO MUCH THAT IT CANNOT TAKE LOAD OF PATIENTS SMOOTHLY ,SECONDLY MEDIA PEOPLE BECOMES SO ACTIVE THAT THEY START REPORTING NEWS OF DEATH AND SUFFERINGS SO MUCH FOCUSING THE STRIKE THAT IT APPEARS AS IF IT IS ALL BECAUSE OF STRIKE WHERE AS FACTS REMAIN THE SAME THAT SUCH KIND OF SUFFERINGS AND DEATH ARE COMMON IN THESE HOSPITALS BECAUSE OF LATE ARRIVALS OF SERIOUSLY ILL PATIENTS,INABILITY TO PROVIDE ADEQUATE MEDICINES,INVESTIGATIONS, TREATMENT FACILITIES TO THESE PATIENTS FREE BY GOVERNMENT WHO SPEND LESS THAN 3% OF GDP ON HEALTH WHEREAS 30% IS PAID FOR ARMY AND DEFENSE,AT MOST OF GOVERNMENT CENTRES ADEQUATE MEDICAL STAFFS,NURSES, PARAMEDICAL ASSITANTS AND HELPERS ARE LACKING,EVERYTHING IS LEFT ON TREATING DOCTORS AS THEY WILL MANGE EVERYTHING AND THEY ARE AT FAULT FOR EVERY MISTAKES OR LACK OF TREATMENT OR IF ANY COMPLICATION OR DEATH RESULT FROM TREATMENT .NOW A DAYS PEOPLE FROM EVERY CORNERS BLAME DOCTORS FOR SUCH PROBLEMS OF NOT GETTING GOOD TREATMENT OR DEVELOPING COMPLICATION OR DEATH AND FOR PROTESTING INSTEAD OF LAUNCHING PROTEST OR COMPLAINS THROUGH HOSPITAL OR POLICE OR ADMINISTRATION,TAKES LAW IN THEIR HAND AND TO MAKE ISSUE HIGHLIGHTED IN MEDIA AND EVEN POLITICAL PARTIES AND MANY CLUBS,NGO.S, SOCIAL WORKERS AND EVEN SOME MISCREANTS JOIN THESE PROTESTORS OPENLY AND ATTACK DOCTORS,NURSES,MEDICAL STUDENT, PARMEDICAL STAFFS AND MEDICINE SELLERS PHYSICALLY INFRONT OF EVERY BODY(MEDIA-WHO INSTEAD OF CONTROLLING SUCH JEHADI PROTESTORS REMAIN ENGAGED IN TAKING PHOTOGRAPHS AND TAKING BITES TO SELL THEIR NEWS TO EARN MONEY BY PUTTING MORE MASALA AND TARDKA AND PRESENTING THEMSELVES AS FIRST CHANNEL TO DICOVER IT AND TO GAIN MORE AND MORE TRP,POLICE; IS OFTEN CALLED FOR CONTROLLING LAW AND ORDER BUT MANY PLACES THEY DONOT REACH IN TIME BECAUSE MOSTLY CRIME IS COMMITTED BEFORE THEIR REACHING AT SPOT AND EVEN REACHING IN TIME,THEY MOSTLY REMAIN SILENT BECAUSE OF POLITICAL PRESSURE OR ATLEAST CONTOL DEMONSTATORS AND PROTESTORS WHO USE BAD UNPARLIAMENTARY LANGUAGES AND SLOGANS TO MALIGN "DOCTORS" AS SPEAKING IS OUR BASIC RIGHT,MOSTLY MOB BECOME FURIOUS BEFORE MEDICAL ADMINSTRATORS AND DOCTORS AND START DAMAGING HOSPITAL PROPERTY BY BRAKING RECEPTIONS,DIGNOSTIC CENTRES,OT, OPD LAUNGE,INDOOR INSTRUMENTS ,BEDS AND FUNITURES,AT SOME PLACES THEY PUT THESE ON FIRE BEFORE LAW PROTECTING FORCE IN NAME OF SHOWING AGONY ,GRIEVNCES AND SHOCK FOR DEATH OR MISS MANGEMENT OF THEIR NEAR ONES AS IF DOCTORS HAS CREATED THE ACCIDENT OR DISEASE TO THAT PERSON AND DOCTOR IS THE ONLY SOLE RESPONSIBLE FOR SUCH ACCIDENT.EVEN IN MOB GENERAL PEOPLE ALSO BECOMES PART OF THESE DEMOSTRATIONS THNKING THAT DOCTORS ARE CORRUPT,THEY EARN HUGH MONEY BY CHEATING GENERAL PEOPLE,MOVE IN GOOD CARS AND LIVE IN GOOD HOUSES BY TAKING COMMISSION FROM DRUG COMPANIES,DIAGNOSTIC CENTRES ILLEGAL PRACTICE FROM GOVERNMENT HOSPITAL TO PRIVATE HOSPITALS AND AS GNERAL PEOPLE ARE NOT GETTING GOOD SERVICE FOR THEIR HEALTH PROBLEMS AS GOVERNMENT CLAIMS AS IT IS FREE AND FAIR BUT PRACTICALLY DUE TO LESS INVESTMENT IT IS ALSMOST ABSENT ,SO DOCTORS BECOME EYESORE OF COMMON PEOPLE TOO AND POLITICIAN AND ADMINSTRATOR ALSO REMAIN SILENT AS THEY KNOW PUBLIC WANTS DEFAME AND DISREPUTE OF DOCTORS SO IF THEY SUPPORT DOCTORS IN SSUCH CRISIS PEOPLE AND MEDIA WILL DESTROY THEIR VOTE BANK AND IMAGE,SO DOCTORS ARE LEFT FOR BEATING AND PHYSICAL HURT IN OPEN DAY LIGHT.
EVEN GOD WILL BE BEATEN ON BASIS OF SOME FILTHY CHARGES WHERE HE IS NOT DIRECTLY INVOLVED OR WHERE DEATH OR COMPLICATION IS A PART AND PARCEL OF THE TREATMENT PROCEDURES WHERE LIFE AND DEATH ARE EXISTING SHARING SHOULDER OF EACH OTHER
,GOD WILL TOO REACT WHAT TO TALK OF THESE HUMAN BEINGS ,HOW ONE CAN ASPECT A FEARLESS GOOD TREATMENT BY DOCTORS WHEN WHOLE SOCIETY IS STANDING AGINST HIM FOR NOT PROVIDING GURANTED GOOD TREATMENT AND RECOVERY,DOCTORS ARE MOSTLY SHACKEN BY CONSUMER PROTECTION ACT,RTI ACT,VIGILANT AND INTROSPECTING MEDIA WHO IS ALWAYS IN HOSPITAL TO CLICK ANY STORY ON DOCTORS PATIENT TUSSEL OR ANY MISHAPPENING IN HOSPITAL TO EARN TRP AND IF SUCH SHOCKED AND TREMOROUS DOCTORS ARE BEATEN OPENLY,THEIR REPUTATION IS CHALLENGED SO OPENLY IN SOCIETY,THRE IS NO OPTION LEFT BUT TO ASK FOR PROTECTION AND FORM GOOD LAWS AND BRINGING STRICT ACTIONS AGAINST MISCREANTS SO THAT SUCH ACCIDENTS DONOT HAPPEN IN FUTURE BUT AS THIS IS A NORM IN OUR PRESENT SOCIO POLITICAL SYSTEM THAT UNLESS YOU PRESENT YOUR SELF IN A VERY SERIUOS UNPARLIAMENTARY MANNER NO BODY LISTENS TO YOU,EVEN PARLIAMENTS AND ASSEMBLY SHOWS US SOMANY ROUDY AND BREAKING MIKES,CHAIRS AND WINDOWS IN THESE HOUSES BY ELECTED MLSAS AND MPS AS GOVERNMENT DONOT LISTEN TO THEIR SIMPLE PROTEST.
EVRY DEATH IS PAINFUL ,NO DOCTORS WANT THAT SOMETHING WRONG OR COMPLICATION OR DEATH OCCURS TO HIS/HER PATIENTS (EVEN EVRY GENERAL PERSON ACCEPTS IT) BUT DURING SUCH ACT SUCH THINGS ARE FORGOTTEN AND AN ONE THEME AGENDA OF BRUTALLY ATTACKING DOCTOR'S AND THEIR FAMILY MEBERS OF MEDICAL WORLD PHYSICALLY AND DAMAGING HOSPITAL PROPERTY IS TAKEN,INSTEAD OF RECOMMENDING FOR PUNISHMENT OF THESE PEOPLE,POLITICAL LEADERS START SCORING THEIR GAIN AGANIST RULING PARTY FOR SUCH ACT,STRATS ENCOURAGING THEM MORE AND MORE AND RECOMMENDS FOR THEIR IMMEDIATE RELEASE EVEN CUGHT BY POLICE ,MEDIA SHOWS THEM AS GREAT PCIFIER,NGO'S ANS SOCIAL WORKERS, CLUB ALL COMES FOR THE RESCUE OF THESE TROUBLE SHOOTERS JUSTIFYING THEIR PROTEST AS NATURAL BECAUSE A HUMAN LIFE HAS BEEN LOST AND DECLARES "DOCTORS"AS CRIMINALS WHO HAS COMMITTED THE CRIME MAKING HIM RESPONSIBLE FOR EVERY SUCH MISDOING FORGETTING ALLOCATION OF MONEY,FACILITIES, INFRASTRUCTURES STAFF,WILL POWER,WORK CULTURE ETC., IN THESE HOSPITALS.
SO MANY TYPE OF CRIMES ARE COMMITTED IN OUR SOCIETY BUT IN MOST OF THEM MASS DOESNOT PARTICIPATE,INVESTIGATION AUTHORIITE S LIKE POLICE,CID,CBI AND STF WORKS AND EVEN PUBLIC OR MISCREANTS TRY TO SABOTAGE SUCH INVESTIGATIONS ,THEY ARE BOOKED AND TAKEN TO TASK BUT IN CASE OF MEDICAL INVOLVEMENT, "DOCTORS" HAVE BEEN MADE SOFT TARGET AS IF ANY BODY CAN HIT THEM PHYSICALLY AND DAMAGE THE HOSPITAL PROPERTY,NO EXELEMPARY PUNISHMENT IS IMPOSED (GOVERNMENT OF ANDHRA HAS BROUGHT A LAW TO ARREST AND RECOVER MONEY FROM MISCREANTS AND PROTESTOR DAMAGING HOSPITAL PROPERTY ) BUT SUCH LAW SHOULD BE PASSED BY OUR PARLIAMENT AND SUCH AN EXAMPLE SHOULD BE CITED BY ARRESTING AND RECOVERING FROM SUCH PROTESTORS THAT IN FUTURE NO BODY SHOULD TAKE LAW IN HAND,MEDIA SHOULD STOP SHOWING AND REPORTING SUCH INCIDENTS AS THEY ENCOURAGE MORE PEOPLE TO TAKE LAW IN THEIR HAND.BUT FACTS REMAIN THIS,MEDIA IS FREE! POLICE CANNOT ACT! POLITICIANS ARE WELL WISHERS OF PEOPLE,NGOS AND SOCIAL WORKERS ARE SERVING SOCIETY! POLICE CANOT BE CONTROLLED AND DISCIPLINED !ADMINISTRATION AND LAW MAKERS NEVER SOLVE PROBLEM BY SIMPLE WRITING, DEMANDS, DEMONSTRATIONS,PROTESTS UNTIL AN EXTREME STEP IS TAKEN IN THE FORM OF STRIKE OR CAESE WORK IS TAKEN ,THEN THEY RESPOND BY GIVING MERE CONSOLATIONS ,ARRANGING POLICE PICKETING AND SECURITY PROTECTION FOR FEW DAYS,AS THE TIME PASSES EVERYTHING AGAIN COMES TO SAME PREVIOUS STAGE, A NEW INCIDENT TOOK PLACE AND EVERY THING IS REPEATED IN THE SAME WAY.
THEREFORE,IT IS NEED OF TIME THAT OUR POLITICIANS ,ADMINISTRATORS,MEDIA AND PEOPLE SHOULD SIT TOGHTHER AND THINK'WHY DOCTORS ARE BOUND FOR STRIKING" ,SOLVE THEIR PROBLEM IN TIME,LISTEN TO THEIR REPRESENTATIONS AND JUSTIFIED DEMANDS (WHEN EVERY PARLIAMENTARIANS AND BUREAUCRATS ARE ENJOYING SO MUCH HIKED PAY AND FACILITIES,WHY DOCTORS WHO TREAT THE PATIENTS ARE PAID SO BADLY,WHY THEIR BASIC AMENTIES,FACILITIES ARE NOT IMPROVED, WHY MORE CAPITA IS NOT EXPENDITURES ON HEALTH,WHY FACILITIES OF BED,DIAGNOSTIC CENTRES,MEDICINES AND ADEQUATE STAFFS ARE NOT INCREASE IN HOSPITALS,WHY A PUBLIC RELATION OFFICERS IS NOT APPOINTED IN HOSPITALS WHO ACCEPTS ALL GRIEVANCES AND REPORT TO MEDIA AS WH IS AT FAULT FOR MISMANGEMENT OF PATIENTS AT HOSPITAL,WHY A DOCTOR IS MADE RESONSIBLE FOR ANY MISHAPPENING IN HOSPITAL?)CREATE SO MUCH AWARENESS IN PUBLIC THAT THEY UNDERSTAND ALL SUCH MIS HAPPENINGS AND NEVER RESORT FOR SUCH ACT OF TAKING LAW IN HAND.
THESE ARE BASIC QUESTIONS WHICH A GOD WILL ALSO LIKE TO BE RESOLVED BECAUSE MOST OF TIME HE IS NOT AT FAULT AND NO BODY ERRONEOUSLY BLAME HIM,SYSTEM IS POLLUTED AND AS HE IS DIRECTLY AT TOP IN HOSPITAL ,SO HE CANNOT BE BLAMED BECAUSE INDIRECT BOSSES ARE IN POLITICS AND ADMINISTRATIONS. EVERY GENRAL PEOPLE HAVE RIGHT TO COMPLAIN TO ADMINISTRATION,POLICE,JUDICIAL COURT,STRICT ACTION SHOULD BE TAKEN IF DOCTOR IS FOUND AT FAULT BY INVESTIGATIONS OF COMPETENT AUTHORITY ,OUR COURT SHOULD BE MADE RESPONSIVE FOR EARLY TRIAL AND JUDGEMENT ,ALL ADMINSTRATIONS AND POLITICIANS SHOULD SHARE THEIR DISCREPANCIES AND FAULTS(INSTEADING OF PASSING WHOLE BUCK TO "DOCTOR")AND RESORT TO DOCTOR'S PERSONAL OR COMMUNITY PROBLEMS AS SOON AS POSSIBLE SOTHAT SUCH A HARSH AND UNJUSTIFIED WEAPON OF PROTEST "STRIKE OR CAESE WORK " IS EVER TAKEN BY DOCTORS .EVEN DOCTORS SHOULD TAKE STERN MEASURES TO IMPROVE PATIENT DOCTORS RELATIONSHIP BY DOING SOME GOOD SOCIAL WORKS AS MANY DOCTORS ARE DOING INVOLVE MEDIA AND GENERAL PEOPLE IN POLITICIANS IN THESE PROGRAMMES SO THAT NOBLE WORK OF DOCTORS GET MAXIMUM EXPOSURE IN SOCIETY SO THAT GENERAL PEOPLE COMES IN SUPPORT OF DOCTORS AND HAVE TO BE REMAIN UNITED SO THAT GOVERNMENT AND ADMINISTRATIONS LISTEN TO DOCTORS ,NOW A DAYS SELF DEFENCE IS BEST DEFENCE RESPECTING LAWS OF OUR COUNTRY.SO MERE CRTICISM WILL NOT YIELD ANY RESULT,DOCTORS ARE MOST IMPORTANT MEMBERS OF SOCIETY WHO SPEND SO MANY VALUABLE TIME ABOUT 15 YRS MINIMUM TO BE A GOOD DOCTOR WHO HAS TO READ THROUGHT OUT LIFE AND UP TO DATE TO REMAN AS GOOD DOCTOR WITH VERY LOW PAYMENT INCOMPARISON TO MBA,IIT,BUREAUCRATS AND CEO OF MODERN COMPANIES AND A PROPER RESPECT AND RECOGNITION IS ESSENTIALS TO THEM AND OUR SOCIETY AND ADMINISTRATION SHOULD BRING ALL CHANGES IMMEDIATELY SOTHAT SUCH HOOGALINISM,VADILISM AND GOONDISM IS STOPPED IN OUR HEALTH ENVIORNMENT.
DR.D.R.NAKIPURIA
SILIGURI