Tropical diseases being ignored

LUCKNOW: Indigenous tropical medicines are need of the hour to counter the spread of diseases like malaria, kala azar, heat stroke, cholera, diarrhoea, dengue etc. Inaugurating the Tropical Medicine Update as part of Continuing Medical Education 2004, Lt Gen AK Bakshi, VSM said that this was indeed a topical issue to address.
Major Gen Sujan Singh, CH (CC) said that nearly 60 per cent of patients are suffering from tropical diseases and the dichotomy is that despite this burden only a few doctors are willing to specialise in the field.Unlike CAD or heart disease, these problems afflict the poverty stricken and there is no glamour attached to it as it not a very lucrative branch. Little wonder then that the level of ignorance is high and so is the mortality rate.
Major Gen M Kesavan released the souvenir. Retd Prof and head of medicine, KGMU Dr AR Sircar said that the dreaded disease typhoid’s transmission is faeco-oral and the disease strain is salmonella typhi. Also apart from humans there are no other hosts for salmonella. The disease breeds in filth and dirt and spreads via food and water. Dr Sircar said that the absence of specific symptoms or signs when diagnosing this disease is one of the biggest predicaments in treatment.
"As a thumb rule any fever persisting for more than two weeks without evident cause should be treated as typhoid until proven otherwise or it may prove fatal after three weeks. Also today resistant strains are being found in India," he added. Sircar emphasised that although Widal test is done to diagnose typhoid, the problem with this test is that it does not distinguish between recent and past infections as the memory of the antibodies may give a false positive in even a ten years old case. Hence he emphasised the role of blood culture.
"Unfortunately in civilian hospitals blood cultures are becoming increasingly rare despite their efficacy as a gold standard for diagnosis. 5-7 ml extra blood should be drawn to do this test," he added.
Lt Col DS Bhakuni added that for victim of snake bite the thumb rule is that if the fang marks or bite is five or more than five it is not a poisonous snake. If it is one fang mark is there, it is 100 per cent poisonous and if three then 50 per cent poisonous snake bit the victim. This avoids the problem of taking anti-snake venom medicine which sometimes has very adverse reactions.
Also in cases where there is say a football muscle injury accompanied by fever an abscess may be formed and should be treated immediately. Lt Col AK Nagpal said that in this age of super-speciality treatment of tropical diseases have been relegated to a secondary place.
There is a rampant problem of mis-diagnosis and also physicians are unaware of the latest developments, newer techniques and therapeutic agents to counter this disease.