Justice delayed is justice done

Health Care, Medicine Comments Off

Dr KK Aggarwal

We are all familiar with saying “Justice delayed is justice denied”. But this by no means is a rule.

Most recently, the parents of the murdered 14-year-old Aarushi Talwar, both dentists, were acquitted of the murder of their daughter after 4 years of imprisonment since 2008 by the Allahabad High Court.

Earlier, Dera Chief Ram Rahim was convicted after 15 long years and sentenced to 20 years imprisonment.

Wrong has been done in both circumstances. While, the parents of Aarushi Talwar suffered imprisonment despite being innocent, in the other case, the Dera Chief was free for last so many years and enjoyed a free life in spite of doing wrong and probably kept on doing wrong.

The irony of the situation is that had these been cases of medical negligence, there would have been a public outrage against the doctor concerned. He/she might well have been arrested without the allegations being substantiated.

Both the above stories with two extreme judgements, became national headlines, exemplify justice delayed but justice done.

This then further raises a question, can the judges be made answerable? One who judged the parents of Aarushi guilty and other, who allowed the Dera chief to lead a free life.

If not, then why action against doctors?

In medical negligence cases, the benefit of doubt should always be given to the doctor unless mens rea can be established or the principle of res ipsa loquitur ‘things speak for themselves’ can be applied.

Justice should be imparted without any delay. It is wrong to delay justice.

Disclaimer: The views expressed in this write up are entirely my own

Fungal infections rebound with reckless use of topical steroid creams

Health Care, Heart Care Foundation of India Comments Off

• People trust quacks and end up buying the medication they prescribe
• Over-the-counter sale of such medicines exacerbates the situation
New Delhi, 21 October 2017: As per the most recent data available, India consumes about Rs1,400 crore worth of topical steroid creams. This is a segment with an annual growth of 16%. This figure, however, excludes the over-the-counter sales.[1] Sale of topical steroids accounts for 82% topical dermatology market. What is alarming is that the top-selling combinations in these topical creams do not have any scientific rationale or logic behind them.

Even the strongest antifungal creams are unable to treat many fungal infections today. This is majorly due to topical steroid creams, which have turned these infections resilient. Topical steroid creams sell fast and are available anywhere over-the-counter. However, whether they are effective or not is still a question that remains unanswered.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “Many fungal infections today tend to relapse as soon as the drug dosage is over. Resistance is a microbiological term based on lab data. However, these fungal infections are recalcitrant and are relapsing. Many topical creams are prescribed by quacks and other so-called medical practitioners. People trust them and buy these in order to get rid of the infections quickly. One major reason for this is also perhaps the fact that Indians are not very kind to those with any skin problems. Such use of creams without knowing their side effects can lead to a weakened immune response bringing back the infection when the dosage finishes. Fungal infections are also more pronounced today as many people prefer wearing tight -fitting clothes.”

Long-term use topical steroids can cause side effects, the most common being skin atrophy. This can become worse due to factors such as higher potency steroids, occlusion, thinner skin, and older patient age.

Adding further, Dr Aggarwal, said, “The fact that such drugs can be prescribed by anyone brings us to a serious issue facing the medical profession today – that of quackery. Unqualified people are masquerading as doctors. In the absence of doctors, people have no choice but to visit such quacks for treatment. The need of the hour is to create awareness among the masses about such people and the fact that one should not take medication unless prescribed by a registered medical practitioner. A stringent anti-quackery law also needs to be put in place.”

Here are some tips to prevent fungal infections.
• Wear cotton underwear Fungi thrive in a damp environment. Cotton clothes absorb moisture and perspiration better.
• Maintain good personal hygiene This one is a no-brainer. Whether it is your skin or the genital area, make sure you maintain hygiene and keep these areas clean.
• Avoid tight-fitting clothes Tight-fitting clothes do not allow the skin to breathe and should be avoided.
• Avoid too many perfumed products These can ay affect the delicate balance of yeast and bacteria and cause infections.
• Destress Research indicates that skin infections can flare up in stress. This is because stress lowers the body’s immune system.
• Take natural yogurt with live cultures Antibiotics destroy good bacteria in the body. Make sure you replenish the good bacteria by taking natural yogurt which contains friendly bacteria.