Health literature, stories and issues

History is the basic of basis of diagnosis  One fine morning I was in OPD with full delight in my face. A woman about 40 yrs of age came to OPD room and sat on the chair.  She spoke with an  unintelligible voice. I thought she had come for the change in voice. But it had been the same since childhood.   The complaints were nonspecific. She had feeling of being unwell and malaise since long time.  I couldn't find any abnormality in examination except for the bluish black discoloration in the palms of hands. I was curious about the very discoloration and asked a few questions. She had such discoloration since long time. I couldn't make out more from her spoken labguage.  Her voice was not intelligible. I was in a rush to screen the clinical symptoms and signs because there was a long queue of patients.   I ordered a few specific  investigations.  Since I couldn't understand her voice, I didn't want to miss the case. The investigation included ANA as well. However, it came

सधैं स्वस्थ पनि रहन नसकिने रहेछ । स्वास्थ्य नै सबैभन्दा ठूलो धन हो भन्ने कुरा आफैं वा आफ्नो नजिकको बिरामी नहुँदा सम्म पत्तो पाइन्न । एक पटक अस्पताल पुग्नपर्छ । धेरै कुराको दर्शन पाइन्छ । सम्पुर्ण जीवन दर्शनको दर्शन हुन्छ । लगभग सबै जाँच हुने विस्वासले बिरामी हुँदा नजिकैको  मेडिकल कलेजमा जान रुचाइन्छ । केही महिना अगाडिको  कुरा हो,  मेडिकल कलेजमा आफन्ती  बिरामीको चेकजाँचको लागि ब्ल्ड टेस्ट आदिको दौड्धुपमा थिएँ ।  साँझको समय थियो । घाम डुबिसकेको थियो ।  म लाइनमा व्याकुल हुँदै उभिइरहेको थिएँ । त्यहीँ लाइनमा मेरो अगाडि एक जना अन्दाजी १५ वर्षीय केटी पनि लाइनमा थिइन् । अलि पुरानो लुगा , खुट्टामा हिलो र फाट्नै लागेको चप्पल लगाएकी थिइन् । उनी टाउको एकातिर बङाउदै कान च्यापिरहेकी थिइन्। सजिलै अनुमान लगाउन सकिन्थ्यो कि उनको कान बेस्सरी दुखेको हुनुपर्छ । उनको साथमा  एक जना अन्दाजी ३०-३२ वर्षकी महिला पनि थिइन् । वातावरण पुर्ण नियाल्न नपाउँदै बिल काउन्टरबाट पैसाको माग आउँछ ।  एमर्जेन्सी टिकेटको मूल्य सुनेर होला । त्यो नानी    केही झस्किन्छिन् , केही हच्किन्छिन् । उनको हातबाट खुम्चिएको रु ५०० को नोटले

हात धुनु- महान् खोज ।  आजको दिनमा हात धुनुलाई सामान्य कुरा मान्न्न सकिन्छ। इतिहासमा कुनै समय यस्तो थियो जुन बेला हात धुने बानी बसाल्नुपर्छ भनेर थाहा पाउनु  शताब्दीको असाधारण खोज बन्न पुगेको थियो । १९ औं शताब्दीको मध्यमा मात्रै हात धुनुको महत्व उजागर भएको थियो । अचेल सबैजनाले तरिका पूरा गर्न नजाने पनि पानी सहजता भएका स्थानहरुमा हात धुनु दैनिकी नै बनिसकेको छ । कोभिड १९ को विनाशमा विकास भएमो एउटा राम्रो बानी भनेको हात धुने बानी हो ।  हात धुने इतिहास पढ्न पनि रोचक नै छ । सन् १८५४ तिर हङेरीका एक जना जिज्ञासु डाक्टरले बिरामी हेर्दा नियमित हात धुनुपर्ने कुरालाई पुर्ण विस्वासका साथ चिकित्सकिय दुनियामा  बेजोड प्रस्तुती दिएका थिए । उनको नाम थियो - इग्नाज सेमेल्विज । उनले काम गर्ने अस्पताल विश्वकै  ख्यातिप्राप्त शिक्षण अस्पताल थियो ।  त्यो अस्पतालको वार्डमा एउटा रोचक तथ्य फेला परेको थियो । नर्सहरुले  सुत्केरी गराउने वार्डमा मातृ मृत्युदर प्रत्येक १००० जिवित जन्मेका वच्चामा ३६ जनाको मृत्यु हुने गरेको थियो भने डाक्टरहरुले सुत्केरी गराउने वार्डमा प्रत्येक हजार जिवित जन्मेका वच्चामा ९८ जनाको मृत्युु

Why do we miss the cases ?  In a busy day OPD when there is burden on only one doctor in hospital, it's likely that things get missed. It was a few years back when I had to see around 100 patients in a day all alone. It was tiring and irritating too and my nerves were about to break.Besides, the postmortem in midst of the OPD added fuel to the fire. A dead person torments one more than walking patients.But the responsibility stands before anything in this critical profession  so i had to carry on and i did. There was a 50 year old man who had estimated weight loss of almost 5 kg in a month. Few people get privilege of awareness to track one's weight. His appetite had been less than normal for a month.  However, he was not sure about fever although he mentioned his body got warmer at times. He was a non smoker. He never consumed alcohol. He looked  quite well.There was a rush in OPD,nothing special rang my bell so, I examined him superficially.  I didn't bother much about hi

महाकवि देवकोटाले "के नेपाल सानो छ"  निबन्धमा  सानो मानिएका कुराहरुको महत्वलाई ओजपुर्ण बनाएका छन् । उदाहरण स्वरुप उनी भन्छन् , आँखाको गेडी सानो हुन्छ । तर सन्सार हेर्न अति आवस्यक हुन्छ । महत्व विशाल छ । त्यस्तै दैनिक कृयाकलापमा पनि स-साना कुराहरूको महत्व निकै  बढी हुन्छ । जुन कुरा सामान्य अवस्थामा ओझेलमा परेका हुन्छन् । पेट दु:खेको बेला दुखाइ कम गर्ने एउटा सानो गोलीको जुन महत्व महसुस हुन्छ, अरु समयमा बिर्सिरहेका हुन्छौं  । कसैको व्यक्तित्वको ओज निभ्न एउटा सानो घटना काफी हुन्छ। क्रान्तिको जग पनि एउटा विचारको झिल्काबाट नै सुरु हुने गर्छ । डढेलो लाग्न एउटा सानो आगोको झिल्का पर्याप्त हुन्छ । कसैको भविष्य कुनै वेला एउटा चिठीले निर्धारण गर्ने क्षमता राख्दछ । हाम्रो वरिपरि त्यस्ता अनेकौं दृष्टान्त देख्न पाइन्छ ।  फोक्सुन्डो ताल घुम्ने ठूलो रहर थियो । त्यो रहर पूरा गर्ने क्रममा साना मानिएका कत्ति कुरा निकै महत्त्वपूर्ण महसुस हुन्छ । परिस्थितिले सबै कुराको महत्व हेर्ने र अनुभव गर्ने दृष्टिकोण  परिवर्तन गर्ने रहेछ।   धेरै भुमिका बाँधेकोमा रिस पनि उठिसक्यो होला । तर भुमिका आफैमा गौण कुरा

Why every crying is not just whining ?  One foggy morning in winter season, a mother brought her child to OPD from a remote village. The mother was sobbing and telling me her baby caught severe cold. When i inquired her about why does she think that the baby has severe cold, she lightened me with the actual complain. Why every crying is not just whining ?  The real concern was that the baby had been crying continuosly for 3 days and wouldn't stop no matter how well she wrapped the baby. when i started examining the child while thinking of some important differential, the mother started showing me dozens of syrups from some local pharmacy prescibed  by some local quack who probably doesnt even know that there are different doctors for adult medicine and paediatrics medicine. She wasn't sure if the baby had spikes of fever because all she was concerned was about why did the baby didn't get well even after spending such handsome amount on syrups. Mother denied any history of c