ABSTRACT
Let’s look at a common case-scenario. A two-year-old presents with recurrent episodes of fever, cold, cough and wheezing since the age of 6 months. Each time, the episode begins with high fever that lasts for 2 to 3 days, accompanied with cold and progressively worsening cough, followed by wheezing. Wheezing settles down within a short time but the cough continues for two weeks. Routine investigations are normal. The child remains well in between episodes, and maintains good growth and development. No one in family has history suggestive of asthma or atopy. The child receives repeated courses of antibiotics and inhaled steroids for 3 months, but there is no change in frequency of episodes. Each and every time pediatrician’s ‘mann ki baat’ rotates around questions like…Is it viral?...Is it bacterial?...Can I label it as asthma?...Kahin ye ‘woh’ toh nahin? (Tuberculosis!)... finally realizing that it is Wheeze Associated Lower Respiratory Infection (WALRI).
ABSTRACT
Recently I met one of my MBBS batchmates (MBBS admission batch to be precise, since departure batches differ!). I casually asked him – How are you doing ? He said – "I am living on one capsule of Dhaklamycin per day." When I asked him about this new medicine, he said –"Zindagi Dhakel raha hoon (I am simply pushing my life). My children are abroad; they are not in medical profession… Lot of money lying idle in the bank and cupboard... I have no interest whatsoever, neither in practice nor in life." Another friend said: "All throughout the life, I have been listening to only ten complaints – cold, cough, fever, vomiting, loose motions, abdominal pain, constipation, itching, breathlessness and febrile convulsions. Why won’t I get bored by listening to the same complaints over and over again?" Sensing frustration from these talks, I started introspecting. Like the layers of an onion, we get surrounded by ‘d’ layers of degrees, dear ones and dollars, and the central doctor starts behaving like a diplomat presenting different faces to different groups of people. The child-like qualities of the ‘child’ specialist start dwindling over time! High fives start taking an upper hand ...High BMI, hypertension, high blood sugar, high lipid levels and the better half start creeping in and becoming difficult to handle!