Is a physician required in every settlement of Sind?

ABSTRACT

Well-Known sntity functional disorders seems to be an important public health problem of all the medical institutions in wich all the age groups are involvedd but the younger females predominate. Functionals commonly labelled as hysterics has always been a problem to the physicians and the families. It is very likely that even a senior physician may miss the diagnosis. Therefore, a thoroughh probe in history, clinical examination and laboratory aids were utilized. Thisis stimulated us to work on this problem. Study was undertaken in 1974-75 by involvingg 50 parameters and interviewing a scheme with the help of questionnaires. The total number of individuals 2234 of both serries and all ages were exaaamined, 92 were labelled as functional [0.24%]. The youngerrs, urban, females found predominantly study reveals more unmarried [54.4], domestic [43.5%] and educatedddd [30%]. The treatment received was from various allopaths [32%], Hakims [26%]. Homeopaths [21%] and Peres [7.6%], 100% were willingg for further treatment. All had the history of death of near relatives while 65% had the family history of functional disordders. They were over protected by relations [75%] with the hope to help them in maintaining this problem. 92% of our respondents were addicts, 85% were smokers. All had behavioural disorders. While the normal appearance, orientation, concentration power and intelligence [97%]. On systemic examination GIT, respiratory and CNS was mostly normal except few minor findings which may be due to functional overley. Investigations in this study were witin normal limits except few who had minoor disorders. The treatment given to these cases under the observations were passage of Ryle's tube, Yranquillisers, medical counselling and golden injections, 27.6%, 21.7%, 8.7% respectively marriages counselling and psychotherrapy of 11.0% and 2.2% done which was quite fruitful in our cases. 2.2% persons got relief by operations. The relapse rate in our study was 3.3%. The functionals are of many type which mimic many organic ailments but the differentiation between a functional and organic lesions is quite important as the ignorance about the fact may lead to may lead to many dangerous results, not only to the patient but to the families and above all the defamation of the physician at the same time. The best medical service should be early diagnosis of the ailment and the prompt treatment based on friendly mutual understanding between the doctor and the patient counselling his status for education wims and local environment [Stetler, 1962 [2]]. As the problem is common in younger age group, therefore, it is advisable that the parent-child and teacher-child relations must be kept in mind to ensure postive health in such ailments