18 Tuesday
May 2021
Black Fungus

Mucormycosis or black fungus is an infection of the sinuses which can extend into the eyes and brain and cause blindness and death. It is caused by a ubiquitous fungus which is present in the air, soil and sometimes as a commensal inside our nose.

It becomes an invasive infection in patients who’s immunity is low like those with uncontrolled diabetes, kidney disease or cancer. When the body’s immunity is low the infection starts destroying the bone and blood vessels and spreads rapidly into the eyes and brain.

The warning signs of this disease include blood stained nasal discharge,black crusting of the nose, pain behind the eye, double vision and severe one sided headache in an immunocompromised person.

Indiscriminate use of corticosteroids and immunosuppressant drugs like Tocilizumab in covid treatment has resulted in a spurt of Mucormycosis patients.

Diagnosis is by ENT examination and endoscopy for nasal crusting and fungal smear/ biopsy.MRI with contrast is the best investigation to look for spread of this disease.

The treatment is good sugar control, antibiotics, IV injection Amphotericin B, a very expensive medicine which has to be given 3 to 6 weeks. Surgical debulking of necrosed tissues may have to be done repeatedly if the disease is spreading. Sometimes the eye ball may also be removed if infection spreads and the patient loses vision. Despite best treatment the patient may die of the disease.

Prevention is most important. Steroids should not be used without doctor’s prescription and sugar levels should we strictly monitor in patients who are on oral steroids. Self medication with anti-viral drugs and steroids can have very dangerous side-effects and are best avoided.

A high degree of clinical suspicion can save lives by early intervention.

Dr.Sarika Verma
ENT Surgeon

ब्लैक फंगस क्या है?

म्यूकोरमाइकोसिस या ब्लैक फंगस साइनस की बीमारी है जो आंखों और दिमाग में फैल सकता है व अंधापन और मृत्यु का कारण बन सकता है। यह एक फंगस के कारण होता है जो हवा, मिट्टी और कभी-कभी नाक के अंदर मौजूद होता है।

जिन रोगियों की रोग प्रतिरोधक क्षमता कम होती है यह उन में आक्रामक संक्रमण बन जाता है

-अनियंत्रित डाईबीटीज
-गुर्दे की बीमारी
जब शरीर की प्रतिरोधक क्षमता कम होती है तो बीमारी हड्डी को नष्ट करना शुरू कर देता है और आंखों और मस्तिष्क में तेजी से फैलता है।

इस बीमारी के चेतावनी संकेतों में शामिल हैं:
– खून के साथ बलगम
-नाक में काली पपड़ी,
-आंख के पीछे दर्द,
-दोहरी दृष्टि
-गंभीर एक तरफा सिरदर्द

कोविड उपचार में कॉर्टिकोस्टेरॉइड्स और टोसीलिज़ुमैब जैसे इम्यूनोसप्रेसेन्ट दवाओं के अंधाधुंध उपयोग के परिणामस्वरूप म्यूकोरमाइकोसिस के रोगियों में तेजी आई है।

ईएनटी चिकित्सक एंडोस्कोपी परीक्षा कर नाक की क्रस्टिंग और फंगल स्मीयर/बायोप्सी लेते हैं । कोंट्रास्ट एमआरआई इस बीमारी के प्रसार को देखने के लिए सबसे अच्छी जांच है।

इसका ईलाज अस्पताल में भर्ती कर – शुगर का सख्त नियंत्रण, -एंटीबायोटिक्स,
-IV इंजेक्शन एम्फोटेरिसिन बी
– सर्जिकल डीबलकिंग
-कभी-कभी संक्रमण फैलने पर नेत्र को भी हटाया जा सकता है
– सर्वोत्तम उपचार के बावजूद रोगी की बीमारी से मृत्यु हो सकती है।

रोकथाम सबसे महत्वपूर्ण है। स्टेरॉयड का उपयोग डॉक्टर के पर्चे के बिना नहीं किया जाना चाहिए और जो रोगी स्टेरॉयड ले रहे हैं उनका शुगर की सख्ती से निगरानी करनी चाहिए । एंटी-वायरल दवाओं स्व-दवा के बहुत खतरनाक दुष्प्रभाव हो सकते हैं और इनसे बचा जाना चाहिए।

डॉ सारिका वर्मा
ईएनटी सर्जन

10 Monday
May 2021
Lest we forget…

Soon after a new era started in Indian history a little known hospital in Gorakhpur had its oxygen supply cut off. The vendor said the Dean wouldn’t pay his dues. And 68 children died in one night. Did we see a case against the Dean or the vendor? No. We saw the arrest of the doctor who worked through that night trying to get oxygen to save the children. Because he had a different name.

And that is how began the story of #NewIndia.There have been so many things to remember…I’m writing them down lest we forget.

Do you remember our money became invalid within 4 hours of his announcements. Do you remember the queues for ATM, to deposit money, to withdraw your own money, we stood in line for 50 days. We were told black money would come, but all that we got was middle men making money changing notes while we stood in long lines amd people died, and people cried. But it made no difference. And now we watch over the years the interest rates on our savings fall. Down, down, down.

Do you remember that certain cooperative banks failed. They let a Modi fly away to UK. They gave an NOC to a Choksi to become a legal citizen of Antigua. And to all the people who had deposited their hard earned money they said all you’ll get is 25,000₹ whether you need it for a child’s wedding or your own surgery….it matters not. People died, and people cried but no one lost except the common man of India, who’s money went down,down,down.

Do you remember they brought a new tax without anyone having a clue how it would work. They had the Parliament release it at midnight, and then ensured businesses lost their sleep. 5 forms to be filled EVERY month. Small businesses shut all over the country. Why would they create the most complex taxation system in the world? One that is unfathomable to even a reasonably computer literate person? The states stopped getting their share of taxes. And they were asked to take loans to make ends meet. The economy goes down, down, down.

Hate grew and criminals were garlanded. Little girl’s rapists were supported with Tiranga Yatras and Bharat Mata ki Jai. People were killed over meat in their fridge. And beards and skull caps. And names. And children beaten up for drinking water from temples. And then some ladies sat and blocked one road. And sang songs and said hum kaagaz nahin dikhayenge. And it shook the government’s ego so …. They used a pandemic to settle the score. And just like that CAA NRC bills went down, down, down.

With 4 hours notice mitron, we were locked in our homes. For 54 days. And then the poor started trickling out of cities. They were beaten with lathis and stopped on borders and sprayed with disinfectant and made to do sit ups. They trudged along rail tracks and got run over. They carried their children on arms, and shoulders and pulled them on suitcases. They died of starvation and thirst in trains which were randomly sent to wrong stations. And they cried, and they died but they wouldn’t count the deaths. They posed with peacocks and gave their Mann ki baat. And humanity in India came down, down,down.

We had a year to prepare for the Covid pandemic. We didn’t increase hospital beds, ventilators or oxygen plants. We did election rallies, and Kumbh melas even as bodies started piling in crematoriums. We gasped for oxygen beds and then for oxygen within those hospital beds. But he declared ₹20,000 crore Central Vista an essential service. While hundreds queue up for Vaccination and thousands try logging into slots from morning to night abandoned to fend for themselves. They fudged numbers of dead by one tenth but hundreds of pyres burned in parking lots. People cried, and people died but no one listened to our Jan ki baat.

Humans tend to forgive and forget. I write this down so we will read and remember. A nation that was a vibrant democracy, a developing country, a power to reckon with has now seen a fall in all its indices- employment opportunities malnutrition, pollution, personal liberties, media freedom have all gone down, down, down.

We need to learn from our mistakes. And promise to never make them again. This regime has to end. Step down. down..down.

Dr Sarika Verma
AAP spokesperson
South Haryana