Introduction
Day Care surgery is rather a difficult proposition in rural areas; the main difficulty being lack of good transport facilities. Even though there is lot of improvement in
 |
| Fig. 1:Mode of transport |
 |
| Fig. 2 : Operation Theater |
transport facilities in recent years, even today, there are many areas where there are hardly any transport facilities and the patient has to be brought to hospital either in a bullock cart, hand cart or even on hands. Therefore, to bring them in the morning and send them home by night becomes almost impossible (Fig. 1).
Secondly if something goes wrong at home especially at night there is no medical person available in the village to look after them.
Moreover, our nursing home charges are hardly Rs 50/- to Rs 100/- per day, much less as compared to the travelling charges for the patient and his 2 or 3 accompanying persons.
Eating food out side is also not a problem as they are allowed to cook food in the rooms or even in open place. Therefore, even if we wish to promote Day Care Surgery in rural areas patients refuse to accept it.
But, at the same time for last 25 years, we are arranging free Day Care Minor surgical camps every year in which around 150 to 200 patients are admitted in the morning, operated and discharged by evening.
On one Sunday patients who have lumps and bumps any where on the body like sebaceous cysts, lipomas, neck glands, breast masses, ganglions, etc. and patients with phimosis who need circumcisions, piles patients who can benefit by band ligations, and patients with any surgical problems who do not need major anaesthesia, spinal anaesthesia and admission more than a day are examined screened and then asked to come on next Sunday for operation.
On the day of Operation around 10 to 12 operation tables are arranged and that many surgeons from round about areas are invited (Fig. 2).
The first patients are the children who need general anaesthesia. Most of the adults are operated under local anaesthesia at times supplemented with sedation or short general anaesthesia.
The operative work starts at around 8:30 AM and finished by 2-30 PM.
By 4 PM almost all the patients around 200, are discharged after giving them necessary medicines. All this is done totally Free of cost including the medicines.
On next Sunday patients are called for stitches removal. Because we take utmost aseptic precaution during surgery, there is hardly any infection.
So far we have arranged 26 such camps most of them being in our own set up but few were conducted in other towns.
Around 3450 patients have been so far benefited.
This is one of the good example of mass scale Day care Surgery.
TOBACCO USE IN INDIA
‘Since early use of tobacco predicts greater likelihood of addiction, longer lifetime use, and higher rates of lung cancer, these findings are of importance to public health’
Tobacco use remains one of the leading causes of preventable death worldwide, but the burden of disease is now shifting from developed to developing countries, with early use of tobacco among young people thought to provide an indication of burden in the future. K Srinath Reddy and colleagues surveyed sixth-grade and eighth-grade students in India about their tobacco use and the psychosocial factors related to onset of use. The investigators noted that, rather than increased grade level relating to higher rates of tobacco use, sixth-grade students used significantly more tobacco than eighth-grade students even though increased age was also associated with tobacco use, this trend was seen within rather than across age groups. An Editorial discusses the first meeting of parties to the WHO Framework Convention on Tobacco Control, and the problems that need to be overcome if target reductions in uptake and consumption rates are to be met.
Lancet, 2006; 542, 589. |
|
