This is the last episode in the series on Kala Azar reported by Suno India’s Menaka Rao.

The Indian government has said that it has hit the elimination target for Kala-azar, a parasitic disease that is life-threatening. But miltefosine, the drug used to treat the skin manifestation of Kala-azar, called Post-Kala-azar Dermal Leishmaniasis (PKDL), is being linked to eye problems, including blindness.

The government has taken steps to try to reduce the side effects in 2021, but not much has been done for those who have lost their eyesight either in one eye or both, possibly as a result of miltefosine. The World Health Organization has found 83 cases of people in India who have suffered a problem in the eye after intake of miltefosine.

In this episode, Menaka spoke to Iliyas Marandi, one of the patients who lost his eyesight completely after taking miltefosine treatment. She also spoke to ophthalmologists Dr Rakhi Kushumesh and Dr Asim Sil who treated such patients, and helped develop the guidelines to prevent such ocular side effects.

References

https://www.indiaspend.com/health/how-a-drug-to-treat-dermal-kala-azar-is-affecting-patients-eyesight-901497

Keratitis occurring in patients treated with miltefosine for post-kala-azar dermal leishmaniasis | British Journal of Ophthalmology

https://ncvbdc.mohfw.gov.in/WriteReadData/l892s/PKDL-Guidelines-220512.pdf

Using focused pharmacovigilance for ensuring patient safety against antileishmanial drugs in Bangladesh's National Kala-azar Elimination Programme

Keratitis After Post-Kala-Azar Dermal Leishmaniasis

Corneal complications following Post Kala-azar Dermal Leishmaniasis treatment | PLOS Neglected Tropical Diseases

Adverse ocular events on miltefosine treatment for post-kala-azar dermal leishmaniasis in India - Suman Saurabh, Manish Mahabir, 2020

Advisory Committee on Safety of Medicinal Products (ACSoMP): Measures to minimize the risk of ocular adverse events with miltefosine

Statement on miltefosine - Potential ocular disorders in patients treated with miltefosine for post-kala-azar dermal leishmaniasis (PKDL).

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On March 20, 2024, the Bombay High Court convicted former police officer Pradeep Sharma in a 18-year-old “fake” encounter killing of Ramnarayan Gupta, who was allegedly from Chhota Rajan gang. Gupta was sentenced to life imprisonment. This is not the norm, but more of an exception.

Encounters are normalised in India. Recently, the UP police encountered a murder accused in Badaun district. The father of two boys who were murdered appealed to the police not to encounter the co-accused because they wanted some answers as to why the children were killed.

This is an episode from April last year when Sneha Richhariya spoke to Prakash Singh, ex-IPS Officer when the UP police killed alleged mafia don and politician Atiq Ahmed and his brother in the presence of media persons. Prakash Singh served as Director general of Police, Uttar Pradesh. He has also served in Assam and Border Security Force. Singh filed a public interest litigation in the Supreme Court seeking police reforms, in which a landmark verdict was delivered.He explained what does the systemic apathy about encounter killings mean for the society.

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In this episode, Suno India's Padma Priya talks to Dr. Abhishek Mangeshikar, a gynecologist specializing in endometriosis. He explains what endometriosis is and why it is difficult to diagnose.
Dr. Mangeshikar also addresses common myths surrounding endometriosis, such as the belief that pregnancy or menopause can cure the disease. He emphasizes the importance of patient advocacy and provides advice on how to push back against dismissive attitudes from medical professionals. Additionally, he discusses risk factors for endometriosis and the presence of silent symptoms, such as kidney damage.

In this conversation, Dr. Abhishek Mangeshikar discusses various aspects of endometriosis, including diagnosis, management, surgical considerations, psychological impact, and patient education. He emphasizes the importance of thorough imaging and the limitations of routine gynecological ultrasounds in diagnosing endometriosis. Dr. Mangeshikar explains that while hormonal treatments can provide relief from pain, they do not stop the growth of endometriosis. He also highlights the significance of choosing an experienced endometriosis surgeon and provides key questions to ask when considering surgery.
The conversation touches on the recurrence of endometriosis, the psychological impact of the disease, and the resources provided by Endometriosis India. Dr. Mangeshikar shares his approach to patient education through social media and emphasizes the need for action in improving the understanding and treatment of endometriosis.

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