[Downloaded free from http://www.jfmpc.com on Tuesday, September 12, 2017, IP: 191.101.99.9] Letters to Editor
Rashmi Patnayak, Amitabh Jena1, Venkat Rami Reddy2
References 1.
Narchi H, El Jamil M, Kulaylat N. Symptomatic rickets in adolescence. Arch Dis Child 2001;84:501‑3.
2.
Sahu M, Bhatia V, Aggarwal A, Rawat V, Saxena P, Pandey A, et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol 2009;70:680‑684.
Departments of Pathology, 1Surgical Oncology, Surgical Gastroenterology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
2
Address for correspondence: Asst. Prof. Rashmi Patnayak, Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507, Andhra Pradesh, India. E-mail:
[email protected]
3. Puri S, Marwaha RK, Agarwal N, Tandon N, Agarwal R, Grewal K, et al. Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: Relation to nutrition and lifestyle. Br J Nutr. 2008;99:876‑882.
References
Access this article online
1.
Quick Response Code: Website: www.jfmpc.com
DOI: 10.4103/2249-4863.148159
Helicobacter pylori: A Common Infection
2. Patnayak R, Reddy V, Jena A, Rukmangadha N, Parthasarathy S, Reddy MK. Utility of immunohistochemistry in demonstrating Helicobacter pylori. Oncol Gastroenterol Hepatol Rep 2015;4:4-7. 3. Patnayak R, Jena A, Reddy V, Asha T. Helicobacter pylori – Indian Perspective. Saudi J Gastroenterol [In Press]. 4. Rizwan M, Fatima N, Alvi A. Epidemiology and pattern of antibiotic resistance in Helicobacter pylori: Scenario from Saudi Arabia. Saudi J Gastroenterol 2014;20: 212-8.
Dear Editor, We read with interest the review article ‘Helicobacter pylori infection among patients with upper gastrointestinal symptoms: Prevalence and relation to endoscopy diagnosis and histopathology’ by Shrestha et al.[1]
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In our study from a tertiary care in South India, we had noted H. pylori positivity in 62% cases of gastritis by using different staining methods like modified Giemsa, Warthin starry, immunohistochemistry apart from routine Hematoxylin and eosin (H and E).[2] Since the authors have not mentioned, we presume that the detection rate referred by them is from H and E stain. Similar to this study, in our study there was not much difference between male and female gender, the ratio being 1.2:1. Our study group has mean age of 47.2 years.[2,3] Another recently published article by Rizwan et al. has highlighted the epidemiology and pattern of antibiotic resistance in H. pylori in Saudi Arabia.[4] They have opined that in developing countries H. pylori infection is more prevalent in children as compared to adults. Majority of cases in our study groups were adults. In the further follow-up period of our cases, which ranged from 1 to 5 years, we did not encounter any other malignancies like gastric adenocarcinoma or lymphoma in these cases.[2] We agree with the message given by the authors that the prevalence of H. pylori infection is high and we would like to add that in selected cases like unexplained gastritis and patients with previous history of antibiotic use, immunohistochemistry may help to improve the detection rare. Journal of Family Medicine and Primary Care
Shrestha R, Koirala K, Raj KC, Batajoo KH. Helicobacter pylori infection among patients with upper gastrointestinal symptoms: Prevalence and relation to endoscopy diagnosis and histopathology. J Family Med Prim Care 2014;3:154-8.
DOI: 10.4103/2249-4863.148160
‘Euthanasia: Right to Die with Dignity’ Dear Editor, The concept of Euthanasia has been a controversial topic since its inception. The word ‘Euthanasia’ is derived from Greek, ‘Eu’ meaning ‘good’ and ‘thanatos’ meaning ‘death’, put together it means ‘good death’. Euthanasia is defined as the hastening of death of a patient to prevent further sufferings. Active euthanasia refers to the physician deliberate act, usually the administration of lethal drugs, to end an incurably or terminally ill patient’s life. Passive euthanasia refers to withholding or withdrawing treatment which is necessary for maintaining life. There are three types of active euthanasia, in relation to giving consent for euthanasia, namely voluntary euthanasia – at patient request, nonvoluntary – without patient consent, involuntary euthanasia – patient is not in a position to give consent.[1] 477
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[Downloaded free from http://www.jfmpc.com on Tuesday, September 12, 2017, IP: 191.101.99.9] Letters to Editor
Other terminology like assisted suicide and physician‑assisted suicide are not synonyms of euthanasia. [1] Do not resuscitate (DNR) order means the attending doctor is not required to resuscitate a patient if their heart stops and is designed to prevent unnecessary suffering. Even though DNR is considered as passive euthanasia, it is practiced in most part of the world without much legal issues.[2]
number of nonvoluntary euthanasia. To conclude, strict standard guidelines should be formulated to practice euthanasia in countries where it is legalized, regulation of death tourism and other practices like mandatory reporting of all cases of euthanasia, consultation with psychiatrist, obtaining second opinion, improved hospice care have to be followed for standardization of euthanasia.
Kalaivani Annadurai, Raja Danasekaran, Geetha Mani
Common conditions which make patients to seek euthanasia are terminally ill cancer patients, acquired immune deficiency syndrome (AIDS) and other terminally ill conditions where there is no active treatment. Factors which are responsible for decision making are classified into physical and psychological factors. Physical conditions that affect the quality of life in these patients are unbearable pain, nausea and vomiting, difficulty in swallowing, paralysis, incontinence, and breathlessness. Psychological factors include depression, feeling a burden, fearing loss of control or dignity, or dislike of being dependent.[2] But some argues that suicidal ideation and inadequate palliative care might also be the underlying reasons for seeking euthanasia.[3] Passive euthanasia is generally accepted worldwide. Active involuntary euthanasia is illegal in almost all countries. Practicing active voluntary euthanasia is illegal and considered as criminal homicide in most of the countries and will faces punishment up to imprisonment for 14 years. While active involuntary euthanasia is legal in countries such as Netherland, Belgium, and Luxembourg, assisted suicide is legal in Switzerland and the United States of Oregon, Washington, and Montana.[4] Previously there was an age restriction for euthanasia in Belgium, but recently the country has passed a bill in the parliament which lifts ban on all age restriction on euthanasia. In Belgium alone, there are 1400 cases of euthanasia practiced. The concept of death tourism or euthanasia tourism is slowly increasing in which patients who want to seek euthanasia or other assisted suicide services will travel to countries where it is legalized to avail those services. Switzerland is known for death tourism, where every year patients primarily from British, German, and French travel there to end their lives.[5] In Netherland, euthanasia accounts for 2% of all deaths.[6]
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram district, Tamil Nadu, India Address for correspondence: Dr. Kalaivani Annadurai, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram District, Tamil Nadu – 603 108, India. E‑mail:
[email protected]
References 1. Chao DV, Chan NY, Chan WY. Euthanasia revisited. Fam Pract 2002;19:128‑34. 2.
British Broadcasting Corporation. Ethics Guide. Euthanasia. 2014. Available from: http://www.bbc.co.uk/ethics/ euthanasia/overview/introduction.shtml. [Last accessed on 2014 Mar 15].
3.
VKS, Basu S, Sarkhel S. Euthanasia: An Indian perspective. Indian J Psychiatry 2012;54:177‑83.
4. Ebrahimi N. The ethics of euthanasia. Aust Med Stud J 2012;3:73‑5. 5.
Rodriguez C. Will Belgium’s Legalized Child Euthanasia Trigger Death Tourism? Forbes. 6th March 2014. Available from: http:// www.forbes.com/sites/ceciliarodriguez/2014/03/06/2378/. [Last accessed on 2014 Mar 17].
6.
Pereira J. Legalizing euthanasia or assisted suicide: The illusion of safeguards and controls. Curr Oncol 2011;18:e38‑45. Access this article online Quick Response Code: Website: www.jfmpc.com
DOI: 10.4103/2249-4863.148161
Many activists against euthanasia feel that legalizing euthanasia will leads to ‘slippery slope’ phenomenon which leads on to more
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