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An eye check-up and a cataract surgery camp in Barwani, Madhya Pradesh created a lot of furor after the patients complained of disturbed vision following the operation. Around 30-35 people took part in the camp held during November 16 to 24. Soon, reports began to flood in from patients complaining of irritation and blurred vision resulting from infection. 32 patients are currently facing possible vision loss.
“When their condition deteriorated and were referred to another ophthalmologist, it was revealed that they were on the brink of losing their eyesight,” said Sharad Pandit, the joint director of health in Indore, who ordered an inquiry into the matter. “It is unfortunate that this happened at a government camp.”
Around the same time, Dr Charanjit Singh of charitable society ‘Sarv Kalyan Sewarth Samithi’ conducted yet another eye check-up camp in Ambala, Haryana. He charged Rs 6,000 to Rs 10,000 from each of the patients who underwent cataract removal surgery in the congested Mahesh Nagar locality on November 24. Of them, 15 patients soon developed infection in their eyes.
They were later admitted to Chandigarh’s Post Graduate Institute of Medical Education and Research (PGIMER), where 11 have received complete treatment, while one is in critical condition and stares at blindness.
Dr VK Gupta, a civil surgeon in Ambala, filed a case against Dr Charanjit alleging that he did not have the required permission to conduct the charitable eye camp. The callous attitude of the management and the unhygienic conditions are the main reasons behind the debacle.
Botched up surgeries are definitely very common in India, especially in the medical camps conducted in rural areas and city outskirts which are far from district hospitals. While medical camps like these bring healthcare to those who cannot afford the traveling cost of going to hospitals situated far away, the possible negative effects far outweigh the positives.
Around the same time last year, in a horrific incident, a government-run mass sterilization camp in Chattisgarh’s Bilaspur district went haywire and resulted in the death of 15 women. Of the 83 women who underwent laparoscopic tubectomies, over 50 were hospitalized with 25 in critical conditions.
Government directives allow a maximum number of 30 operations in a camp in a single day. It’s not uncommon for districts to receive 15,000 operation cases in a year. Usually there is just one team with one lacroscopic surgeon to carry out this work. The target is divided amongst the different health centres, who then proceed to outdo each other in conducting medical camps, not taking into account that there is usually just one surgeon to carry out all the procedures.
While trying to manage all the cases, the surgeon hops from one camp to the other, and is forced to cross the 30-case limit. Moreover, the hospitals receive just the period of October to February to hold the camps.
In Bilaspur, just one doctor, Dr RK Gupta, though considered an expert in such cases, conducted a staggering 83 operations with one instrument within five hours.
Barely any patient is aware of the possibility of HIV infection which can be caused by the surgical instruments being used repetitively without being properly desensitized. The antiseptic solution used to ‘sanitise’ the instruments is basically just an eye-wash. Moreover, the instruments spend hardly around 2-3 minutes in the solution, which is not strong enough to kill the HIV, even if it used for an entire day.
Moreover, this camp too violated the government regulations and underscored the need of performing such surgeries in “established healthcare facilities”. This camp was carried out in an almost abandoned private charitable hospital in Pendri village.
A health-worker informed that just one room was opened at the hospital and all the women were made to lie down on the floor for the surgeries.
The very next day even as several women who got infected from the surgeries performed in this camp were getting admitted to hospitals for proper treatment, in another hospital in Bilaspur, 26 tubectomies were carried out in an hour in another sterilization camp by the government; amounting to one surgery every two minutes.
In rural areas, Community Health Centers (CHC) are the designated hospitals, which have very few beds. Routine patients take up most of these beds and even resort to lying in the spaces between the beds. As such, if any surgical camp is carried out here, there can never be enough beds for the patients.
Due to this issue, in a mass sterilization programme carried out in Malda, West Bengal, in February 2013, around 100 women were dumped unconscious in a nearby field as the hospital could not accommodate more than 30 women.
The hospital could not even provide ambulance services, and as one woman was being taken home on a cycle van after the operation, it collided with a matador, resulting in grave injuries.
In December last year, soon after the fiasco in Bisalpur, an eye camp organised by an NGO in Gurdaspur district in Punjab, under “severe unhygienic condition” caused permanent damage to the eyesight of all the 60 patients.
The health ministry, in an answer to a parliamentary question two years ago, had stated that between 2009 and 2012, the government had paid compensation for 568 sterilisation-caused deaths.
Sterilisation camps are carried out regularly in India to control its booming population, and the government provides cars and electrical goods, along with money, as incentives to women who volunteer to undergo this operation.
Moreover, certain quotas and incentives are also offered to the doctors, which cause them to rush procedures. The medicines in the public health sector are also frequently found to be out of date or of poor quality. Corruption is so widespread in this sector that even basics such as disinfectant are watered down to save money.
Sterilization camps always see young mothers come for the surgery with infants and young children tagging along, who face a high risk of exposure to infection and diseases. Additionally, the children, along with mother-in-laws and other family members who accompany the young women substantially increase the floating population of the camp. As the hospitals get only a limited staff to take care of the entire cleaning processes, including OT hygiene and the toilets, sanitation becomes a big issue with a greater number of people.
Since laproscopy requires patients to be on an empty stomach, most women spend the entire day without food, as they reach early to get a place in the day’s limited number of operations. This results in many of them going into hypotension or low blood pressure.
The undue pressure these camps create on the hospital’s one or two attending doctors is a major reason for the numerous fiascos. India is one of the few countries in the world where pre and post-operative cares, checking blood pressure, and taking pathological tests are all carried out by a doctor instead of a nurse. The hospital doctors are also expected to take care of paperwork and emergency cases among other regular work.
These issues need to be taken care of, especially by the public health service. Medical camps are in dire need of more health care personnel and better sanitation. Work needs to be done to stop the inherent corrupt practices and better funding needs to be provided to the CHCs and such medical camps.
Bisalpur sterilisation camp: https://www.youtube.com/watch?v=Wl_TRo0RXgk
It is true that street performances has been existing in India since ancient times. But, it was Philip Astley who brought the concept of circus in India in the 1880s. Interestingly, Astley is known as the father of modern circus.
Birth of the Great Indian Circus
In 1879, the Royal Italian Circus by Giuseppe Chiarini came to India. Before any of his shows, he would often say that India did not have a proper circus, and apparently, the country would have to wait for many years in order to develop the "circus trend".
Once, Balasahib Patwardhan, who was the king of the Kurundwad state of Sangli (today's Kolhapur) went to watch the circus. He was accompanied by Vishnupant Chatre, who was the keeper of his stable and also a riding master at the stables. As it was ritual, before starting with any performance, Chiarini used to challenge the audience by saying, "a thousand British Indian rupees and a horse would be given to anyone who would repeat his daring effects within six months". Interestingly, this time, the challenge was accepted by Chatre, and he announced that he will perform the same in Kurundwad within three months. And if he fails, he promised Chiarini that he would return "ten thousand British Indian rupees and top ten horses. On March 20, 1880, Chatre came to perform his circus at the Kurundwad Palace Grounds. But Chiarini did not come to see it.
Soon after this, Vishnupant Chatre bought most of the circus equipment from Chiarini, and within a year, he formed a new circus company called the "Great Indian Circus". This is referred to as the first circus company in India. Chatre's Great Indian Circus toured various parts of India and the world. Later on, Chatre merged his circus company with his cousin's company to launch a new company by the name of "Karlekar Grand Circus".
Other Famous Circuses of India
After the coming of Karlekar Grand Circus, many circuses came into being in India. In 1904, the Malabar Grand Circus, which was the first circus company in Kerala came into being under the leadership of Pariyali Kannan. Another circus named the Great Royal Circus was started in 1909. Though, its previous name was Madhuskar's Circus. One of the famous circuses of India was also the Grand Bombay Circus which was founded in the year 1920 by Baburao Kadam. Since a long time, tradition of circus as an art has been prevalent in India, though slight decline in its practice is evident now.
Keywords: India, Circus, Tradition, Art, Performance, Great Indian Circus, Philip Astley, Culture
By- Naman Rastogi
The first thing to understand about API security testing is that it is not a one-size-fits-all process. Testers must take into account the scope of the project, as well as the specific needs of developers and end-users. This article will provide you with some basic guidelines for an API security testing program. It will also outline some API security tests that you should consider including in your API testing process.
API security testing is a process that checks API functions for security vulnerabilities. These tests are intended to identify problems with the API's design, functionality, and implementation. API security testing is a proactive way to check the API for potential exploits.
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Tests To Include in API Security Testing
The API's parameter tampering test is a way to check any API calls that contain parameters for known attack patterns. The API security testing tool you use should provide warning alerts when it finds these types of vulnerability points.
Parameter tampering occurs because developers aren't properly securing the input data before it enters an API call from another application or web service. This gives attackers the ability to tamper with API input data. You can checkout this detailed guide on How to Perform Web Application Testing
Testing for API parameter tampering can include looking at all variables within API calls and checking whether they need to exist or not. In your tests, you'll also want to check how values are passed into API calls and whether or not they can be changed once data is passed in.
Also Read: No Halfway Deal In Security
Input fuzzing is one of the most basic kinds of testing you can perform on an API. It occurs when attackers send API inputs that contain random or unexpected values. This test will show you whether the API can handle random data or not. It should do so without impeding its performance, but rather enhancing it.
The API security testing tool you use should allow for several different types of fuzzing:
●Data Format Fuzzing: An input format can be modified to see how the API responds when an invalid value is received.
●Range Fuzzing: Some APIs only accept certain numeric ranges from authorized users, such as credit card numbers and phone numbers. You should check whether your API functions properly under this type of condition.
The first thing to understand about API security testing is that it is not a one-size-fits-all process.Getastra
●Boundary Fuzzing: This type of fuzzing should be used to check for boundaries within the API itself. For example, checking if a string is between certain character lengths, determining whether it's possible to pass in an empty parameter value that will still produce valid results, etc.
Testing for API input fuzzing can also include randomizing parameters that are always required by the API function being tested (e.g., session IDs). If these values don't need to exist, hackers will be able to bypass any checks made by the developers who have implemented strict guidelines regarding API usage.
Another API security test you should consider is to check for unhandled API functions. Unhandled API methods are those that developers didn't code into the API. This happens either because they were unaware of their necessity or simply forgot about them.
Allowing access to these functions creates a vulnerability point in your API's functionality. Unfortunately, attackers can use these vulnerabilities as attack vectors. API security testing should search for unhandled API methods and alert you to their presence.
This API security testing method will help you determine how well the API performs under different input conditions without any malicious actors trying to tamper with it.
A final API security test you should consider is to check for possible injection attacks. This type of vulnerability occurs when user-defined input data can be inserted into API calls as part of the API's scripting language.
Injecting attacks have been a long-time security threat for APIs. This is because they allow attackers to use any type of data that can be manipulated and inserted into an API call. They should ideally only allow what is provided by regular users or applications trying to access the API.
The API security testing process goes beyond just finding the presence of common API attack vectors like cross-site scripting (XSS), SQL injection, remote code execution, and much more. It also looks for other API features that can put your system at risk if they aren't properly secured with input validation defenses or strict API security features.
Though API security testing may seem daunting, it's a necessary step in securing your systems and data. As the saying goes, an ounce of prevention is worth a pound of cure! If you don't have time to do this yourself, you can always seek help from security experts. The costs are justified by the benefits. So, make sure to conduct API security testing if you haven't already!
Disclaimer: (This article is sponsored and include some commercial links)
By TS Kler
COVID-19 has led to complications and health risks manifold for patients with non-communicable diseases. Almost 75-80 percent of the COVID patients don't require hospitalisation and can recover at home with teleconsultation, but COVID-19 infections can leave the patient with long-term side effects. There are many instances where symptoms of COVID-19 have persisted for several months. Apart from damaging the lungs, the virus can also cause acute myocardial injury and chronic damage to the cardiovascular system.
According to research published in the European Heart Journal, Covid-19 patients who suffer cardiac arrest have a higher possibility of dying as compared to those who are not infected with it, and especially women are at an increased risk of death for the same reason. The virus may directly breach the ACE2 receptor cells, within the myocardium tissue and cause direct viral harm. COVID can result in inflammation of the heart muscles which is known as myocarditis and it can lead to heart failure over time, if not taken care of.
People with a pre-existing heart problem need to be extra cautious. A significant number of patients have suffered cardiac arrest during the recovery period, often resulting in death. Expert suggests that even though the COVID virus wanes, the immune response continues to be hyper-active and that often ends up attacking other organs. It has been observed that almost 80 per cent of these patients have had cardiac arrests 2-3 weeks after testing COVID positive.
Covid-19 patients who suffer cardiac arrest have a higher possibility of dying as compared to those who are not infected with it | Photo by benjamin lehman on Unsplash
We tend to ignore some of the warning signs and due to lack of awareness, sometimes, we fail to prevent certain cardiovascular issues during COVID or even after recovering from COVID. After someone has had COVID-19, if that patient is experiencing a rapid heartbeat or palpitations, it is recommended to contact the doctor immediately because even a temporary increase in heart rate can signal a lot of different things, including the aftermath of being very ill, prolonged inactivity and spending weeks convalescing in bed and even dehydration.
It is necessary to make sure that the patient is drinking enough fluids, especially if the fever persists. Sometimes, people who are recovering from COVID may show symptoms of a condition known as POTS (Postural Orthostatic Tachycardia Syndrome). However, the link between the development of POTS and COVID is yet to be established. Although, POTS is a neurologic problem, and it is not directly a cardiac issue. It affects the part of the nervous system and may hamper the heart rate and blood flow. The syndrome can also cause rapid heartbeats while standing up. Some of the symptoms of a rapid or irregular heart rhythm may include:
*Feeling of a rapid or irregular heartbeat in the chest (palpitations)
*Shortness of breath
*Feeling lightheaded or dizzy, especially upon standing
*Rapid ups and downs in the pulse rate
COVID-19 has led to complications and health risks manifold for patients with non-communicable diseases.| Wikimedia Commons
Several instances of cardiac arrests post COVID recovery has emphasized the importance of frequent monitoring of heart health. As per experts, cardiac tests like ECG, X-Ray Chest, and lipid profile should be repeated every six months in high-risk individuals with pre-existing conditions like diabetes and hypertension in order to understand whether there is any damage to the heart. Apart from regular monitoring, post-COVID patients must stick to a healthy diet consisting of all the essential nutrients and spicy, oily, canned, artificial sweeteners and processed flavours, or junk food should be strictly avoided. Taking out time for physical exercise, cutting down on alcohol and smoking is necessary. Even the smallest of the symptoms should be taken into consideration and should be immediately addressed by an expert doctor. (IANS/ MBI)
Keywords: covid, pandemic, testing, health, testing, cardiac arrest, heart