"This Endoscopy is not NORMAL": (my input as an endoscopist and a gastroenterologist)We live in such a world where medical conditions and scientific knowledge are ridiculed on political basis. Since morning, I have been seeing comments of various anchors and politicians on
#BushraBibi Endoscopy reports where every one is pretending to be a doctor. As a gastroenterologist working in this field for more than 8 years, I am writing my analysis of the report with clinical correlation. And I challenge any one who belongs to the medical field to come forth and rebuke these points. The people who are calling this report "NORMAL" must be questioned as given the clinical background of suspicion of a corrosive intake, there is no way this report can be called Normal. I will base my analysis on following points:1. With corrosive intake, we gastroenterologists grade the damage to esophagus using a scale called "Zargar Grades" that quantify the damage in five grades from Zargar 0 to Zargar-4, where Zargar 0 means "Normal". Her endoscopy is not Normal at all. It shows erythema/ hyperemia and erosion called " mild esophagitis" which is graded as Zargar 1 (as you can see in the image). So there is no way one can rule out the possibility of corrosive ingestion.2. When ever someone is given a corrosive agent like Lye or acid or Harpic etc., she or he must get an upper endoscopy with in 48-72 hours of the incident to analyze the correct assessment of the damage to esophagus. Otherwise, the damage can be underestimated if the endoscopy is delayed by weeks. This is because after damage by the corrosive to the esophagus, it undergoes natural healing process in three phases:a. Liquefactive necrosis - 1-4 daysb. Granulation tissue formation: 4 days to 14 days.c. Re-epithelization: 3 weeks to 6 weeks. So if endoscopy is delayed, then Zargar class or grades can be undercounted due to natural healing of esophagus. In case of Bushra bibi, the endoscopy was delayed by 4 weeks after the intake, so her esophagus must be in phase c (re-epithelization), but still mild esophagitis (Zargar -1) is noted. 3. There is no prior diagnosis of GERD (acid reflux) in her case to justify the cause of distal esophagitis. Based upon above evidence, I can objectively prove that there is no way you can rule out the possibility of Corrosive intake in her case. This is a serious issue as 30 % of such patients who are given corrosives can develop esophageal cancer in 10-20 years after the incident. This is a known medical fact and I again challenge that no physician can deny it. Then the question arises why the Shifa doctors did not point out these points?I feel sad about the doctors of Shifa doing this procedure and not mentioning these points. Indeed, in a country where the High court Judges are intimidated and the police officers are beaten in the police stations, there is no way a doctor can do justice to his profession. Unfortunately, like our bureaucracy, judiciary and military, our science has also been "Politicized". This is a new low where our science and medical profession has fallen to.
https://twitter.com/x/status/1781898297524769048
