STEROID MEDICATION

Our LOVE – HATE RELATIONSHIP with Cortico-Steroids is the Blog Theme for today.

Over the last 3-4 decades of our evolutionary journey as Medical Practitioners,  we have undergone a  ” SEA CHANGE ”  in our usage of Cortico-Steroids as an armamentum to heal our patients. The PLOTTED GRAPH of Steroid Usage Indications in Modern Medicine is constantly INCLINED UPWARDS . 

Starting with a HATE trend for a Steroid Prescription by our local colleagues, we have now developed ( more so,  in the last decade ) a GREED-BASED FASCINATION ………………..for this unfortunate victim of our whims directed  towards IRRATIONAL Medications in general and CORTICO-STEROIDS in particular.  We have,  historically speaking,  made such judgemental errors in gauging the inherent value of Cortico-Steroids in Pharmaco – Therapeutics and later realized HOW they are the best and preferred LIFE-SAVERS in our Intensive Care scenarios and COVID CARE CENTERS. 

A couple of decades ago,  we,  as Doctors were bogged down 🙃👎🏻🙁 by the POTENTIAL and PLURAL SIDE EFFECTS of Cortico-Steroids like Growth Stunting, Moon facies, Immune Suppression etc.  This proverbial TABOO of  towing exclusive RATIONAL THERAPY is now totally replaced by JUDICIOUS  and TIMELY DEPLOYMENT of Cortico-Steroids in Asthma Management and in worsening COVID complications. 

One more area,  where Steroids are the ONLY PANACEA are the AUTO – IMMUNE  DISORDERS,  which can RUN AMOCK and CAUSE HAVOC ,  if this Taboo of withholding Steroids is not thrown out of the Window.

  •  The FIRST LANDMARK in endorsing our conceptual STEROID BENEFITS PERSPECTIVE amongst Medical Professionals , came with the revised Management Approach to Asthma. We discovered that Inhaled Steroids are of immense value here and they are LIFESTYLE MANAGERS for millions of Asthmatics 🤧🥱🤕
  •   The  SECOND LANDMARK emerged with the COLLAGEN and CONNECTIVE TISSUE DISORDERS like SLE,  JIA and Vasculitis Syndromes like HS PURPURA. 
  •  The THIRD LANDMARK emerged with these miscellaneous disorders  :  Nephrotic Syndrome,  Croup ,  Chronic Hepatitis,  Ulcerative Colitis ,  TB MENINGITIS  (  + severe IRIS and CNS Tuberculomas with Raised ICT ),   Thyroid Storm,  IBD and at the top of all these – I.T.Purpura . 
  • The FOURTH and RECENT LANDMARK for STEROID USAGE emerged with the COVID 19 PANDEMIC . 😷😷😷 STEROIDS like Dexamethasone became household names, wherever their own relatives were stuck with devastating Covid complications and impending Death. 

Cortico-Steroids are basically the essential hormones of the human body,  that pop up and keep us safe in critical situations. But, surprisingly,  when administered as a Prescription Drug, we used to carry a biased opinion. I fail to understand : How can hormones produced by the human body, or their synthetic analogues, be labelled as TOXIC or TARGETS of hate.

Long – standing HYPOTHESES  on various  Chronic, Recurrent and Acute illnesses have been revisited and revised , over the last few decades.  STEROIDS  have emerged as the PANACEA  for Disease Modification Strategies and have been  The Life Saving Emergency Interventions . 

To sum up and conclude , MODERN  MEDICINE  has never endorsed any   PERMANENT TRUTHS and FINAL SOLUTIONS for any ailment ,  be it  ASTHMA,  AUTO-IMMUNE DISORDERS  or  COVID INFECTIONS. 

 CORTICO-STEROIDS have lately put their final undisputed STAMP OF AUTHORITY in the Emergency Room as well as the INTENSIVE CARE  UNITS.

 Blog Concept (  based on  Personal Experiences over 40  yrs )  

Dr . Dhananjay Shah
Ped. Practice of 40 years
@ Rajkot. Gujarat.

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