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| Sunday, 13 October 2002 |
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Features |  |
| News Business Features Editorial
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You &our doctor Stones in the body Q: I am a 36-year-old male teacher, who developed puffiness and discomfort in my stomach for about three years during which time I was treated by many doctors, including specialists, for gastritis as the cause. Ultimately my condition was found to be a 'stone' in the urine passage which was operated. Now all my 'so called gastric' symptoms have disappeared and I am ok for the last one year. My questions are: (a) Why did those doctors (even specialists) misdiagnosed my condition? A: Stones are called Calculi by doctors. They are hard concretions composed of various minerals. They are found in two main sites i.e. urinary tract and the gall bladder system, but rarely in the saliva producing gland and in the nose (called Rhinolith). In the urinary tract stones may form within the kidney itself or more commonly in the ureter (the slim tube between kidney and bladder). In the ureter a stone may jam, and produce a severe excruciating pain, often described as running from the "loin to groin". Stones are also commonly found in the bladder, where they may attain considerable size. A stone anywhere in the urinary passage may cause bleeding in the urine or will produce infections, or exert a back pressure on the kidney - producing weakness of the kidney functions and high blood pressure. Stones may be formed in the gall bladder too. They are made up of various chemicals including cholesterol and calcium. Traditionally gall stones are said to be common in women who are fair, fat, fertile, and forty to fifty. Some gall bladders are found to have hundreds of tiny stones within them. Some people who have stones can present with symptoms, similar to 'gastritis' - i.e. discomfort and puffiness of abdomen. Specially problems in the abdomen should be reviewed very carefully. You may get repeated formation of stones. The formula for prevention is simple. Drinking at least three litres of water daily and regular exercise. ******************** Anorexia Nervosa Q: My 16-year-old daughter has developed nausea to food for the past year. At times she vomits after taking food. She was rather fat earlier. But now during the last six months she has wasted completely, feeling sleepy all the time, and not attending to her studies either. She was seen by various specialists and they say is nothing wrong in her. Please advice me on what to do. - A worried mother A: Your child seems to be having an illness which should have originated from the mind and expressing in the physical body. This worrying condition is seen in adolescent children, mainly in girls. It is called 'Anorexia Nervosa'. It often starts in an effort to slim, the girl's intake of food being reduced, until she is virtually eating nothing and becomes very thin, but still does not see herself as thin enough. She develops a distorted image of her own body, in her mind. The sufferer may further restrict intake of food, for example, by hiding food and deliberately vomiting food already eaten. This is a personality disorder which occurs in people who set very high standards for themselves, and any failure to reach their idea of perfection results in a breakdown. Fear of failure in any undertaking also plays a part in the onset of the disease. Any criticism may be the final precipitary factor in the food refusedt. Urgent counselling is needed early to prevent progression to a serious illness. Your family doctor is the best person to meet first. You may try clinical hypnotherapy by a qualified doctor. (Western qualified clinical hypnotist specialist's services are now available in Sri Lanka). - Dr. Sampath R. Nanayakkara ******************** Cholera alert! A cholera outbreak in the North has prompted the Health Ministry to warn the public especially those travelling to the North, to take precautionary measures to avoid getting the disease. Upto date around 28 cases of cholera have been detected in the Jaffna district and in Anuradhapura, Puttalam and Kandy. Health Ministry sources have warned the public that the disease could spread to other parts of the island. The Health Education Bureau has listed the following ways in which the disease could be transmitted. Avoid drinking water that has been contaminated at its source (e.g. facially contaminated surface water entering an incompleted sealed well or during storage e.g. by contact with hands soiled by faces), and ice made from contaminated water. Avoid eating food contaminated during or after preparation. e.g. milk, cooked rice, lentils, potatoes, beans, eggs and meat. Sea food Particularly shellfish, taken from contaminated water and eaten raw or insufficiently cooked. Fruit and vegetables Grown at or near ground level and fertilized with night-soil, irrigated with water containing human waste, or 'freshened' with contaminated water, and then eaten raw. * Drink only water from a safe source or water that has been disinfected (chlorinated), preferably boiled cool water. Give your child a bottle of cooled boiled water to take to school. * Cook food or reheat it thoroughly; and eat it while it is still hot. * Avoid uncooked food unless it can be peeled or shelled. * Wash your hands after any contact with excreta and before preparing or eating food. * Dispose of human excreta (including children's stools, promptly and safely.) Remember * With proper treatment, cholera is not fatal. * To take patients with suspected cholera immediately to the nearest health worker for treatment. * To give increased quantities of fluids (if available, oral rehydration salts solution) as soon as diarrhoea starts. * Vaccination is not recommended. * To avoid partaking of meals whenever possible if you visit an affected area. Symptoms According to Health Education Bureau Director Dr. Latha Hapugoda anyone who develops the following symptoms should seek treatment at a medical unit immediately. 1. The Commonest symptom is watery diarrhoea with or without fever. Treatment Since patients pass a lot of water and electrolytes (e.g. potassium, sodium, chloride) it is important to replace fluids and electrolytes very quickly as they can get dehydrated quickly. So if anyone has been to an area where cholera is prevalent and experiences diarrhoea, he or she must go to the nearest hospital for treatment. It is also important to mention to the doctor that he/she has been in that area. Till you receive medical attention, start taking home based fluids such as rice conjee, king coconut, plain tea and water. If you experience symptoms of dehydration such as increased thirst, reduced output of urine and severe thirst, then it is important to start taking Jeevani (oral re-hydration therapy). Jeevani is available in readymade packets at all pharmacies.) Here is how you can make it at home. Method: Take one litre of boiled water, empty the packet of Jeevani and dissolve well.Consume it within 24 hours. In children it can be fed in spoonsful throughout the day within 24 hours. This treatment must be continued even if the patient vomits. You can wait a while and resume treatment if the patient vomits, as vomiting is also a symptom of the disease. ******************** October 10 was World Mental Health Day : Depression... The 'hidden' disorder Depression is not something that's imagined, or 'all in your head.' It's a very real medical disorder that affects millions of people. Yet as common as it is, depression is also misunderstood, and many times not recognised. How could something so common go untreated so often? The reasons are many. Some people may not seek treatment for depression because they feel that, sooner or later, they'll 'snap out of it.' Some may consider depression a weakness or personal failure that they should be able to handle on their own. And some may not realise that there may be effective medical treatment available. So people who may be depressed often don't discuss their symptoms with their doctors, and their depression remains hidden. ******************** Screening cancer: 20 points Q: What is screening in general? What is cancer screening? A: Screening is the examination of an asymptomatic (healthy) population, in order to detect a certain disease, most probably at an early stage. Screening is a widespread practice in industrialised countries. Q: Can cancer be screened in general? A: There is no way to screen cancer in general. There is no single test or a group of tests which can tell whether a person has, or does not have, cancer in general. Q: Is cancer curable at all? A: Yes. Cancer is indeed curable, especially if detected early. Q: Does screening ensure 100 per cent protection? A: No. There is no 100 per cent assurance. Some cancers may have a masked appearance. Therefore, there is no effective screening for some cancers. Q: What kind of co-operation may one expect from the population? A: To go for regular screening self consciously. Those who do, benefit in two ways: Precancerous lesions may be detected and they can be easily cured. This is called direct prevention of cancer. Screening may detect a cancer at an early curable stage. The life expectancy of such a patient is dramatically better than that of the unscreened population. Q: What kind of cancer can be screened by simple inspection? A: The surface of the human body, especially the skin, can be screened by simple inspection, with or without a magnifying glass. Q: Is there any guideline as to who has to consult a specialist for head and neck (oral, pharyngeal) cancers? A: Yes, people who are in the habit of chewing or smoking tobacco and even drinking are at risk of developing cancer. Therefore, regular screening is advisable for these people. Q: Which segment of the population should be screened for lung cancer? A: There is no well defined section of the population as such. However, heavy smokers are advised to consult a specialist in order to have a tailormade program for them. Q: Is there any screening procedure for cancer of the digestive tract? A: Yes an no. Cancer of the oesophagus, stomach and the large bowels can be detected at an early stage by an endoscopic examination. Q: Does it mean that people should undergo regular endoscopy for the digestive tract? A: Not at all. This examination is relatively expensive and involves a degree of inconvenience. Endoscopy of the digestive tract is not regularly used in general screening. Individual programs can be created for persons at increased risk. Q: Can cancer of the prostrate be screened effectively? A: Yes. A clinical examination and/or trans or trans-rectal ultra-sound may detect early prostrate cancer. However, there is a relatively new blood test: Prostrate Specific Antigen (PSA) which is effective in the screening of prostrate cancer. Q: Is there a screening procedure for cancer of the reproductive organs? A: Yes, there is Male reproductive organs are clinically screenable. Q: What about the female organs? A: This is one of the most wide-spread cancer screening tests available all over the world. Cancer of the uterine cervix (lower segment of the womb) is quite common and screenable. Q: What is the appropriate age for a woman to start attending cancer screening of the cervix? A: Right from the time a woman becomes sexually active. Q: What about women who are sexually inactive? A: There is no exception. All women are advised to undergo screening regularly. However, the frequency may differ. Q: What does gyneac-screening mean? A: Screening for cancer of the uterine cervix means clinical examination and collection of material for PAP smear. It is very effective and inexpensive. Q: Is there any screening procedure for breast cancer? A: Yes. Clinical examination and a mammography. Q: Is mammography risky? A: No. An x-ray is not risky. Theoretically, an x-ray can cause genetical disorders. Fortunately, however, with human beings, the risk of genetic damage due to exposure to diagnostic x-ray is quite insignificant. Q: What about the other organs? Is there any screening for the heart, brain or bones? A: Not really. Any part of the body can develop cancer. Screening is advisable for more common types of cancer. Also, early detection should result in a better chance of recovery. Q: The most important question is this. What is the general impact of screening in relation to curability? A: Screening of the population which has no symptoms has a major impact on curability in general. In developed countries (with appropriate screening) about 70 per cent of detected cases can be cured. In countries without regular screening 70 per cent of cases pass away despite therapeutic intervention. Apollo Cancer Hospital Chennai. ******************** Teeth for a lifetime Dental problems affect a large percentage of Sri Lanka's population. Dental caries is widely prevalent among schoolchildren affecting some 80% of children below 14 years, while gum diseases affect over 70% of the adult population. These diseases can be avoided and prevented. The following guidelines from the Health Education Bureau of the Ministry of Health show you how. Why should we have teeth for a lifetime To chew and eat The first milk tooth erupts in six months after birth. The full set of twenty teeth completes in 2 1/2-3 years. Permanent teeth At the age of six years the first permanent tooth erupts which is the first permanent molar. When a person is 18-20 years old the full set of 32 teeth completes. It is a wrong idea to say that teeth drop off with old age. What are the major dental diseases? There are two major dental diseases 1. Dental caries How do these diseases occur? Dental caries When one eats sugary food the bacteria in the mouth acts on the sugar forming an acid. The acid gradually dissolves the tooth tissue starting the process of caries. Gum disease Dental plaque is the main cause of gum disease. It is formed by bacteria acting on the food debris left in gum margins and between teeth. Dental plaque is a thin yellowish substance slippery in nature formed at the margin of gums and between teeth. Due to bacterial activity in the dental plaque toxins are released which causes an inflammation of the gum, starting the process of gum disease. If dental plaque is not removed with time it hardens to form calculus or tartar. Dental plaque could be removed by correct tooth brushing but calculus could be removed only through proper dental treatment. How will you recognise the first signs of these diseases? Dental caries * A whitish or brownish patch on the surface of the tooth. Gum disease * Bleeding gum, * Redness, * Swollen gum margins, * Bad breadth How would you prevent these diseases? Eat less sweets Reduce the number of times and amount of sweets you eat. If you like to take sweets eat only during main meal times. Parents should train children to eat fruits instead of sweets from the time they are very young. Brush correctly Brush your teeth at least twice a day morning and night after meals. * When brushing use a tooth brush with a small head and medium texture bristles. * Dental plaque is mostly seen at gum margins and between teeth. Thus you should angle your tooth brush in to the gum margins to brush off the plaque. Always use a fluoridated toothpaste It has been proved scientifically that fluoride reduces dental decay. Thus you should always use a fluoridated toothpaste. Periodic check-ups with the dentist If the dental diseases are detected at the early stages they can be easily treated and the teeth protected. Thus periodic check-ups and dental advice will help prevent dental diseases. ******************** Menopause and Colon Cancer Did you know that, at menopause, your body loses estragon.... and that menopause places women at risk to a number of conditions? For every 5-year increase in age over 40 years, a woman's risk of colon cancer escalates - often nearly doubling. Ongoing clinical research currently under way in the United States is examining the relation between menopause and colon cancer. Risk fators In the United States, an estimated 24,000 women die each year from colon cancer. Prevention Reduce fat in your diet. Talk to your health care provider about menopause, colon cancer, and treatment options. |
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