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| Sunday, 20 October 2002 |
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| News Business Features Editorial
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Compiled by Carol Aloysius When you are short of breath..... There are approximately 2 million asthma cases in Sri Lanka, including children. In Sri Lanka 10 per cent of both adults and young of the total population suffer from asthma. What causes asthma? How can it be prevented? Dr. Bandu Gunasane, Consultant Chest Physician at the Galle Teaching Hospital discusses the subject with the Sunday Observer staffer Don Asoka Wijewardena
By identifying and eliminating triggers, routinely monitoring your breathing and properly using medications, you can help control symptoms and maintain your usual lifestyle. If you've never had to work for each breath, you can't really know what it's like to have asthma. This exercise can give you a better idea of what someone with severe asthma endures during an attack. Following are some important facts on prevention and management of asthma. Put a straw in your mouth and close your lips tightly around it. Hold your nose then exhale. Some people have occasional episodes of asthma symptoms that mild and brief. In others, mild coughing and wheezing occur most of the time, accompanied by severe worsening of symptoms after exposure to a trigger. For some people an asthma attack can be life-threatening. Asthma attacks always give a warning. Learning to recognise warning signs can help you prevent severe attacks by treating symptoms early. Warning signs of an attack in adults: 1. Increased shortness of breath 2. Sleep disturbed by shortness of breath or wheezing 3. Increased use of as needed bronchodilators 4. Fall in peak flow rate 5. Use of accessory muscle of respiration 6. Agitation 7. Audible wheezing You can develop asthma at any age, most likely as a combination of genetic predisposition and environmental exposure. Asthma is an inflammatory disease. Airway constriction, swelling and damage to the lining of your airways, along with increased mucus secretion, are the results of inflammation. In addition to blocking air flow, inflammation makes airways overly sensitive to a wide range of triggers, including allergy-causing substances, viruses and environmental irritants. Chronic airway inflammation, coupled with tendency toward narrowing and constriction sets the stage for an asthma attack. Typical symptoms - shortness of breath, chest tightness, coughing and wheezing - usually begin within minutes of exposure to an allergy trigger. Asthma attacks triggered by a cold virus may develop over a day or two. In most people younger than age of 30, asthma is triggered by allergies. About 40 to 50 percent of adults with asthma are allergic to airborne particles. Skin testing is the best way to determine what substances you may be allergic to. In some adults with asthma, particularly older adults, allergies do not appear to play a role. Exposure to any irritant - from virus to cigarette smoke - can trigger wheezing. Overall, though, most cases of asthma are the results of a combination of allergic and non-allergic mechanisms. Triggers include: 1. Allergen, including pollen and molds 2. Air pollution and irritants 3. Smoking and secondhand smoke exposure 4. Respiratory infections, including the common cold 5. Exertion of cold weather 6. Certain medications, including aspirin and other nonsteroidal anti-inflammatory drugs 7. Sulfites (preservatives added to some perishable foods) 8. Emotional stress Diagnosing the disease Asthma is often difficult to diagnose because it has varying degrees of severity and its symptoms are similar to other lung conditions. To diagnose asthma and distinguish it from other lung conditions, doctors rely on a combination of evaluation methods. Diagnosis usually starts with a complete medical history and physical examination. One of these tests is a lung function test that measures the amount of air you expel is reliable method for diagnosing asthma and evaluating its severity. One of the simplest tests measurement peak airflow using a peak flow-metre determines the rate at which you can expel air. Lung function tests should be done before and after you take a bronchodilator - a medication that opens up your airways by relaxing muscles surrounding your airways. Improvement in lung function with use of a bronchodilator points to asthma. If a diagnosis of asthma is still in doubt, your doctor may do a methacholine (bronchial challenge test). If you have asthma, inhaling methacholine will cause mild airway constriction confirming the diagnosis. Dengue alert With the onset of the monsoons, the Health Ministry has warned the public of a possible outbreak of several water related diseases. Last week the Health Education Bureau sent out a cholera alert. This week Health Ministry sources have advised the public to take precautions against the outbreak of Dengue (which) commonly occurs at this time of the year. This page will continue to carry articles on common water related diseases over the next few weeks. Dengue Fever/DHF How is it caused? . It is caused by a virus. How does it spread? . This is spread by the bite of an infected mosquito Aedes Aegipti and Aedes Albopictus. The dengue mosquito usually bites during day time specially in the morning and evening. Therefore you could be bitten while at work place, school or travelling. Symptoms on Dengue fever . High fever. . Headache. . Rash on the face, trunk and extremities. . Muscle and joint pains. . Nausea and vomiting. The symptoms subside in about 3-4 days and the patients recover. Some may progress to Dengue Haemorrhagic Status. Symptoms of Dengue Haemorrhagic Fever (DHF) . Symptoms similar to dengue fever. . Haemorrhagic manifestations petechial rash. . Bleeding from nose. . Bleeding from gums. . Brown or black coloured vomitus or faeces. . Severe and continuous stomach pain. . Enlargement of liver. If these symptoms appear take treatment immediately from a hospital. Dengue shock syndrome Warning! The fever may suddenly go down in a patient with DHF. But if the patient still feels ill, it may be a sign of shock. In a patient like this, symptoms of shock like . Coldness of body . Paleness of body . Restlessness and drowsiness . Acceleration of breathing and increase in pulse rate, Indicates worsening of disease. Be alert to a sudden drop in temperature in a child having fever. Refrain from giving Aspirin or drugs containing Salicylates to the child. Use only Paracetamol, in correct dosage. Don't exceed 4 times a day. Prevent Dengue fever by elimination of breeding places of mosquito transmitting the Dengue virus. Such mosquitoes breed in containers where there is collection of clean water. These containers lie in and around homes, schools and work places. If Dengue fever is suspected... . Get the patients with fever to rest in bed. Refrain from sending children with fever to school. . Give plenty of fluids to drink. . Refrain from giving Aspirin or drug containing Salycilates. If DHF is suspected... . Take treatment immediately from a hospital/ Qualified doctor. . Early treatment of DHF can prevent serious sequalae. . Monitor the child/patients for dengue symptoms even after taking treatment. Ministry of Health/ Health Education Bureau Sponsored by WHO You & our doctor Sore throat Q: I am a 28-year-old female law student. I used to get pain in the throat since I was about 15 yrs; I used to think it was "Tonsils" and in fact, tell my own diagnosis to the doctor without even telling him that I was having sore throat. But I happened to see another doctor for my sore throat this time, but he told me that I was not having "Tonsils" but some other disease the name of which I have forgotten. Dear Doctor, please tell me what I am really having. A: "Sore throat is not tonsillitis". Most people tend to believe that a sore throat the same thing as Tonsillitis. Most of them who develop sore throat come to a doctor and say "I am having Tonsils." This is misleading. Sore throat is the disorder in the Pharynx, and is one of the commonest of all disorders. Pharynx is the medical term for the cavity behind the mouth, corresponding more or less to the word "throat". The pharynx joins the mouth in front, to the nasal cavity above and the "gullet" and "wind pipe" below. So inflammation of the pharynx is called sore throat. Apart from an occasional cause due to overuse of the voice, almost all sore throats are due to infection by Bacteria or Virus. Sometimes it is difficult to say whether in any given case is due to bacteria or virus. Therefore treating all sore throats with antibiotics is not scientific and may be dangerous too. There is no such disease called "Tonsils" even though most people think. Tonsils are a pair of glands of Lymphoid tissue (Defense system) on either sides of the throat behind the base of the tongue. Any inflammations of the tonsils is called 'Tonsillitis'. Therefore the sore throat does not always mean Tonsillitis. For sore throats one can use home remedies first - if possible physical rest for 48 hrs. Generous portions of high protein diets, plenty of water and fruit juices, stop smoking, and stay away from iced cool drinks, before calling your doctor. ****** Travel sickness Q: I travel daily from Kandy to Colombo by bus. I am 30 yrs old. My problem is that I tend to vomit during my journey. I have to carry polythene bags in my pocket to collect my vomit. I am desperate and I feel like giving up my job. Please tell me how I can stop feeling sick while travelling by bus. A: It is obvious that you suffer from travel sickness. It is a condition where you develop nausea and vomiting during any kind of travel, whether by bus, car, aeroplane, train or boat. Though all these types of illnesses are similar, "Sea Sickness" is a little different from the rest in that the major factor is usually the persistent, up and down motion of the boat. This has a marked effect on the body's balancing apparatus in the 'Inner Ear' (called fluid filled semi-circular canal). When this fluid is subjected to continuous rhythmic disturbances of sufficient strength for long enough, nausea and vomiting are likely to follow. However, in other types of travel sickness although there is not much up and down movement, passing objects can have an effect through the eyes, on the balancing apparatus. Sometimes the noise in the bus itself may directly have an impact on the ear drum to produce irritation of the balancing apparatus. There are certain drugs to sedate the balancing apparatus. One has to take such medicine at least half an hour before the commencement of the journey. But any medical drugs should not be taken without medical supervision, as such you are advised to meet your family Doctor for drug treatment. There may be some psychological factors too which play an important part in bringing on nausea. by Dr. Sampath R. Nanayakkara. How trauma and violence affects childrens' health Trauma and violence on children and adolescents can cause physical and mental scars that can last ones a life time. Trauma and violence either within the house or outside affect their lives, health, happiness and ability to function productively. Violence and trauma can affect children drastically even if they are only witnesses to the violence. Effects of violence and trauma include the following: * Fear * Confusion * Depression * Avoiding activities * Withdrawal * Haunting memories * Nightmares * Lack of concentration * Anger * Digestive problems * Sleep problems Children may also revert to behaviour they grew out of years ago, or may any more easily. Adolescents may become more aggressive or begin to use drugs or alcohol to feel better. Some children and adolescents develop Post - Traumatic Stress Disorder (PTSD) or other mental diseases that damage their lives, and has a negative effect on their own child rearing abilities in the future. Violence occurs in three ways: * Domestic violence or family community abuse * War * Violence in the media How you can help Prevent violence and trauma from occurring. Intervene quickly and effectively especially when children are exposed to violence and trauma. A message from the Health Ministry on International Day of Mental Health which fell last week. Natural and artificial diseases by Dr. Y. Mansoom According to Dr. Hahnemann the founder of Homoeopathy and a qualified physician of Allopathic's system of medicine, there are three causes of diseases: Exciting causes, Contributory causes and Miasmatic causes. Exciting causes produce acute diseases. They may be mild or fatal. Contributory causes produce the inappropriately called chronic diseases. For examples, diseases due to living in damp places, eating an unbalanced diet, working in mills and mines etc. Miasmatic causes also produce chronic diseases. They may be of non-venereal origin eg. Psora or of venereal origin eg. syphilis and sycosis. Natural diseases are due to natural causes. They may be acute or chronic. In acute natural diseases, there are Epidemic diseases like smallpox, chickenpox, measles etc. These occur in a locality, where many persons suffer from the same disease, sporadic diseases are those which occur sometimes in one locality and sometimes in another locality involving many persons at a time; for example diarrhoea, dysentery, typhoid etc, and personal diseases or allergic diseases are those which affected certain persons due to certain foods, drinks, change of weather etc. The Chronic natural diseases are Psora, syphilis and sycosis. Psora is a non-venereal chronic disease due to suppression of itch diseases. Syphilis is a venereal diseases due to contact with an infected person and not treated properly by the physician. Sycosis is also a venereal diseases due to maltreated or suppressed gonorrhoea. Artificial Diseases are those which are due to artificial cause, for example strong medicines were used for the treatment of diseases. Even now despite scientific advances modern medicines produce artificial diseases due to mistakes of the physician in treating the disease, for example toxic effects of antibiotics such as penicillin, or sulpha drugs. Since artificial or doctor made diseases are becoming widespread and sometimes more acute than natural diseases, great care should be taken when undergoing western medical treatment. Medical update Heart facts Did you know that your heart is a muscle? It is stronger than the muscles in your legs and arms. It needs to be strong because it pumps blood (about 2,000 gallons every day!) to all parts of your body, all day and night. The following are tips to help get you on your way to a healthy heart: * Eat breakfast. It prepares your mind and your body for the day. * Exercise!! Exercise is good for you and your heart. It can be fun for your whole family. Playing sports, skating, hiking, biking, and walking are good ways to get in extra activity. * Don't smoke. Smoking is a bad habit that can last a lifetime. Smoking makes your heart beat faster, narrows your arteries and veins so less blood gets to your heart, and makes your blood pressure go up. It also decreases the amount of oxygen in your blood which makes it harder to exercise. * Maintain a healthy weight. A well-balanced diet and regular exercise can help keep you healthy. * Watch the extra salt and sugar. * Prevent high blood pressure. Exercise, maintaining a healthy weight, and cutting back on sodium can prevent high blood pressure. * Choose foods lower in fat and saturated fat. Watch your intake of cheeses, butter, sausage, whole milk, chips, fries, ice cream, and sweet desserts. * Eat whole grains for energy and fibre. Hope for Alzheimer's patients Alzheimer's Disease (AD) is the most common cause of dementias in the western countries. Approximately 10 per cent of all persons over 70 years of age, have significant memory loss and more than half are due to AD. In its early stages the disease goes unrecognised and as it advances it starts affecting the cognition slowly and thus gradually interferes in day to day activities. With the increasing understanding of genetics now there is hope in the form of gene therapy for Alzheimer's patients. In a pioneering procedure the neurosurgeons for the first time, have injected genetically modified cells into the brain of an Alzheimer's patient to achieve halting or reversing the brain cell loss caused by the disease. The procedure was carried out at the University of California, San Diego (UCSD). Though this is unlikely to cure the disease but the procedure is likely
to delay the progress of the disease and improve the quality of life for
several years. For more details see www.health4india.com |
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| Editorial | Security Produced by Lake House |
Asthma is a treatable and preventable disease. Most deaths caused by
acute asthma could have been avoided with proper health care. In the past
20 years, medical scientists have gained a better understanding of the
causes of asthma. New drugs have been developed to replace standard
medications, and there is greater emphasis on managing asthma with the
patient-doctor working together.
