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| Sunday, 17 November 2002 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Do you mis-articulate? Mis-articulation or articulation disorder is generally characterised by difficulty in producing speech sounds correctly. This could be classified into several main types, namely, substations, omissions, distortions and additions. Now, let us take a look at each of them respectively. Substitution is one of the most common types observed, and this could be easily identified by a substitution of one particular sound for another, such as while saying 'buth' for 'bus' or 'pothatho' for 'potato'. Omission characteristically exhibits an omission of a syllable, as per the name suggests. This could be mostly seen among clusters such as in examples like,/pane/for/plane/and/tee/for/tree/. Distortions could be observed even among adults and here, the speaker tends to alter the place of articulation, while producing a particular sound. Eg: some, push the tongue out, in between the teeth while producing /s/, which makes their speech, sound highly distorted. Some people do add a syllable or a sound, especially a vowel in between a cluster, such as in the example..../pelane/-for/plane/. This type of mis-articulation is called "addition" and this could be encountered only rarely. Mis-articulations could be caused by many factors, out of which faulty modelling is known to be a very common one. The child could possibly be imitating a younger sibling, who's at the stage of mis-articulating due to age or even an adult for that matter, who has speech problem. Another common cause is hard of hearing due to which, the child doesn't receive an appropriate auditory feedback of what he orally produces and hence is highly confused about the discrimination of different speech sounds. This confusion not only affects the auditory perception, but also his verbal production as well. Even children with cleft lip and palate,face this problem, due to two main reasons. One could be a structural deformity, such as a cleft of the palate, or a velopharyngeal insufficiency which interferes with the child's nasal air escape. The other reason could be a functional disturbance, probably due to persisting nasality by habituation, or even due to velopharyngeal weakness as well. Patients with dysarthria, is another group closely related with articulation disorders. Generally, what instigates mis-articulation in such cases, is the restricted movement of the speech musculature. Another common condition which restricts the tongue movement and thus provokes mis-articulation, is the "tongue-tie" and this shows a remarkable influence on the production of/r/&/t/to a greater degree. As we have a fair knowledge about the types and causes of articulation disorders by now, it is important to consider the remedies as well. However, if we let ignorance rule over intervention, the expected result could be drastically embarrassing. Therefore, be wise enough to avail yours self of the facilities provided to you surgically and therapeutically (therapy), which would help you to sound more intelligible to your listener. - Savithra C. Panagoda, Speech Pathologist and Audiologist. Calling all heart patients! by Shanika Sriyananda Liyanage Here's good news for all heart patients. The recently formed Heart Patients' Association (HPA), invites all those who are suffering from heart aliments to join the HPA. President of the HPA, S. De Alwis said that the main objective of the Association was to raise awareness among the patients, to have better care, to help the families of the patients, to provide medical advice and to stress the importance of doing exercises after the surgery. According to him, those who are already suffering from heart diseases or have undergone heart operations or are in the waiting list for heart surgery can join the HPA. "Not only patients of government hospitals but those in the private hospitals too can join this Association. Little children with heart defects can also become members of the HPA", Alwis said. The inaugural ceremony was held at the Ward No. 36 of the Colombo National Hospital (CNH) under the patronage of Dr. Hector Weerasinghe, Director of the CNH, who stressed that, the HPA served a timely need offering counselling prior to surgery. He said that the HPA was grateful for the support given by Dr. P.N. Rajapaksha, Consultant Cardiologist of the CNH, to form the Association. The Secretary of the HPA is Kularatne Bandara and the Executive members
are Dayananda Bogahawatta, Jayaratne Kariyawasam, K.G. Ram and K.K. Ananda.
The HPA intends to hold an awareness program once a month at the Ward No.
36 at the CNH. World's doctors back global anti-smoking treaty Doctors from around the world voiced their support for World Health Organization (WHO) efforts aimed at reducing the millions of deaths a year linked to smoking. Associations representing more than 8.6 million doctors from 116 countries submitted to WHO Director General Gro Harlem Brundtland a document backing efforts to pass a global anti-tobacco treaty. More than 120 countries are taking part in talks aimed at creating global rules to curb advertising, marketing and sales of tobacco products. The WHO has set a May 2003 deadline to complete the Framework
Convention on Tobacco Control (FCTC). The document, entitled "Tobacco
Under the Microscope: The Doctors Manifesto for Global Tobacco
Control," calls tobacco "one of the greatest health
dangers" and estimates that it could kill a billion people in the
21st century. When your joints begin to ache... Do you get joint pains frequently? Do they become worse during a bout of cold weather? If they do, then you are likely to be suffering from arthritis. This crippling disease is on the increase in Sri Lanka. The most common type of joint infection is arthritis, meaning "Inflammation of the joints." There are many causes of arthritis. Infection, injury, metabolic disorders, connective tissue disorders, autoimmune disorders and aging process are the common causes. When doctors make diagnosis of arthritis, most of them explain to the patient that the bones inside the joint are destroyed. But this is misleading because bone damage in arthritis occurs only in the late stages. There are four stages involved in developing arthritis. They are: (i) The stage when the synovial membrane which surround all joints gets inflamed. (ii) When there is damage to the cartilage between the joint surface. (iii) When fluid collects inside the joint space. (iv) When bone damage and gross destruction of the joint occurs. Types Arthritis is commonly divided into Acute Arthritis and Chronic Arthritis. There are various types of Arthritis. Pyogenic Arthritis, TB-Arthritis, Syphilitic Arthritis, Gonococcal Arthritis, Viral Arthritis and Rheumatic fever with Arthritis are some of acute Arthritis. Rheumatoid Arthritis, Osteoarthritis, Ankylosing Arthritis, Psoriatic Arthritis, Tumorous Arthritis, Gout, are some Chronic Arthritis. Investigations : i) X-Ray to determine bone strength (ii) Blood Examination (a) Calcium, Phosphorous, Alkaline, Phosphatase - Bone strength and metabolic diseases. (b) Uric Acid - Gout (c) Rheumatoid Factor - Rheumatoid Arthritis (d) E.S.R. - To determine the severity of disease (e) Blood Sugar - Diabetic (f) Mantoux Test - TB (g) VDRL - Syphillis (iii) Aspiration of joint fluid and examination - Pus; Gout (iv) Arthroscopy - An endoscopic tube is inserted into the joints and the interior is visualised (v) Scan - To detect spinal lesions (vi) Hormone assay (a) Thyroid (b) Parathyroid (c) Oestrogen (d) Testosterone Treatment Treatment is the next point after the investigation. Specific treatment to treat the basic cause. e.g.: Antituberculous drugs for TB-joints. Exercises are recommended to increase mobility and to improve stability. Physiotherapy Equipments are also used. Simple analgesics and non-steroid anti-inflammatory drugs (NSAID's) are mostly used in Allopathic system. And also there are second and third line - drugs, such as Penicillamine, Chloroquine and Hydroxychloroquine etc. Paracetamol is used as a simple analgesic. The above mentioned drugs are prescribed only for three reasons. (1) To reduce pain, (2) To reduce stiffness and improve mobility, (3) To prevent chronic deformity by minimising the inflammation which results in synovial membrane proliferation and bone erosions. However, there are a lot of side effects in this treatment, unlike in homoeopathy. Homoeopathically, Belladonna and Nux vomica do the work of Aspirin without side effects, sulphur, Rhustox, Apismel, Arsonicum Alb and Phosphorous are the homeopathy medicines used in place of Procain-Penicillin without side effects. Depending on the basic cause of arthritis, there will be slight alteration in the dietary supplements. The basic diet for arthritis is a high protein, high calcium, high phosphorous and high vitamin diet. Protein is the basic building block of bone. Inadequate protein in diet will result in gross muscle mass loss and deformed joints. Calcium and Phosphorous are very essential in bone building. Increased calcium and Phosphorous after menopause delays the occurrence of arthritis. Calcium also prevents bone loss in Steroid Therapy. Zinc: Increased Zinc intake is effective in Rheumatoid Arthritis, as it reduces morning stiffness and swelling of joints. Iron: As there is very minor loss of blood due to drug treatment for Arthritis. Iron therapy correct it. Vitamins Vitamin C: The Vitamin C enhances the immune system and so it is effective in infective Rheumatoid and traumatic arthritis. Vitamin D: The main function of it is to enhance - Calcium absorption and deposition. Vitamin E: This vitamin is said to be a youth Vitamin. Enhancing the immune system and helping cell and proliferation are said to be the mode of action. Vitamin A and B Complex: These Vitamins enhance healing process and they also counteract the harmful effects of antiarthritic drugs. Fat: Reduction in dietary fat will result in weight reduction. This will indirectly help arthritis of the lower limbs and spine. Diet in low purine: Purine is a constituent of nucleoproteins from which Uric Acid is derived. Gout is thought to be associated with the disturbed metabolism and excretion of uric acid, and foods of high purine content are excluded in its treatment. - Dr. Y. M. Mansoom Homoeopathy and Unani Practitioner Tea and health For your information... The Tea Research Institute (TRI) has published a new book 'Tea and Health' for the benefit of tea drinkers. The book gives a good insight into how this popular beverage can bring beneficial effects on your health. We publish an edited version of a review of the book that has been sent to us. by W. W. D. Modder and A. M. T. Amarakoon An ancient Chinese legend proclaims that the New Stone Age Hero, Shennong, "meets 72 toxins everyday and counteracts them by tea." Today scientific research reveals that viral particles causing HIV are destroyed by epigallocatechin gallate present in tea. This book enables one to virtually watch myth being transformed into scientific evidence. People these days are generally aware of the 'free radicals' generated in our bodies, and of the 'antioxidants', many of them in food, that can prevent free radicals from causing degenerative and progressive pathologies, associated with modern stress and environmental pollution. Your daily tea, whether black, green or other, hot or iced, provided it comes from the "true" tea species, Camellia sinensis, contains the magic bullet for health and well-being: a class of polyphenols called the flavonoids, said to be the most effective antioxidants found in nature. The book contains 17 chapters which takes the reader through the historical use of tea as medicine; the latest research into tea as a 'nutraceutical,' and the research methodologies used; the chemicals in the tea shoots and the tea brew, and their dietary value; the bioavailability and metabolism of tea polyphenols; the antioxidant systems in the human body which protect it from free radicals; the antioxidants in tea that are active against ageing, cardiovascular diseases, diabetes, and cancers; tea components that inhibit infective micro-organisms and inflammation, and boost the immune response; and the action of tea in strengthening teeth and preventing caries, plaque, and the risk of oral cancer and infections. The questions of tea being possibly implicated in iron-deficiency, in
the formation of kidney, bladder and gall stones, and in boosting caffeine
levels, are also discussed rationally and without bias. Medical happenings The Respiratory Disease Study Group will hold a Symposium on varied Facets of Bronchial Asthma from 7.30 a.m. to 5.00 p.m. today at the Hotel Hilton. 22 specialist speakers will make presentations. There will be plenary lectures, interactive sessions, a poster display and an exhibition. Doctors are requested to telephone 695418, 05522483 for further particulars. Presentations will be on the following subjects: Current scenario in asthma - Dr. Kirthi Gunasekara Inflammatory mechanisms and airway remodelling - Dr. Manela Joseph Natural history and clinical spectrum - Dr. A. T. Munasinghe Allergens, immunology and immunotherapy - Dr. Anura Weerasinghe Recent developments in occupational asthma - Ms K. N. Lankatilaka Clinical studies in asthma - Dr. Rajitha Wickremasinghe Diagnostic dilemmas in asthma - Dr. Chandana Amarasinghe The difficult asthmatic - Dr. J. H. L. Cooray Acute severe asthma - Dr. Shyam Fernando Ventilatory strategies in asthma - Dr. Vajira Tennekoon Conventional pharmacotherapy - Dr. Bandu Gunasena Inhaled corticosteroids - Dr. B. J. C. Perera Interactive sessions: Asthma in general practice - Dr. Seneth Samaranayake, Dr. B. J. C. Perera, Dr. Chandana Amarasinghe Inhaler device - Dr. Shyam Fernando, Dr. Wijitha Senaratne, Dr. Senaka Gunatilleke Management of the wheezy child in the community - Dr. Shanthimali de Silva, Dr. Sarath Paranavithane, Dr. Amitha Fernando Asthma in pregnancy - Dr. Anoma Siribaddena, Dr. Dushantha Madegedera, Dr. Athula Kaluarachchi Patient education and self management - Dr. Kirthi Gunasekara, Dr. Preethi Wijegoonewardena, Dr. Saman Kularatna Colloquium on management Dr. Wijitha Senaratne, Dr. B. J. C. Perera,
Dr. Anoma Siribaddena You & Our Doctor Pregnancy and folic acid Q: Pregnant women are given Folic Acid tablets at the early days of pregnancy period. Why is this vitamin so necessary? - A mother to be A: Folic Acid is one of the most essential vitamins required for proper development of the brain and spinal cord of the foetus. Lack of this vitamin in the mother's diet may lead to disorders in the brain and spinal cord tissues of the foetus. Folic Acid is a member of the B group vitamins. It is found in many green vegetables. But during pregnancy demand of the foetus and mother is high. Folic Acid is also necessary to the formation of good quality blood. It is advisable to start Folic Acid tablets even 1-2 months before conceiving. Crying baby Q: I am a 22-year-old mother. My baby is three months old. My problem is that my baby, cries most of the time, specially in the evenings. He screams at times. No child specialist could detect a cause, but they advised me to feed him more. Now I feed him very often, but he still continues to cry. I'm now worried and afraid. I was told by a relative that the reason could have been due to the "Heaty Food" that I have taken during my pregnancy. Please tell me how I could overcome this problem. - A worried mother A: Persistent crying can be very worrying especially to a 'first-time mum' like yourself. Do not blame yourself for your crying baby. Heaty food has nothing to do with his crying. Since your child specialists have examined him and ruled out any serious illness, please calm down and get rid of your own tensions. Remember, your baby can pick up your anxieties. Crying is the only way in which a baby can communicate his needs. Every baby has his own distinctive cry for his different needs, which could only be understood by the mother. For a new mother it takes some time to get tuned to her baby's cry and say whether he is hungry, uncomfortable, in pain or just feeling lonely. How do you know your baby is hungry? If your baby cries within two hours of a good feed, hunger is unlikely. Is it due to 'Wind?' Bubbles of gas in the stomach may cause discomfort. Then check your nipples; if the child is bottle feed, check the size of the hole in the teat of your feeding bottle. If the hole is small, your baby has to suck harder to get sufficient milk out. Equally, if it is too big, milk may be pouring into the mouth in a large quantity and the baby will gulp more air, as well, in order to breath. This may be noted at the beginning of the breast feeding too. If so you may press a little milk before start feeding. Is he wet or dirty? It is worth checking your baby's nappy. Is he lonely? Having come out after completely secure environment in the womb, some babies do not like to stay all alone in a cot. Wrap your baby in a blanket, rather than leaving him lying free under the covers. Baby needs a companion all the time. It is better for yourself to pick up your crying baby than handing him over to someone else. Baby's room environment may be too warm or too cold? Adjust it accordingly. Flies, mosquitoes, bed bugs and other insects are also culprits. - DR. SAMPATH NANAYAKKARA |
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