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| Sunday, 13 June 2004 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Gift of life Safe blood saves lives. Hence every hospital in Sri Lanka should have a regular and safe supply of this life giving elixir. But this can only be achieved through a significant increase in the number voluntary donors says Champa Manchanayaka, Senior Medical officer in charge of the blood donor section of the National Blood Transfusion Bank. She was interviewed by Carol Aloysius following a seminar organised by the Health Education Bureau last week. Q: Which category of patients benefit most from blood donations? A: Children and mothers with anaemia, women with birth complications, haemophilic patients, dengue patients, cancer patients and patients with trauma. Q: For how long can blood be stored? A: Only for a limited period. This is another reason why we need a regular in-flow of blood to our banks. Q: What are the procedures involved in donating blood? A: You will undergo a rigorous screening check to make sure your blood is safe for the person who receives it. You will be asked about your medical history, current health and life style, and whether you are living in a malaria prone area. Any personal information you give is strictly confidential. It is important that you answer these questions truthfully as you can infect the person to whom it is donated. Q: How much blood will be taken? A: In most countries the volume of blood taken is 450 millilitres-less than 10 per cent of your total blood volume (the average adult has 4.5 to 5 litres of blood). Your body will replace the lost fluid within about 36 hours. Q: Is it safe? A: Yes. You will only be accepted as a blood donor if you are fit and well. The donor should also be between the age of 18 to 55 years and the body weight should be 50 kgs for both men and women. Q: What are the most common blood groups? A: Broadly speaking there are four groups - A, B, AB and O as well as RH negative and RH positive. There are also a few exceptions such as Bombay 0 which is quite rare (we have found only six to eight patients in Sri Lanka( so far), and about 300 minor blood groups. In Sri Lanka 45 per cent belong to the 0 group, 26 per cent to the B group, 22 per cent to the A group, 5 per cent to the AB group. Q: Once the blood has been collected, what is the next step? A: To separate the components; White cells (for cancer patients) Red cells (that detect anaemic patients), Plasma which detects those with haemophilia and Platelet that can detect dengue patients. Q: How are these products stored? A: We freeze them in special freezers. But their life span varies. Red cells can be stored for 35 days, plasma for one year and platelet for five days. White cells have the shortest life span of one day. Hence the latter two are very much in demand. Q: How often can you give blood? A: Healthy adults can give blood regularly in every three months and women can donate blood in every four months. Q: When should you not give blood? A: If you feel unwell, or you are anaemic or pregnant, or have certain medical conditions such as heart disease, high blood pressure or diabetes. Or else if you are taking antibiotics. Q: How many blood banks are there to receive blood ? A: We have 62 hospital based blood banks islandwide as well as the National Blood Transfusion Centre at Narahenpita. Q: Is the blood donated on a voluntary basis or do you also accept paid donations? A: Paid blood donations is prohibited in Sri Lanka. Unfortunately some people try to break this law by giving wrong information to us e.g. by paying a donee to get blood to save a relative and telling us that the blood was given voluntarily. This is a dangerous practice which must be stopped. We also have replacement donors, usually relatives of a sick patient in need of blood urgently in a hospital. Q: What is the safest blood?. A: Blood collected from voluntary donors. Q: How much of the blood collected in your banks comes from voluntary donations? A: In Colombo 82 per cent of the blood is by volunteers. We collect blood at their request via our mobile blood collecting banks. In the outstations voluntary donations of blood is still very low, only 29 per cent. Q: Why? A: Because of a lack of awareness and misinformation. Many people think they have to come all the way to Colombo to donate blood whereas we have hospital based blood banks islandwide. Q: What kind of persons can donate infected blood? A: Those who have recently contracted a sexually transmitted disease such as HIV or syphilis that can be passed on to a patient via the blood; Or, if you lead a risky life style i.e. have more than one sexual partner or have sexual contact with prostitutes; or else you have recently injected drugs, had a tattoo, or ear or body piercing. Q: World Blood Donor Day is being celebrated on June 14. What plans does the NBTS have to mark this important event? A: On June 14, we hope to have a 'Walk for Life' at Independence Square in which people from all walks of life and professions including patients will be involved. On the following day there will be a felicitation ceremony to reward those who have been very active in the field of blood donations. Q: Is there a special message you would like to give to our readers? A: We need much more volunteers to donate their blood. This is the only way that our blood banks can be safe and regular supply of blood. Q: And what is your future vision? A: Develop a National Blood policy and have a blood bank with hundred per cent voluntary blood donations. Q: Is there a hot line to National Blood Transfusion Services? A: If you want to donate your blood voluntarily just drop in at our bank at Narahenpita. Or call us on 0777-272985 and we will come to you. **************** When your stools turn watery ... Diarrhoea can be described as the passage of three or more loose or watery stools within a period of 24 hours. this definition will not apply to newborn babies who may have 8 to 10 watery stools as a normal occurrence.
Diarrhoea in children may be acute or chronic. When the abnormal stools last for less than 2 weeks the diarrhoea is said to be acute, and when the durations is over 2 weeks it is referred to as chronic or persistent diarrhoea. Acute diarrhoea is also referred to as acute gastro-enteritis (Gastro refers to stomach, and enteritis means an inflammation of the intestine). Gastro-enteritis, though often due to an infection, may also be due to non-infectious causes. The commonest type of diarrhoea is where the child passes copious amounts of watery stools. This is most often due to an infection of the small intestine caused by viruses or bacteria. In children under 2 years of age, about 50 percent of the watery diarrhoeas is caused by viruses. When the diarrhoea is predominantly associated with frequent small stools with blood and mucus, it is the large intestine that is the site of infection, and the condition is known as dysentery. Dysentery is most often caused by bacteria called Shigella, and rarely by Amoebae and other infective agents. Once this organism enters the gastrointestinal tract through the mouth, it damages the inner lining of the large bowel, causing extensive ulcers. This leads to bloody diarrhoea and usually severe abdominal pain, Shigella dysentary, unlike watery diarrhoea carries a high death rate due to complications in the blood and kidneys, children with blood and mucus need to be hospitalised, treated with antibiotics and closely watched for complications. Infecting organisms (usually viruses and bacteria) get into the intestine as follows: . contaminated food (whether solids or fluids) - milk, unboiled water, etc. . unwashed fingers, unclean nipples of the mother, unclean bottles and teats (in bottle feeding), unclean clothes, through flies, picking up and putting in the mouth food, fruits, toys etc, from the floor or garden. Why is diarrhoea dangerous ? Water constitutes about 70 per cent of a baby's body. Vitally important substances called salts are dissolved in this water. During watery diarrhoea there is an excessive loss of water and salts from the small intestine. This is due to a process called secretion (caused by the germs) whereby excessive amounts of water and salts are transferred from the body to the cavity of the small intestine. These secretions go down the intestines and pass out as watery stools. This causes dehydration (loss of water and salts) and eventually death if no action is taken, in the same way as a plant will shrivel up and die if not watered. Dehydration can be made worse by vomiting, which is often associated with diarrhoea. Dehydration occurs faster in infants and young children than in older persons. Diarrhoea becomes a serious illness in a child who is undernourished. existing undernutrition is aggravated when: . The body loses nutrients. the child is usually not hungry and refuses feeds. It is very necessary that foods are given during diarrhoea as soon as the child will eat, and after that an extra meal for a few days to catch up the lost weight. Dehydration The first symptom of dehydration is thirst. Thirst may manifest itself as excessive crying, irritability and fretfulness. In addition to thirst (or its manifestations), other features of dehydration include: reduction in urine output, dryness of mouth and tongue, sunken eyes, and reduction of tears on crying. Dehydration may be mild, moderate or severe. If thirst is the only symptom, it is reckoned to be mild; if any of the additional symptoms mentioned above are present, it is moderate. In severe dehydration, they will become drowsy and have a rapid and feeble pulse, low blood pressure, cold and moist extremities, total absence of urine, and rapid and deep breathing. If not treated vigorously at this stage, they will go into a coma and die. Prevention Dehydration is prevented by the use of home based fluids. As soon as the child starts watery stools or vomiting, fluids such as rice cungee (preferably roasted rice cungee), young coconut water (king coconut water has a similar composition), fruit drinks etc., should be given to replace the continuing losses of fluid. When the child has mild or moderate dehydration a calculated amount of oral rehydration fluid (ORF) is given over a period of 4 hours to correct the dehydration. . If severely dehydrated the child should be rapidly rehydrated at a hospital using intravenous fluids. . 90 to 95percent of children with acute watery diarrhoeas can be treated with either home based fluids or ORF alone. . In the management of dehydration using ORF (Jeevani), the proper reconstitution of the packets of salts is extremely important. It should be reiterated that for each packet, 1 litre of drinking water is added; once reconstituted, it can be kept only for 24 hours. If less water is added to the packet the sodium and glucose concentration of the fluid will be too high, exposing the child to the risk of fits. If more than 1 litre of water is added, the fluid will be too diluted and would fail to correct the salt losses. No other substances such as sugar, fruit juices, or flavours should be added to the fluid. If the child develops a puffiness below the eyes, it means that too much of ORF has been given - this is an indication to stop it. Breast feeding of infants is one of the most effective ways of preventing a diarrhoea. From 'Your Child Your Family'by Dr. H.A. Aponso et al **************** From a reader... : The 'Don'ts' after a meal smoke. Experiments by experts prove that smoking a cigarette after a meal is comparable to smoking 10 cigarettes (chances of cancer higher). Eat fruit immediately. It will cause stomach to be bloated with air. Therefore take fruit 1-2 hours after meals or 1 hour before a meal. Drink tea after a meal because tea leaves contains a high content of acid. This substance will cause the protein content in the food we consume to harden and difficult to digest. Loosen your belt after a meal. It will only cause the intestine to be twisted and blocked. Bathe. Bathing will cause the increase of blood flow to the hands, legs and body thus the amount of blood around the stomach will therefore decrease. This will weaken the digestive system in our stomach. walk about. People always say, after a meal if you walk a hundred steps you will live 99 years. But the truth is walking prevents the digestive system from absorbing the nutrition from the food we take. Sleep immediately. The food we take will not be digested properly. Thus will lead to gastric and infection in our intestines. Sent by Shirantha de Alwis **************** A medical check - who needs it? If you are above 35. If you are overworked. If you have a family history of heart attack, diabetes, hypertension etc. If you lack exercise. If you drink or smoke. If you feel tired at the end of the day. If you sweat excessively. If you pass urine very frequently. If you feel breathless when you climb stairs. If the answer is 'yes' a health check is mandatory for you. |
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If the loose stools contain blood and mucus, the diarrhoea is called
Dysentery. Diarrhoea may be associated with other symptoms such as
vomiting, fever,or abdominal pain.
