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| Sunday, 17 October 2004 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Thyroid disorder: Women at greater risk by Dr. Sampath R. Nanayakkara
The thyroid gland is situated in the front side of your neck. This tiny gland, if it does not function properly can change one's physical appearance drastically. The thyroid gland is of very great importance for the effective functioning of the body, since it produces a vital Hormone called Thyroxin, regulatory influence of which is essential to many chemical processes upon which life depends. Swelling of the gland is called A Goitre a serious disfigurement of one's appearance. Apart from the adverse health effects. Over activity of the gland is known as Thyrotoxicosis. The underactivity is called Myxoedema in adults. In new born babies Cretinism if not detected early can give rise to Mental Retardation. Women are eight times more likely to suffer from thyroid defects than men. Approximately one woman in ten is likely to develop a thyroid disorder at anytime of her life. As many as 17 per cent of women have an underactive thyroid after the age of 60. About 10 per cent of women can develop Thyroid problem after giving birth. Detecting a thyroid A simple self-help examination by you can determine whether you have a Goitre. What you need is a glass of water and a mirror. 1. Hold the mirror focused on your neck below the 'Adams Apple.' 2. Take some water into your mouth, do not swallow yet. 3. While not allowing the mirror to go out of focus, tilt your head back and swallow the water. 4. As you swallow, observe your neck in the mirror for any bulge. 5. If you see any bulge it may be an enlarged thyroid you had better see your family doctor for confirmation. Most of the symptoms of Hypothyroidism are disguised as symptoms of Stress, Ageing, Depressive Disorder and Menstrual problems. Symptoms Some of the symptoms are: Inappropriate weight gain; Abnormal menstruations; Muscle or Joint pain; Reduced sex drive; Dry hair or loss of hair; Tiredness; Dry Flaky Skin; Brittle Nails; Anaemia; Constipation; Feeling of Fullness in the neck when swallowing. Swelling and puffiness of eyes, face, arms and legs. Early detection and treatment make a world of difference. A simple blood test can detect even a mild form. Hypothyroidism can be safely and inexpensively treated by tablets to prevent the onset of symptoms by detecting it in its early stages. Since women are especially at risk, I strongly advise a Thyroid check to prevent later complications. Save your breast from cancer
Breast Cancer occurs in one out of eight women in Sri Lanka. It is the commonest form of cancer in the country. Dr. Shayama Fernando, Senior Medical officer, Ceylinco Cancer Detection Centre speaks to Carol Aloysius about how the disease is caused and how it can be detected before it is too late. Q: The incidence of Breast Cancer is on the increase both in Sri Lanka and in many other countries. Why ? A: For several reasons. Actually the causes of breast cancer are multi-factorial and one can't pin point one single cause. Causes could range from genetic, (if there is a family history of Breast Cancer or a personal history of Breast Cancer or benign breast disease) to environment and diet to smoking and lifestyle. Another cause could be taking hormones (HRT) or contraceptive pills over a long period of time. Q: Who else falls into the high risk group of women likely to get breast cancer ? A: Other factors that increase risk are; women who have had early onset of menarche (before the age of 12 years); those who have had late menopause (after the age of 55 years); those who have never had a pregnancy, or those who have given birth after the age of thirty years. Q: What are the common symptoms one must look for in Breast Cancer ? A: The most significant sign is a lump or thickening of the breast. Q: Are all lumps in the breast cancerous ? A: No, In fact eight out of ten lumps are no cancerous and could be just glands or innocent lumps. Q: What other signs should we look for ? A: A change in the texture of the breast skin (dimpling or puckering; discharge from the nipples or if the nipple is pushed in (inverted) Q: Can Breast Cancer occur at any age ? A: It can occur at any age, but it is more common in women over fifty years of age. Q: Is it possible to detect these symptoms by a self examination procedure ? A: Yes. Q: How ? A: Stand in front of a mirror and see if you can detect any changes in the shape of either of your breast. Or, while standing or lying down feel each breast with your fingers to check for any thickening lump in any of the breasts. You can also squeeze the nipple to check for any bleeding or discharge. Q: How often should they do this and when ? A: This is best done five to six days after the period and on a monthly basis. Q: If Breast Cancer is not visible to the eye or cannot be felt is there any other way of detecting it ? A: Yes. For women over forty years we recommend a mammogram which is a special X'ray picture of the breast which provide a clear image of the inner structure of the breast. It can detect a Breast Cancer that is too small for you or your doctor to feel. Q: Is it safe to do a mammogram ? Does it involve a lot of time ? How do you prepare yourself for a mammogram ? A: Firstly, don't apply deodorant or talcum powder on your armpits or chest area on the day of the mammogram because this might make x-ray reading difficult. During a mammogram you stand in front of an x'ray machine and the person who takes the x'ray places one of your breasts between the two plates. The plates press your breast and make it flat. This may be slightly uncomfortable but it helps get a clear picture. A mammogram takes only a few minutes. Q: Is it a safe method ? A: It is a safe and painless procedure, which should be repeated annually for anyone over forty years. Q: What happens if a cancer is detected ? A: Then further testing will have to be done and if necessary a biopsy of the lump will be required. Q: How is this done ? A: The least invasive technique, is called the stereo tactic biopsy. This is used for the mammographically detected abnormality which can't be detected by the visible eye or by palpation. For this you don't require hospitalisation, no anaesthesia and no operation scars. Q: How can early detection help Breast Cancer patients ? A: The earlier a Breast Cancer is detected, the easier it is to treat, Ninety six percent of Breast Cancer is curable if detected early. A 'driving' guide to heart patients by Dr. D.P. Atukorale It is not advisable for heart patients to drive if they: (a) have had a heart attack within the last 2 months; (b) have angina frequently while driving; (c) take drugs that cause vertigo (sensations that the body or the world is spinning), fainting, loss of consciousness, lack of alertness or rapid onset of tiredness; (d) have unexplained periods of syncope (temporary loss of consciousness caused by lack of blood flow to the brain); (e) have untreated heart block (impaired conduction of electrical current through the heart) Most people with diseases of the heart valves or with artificial valves are able to continue driving though not, of course, if they experience fits of disabling giddiness or fainting. People with artificial pacemakers (pacesetters) are allowed to drive provided that their underlying heart condition is not dangerous; and that the working of the pacemaker is regularly checked (at least once in 6 months). Driving may be resumed one month after successful implantation of the device. Patients who have had successful coronary artery bypass surgery (CABG) may return to driving once they have recovered from the operation and it is always advisable for CABG patients to ask their heart surgeons regarding advice about fitness for driving when they come for follow-up to the cardiac surgeon. Heavy Vehicle Driving Regulations are more strict and considerably more complicated when driving involves heavy goods, passenger transport and public service vehicles (including taxis and three-wheelers). Generally speaking goods and passenger vehicles should not be driven by anyone who has (a) any form of angina; (b) evidence in the ECG of lasting damage form a heart attack; (c) had more than one heart attack; (d) dangerous narrowing of vital sections of major coronary arteries (revealed by coronary angiography); (e) a pacemaker; (f) significantly enlarged heart (cardiomegaly) confirmed by chest x-ray and 2D - Echo and (g) seriously raised blood pressure For people who drive professionally, yearly medical examinations may be advisable to confirm continued fitness to drive. Professional drivers who have had angioplasty (PTCA) or coronary artery bypass surgery (CABG) will need to have regular check-ups using exercise ECG (stress testing) 2D-Echo and if necessary coronary angiography to confirm that there is adequate supply of blood to the heart muscle. As a rough guide, driving may be permitted if yearly checks reveal no symptoms, no ECG signs of inadequate supply of blood supply on exercise testing, no recent heart attack, good pumping performance by the left ventricle (main pumping chamber of the heart) as revealed by a 2D - Echo, and coronary artery grafts that show no signs of becoming blocked by atheromatous plaques. Rice ORS reduces diarrhoea significantly - study How often have we heard our mothers or grandmothers advising us as to the merits and demerits of certain foods and the times they should and should not be consumed ? Powdered foods are 'heaty'; buffalo curd should not be eaten at night: pineapple is taboo to the pregnant mother: tuna fish, prawns and lobsters are anathema to those with skin problems. This list is endless. But although we tend to scoff at what we consider old wives tales, most of these have an underlying scientific backing although this is not often recognised. Going back to childhood, one of the first foods an infant is fed in Sri Lanka is rice cunjee. As an extension to this, during childhood diarrhoea, most children in rural Sri Lanka are given a thin gruel made of roasted rice. Diarrhoeal diseases are very common in developing countries and many children die as a result of dehydration. Fluid replacement is therefore essential to prevent dehydration. Cunjee is actually the water-soluble portion of rice that is extracted by heating rice in water. This solution provides the electrolytes and fluids that we lose through vomiting and diarrhoea and maintains the blood-glucose balance in the body by slowly releasing glucose from starch. Oral rehydration powder Jeewani is used as the panacea for any dehydration problem. What exactly is Jeewani ? It is essentially a formulation based on glucose powder with a mixture of a mineral salts in the WHO recommended proportions. When mixed with water, it provides the energy giving glucose along with the rehydration action, to the patient. Comparing this with rice cunjee, rice is broken down into more digestible dextrins during roasting and acts as a store of nutrients releasing glucose to the intestine. Thus fundamentally it has the same effect as Jeewani. This brings our attention back to that all important and often undervalued commodity, rice. Although rice is our staple diet, many factors prevent it being consumed in the way our forefathers did, price being a significant one. However the nutritional values of the different varieties of rice do not show much variation and has around 75 per cent of Starch (Carbohydrates), 7-9 per cent Protein and 0.5-1 per cent Fat. Rice starch is highly digestible compared to all other foods rich in carbohydrates. The digestibility of rice starch is said to be 98-100 per cent and is classified among the "Most digestible starches' by scientists. Because of this fact, rice is included in many "Baby foods" in the form of rice flour. We in Sri Lanka are very familiar with many rice flour based products like, String hoppers, Hoppers, Pittu. Traditionally and our breakfast table always had either one of these. This selection by our forefathers could be due to the fact that Rice starch is easily digestible and once converted to rice flour, the starch granules are broken and made available even more easily thus releasing the much needed glucose for all our activities. Rice flour based products are therefore ideal as they are quick releasers of much needed energy. Using this knowledge, the Agro and Food Technology division of ITI has developed a rice based oral rehydration salt (RBORS) which is soluble in water and available in ready to use form like Jeewani. Studies in other countries have shown that this rice based oral rehydration salt is advantageous over the glucose based products, since it reduces the duration of diarrhoea by thirty per cent with significant reduction in stool volume. In countries like Bangladesh where diarrhoea is very common among children, rice powder is dissolved in water boiled and given to children with the electrolytes added. The RBORS developed by ITI has used amylase enzyme to digest rice starch and it is substituted with the required electrolytes like sodium citrate, potassium chloride and sodium bicarbonate. The acceptability of this product compares well with Jeewani, and plans are now ahead to carry out clinical trials. The moral of this discourse perhaps, is that rather than dismissing what is considered to be old fashioned practices and mere folklore, more scientific research into these could yield very interesting results which could have a positive outcome. - ITI Bulletin |
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