|
|
|
  |
| Sunday, 1 May 2005 |
 |
|
 |
Features |  |
| News Business Features Editorial
|
Compiled by Shanika Sriyannanda When the sense of smell goes awry by D. R. W. Ratnayake, Consultant ENT Surgeon It is common for most people to notice changes in their sense of smell at some stage in their lives. While some people ignore such symptoms others would get very upset over this. How does one smell? When we breathe in, the inspired air circulates inside the nose before proceeding into the throat, windpipe and the lungs.
Loss of smell Any obstruction to the flow of inspired air reaching the smell sensitive area at the top of the nose, any damage to this area and the olfactory nerve either due to infection or injury can cause either a decrease or a complete loss of the sensation of smell. This is commonly seen in catarrh (allergic rhinitis) where the lining tissue inside the nose swells up causing obstruction to the circulation of air inside the nose. This situation worsens when catarrh is complicated by the formation of polyps, which are grape-like protrusion inside the nose. Those suffering from catarrh may also experience excessive sneezing, nose blocking and watery discharge from the nose. This loss of smell often improves with treatment but occasionally may not improve satisfactorily. Total loss of sense of smell is sometimes seen following head injuries. Severe head injuries can damage the nerve or its branches that conduct the 'smell message' to the brain. Unfortunately, this condition rarely improves, whatever the treatment given. Also, brain tumour may press on the nerve, or a vial infection may damage the nerve causing loss of smell. Sense of smell is vital for appreciation of taste especially flavours. Therefore those with loss of smell may have problems with taste. Another disadvantage is the inability to detect gas leaks and things burning inside the house. 'Bad' smells Unpleasant smells are often noticed by patients having infections in the nose and sinuses. In these conditions, the patient may also feel recurring headaches, nose blocking and a bad taste in the mouth due to dripping of infected phlegm into the throat from the back of the nose. A bad smell emanating from a child's nose is often due to a 'foreign body' (i.e., something the child has inserted into the nose, but had gone undetected). Occasionally, a bad smell could be from a tumour inside the nose like a cancer, which fortunately is not common in our country. Abnormal smells Abnormal smells are felt sometimes by those suffering from neurological disorders. Some epileptics notice abnormal smells before the onset of a fit. Certain drugs taken by a patient can also give abnormal smells. Psychological diseases also can cause a sensation of abnormal smell. The abnormality is in the imagination and not real. The patients assume that there is a smell, felt by others. This obsession can become so severe, that they would shun meeting people. When confronted with such a problem, the doctor will have to investigate thoroughly to exclude other causes mentioned above before labelling as psychological. Smell felt only by others In the condition called atrophic rhinitis, the lining inside the nose decays causing collection of phlegm produced in the nose to dry up resulting in thick greenish pieces which cause a smell. When the disease progresses, it destroys the smell sensitive area and the patient develops loss of smell, after which only outsiders will notice the smell. Unfortunately, there is no cure for this embarrassing condition, and whatever treatment available now can only minimise the bad smell, fortunately, this condition is rare. Stroke unit re-opened The Stroke Unit at the Colombo National Hospital (CNH), which was closed down for the last eight years, was re-opened on April 28. Stroke is the 3rd leading cause of hospitalised deaths in the country and according to Dr. Padma S. Gunaratne, Consultant Neurologist and the Head of the Stroke Unit, many deaths could be avoided through proper medication and timely treatment. According to hospital sources, the Stroke Centre will be the first of its kind. Dr. Gunaratne said that the rehabilitation of stroke patients was best done by a team of multidisciplinary professionals working in the stroke unit. " In our unit there are consultant doctors, nurses, physiotherapist, speech therapist, occupational therapist and social workers", she added. The picture shows Director General of Health Services Dr. Athula Kahandaliyanage admitting the first patient to the newly refurbished stroke unit opened at the National Hospital, Colombo last week. Hospital's Director Dr. Hector Weerasinghe and Consultant Neurologist in charge of the unit Dr. (Mrs.) Padma Gunaratne are also in the picture. (Picture by Roland Perera) All you need to know about acne (Continued from last week) How do you manage acne: Managing of acne depends on your age, sex, type of acne and its severity. General measures: Diet: as I have mentioned earlier eat anything in moderate amounts is the best advise one can give. Skin care: Patients should cleanse their acne skin areas twice daily with a medicated anti-acne soap. Avoid rough clothes and other scrubbing materials. Acne patients should cleanse their skin gently. Moisturizers can be useful for people with dry skin. In addition acne patients should use non-comedogenic skin care products and cosmetics. In general: lotions and oil based products are more comedogenic than gel based products. Treatment methods: * Topical therapy * Oral therapy * Physical methods Topical therapy: A wide variety of topical creams are available in the market. Some of them do not even mention the ingredients in it. The choice of therapy depends on your acne grade and several other factors. So it is very important that you consult your doctor prior to starting treatment. Some of the widely recommended and scientifically proven anti acne creams are available in the market. Topical Retinoids: This is a very effective treatment for acne. It has an antimicrobial, anti inflammatory as well as anti-comedonal effect. It also reduces scarring. It is available as retinoic acid, Isotretinoin and adapalene. As these have several side effects it is very important that you be under a doctor's supervision during treatment. Especially retinoid drugs should not be used during pregnancy and lactation. Oral therapy: When you are unable to control with topical therapy or for moderate to severe acne, oral therapy is given. 1. Antibiotics 2. Hormonal treatment. Anti-androgenic hormones are used. Can also be used as a contraceptive method. Should not be used in males. 3. Oral Isotretinoin This is the most effective anti-acne therapy. But unfortunately because of it's high cost and side effects, isotretinoin is not widely used in Sri Lanka. It should be used with caution in women of child bearing age as it may lead to the birth of deformed babies. 4. Other therapies like dapsone, zinc, vitamin A are occasionally used. Physical modalities: are used as an adjuvant to topical and oral treatment. Comedones extraction is one such method. As this procedure is painful, it should be done by a skilful person. Although hot compresses help to remove comedones, facial saunas and heat can worsen acne. Cryotherapy with liquid nitrogen as well as intralesional steroids can be used for nodular lesions and keloids. Dermabrasion is useful for scars but it has it's own side effects. Whatever, the treatment used, as acne is a chronic disease, the treatment should be long term. Even after you are free of acne sometimes maintenance treatment may be needed until you pass the age you are prone to get acne. Patient advice: As acne is a chronic disease patience is important. Because the tendency to get acne persists for sometime. And you should continue treatment as long as your doctor tells you. It is important for you to realise that even if you have mild acne it will persist for about five years and if you have severe acne it could be more than 10 years. With standard therapy little improvement is seen after one month. Sometimes acne can get worse initially even with treatment. So you should realise this and continue to follow your doctor's advice and the treatment given. Finally if you have acne don't just apply anything and everything you get hold of. It's a common disease which can be cured. So hurry up and get your doctor's advice. - Dr. (Mrs.) Sharnika Abeyakirthi, Senior Registrar, Dermatology Unit, National Hospital of Sri Lanka. Pregnant with twins With Dr. Hemantha Dodampahala, Consultant Gynaecologist and Obstetrician, De Soyza Maternity Hospital 'To have twins' is the dream of most young mothers today. And it is also becoming very common. Latest scientific data shows that one in 80 pregnancies would end up in twin pregnancies. Geographic variations too show an increase in twin occurrences. And having twins is a very interesting and joyful thing in a woman's life. But women pregnant with twins have to take extra care as twin occurrences carry the risk of high mortality and morbidity and high pre-natal mortality. Twins belong to two category - the 'monozygotic' which happens due to early division of the embryo where the outcome is the identical twins of same sex and complex. This is a rare twin occurrence. The second type is 'dyzytic' where two different embryos form due to the release of two eggs. These twins are of different sexes but looks alike. This is a common occurrence. Congenital twinning belong to the 'monozygotic' variety. This is due to late splitting of the embryo. Early splitting will lead to total independent twins with different sexes and intermediate division may result in two babies living in the same sac. It is called 'monochrinomic' twining. They may be joined from their heads, chests or backs. Their division depend on the body part where they are joined. If their bones and tissues are joined division is easy but if they are joined from the brain, heart or other major organs the division is complicated. Whether it is normal twins or congenital twins lots of problems are associated with conception to child bearing. These occurrences are rare and if you are going to deliver twins you should not worry as it is going to be a wonderful experience in your life. However, pre-term labour in this rare occurrence is three to four times higher than the common pregnancy. Pregnant women run the risk of getting high blood pressure, diabetic, anaemia, varicose, piles, constipation, gastritis and excessive vomiting. They may have higher risk of mis-carriages. Caesarean section delivery is most possible and those who expect twins should always go to a recognise hospital for delivery. Holistic healing : Fundamentals in Ayurveda The root cause by Dr. Danister L. Perera All causative factors of disease internal or external directly or indirectly create an imbalance (increase or decrease) in these doshas first and only then do the symptoms of the disease manifest. The causative factors can be the food, life style or other activities. All these factors are affecting one, two or all the three doshas. So, if you want to stay healthy, you must know what are the factors which create an imbalance of doshas. As said, earlier these factors could be your diet, life style or daily activities. You will soon discover that the majority of foods we intake and the activities we practise in the modern world are increasing one or more doshas. Diagnosis according to Ayurveda is to find out the root cause of a disease. It is not always necessary that the root cause be inside the body. Many times the cause may be outside the body. There may be a problem in the family relations or sometimes a problem at your work place. To give permanent relief, the root cause has to be removed. When we cure some disease according to Ayurveda, we do not just treat the physical symptoms. The person is treated as a whole. Different kinds of examinations are made to find out the root cause of a disease. One of them is pulse examination. By checking the pulse, the Ayurvedic physician finds out the position of three doshas. So, once you know which dosha is aggravated or out of balance, it is easy to bring it under control by using different kinds of therapies. The mental situation, family relations and other outside factors are thoroughly examined. Many times the root cause of a disease may not be physical but the symptoms might be so because you are being unhealthy in your mind. Thus we can relate every aspect of our life with these three doshas. If we have proper knowledge, we can maintain a balance of these three doshas and avoid many serious problems and can thus stay healthy. The treatment according to Ayurveda is to balance the three dosha. While making a diagnosis the Ayurvedic physician finds out which dosha is out of balance and try to balance it by prescribing some natural medicines, diet and life style. Regulate some of your activities, control your diet and in a few weeks you can see the change. Treatment means removing the root cause. Ayurvedic treatment does not mean suppressing the main symptoms and creating some new ones as side effects of the main treatment. It is to remove the root cause and give permanent relief. The treatment mainly comprises powders, tablets, decoctions and medicated oils prepared from natural herbs, plants and minerals. Because the medicines are from natural sources and not synthetic, they are accepted and assimilated in the body without creating any side effects and on the other hand, there may be some side benefits. Along with medicine, a proper diet and life style is also advised. This is equally important. If we are taking medicine to remove the root cause and at the same time we are taking some food or following a life style which increases the cause of disease, then we may not get well or will be getting less relief. Pancha karma therapy is also used as a treatment in many diseases. Thus we find that the methods of diagnosis and treatment are based on simple and natural principles. To conclude we can say that, Ayurveda teaches a very systematic and scientific way of life which is important to pursue both materially and spiritually. Fundamental principles, health rules, knowledge of individual Constitution of our body, use of various herbs, minerals and specially Pancha Karma therapy can be very safely used by one and all, all over the world to, promote good health, prevent diseases and acquire longevity. This is definitely not going to make you an Ayurvedic physician. But if you are a beauty culturists who tries to utilise Ayurveda in your personal as well as professional life, you will be able to understand the fundamentals of Ayurveda and their application on your day to day life. We will discuss these things in detail gradually.
|
|
| News | Business | Features
| Editorial | Security
| Produced by Lake House |
During
this process air touches the upper part of the nose which is sensitive to
the sense of smell, and thereby records such sensory message. This message
is then carried to the brain through the olfactory nerves. Once the smell
sensitive area of the brain receives the message, that person will
experience that particular smell. But sometimes there may be problems with
regard to the sense of smell. 
