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Health Guide
Compiled by Shanika Sriyananda

Combat meningitis with good hygiene

Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord. The inflammation is usually caused by bacteria or viruses (viral meningitis is also called aseptic meningitis).

Before the current vaccines, most meningitis cases occurred in children younger than 5 years, but the incidence of the disease has increased among young people between the ages of 15 and 24. Older adults also tend to have a higher incidence of meningitis.

Many of the bacteria or viruses that can cause meningitis are fairly common and are more often associated with other everyday illnesses. Sometimes, however, they spread to the meninges from an infection in another part of the body. The infection can start anywhere, including the skin, gastrointestinal tract, or urinary system, but the most common source is the respiratory tract.

From there the microorganisms can enter the bloodstream, travel through the body, and enter the central nervous system. In some cases of bacterial meningitis, the bacteria spreads directly to the meninges from a severe nearby infection, such as a serious ear infection (otitis media) or nasal sinus infection (sinusitis). Bacteria may also enter the central nervous system after severe head trauma or head surgery.

Bacterial meningitis is less common than viral meningitis but is usually much more serious and can be life-threatening if not treated promptly. But the widespread use of the Hib vaccine as a routine childhood immunization has dramatically decreased the frequency of meningitis caused by Hib. Viral meningitis is relatively common and far less serious than bacterial meningitis. It often remains undiagnosed because its symptoms are similar to those of the common flu.

Bacterial meningitis occurs in people of all ages but is more common in the very young (infants and young children) and the elderly (people above age 60). Teenagers and college students are also slightly more at risk, because of time spent in close contact with many of their peers. Viral meningitis occurs in people of all ages, although it is more common in children.

People with less competent immune systems, such as the very young or those whose immune systems have been compromised by disease, are more at risk for all types of meningitis. Some types are more common in child-care centres, boarding schools, dormitories, and military bases, mainly because infectious diseases tend to spread quickly among large groups of people. Not receiving routine vaccines for certain infectious agents that can cause meningitis - including those for mumps, Hib, and pneumococcus - also increases a person's risk.

Contagiousness

Most cases of meningitis result from infections that are contagious. The infectious agents usually spread from person to person in tiny drops of fluid from the throat and nose of someone who is infected. (This could be a person with either meningitis or, more likely, the common infection caused by that germ.) The drops may become airborne when the person coughs, laughs, talks, or sneezes. They can then infect others when people breathe them in or touch the drops and then touch their own noses or mouths.

Sharing food, drinking glasses, eating utensils, tissues, or towels may all transmit the infections as well. Some infectious organisms can spread through a person's stool, and someone who comes in contact with the stool - such as a child in a day-care may contract the infection.

The infections most often spread between people who are in close contact, such as those who live together or people who are exposed by kissing or sharing eating utensils. Casual contact at school or work with someone who has one of these infections usually will not transmit the infectious agent.

It is important to remember that just because someone becomes infected with a particular bacterium or virus does not automatically mean that person will get meningitis. In most cases, the microorganism will simply cause a run-of-the-mill respiratory or gastrointestinal infection. In some instances, people may carry one of the germs that can cause meningitis without becoming ill at all. Even though they have no symptoms of disease, they can still spread the germ.

Patients with meningitis typically remain contagious while they still have symptoms. People who have bacterial meningitis can be contagious for about 24 hours after they begin taking antibiotics.

Prevention

Routine immunization of young adolescents will help prevent this rare but serious infection. Experts now recommend that kids who are 11-years-old get vaccinated for meningococcal disease, a serious bacterial infection that can lead to meningitis. The vaccine is called quadrivalent meningococcal vaccine, or MCV4. Children who have not had the vaccine and are 15-years-old, should also get the vaccine. People who are entering college, and will be living in a dormitory setting should also get the vaccine.

Many of the bacteria and viruses that are responsible for meningitis are fairly common. Good hygiene is an important means of preventing any infection. Encourage your family members to wash their hands thoroughly and often, particularly before eating and after using the toilet.

Avoiding close contact with someone who is obviously ill and not sharing food, drinks, or eating utensils can help halt the spread of germs as well.

In certain cases of meningitis, doctors may decide to give antibiotics to anyone who has been in close contact with the person who is ill to help prevent additional cases of illness.

The vaccines against Hib, measles, mumps, rubella, polio, and pneumococcus can protect against meningitis caused by these microorganisms.

Incubation

This varies with the organism causing the meningitis. The incubation periods for the most common causes of meningitis range from 2 days to 2 weeks.

Duration

Even with proper treatment, bacterial meningitis may take days (and sometimes weeks) to resolve, and recovery from its effects may take even longer. Most cases of viral meningitis resolve completely within 1 to 2 weeks.

Source: Meningitis Research Foundation

***

Signs and symptoms

It's easy to mistake the early signs and symptoms of meningitis for the flu. They may develop over a period of one or two days, but some types of meningitis can prove fatal in a matter of days.

If you suspect that you or someone in your family has signs or symptoms of meningitis, seek medical care right away. There's no way to tell what kind of meningitis you have without seeing your doctor.

Seek medical care right away if you or anyone in your family has any of the following signs or symptoms:

A high fever

Severe headache

Vomiting or nausea with headache

Confusion

Seizures

Sleepiness or difficulty waking up

Stiff neck

Sensitivity to light

Lack of interest in eating and drinkin

Access to primary healthcare a fundamental right

by Ranga Chandrarathne

Patients' rights is still an alien concept to most Sri Lankans.In the health sector, doctors and authorities often take the upper hand in making vital decisions that affect not only the patients' rights to access to quality drugs at an affordable price but the patients' fundamental right to live.

The People's Movement for the Rights of Patients (PMRP) is a group active in the health sector that campaigns for the formulation of a national policy on importing and dispensing drugs and for mandatory use of the generic name in prescriptions.

The PMRP was able to raise public awareness on the issue of Rights of the patients which is not known to many Sri Lankans.

Though Senaka Bibile had introduced a national policy on the import and the dispensation of medicinal drugs, Sri Lanka has still failed to draft and implement a national policy on drugs and prepare a list of essential basic drugs. 150 countries across the globe including some European countries have adopted this policy on the import of drugs.

PMRP is a network of civic action groups campaigning for the protection of patients' rights. The rights include the provision of quality drugs at affordable prices and the Formulation of a National Health Policy and Patients' Charter.

Presenting a paper at a seminar organised by the PMRP, Dr. K. Balasubramaniam acknowledged the importance of implementing the draft of the National Policy on the rational use of drugs, which was presented to the Minister of Health.The objectives of the National Drug Policy are to ensure access to good quality, safe and effective drugs at affordable prices to all Sri Lankans.

Currently over 8000 drugs are registered in Sri Lanka and 5000 are marketed. However the Expert Committee of the World Health Organisation has strongly advised the Minister of Health and the Health Authorities that 300-500 drugs will be sufficient to provide optimal healthcare.

The Drug Regulatory Authority has not enough resources to ensure safety, effectiveness and the good quality of the 5000 drugs available in the market. The first obstacle will be overcome with the preparation of the list of essential drugs to meet the health needs of the entire population and the registering of not more than 4-5 forms of one drug and approving them for marketing. This list should be formulated by a panel of experts and should be periodically reviewed and updated.

The retail price of the drugs available in the market differs from brand to brand. In comparison to India, six generic drugs are cheaper in Sri Lanka than in India. However, innovators brand of the same drugs are more expensive in Sri Lanka than in India.

By 1999 the public sector provided 95 per cent of the in patient care, while the private sector was responsible for only five per cent. Public sector cared for just over 50 percent of out patients.

However, the cost incurred in the private sector was Rs. 1799 million for 5 per cent of in patient care compared to Rs. 7100 million in public sector, which provided 95 per cent of inpatient care.

The medicine prescribed and dispensed for private sector outpatients was Rs. 9994 million compared to only Rs. 384 million for the public sector outpatients which provides more outpatient care than the private sector.

One contributory factor for the drastic difference in healthcare expenditure in public and private sectors is the prescribing practices: in public sector, the doctors and consultants working in 10 teaching, 4 provincial and 35 based hospitals use only low priced SPC drugs and have found them safe, good quality and effective.

However, the same doctors and specialists when working in private sector practices differ in their prescription habits.

Due to the bulk purchase of drugs by the SPC, safe, good quality drugs are available in Sri Lankan market. Manufacturers give large-scale discounts when drugs are purchased in bulk. The main suppliers of drugs to retail market are the private sector and the SPC through its Osu Sala outlets.

Through skilful and aggressive marketing the proprietary brands of the innovators drugs has retained a market share despite artificial higher level of pricing. The new draft of the National Drug Policy has provisions for administrators that it can be used to reduce the cost to consumers.

This provision will be taken into consideration when the Drug Regulatory Authority (DRA) registers a drug and an approval is given to market it.

The next step would be that the Drug Regulatory Authority should initiate an action plan in collaboration with the Consumer Affairs Authority to inform the drug manufacturers and importers that they should be registered with the Drug Regulatory Authority in terms of the provisions of the National Drug Policy.

Aspirin cuts cancer risk

A latest study says that aspirin cuts colon cancer risk, but it takes a lot over a long time. The researchers say that long-term use of aspirin does help ward off colon cancer, but only at high doses that could cause gastrointestinal bleeding.

Previous studies have shown that patients with a history of colon polyps or colon cancer who take aspirin regularly can prevent recurrence, and researchers at Massachusetts General Hospital and Brigham and Women's Hospital in Boston sought to determine at what levels the painkillers were effective.

"Our study did find a protective effect of long-term aspirin use on risk of invasive colorectal cancer, but only at dosage levels considerably higher than those used to prevent cardiovascular disease," said Dr. Andrew Chan of Massachusetts General Hospital.

To stem cardiovascular disease, some people take "baby" aspirin, which is one-fourth the dose of full-strength aspirin, daily.

The maximum benefit from full-strength aspirin was a 53 percent lower risk of colon cancer among female patients who took more than 14 tablets a week for more than 10 years.

The reduction in cancer risk declined along with aspirin dose - disease risk was cut by 22 percent for those taking between six and 14 tablets a week.

But for every one or two cases of cancer prevented by taking high doses of aspirin, eight people would develop serious gastrointestinal bleeding, the researchers estimated. Reuter news

Hypertension: The Hidden Threat

Hypertension is one of the most common cardiovascular diseases in Asia, but many people know little or nothing about it. For example, the 1996 Malaysian National Health and Morbidity Survey estimated that only 33 per cent of Malaysians who suffered from hypertension were aware that they had it.

Although hypertension itself doesn't kill, its complications can be deadly: increased risk of heart attack, stroke and kidney failure.

The condition is caused by an increase in the amount of blood pumped by the heart or an increased resistance to blood as it flows through the arteries. "A person suffers from hypertension when their blood pressure is persistently elevated beyond a normal level," says Dr. Philip Chua, chairman of cardiovascular surgery at the Cebu Cardiovascular Centre in the Philippines, where 10 million people are in that condition.

Adds Dr Goh Ping Ping, a senior consultant cardiologist at Changi General Hospital in Singapore: "The majority of patients don't usually see or feel any clearly identifiable symptoms." If symptoms do occur, they may include headaches, weakness (especially on one side), poor vision, chest pain or tightness, shortness of breath, numbness and tingling. Often, hypertension is detected during a routing screening or when a patient sees a doctor for some other illness.

The condition tends to run in families, not because it is genetic but because family members often share unhealthy lifestyles, including smoking, drinking too much alcohol or coffee, and eating too much salt - all of which elevate blood pressure.

Unfortunately there's no cure for hypertension, but it can be managed with proper monitoring of blood pressure, medication and a healthy lifestyle. "Hypertension is for life," says Dr Chua. "It's important to continue to take the medications even after your blood pressure has been returned to normal."

If you experience any symptoms of hypertension, see your doctor immediately.

Holistic healing

Diet during common cold

by Dr. Danister L. Perera

It is very important to follow proper dietary routine during the ailment. Cold foods, cold drinks, ice cream, sweets, fried foods, milk products like cheese, creams, yogurt etc. should be avoided. Hot milk without fat can be taken if boiled with a slice of crushed ginger.

Half a teaspoon of turmeric powder is good to mix with the milk. Sweet fruit juices should also be avoided. Bread, meat, nuts and pastries are not good. It is good to partake in light and warm diet like boiled or steamed vegetables, vegetable soup and fruits which are not juicy like papaya and apple.

Spiced teas, herbal teas and some other hot drinks are good. As a rule eat and drink warm foods and liquids only. Take at least a few swallows, or more according to your thirst, of plain hot water every half hour throughout the day.

Eat lightly, meaning less than you normally do. Avoid rich, fatty or oily foods at this time. Have fewer dairies in your diet. For a day, have a liquid diet. Vegetables, fruits, soups, grains, dhal, etc, may be included, but should be liquefied in a blender first.

It is very important to stress that suppressing early symptoms will make the condition worse. When the body is trying to throw out waste products that had accumulated in the lungs or sinuses, you must facilitate it. Sneezing is a natural mechanism of the upper respiratory system for clearing foreign matter. It may sometimes make you uncomfortable for a short time but it helps you in the long run.

Taking drugs to arrest run down secretions is not recommended. It is not rational to take antibiotics for a mere common cold since it is a viral infection according to the Western medicine. But if you are easily prone to any secondary bacterial infection after a common cold it is wise to consult a qualified physician to get an antibiotic prescribed.

It is a proven fact that taking antibiotics unnecessarily has become a global problem which leaves a society with anti-microbial resistance in the system. But in Ayurveda there are herbal remedies for controlling and pacifying these difficulties. Specially Indian gooseberry or Nelli is one of the best fruits recommended in Ayurveda. It is scientifically found that Nelli is a fruit having the highest percentage of Vitamin C, which helps to enhance the restorative power of the respiratory system.

Also herbs like Thulsi (Holy basil), inguru (Ginger), Thippili (Long pepper) identified as effective herbal remedies can reduce the provocation of Kapha and act against the virus.

In the case of a dry cough especially during the night, take cardamom, dry ginger, black pepper and cinnamon in equal quantities, say 10 gms. each. Take white sugar or rock candy equal to the total weight that is 40 gms. Grind them and make a fine powder.

From this take half a teaspoon (about 3 gms.) twice a day with honey or warm water after meals. In a case of sore throat a clove or two cardamoms or rock candy or a few raisins can be chewed. Gargling with warm salt water is also beneficial. This can be done two to three times a day.

For a hacking cough and Laryngitis: Equal parts of honey and juice of baked lemon, ( i.e. sour citrus fruit) or 10 -15 drops of betel leaf juice with honey three times a day.

Take 1 teaspoon of the following mixture 2-3 times per day: teaspoon honey, 1/2 teaspoon turmeric, 1/4 teaspoon ginger, before meals, preferably.

With Ayurvedic remedies help the body to relieve the troublesome symptoms and ease the system for getting back to normalcy. Those remedies promote the body resistance and create an environment where the virus cannot live. It changes the virus-friendly atmosphere in the respiratory system in a natural way. For that not only medicine but also your diet and behaviour will help.

In most cases, the appropriate use of nutrients and herbs can check the cold in its tracks. However, you should consult a health care provider or consult your physician for further evaluation if:

Your symptoms are getting worse

Your fever exceeds 102 degrees

You have severe nausea, with vomitish feeling, and can't retain fluids

You have a moderate or severe headache

You have difficulty in breathing

Your mucus has turned thick yellow or green

You have a moderate to severe earache

Severe or persistent sore throat

But remember if you manage the common cold in a proper way it is easier to heal naturally. If you don't assist your body to combat the condition you will suffer with severe complications for a long time.

www.ceylincoproperties.com

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