A ray of hope for curing paralysis

By Nilma DOLE

Falling prey to stroke and paralysis could be a condition that is life-threatening and one of the most unbearable illnesses in the world. Imagine going from being the sole breadwinner of the family to a 'vegetable' at home unable to do anything. For those who have been stricken with stroke, there is hardly any hope except to be a burden on the family medically and physically.

But today, Sri Lanka will be one of the first countries to introduce an innovative technology which is the first step in curing paralysis in strokes.

Dr.Githanjan Mendis

prof.Mark Dallamore

Speaking to the Sunday Observer was consultant neurologist Dr. Githanjan Mendis, and Prof. Mark Dallamore, UK neuroscientist who told about this great technological breakthrough in the form of a microchip. "Paralysis affects in many forms. Paralysis below the waist is known as Paraplegia, Tetraplegia (Quadriplegia) is paralysis in the partial or total loss of use of all their limbs and torso and more types of conditions such as these affect stroke patients," said Dr. Mendis.

He said that while he and Prof. Dallamore were in the team, there were two other doctors, Dr. Sugath Gunasekera (neurophysiologist) and Dr. Fred Perera (consultant neuro surgeon board certified) who were part of the team working to make this stroke miracle a reality.

Death

According to research, strokes are most common condition which is the second leading cause of death and paralysis in Sri Lanka. While some can be completely cured with the proper treatment and physiotherapy, more often than not, it takes time and most don't even make it. But today, Prof. Dallamore is hopeful that there is good news for stroke patients in Sri Lanka.

Prof. Dallamore is an expert who started researching this technology from 2003 and claims to has successfully managed to trial test this innovation to stroke patients.

The technology has been successfully developed to permit paralysed patients to regain normal bodily functions and to walk again. Prof. Dallamore, who won the Albert Schwietzer Prize for Humanitarianism in 2005, said that there was an American scientist who had a similar technology but he controlled it himself through wires and a sort of remote control.

But in his technology, called the Dallamore Neuro Spinal Implant, it is a small microchip, much smaller than the traditionally-fitted pacemakers which would get the job done. He said, "It is a special microchip technology that regenerates itself using the body's own mechanisms to develop Nerve Regeneration.

This chip picks up instructions from the brain and transmits them past the damaged area of the spinal cord, and is ready to perform the first such operations." He explained the technology in a nutshell that the nervous system is divided into the Central Nervous System (CNS) and the Peripheral Nervous System (PNS).

"The CNS consists of the spinal cord and the brain and the PNS is the nerves and ganglia that transmit information between the CNS and the rest of the body. Its main function is to connect the CNS to the limbs and organs," said the Professor. Even when an injury blocks the transmission of signals through the spinal cord, the PNS still functions normally.

"The Dallamore Neuro Spinal Implant bypasses the damaged area of the spinal cord, so allowing the body to recognise and respond to instructions from the PNS," he said. Prof. Dallmore founded Neuroscience for Nerve Regeneration International to implement his development and to research further medical advances. Last year, Prof.Dallmore was awarded the Knight Commander, Sovereign and Military Order of the Knights Hospitaller of St. John which made him a more credible neuroscientist.

"I have developed this technology in the UK with trial testing and the reason why we could initiate this breakthrough medical innovation was because we got the license to do it here. The Professor and his team are licensed to perform this procedure in Sri Lanka which has been seen as a medical miracle for giving hope to stroke patients. After qualifying as a physician in 1991, Professor Dallamore has had plenty of experience working with stroke patients that have led to his patients regaining full mobility and to the realisation that nerves can be regenerated.

In London, Prof Dallamore further studied Neurophysics and researched spinal conditions - gaining a PhD in the Philosophy of Medicine in 2001. In early 2005 he qualified as a Neuroscientist with a PhD in Neuroscience, and a PhD in Neurophysics later in 2005. In 2010, he founded a team to complete the development of his research and create a chip implant system to restore mobility and bodily functions to paraplegic patients.

The professor even has a foundation called the Sir Mark Dallamore Foundation for children which treats children with nerve and muscle conditions. "We take our research seriously and we can assure all stroke patients that there are absolutely no side effects when it comes to inserting this microchip in your spinal cord.

"People might worry at first whether it is safe-proof but we can guarantee and give an assurance that it won't harm the patient in any way," said the Professor. The final testing of the Dallamore Neuro Spinal Implant has been successfully completed. "The whole development process is now complete and the chips and connectors have entered production in September. We are on course to meet our target of performing the first surgical procedure in the last quarter of 2011," said the Professor.

"It isn't easy to be a burden to your family after being the main income-earner. In this way, while stroke patients have no hope of helping themselves, I am sure this technology will be embraced with arms wide open," predicted Dr. Mendis.

"We will give concessionary rates for Sri Lankan stroke patients and their families to purchase the microchip. It might mean a big investment but it is a worthy and reliable cure in the long run," said Dr. Mendis.

Reference : www.neurosciencenerveregenerationint.com

No taboo or shame in mental illness

by Lionel WIJESIRI

Mental illness is becoming common in Sri Lanka. One in ten Sri Lankans suffer from some type of mental illness or trauma, the National Institute of Mental Health (NIMH) revealed recently. The study had found that the causes for mental illness in Sri Lanka were both varied and complex.

It is human nature to fear what we don't understand. As such, mental illness is feared by many people and, unfortunately, still carries a stigma. Because of this stigma, many people hesitate to get help for a mental health problem for fear of being looked down upon. It is unfortunate that this happens because effective treatment exists for almost all mental illnesses. Worse, the stigma experienced by people with a mental illness can be more destructive than the illness itself.

Words like "crazy," "psycho," "wacko" and "nutso" are just a few examples of words that keep the stigma of mental illness alive. These words belittle and offend people with mental health problems. Of course, many of us use them without intending any harm. Just as we wouldn't mock someone for having a physical illness like cancer or heart disease, it is cruel to make fun of someone with a mental illness.

A few days ago, at a casual meeting with a group of foreign social friends, I was introduced to Dr. Emil Gerald Kretschmer, M.D., retired German psychiatrist, who had a 30-year medical career specialising in child and adolescent mental disorders.

He was holidaying in Sri Lanka and when requested, he agreed to share his experiences and also to explain his opinions of mental disorders and their prevention. This article is written based on the views expressed by him.

What is Mental Illness?

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Mental illnesses can affect persons of any age, race, religion, or income. Most of them are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan.

In addition to medication treatment, psycho-social treatment such as cognitive behavioural therapy, interpersonal therapy, peer support groups and other community services can also be components of a treatment plan and that assist with recovery. The availability of proper diet, exercise, sleep, friends and meaningful paid or volunteer activities contribute to overall health and wellness, including mental illness recovery.

What causes mental illness?

There is no simple answer to this question as there are lots of reasons why someone might develop a mental illness. Usually it is a combination of a number of those reasons, and not only one.

Dr. Kretschmer explained these causes in detail:

1. Physical causes: These are those, which are biological in nature. Someone might inherit characteristic from their family through their genes which mean they are much more at risk than other people.

For example, it has also been found that people who have suffered head injuries can experience changes to their personality, and in some cases may begin to experience schizophrenia and psychotic type symptoms. (By the way, schizophrenia means any of several psychotic disorders characterised by distortions of reality and disturbances of thought and language and withdrawal from social contact)

Another example is if a mother is taking drugs while she is pregnant, or if she gets a virus (like the flu) this might affect on how the baby's brain develops. There have also been reports that suggest vitamin and mineral deficiencies such as Vitamin D, zinc and certain fatty acids may also be related to our mental health.

2. Social and environmental causes : When we talk about social and environmental causes, things that are going on around us, and how we feel about them can have a big impact on our mental health.

These might be things such as, where we live, our place of work, whether we have close family and friends and how and where we can relax.

Details.

(a) The physical environment where we live can be very stressful, particularly when there are problems with neighbours, or if there are high crime rates and other such issues.

(b) Whether you enjoy your work, or feel you are under too much pressure, are unable to find employment or hold down a job, can all put pressure on your mental well-being.

(c) When we face difficult times our support networks become very important - those who do not have close friends or families, or those who do not live near the people who support them may find it increasingly difficult to cope alone.

(d) All these kinds of problems will increase the amount of stress people are under, and can cause depression and anxiety especially in situations where people don't have a time or a place to relax.

(e) Environmental triggers leading to mental illness include living in poverty, being raised in a dysfunctional family and frequently changing schools or home situations. Certain societal attitudes, such as about weight and physical appearances, for example, may also make people anxious or depressed.

3. Psychological factors

Our psychological state can influence our mental and emotional state, particularly if we are coping with a traumatic and abusive past or current experiences. It is recognised, for example, that sexual and physical abuse can result in a range of mental illness symptoms from anxiety to multiple personality. Other psychological causes include neglect and loss of a loved one at an early age. Most of these problems lead to low self-esteem and self-confidence.

4. Food

Increasingly, researchers are looking more at the correlation between food and mental illness. For example, scientists have found out that normal brain development in infants and children may be hindered due to a diet lacking in omega-3 fatty acids.

5. Genes

Mental illnesses are often found to run in families. When looking at a family tree, for example, one can often trace mental illness from one generation to the next. This is because there are certain mental illnesses that may be linked to genes. A person may not necessarily become mentally ill, but will have a greater risk of developing a mental illness.

How do we prevent or minimise mental disorders?

An essential first step in a prevention effort is to use a risk reduction model as the basis for prevention. Risk factors are those characteristics, variables, or hazards that, if present for a given individual, make it more likely that this individual will develop a disorder.

If causal risk factors can be decreased or if protective factors can be enhanced, the likelihood that at- risk individuals would actually develop mental disorders would decrease.

This risk-reduction model is widely used to prevent physical disorders. Smoking is a classical risk factor for a variety of physical disorders, and prevention programs aimed at persons who smoke and are, therefore, at risk, is an example of an approach to the prevention of physical disorders.

Another suggestion is for an increased application of rigorous research methods to the prevention field. One example is the use of nurse home visitors for high-risk pregnant women. In a well-controlled trial, the study has shown the reduction in low birth-weight infants, and following the birth of the baby, a reduction in unintentional injuries and child abuse.

These medical problems have all been shown to be risk factors for mental illness.

Another group of studies dealt with young people at increased risk for depression because of family history. Carefully controlled interventions on small groups have demonstrated decreased risk of depression.

Bigger picture

Mental illnesses present an important public health challenge for Sri Lanka. All sectors of society and all levels of government have roles to play in responding adequately to this challenge.

I believe we urgently need a national action plan to guide the national response to mental illnesses. This can act as a blueprint that may be expanded upon and further developed in collaboration with other stakeholders.

Overcoming suicide and causes that lead to it

by A.M. Ahamed

There are two kinds of terminological concepts which are related to the definition of suicide. Committed suicide and, Attempted: Suicide

Committed Suicide

Committed suicide means taking of one's own life. If one plans to kill one's self, or destroys one's life, it is referred as committed suicide. It is very difficult to understand why some people do this or intend to do this.

Attempted Suicide

It is a conscious and voluntary act, which the individual has undertaken in order to injure himself, where the injury has not led to death. We can define in an other way that if one plans to kill himself, that plan sometime fails to destroy his or her life due to provision of medical treatment, etc. such acts are referred to as attempted suicide. Attempted suicide is a life threatening act.

Some people attempt suicide to get attention from society on some problem he or she faced. Such person may die from that attempt, even though, he or she does not wish to destroy his or her life. There are some cases who merely try to attempt suicide to get attention from society. If the person died in this attempt, it is recorded as committed suicide, if not it is recorded as attempted suicide.

Common characteristics

a) Expecting higher achievement b) Fear of failure c) Psychological pain d) Frustrated mind e) Hopelessness and helplessness f) Religious factors Perspective on the Causes of the Phenomenon of Suicide

Number of cultural, social, environmental, biological, psychological factors can influence on a person who interested in suicide commitment. These factors can vary based on age, gender and ethnic group and they can change over time. So suicide is a consequence of complex interaction among different factors.

Psychological factors

The psychological factors associated with psychological disorders, particularly, depression, feelings helplessness and hopelessness, inability to experience pleasure, aloneness and preoccupation with death. These factors affect not only the career personality status but also the motivations for his actions, thoughts, or feelings, that lead him to suicide.

Socioeconomic factors

A variety of socio economic factors affect suicide risk. Most social scientists believe that a society's structure and value can influence the suicide rate. The low social status of women influences the rate of female suicide in Asia. For example, in some Asian countries, lovers of different social status, whose marriage would not be approved by the parents or family may choose suicide. Social isolation or lack of social support is associated with suicide.

While social isolation refers to relationship with others, social support refers to the quality of those relationships. Social support entails emotional support, affirmative support and tangible support.

The growth of population and technology in the nation, leads to a greater division of labour and lower social integration. Divorce is a central indicator of social disintegration and may lead to suicide risk in our society. Unemployment and urbanisation also contribute to increase the risk of suicide. Urbanisation of areas can be expected to have a higher degree of disintegration, which, in turn, increased the suicide risk.

Cultural factors

A suicidal person is generally affected by cultures. Different national groups have different suicide rates. For example, in the United States, young adult males are most likely to commit suicide by firearms, but in China, Japan, India and Sri Lanka more likely to commit suicide by burning. Myth and folklore also illustrate some kind of suicide attitudes. Culture may also determine interpersonal relationships that influence the occurrence of suicide.

Death and the after life

Convictions of Eternal peace after death, the possibility of reunion with a deceased love one, acute pain, natural faith in black magic may be key factors in an individual's suicide behaviour.

Religious Factors

Religions have been thought to influence suicide through three mechanisms:

1) Religious integration, beliefs and practices.

2) Religious commitment or adherence to a few specific beliefs such as belief in an after life.

3) Religious network or the special support derived from interaction with coreligionists.

Measures for remedy and strategies

Develop favourable attitudes towards the problems. Develop and enrich religions teaching and concept. A balance should be maintained between the physical and intellectual needs.

Develop positive interaction with neighbours, family and society.

Learn from failures

Improve favourable attitude towards education and learning.

Develop constructive attitudes towards nation and its culture. Conduct positive attitude towards the relations.

Constantly develop in the mind the conviction that they would succeed and are capable to gain good achievement. Encouragement should be given to each man and woman to live with the present but not with the past and the future.

(The writer is Deputy Director of Education, Value Education Branch Ministry of Education, Isurupaya, Battaramulla.)