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| Sunday, 9 June 2002 |
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Features |  |
| News Business Features Editorial
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Advanced treatment of brain tumours by Prof. Dr. Amarasiri Wijenayake Brain tumours are successfully treated with today's diagnostic and operative surgical techniques. Finding the symptoms of the patient and diagnosing could remove benign tumours totally giving the patient a relief. An infiltrating tumour would be difficult to be removed as it would be infiltrating the adjacent brian tissue. Sometimes a benign tumour growing on an anatomical position that is difficult tor each without brain damage would need techniques like steritactic surgery. With modern CT Scanning both vascular and other types of tumours could easily be diagnosed. Gamma surgery had been used widely during the past few years in treating tumours in certain parts of the brain. Blood radiosurgery or Gamma surgery without using operative knife preferred by many patients seems not to give almost full results. Recurrence of tumour is often unable to avoid. Symptoms Symptoms of brian tumour vary depending upon the location of one's limbs whether the upper limbs or lower limbs. Often one upper limb and one lower limb on the same side or one limb on one side and the other limb on the opposite side get affected as a result of a brain tumour. Hemiplegia or loss of strength on one side could mean the brain tract known as the pyramidal tact is affected. Sometimes both upper limbs or both lower limbs would be affected. If both arms and legs are involved, then it is necessary to examine the patient for additional symptoms consciousness, visual field defects, difficulty in speaking or known dysphasia. A lesion on the cortical surface of the brian or below the cortical surface known as the internal capsule lesion could be suspected. Lesion on the same side as the lesion would be situated on the spinal cord. Pyramidal pathway in the brain running down from cortex the spinal cord is one of the most important pathways in the brain. When a lesion affects the pyramidal pathway paralysis would not result equally on the whole side. As the pathway runs downwards, representations of face arm, leg are closely packed. This would give rise to total hemiplegia. Total paralysis of all four limbs would be caused by bilateral pontine lesion or bilateral medullary or cervical spine lesion. In the case of a bilateral pontine lesion, due to the seventh nerve face being involved sides of the face would be affected as both sides of the pons is involved. Cervical or neck cord that is surrounded by the skeleton of the neck if diseased would cause no facial involvement. Respiration of the patient would be affected and artificial respiration may be needed, Paraplegia or loss of strength of both lower limbs, with difficulties in urination as urine retention and the inability to pass urine also occur. In the case of cruciate hemiplegia which means weakness in one arm and the opposite leg including weakness of the palate and tongue on the side of the weak arm, a lesion on the brain could be suspected. If both legs are weak, cord damage could be suspected. If the nerve roots are compressed as often found in patients with prolapsed disc weakness in limbs could be seen. Weakness would be seen on the side of the disc lesion. It may be caused by hysteria, in which case weakness would shift from one side to the other. Anatomically the brain is divided into two parts, the supra tentorial part and the infra tentorial part. Weakness of limbs would be seen on the same side as a lesion above the
tentorium. Weakness of limbs with fluctuations of consciousness would be a
sign of affection of the alert system of the brain known as the reticular
formation. Papaya (papaw), the fruit of the angels by Dr. D. P. Athukorale Papaya, sometimes called papaw (not to be confused with the North American papaw or custard apple) is known as the melon of health. In Costa Rica and Mexico the natives refer to papaya tree as "the tree of good health". It is an exotic fruit which is commonly available in village markets (pola) green-groceries and super markets in Sri Lanka. According to Christopher Colombus the original Carib name for this fruit "ababi" means the fruit of the angels. Papaw leaves and the milky latex exuded by the unripe fruit are used to make tough meat more palatable. Until the practice was banned certain Western slaughter houses would inject papain (which is an enzyme having the ability to breakdown muscle structure of flesh) into live animals to make the tough meat softer and more palatable. Clinical uses of Papaya Papaya helps to breakdown proteins, fats and carbohydrates. Papaya is primarily used to treat chronic diarrhoea, coeliac disease, gastrointestinal discomfort and intestinal parasites. Papaya is used as a sedative and diuretic. It fights allergies, infections, inflammations, treats soft tissue injuries, strains, sprains, haematomas, contusions, abrasions and pulled muscles. In short some of the beneficial effects this fruit provides are 1. It stimulates the stomach to increase secretions, 2. It releases histamines from body tissues. 3. It depresses the central nervous system. 4. It kills some intestinal parasites. As a digestive By nature the human beings have weak hydrochloric acid (HCL) secretions in our stomach not acidic enough to digest animal proteins. Furthermore human gut cannot secrete uricase, the enzyme that breaks down animal proteins (all carnivores have uricase unlike vegetarians). This is where papaw comes in. Being rich in enzymes it can digest food in acid, alkaline and neutral environment. Thus papaya takes care of our HCL deficiency breaking down animal protein in a better way, so that the body can use the totally digested protein particles. The changes of toxin build up are also minimised. Papaya is also frequently used to treat mild constipation in most of the Asian countries including Sri Lanka. Papaw is said to have antiseptic properties too, preventing over growth of harmful germs in the intestine. As a cleansing agent Papaw is known for its detoxifying/cleansing ability as well. It is referred to as surgical scalpel, selectively but gently scraping mucus, pus, dead tissue, injured tissue, hardened tissue and other debris from the body and yet sparing the normal living tissue. Also with the finding that proteolytic enzymes like papain enhances the immune function, building the immune system through papaya intake makes sense. So everyone with weak stomach or poor digestive function and constipation can greatly benefit from regular intake of papaya. Nourishing the endocrine system Papaya helps to nourish the endocrine system. It helps the body to produce more arginine which is a semi-essential amino-acid that activates the human growth hormones. These hormones are important for cell rejuvenation and rebuilding the cells of the liver, muscles and the bones. Arginine also exerts an anti-atherogenic effect as it improves small vessel endothelial function. As a beauty agent The women in the tropics are known to use unripe papaya juice on their skin. When scientifically researched it also had a peeling effect on freckles and sunspots and also relieving the itchy exzema. It has been found that it has an effort of staving off wrinkles in women. Papain is one of the ingredients of some skin ointments prescribed for the treatment of severe wounds and skin ulcers. Papaya has also been used in leprosy. For the heart According to Dr. Kesheva Bhatt, Professor of Medical botany at the University of Caracas, he cured remarkably, cases of heart disease simply by prescribing a weeks fast on papaya fruit and water. He is also said to have cured scores of cases of angina by this amazingly simple prescription. Cancer cure In a study made by Herbert Fraut, Professor of Medicine at the University of California, papain solution was used to diagnose cancer. It was found that by administering this enzyme solution, those who had cancer became sick and nauseated due to the ingestive action of the enzyme on the tumour. In pregnancy and bleeding disorders Avoid papaya preparations during pregnancy, lactation and bleeding disorders. Although there is no scientific proof, it is advisable to avoid papaya by those who have miscarriages. Nutritional value of papaya One fresh papaya (304g) has 118K. calories, 0.43gm of fat, 0.12g of saturated fat, 29.82g of carbohydrates, 1.85g of protein, 2.34g of fibre, 85.12 RE of vitamin A, 187.87mg of vitamin C, 0.08mg of thiamine (B1), 0.10 mg of riboflavin, 1.63mg of nicotine acid, 0.66mg of pantothenic acid, 0.06 mg of vitamin B 6, 115.52 mg of folic acid, trace of vitamin D, a trace of vitamin K, 73 mg of calcium, 0.30 mg of iron and 0.21 mg of zinc. Thus one average raw papaya contains 3 times the daily recommended dose
of vitamin C, two thirds of vitamin A requirement and over a third of the
potassium requirement. Diseases from too much, too little water Almost two billion people - one-third of humanity - were affected by natural disasters in the last decade of the 20th century. Floods and droughts accounted for 86% of them. Quick-onset disasters like earthquakes, volcanic eruptions and landslides may be more dramatic and take a very high toll in human lives. But floods and droughts - too much water or too little - often have longer lasting and more far-reaching effects on the health of their victims. "The most vulnerable victims are the poor and the marginalized, most of whom live in low-quality housing in flood-prone or drought-prone regions," says Jamie Bartram, Coordinator of the World Health Organization's Water, Sanitation and Health Programme. "In periods of drought, their desperate search for water leads them to drink contaminated water and fail to exercise personal hygiene. And those fleeing floods often drink unclean water too. "If the drinking water supply and the sanitation systems are already inadequate, flooding poses a major health threat. Inundated industrial waste, such as used engine oil and refuse dumps add to health risks. People who have lost everything in the flood - their homes, their food, their livelihood - are all the more vulnerable to disease." Floods are the second most frequent cause of natural disaster after windstorms, but affect more regions and more people than any other phenomenon. Drought is the largest cause of death because if often leads to famine. Notwithstanding the magnitude and widespread geographical distribution of floods and drought, a great deal can be done to prevent or mitigate their adverse effects on health. Clean, safe water is the key. Simple, practical measures such as teaching people how to conserve water and keep it safe from contamination and how to store emergency supplies of safe drinking water will go a long way to helping communities at risk. Chlorination is known to reduce diarrhoea, cholera and other diseases. A four-month study of water contamination in a Malawi refugee camp, where there had been repeated outbreaks of cholera and diarrhoea, showed that the water flowing from source wells had little or no microbial contamination, but that refugees collecting the water quickly contaminated it, primarily through contact with their hands. The introduction of a simple improved container for collecting the water resulted in a 69% reduction in faecal coliform levels in household water and 31% less diarrhoeal disease in children under five years of age among those who used the improved bucket. In tropical countries receding floodwaters provide an ideal breeding ground for mosquitoes, and create an increased risk of such diseases as malaria, dengue and Riff Valley fever. Floodwater combined with effects of open sewage and reduced opportunities for good personal hygiene, lead to cholera, diarrhoea and gastrointestinal viruses and displace rodent populations which can cause outbreaks of leptospirosis and hantavirus infection. Early warning systems to detect rises in mosquito-borne and diarrhoeal diseases and to evaluate the risk of floods and drought also need to be set up. Sanitation in many regions should be improved because countries with a good infrastructure for drainage and disposal of human waste have far fewer direct health problems during water-related disasters. Most important, however, is helping local communities themselves to prepare for and respond to these disasters. Drought triggers or exacerbates malnutrition and famine. In hot countries or during heat waves deaths may be caused by a combination of heat and shortage of water. Courtesy WHO Eggs and egg products - what the consumers and handlers should know Consumers, including travellers, should avoid eating raw eggs or uncooked foods made with raw eggs. Dishes containing undercooked eggs may also be dangerous. Foods made with unpasteurized eggs like ice creams, desserts are particularly dangerous, particularly if they are homemade. Vulnerable groups, such as the elderly, infants and young children, pregnant women, and persons with suppressed immune systems are more susceptible to infections, including salmonellosis, a major microbiological problem in eggs and egg products, and may suffer severely. The following hints may be useful for consumers and food handlers in preventing such food safety hazards. Store shell eggs (whole) under refrigeration (10 degrees C) Use pasteurized eggs (if available) Eggs that have not been pasteurized should be cooked until all parts reach a minimum temperature of 70 degree C. Both the yolk and the white should be firm. Scrambled and fried eggs should be cooked in small batches until they are firm (not runny) throughout. Eggs when boiled may require a minimum boiling period of 7-9 minutes (depending on their initial size and temperature) to ensure that the yolk becomes firm. Dishes made with raw eggs should also be well cooked. Leftovers and foods prepared in advance should be kept at refrigeration temperature or kept hot at minimum of 60 Degree C. Stored food containing eggs should be thoroughly reheated to a minimum temperature of 70 Degree C. Avoid cross-contamination between raw eggs and other food. Surfaces which have been in contact with raw eggs as well as the utensils used for the preparation should be carefully washed. Hands need frequent and careful washing; before preparation of food, after handling shell eggs and other foods that may be contaminated, and after every interruption in food preparation, particularly after having used the toilet. Shell eggs should not be washed. If they are soiled with faecal matter or blood and therefore must be washed, they should be used immediately. Cracked eggs are more likely to be contaminated and thus present a higher health risk. Cracked eggs should therefore be used immediately after the crack occurs. If the time of crack is not known, the eggs should be destroyed. |
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