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| Sunday, 19 January 2003 |
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Features |  |
| News Business Features Editorial
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Compiled by carol aloysius Headache? Fever? Nausea? You could be suffering from any one of the following... : Infectious viral diseases At this time of the year, following the onset of the monsoon rains, Sri Lankans suffer from a number of viral illnesses. A 'mysterious viral flu' has already claimed the lives of many residents in Jaffna where there is also an outbreak of Typhoid and Dengue. In Colombo infectious diseases such as measles and chickenpox have been reported among school children. The following article from the book 'Your child, your family' by Dr. H. Aponso et.al discusses some of the common infectious viral illnesses... What are infectious viral fevers? They are feverish illnesses, which are caused by various kinds of viruses. They are called infectious fevers because the virus is easily transmitted from person to person through the droplets of sputum that contaminate the air during coughing, laughing, or even when talking. They include the following: Measles (medical term: rubella) is an infection caused by the measles virus, which enters the body through the respiratory tract. On entering the body, the virus starts multiplying and produces thousands of viruses. After a few days it causes the illness. The period between the entry of the infective agent and the development of an illness is referred to as the incubation period. The incubation period for measles is about 2 weeks. The illness starts with fever, which can be very high - sometimes 40 to 41 degrees C (104 to 106 degrees F). Usually there are aches and pains, vomiting, loss of appetite, and cough; sometimes, loose stools (occasionally with blood and mucus). The eyes are often somewhat red and tearing. The inside of the cheeks and throat also may be reddened. On about the 4th or 5th day of the fever, a rash appears, first on the face and then on the chest, trunk and limbs. Usually, about a day after the rash, the fever comes down, and the patient feels better. The rash usually clears up in 3 or 4 days. The patient is infectious from about 2 days before the fever to the time of disappearance of the rash. during this period the patient can convey the infection to someone else, by scattering the virus during coughing, talking, laughing, or even when breathing out. While most patients get well within a week, there are some, especially malnourished children, who develop serious complications such as pneumonia, diarrhoea and brain fever (encephalitis). Some develop a bacterial infection of the eyes, which, if not properly treated, can lead to blindness; or middle ear infections, which can lead to deafness. If the chest infection is not properly treated, a chronic lung infection called bronchiectasis may develop. Another dangerous repercussion is the reactivation of healed tuberculosis of the lungs. Yet another serious but rare complication is a chronic incurable disorder of the brain - subacute sclerosing pan encephalitis (SSPE), which may occur years later. Fortunately, the measles vaccine (given on completion of 9 months of age (138) has brought down the incidence of this disease dramatically. Treatment: There is no special drug that kills the measles virus, in the way that antibiotics destroy bacteria. The treatment which is directed towards the relief of symptoms, maintenance of proper nourishment, and the prevention of complications, include the following: . treatment of the fever, a nourishing diet and sufficient fluids. there is invariably a poor appetite, and perhaps vomiting and loose stools; small amounts of nourishing fluid (milk, soups, or any other palatable drink) should be given at frequent intervals. eyes should be protected from the glare of lights; . consult a doctor without delay if there are any of the following: persistent fever and cough, fast breathing or difficulty in breathing, fits, persistent vomiting and diarrhoea, or any other abnormal changes. Mumps: This is an infection by the mumps virus, mainly affecting the parotid glands. These are a pair of glands, situated on either side below the ears, between the jaw and the lower part of the skull. These glands are called salivary glands - they produce saliva. The illness starts with mild fever, and a pain and swelling of either both or one of the parotid glands. In most cases, the pain and swelling go down within a week, and the patient is well. The incubation period is about 2 to 3 weeks. The infectious period is from about 2 days before the swelling up to the time when it has completely gone down. Some complications may occur: . abdominal pain, due to involvement of the pancreas; this is a gland situated behind the stomach; . pain and swelling of the testes which may result in subfertility. occasionally the ovaries may be affected (by females), gives rise to pain in the lower part of the abdomen; . very rarely, brain infection - encephalitis. The treatment of mumps consists of; . rest, especially in the males, because they may get a swelling of the testes; if this happens, consult a doctor. . maintenance of a normal diet; . if there is severe headache or drowsiness, consult a doctor. Mumps can be prevented by giving the mumps vaccine, or the combined measles, mumps and rubella vaccine (MMR). Chicken-pox (CP) - medical term: varicella This is caused by a virus called the varicella - zoster virus, which enters the body through the respiratory tract or by direct contact with the skin lesion. CP has an incubation period of about 2 weeks. It usually starts with fever, and sore throat; within about 24 hours there is the beginning of a characteristic rash, what first appears on the chest and face and then spreads to the trunk and upper and lower limbs. At first there are reddish spots on the skin, which quickly become blisters (vesicles), i.e. like water-bubbles. The fever usually lasts only for 2-3 days. The vesicles may occur in several crops during the first 4-5 days; they start scabbing after 5-7 days. Due to scratching, these vesicles can become infected and cause a bacterial skin infection. If this happens antibiotic treatment is necessary. In adults the symptoms may be more marked than in children and they may have high fever, aches and pains, and vomiting. CP, in the first month of life, carries a high death rate. If CP occurs in the first three months of pregnancy, the baby may develop abnormalities in its organs; if it occurs during the last three months of pregnancy, the baby is likely to develop complications in the lungs. The infectious period is from the day before the appearance of the rash till the skin scabs fall off, which is generally about 7 days. Almost always, there is life-long immunity following the infection; however, the virus may remain latent in the nerves and in a very few persons, appear later as herpes zoster. Prevention: A chicken pox vaccine which has been developed recently, is now available in Sri Lanka. It is advisable to give the vaccine to those over 20 years and to women before they become pregnant, if they have not had CP, and to the other risk groups that have been mentioned above. The treatment is directed towards the relief of symptoms: * application of a soothing lotion (such as calamine lotion) if there is a marked skin irritation; * washing with margosa leaves - a traditional practice in Sri Lanka - is helpful; margosa is soothing, and is claimed to have antiseptic properties. * for severe cases an anti-viral drug - acyclovir - is recommended. Dieting myths There is a common misunderstanding that weight control can be accomplished overnight. Not surprising, with so many 'wonder diets' around. Losing excess weight is a gradual process. You should aim to lose about 1-2 lbs per week until you reach a weight which is ideal for your height and build. The most effective way to lose weight is by modifying your diet and taking regular exercise. To lose weight you will need to take in less energy (calories) than you burn up. Many people think that to lose weight the sugar in their diet is the only thing that should be reduced. However, it is more important to reduce the amount of fat that you eat, whilst remembering that some is essential for good health so it should not be cut out altogether. Being excessively overweight is not just a cosmetic problem - your health will suffer if you keep your weight higher than is ideal for you. Once you have reached your ideal weight you should continue to exercise and eat a well-balanced diet to maintain your ideal weight. Once your weight is right and you've made new food choices to help
maintain a healthy weight, you'll look trimmer and feel better. Your risk
of serious illness will have been reduced along with the reading on the
weighing scales. Your extra confidence and energy will have you wanting to
improve in other areas of your life. Soon you will be taking on challenges
that you would not have dreamt of before! A second chance for women Despite a drop in birth rates in Sri Lanka, many women continue to have unwanted babies. Evidence lies in the rise in illegal abortions that occur daily in this country. To prevent this the Family Planning Association (FPA) now offers 'Emergency Contraceptive Pills' to give women who have unprotected sex a chance to prevent an unwanted pregnancy. The following article discusses this new pill and how it works. What are emergency contraceptive pills? These are oral contraceptive pills that a woman can take within 72 hours of unprotected intercourse to reduce her risk of becoming pregnant. They contain the active ingredients in regular birth control pills, except in higher doses. Recent research suggests the pills may also be effective if taken within 120 hours. When should emergency contraceptive pills be used? They are intended for use after sexual intercourse when no contraception is used, when a couple's regular contraception does not work properly (as when a condom breaks or slips) or if a woman is sexually assaulted. The pills may be appropriate for adolescent women. How do the pills work? Depending upon when the pills are taken during the woman's menstrual cycle, they may: . prevent or delay ovulation, the release of an egg from the ovary . prevent fertilization . stop a fertilized egg from attaching to the uterus The pills will not work if taken after pregnancy has started. While studies indicate the pills prevent ovulation, more research is needed to show conclusively that they prevent fertilization or stop a fertilized egg from attaching to the uterus. How effective are the pills? A woman should begin the pills as soon as possible, since effectiveness declines as time passes. If a woman uses them within three days (72 hours) after sex, progestin-only pills lower the chance of pregnancy by about 85 per cent. Combined pills are about 75 per cent effective if used within three days. What if a woman had unprotected sex more than three days ago? The pills may still work, but the risk of pregnancy increases with time. Another option after three days is the insertion of an intrauterine device (IUD), considered to be effective within five days of unprotected sex, but usually recommended for women who would then continue using an IUD as their routine family planning method. Do the pills cause side effects? The pills sometimes cause nausea, vomiting, headaches, dizziness, cramping, fatigue or breast tenderness. If vomiting occurs more than one hour after taking the pill, the woman need not worry because the medication is already in her system. The pills also may cause irregular bleeding until a woman menstruates again, and menstruation may begin early or late. What should a woman do after using the pills? If a woman's menstruation is more than a week later than expected, she could be pregnant and may want to see a health care provider. If she is pregnant, all available evidence indicates that use of emergency contraceptive pills will not have harmed the pregnancy. Can a woman use these pills every time she has sex? Emergency contraceptive pills should not be used routinely to prevent pregnancy because they are less effective than other family planning methods such as condoms, regular oral contraceptives, injectables, intrauterine devices and sterilization. Also, they have more side effects than other methods. Do the pills protect against sexually transmitted infections? No. They provide no protection whatsoever. Latex condoms provide the best protection against sexually transmitted infections, including HIV. Is the emergency contraceptive pill the same as the "morning-after pill"? Yes, but the term "morning-after pill" can be misleading. Women might think they must wait to begin treatment until the morning after unprotected sexual intercourse. Or, they might think incorrectly that it would be too late to use this method if they cannot obtain treatment until the afternoon or evening after unprotected intercourse, or two days after unprotected sex. Source: Consortium for Emergency Contraception Plumbing the world of 'fatties' Many factors, both social and genetic have an influence on obesity. In the past, obesity was seen as a sign of wealth and health, the opposite of wasting and disease; today, some cultures still prefer their women obese. In Sri Lanka obesity is more common among women than men and in the working classes than the professional and the managerial classes. It is sometimes seen in children, mainly in the youngest child in a family. Obese people fear an endless cycle of impulsive overeating and weight gain with progressive obesity, increasing humiliation and diminishing self-esteem. Research conducted by psychologists has centered on the question of whether the psychological effects of obesity or the psychological factors leading to it are more important. Overall, it must be emphasized that eating behaviour cannot be studied in isolation. It is associated with many other aspects of behaviour such as sleep patterns and physical and sexual activity. Overeating or hyperphagia commonly occurs between both adolescents and in massive obese people and in others with a history of weight disorder. Overeating in childhood often seems to have been accentuated by the challenge of adolescence, when rapid growth (sometimes as a result of childhood over-nutrition), pubertal plumpness and initial low self-esteem have set the scene. Obesity is more common among females than males in most present-day western societies. For the female, fatness seems to be complexly bound up with her sexuality, both biological and social. Reaching puberty earlier than the male, she finds her shape beginning to change under the influence of hormones governing new fat deposition which confer upon her and those around her a sense of her biological ripeness and readiness for reproduction. At the same time it commands the attention of the male. By the age of 17, the majority of young women are striving to reduce their fatness, when clearly not all of them are obese in a statistical or medical sense. Fashion is not a sufficient explanation; the need to loose weight is often seemingly rooted in such need as conformity, the search for increased self-esteem, and the need to self-control. Women's dislike of their fatness can also reflect a male preference for shapely women. The majority of men, while sometimes admiring such women, feel much less concerned about obesity in their own sex. The male with a hearty appetite is often admired; moreover, the female does not often condemn male fatness. The adolescent male will often have been more preoccupied with increasing his bulk than with reducing it. Massive weight gain might occur in adolescence, in relation to such experiences as loss (provoking over-eating) or sexual conflict (for which the immobility of massive obesity became protective). Treatment combining diet and psychotherapy is used to treat them. It is likely that personality is merely one integrated aspect of our constitution that we deploy particularly in our search for optimal personal adjustment in life. It involves our relationships with others and it involves others. Our shape, eating patterns, energy balance and physical activity levels are a major aspect of such adaptation, and it is likely that these factors both contribute to and stem from other aspects of our personalities. - Dr. R. A. R. Perera. Mental health abuse by Dr. H.R.S. Keerthisinghe Physical abuse, mental abuse, emotional abuse, sexual abuse, discriminations, exploitations, brain-wash through media or otherwise, are all mental traumatisations. Research conducted among Nurses Training Schools, Free Trade Zones, teachers, university students, school hostels, children's homes, pirivenas, seminaries, refugee camps, and street dwellers, uncovered the persistent feelings of 'Disgust with Life'. It has a shocking revelation to note that the highest percentage of such people were university students (88 per cent) followed by school children (87 per cent). Feelings of 'Disgust of Life' usually precede thoughts. So how do we treat 'Suicidal Tendencies' of these people? Are we going to medicate all of them? So many young lives and also adult lives have been lost through suicides by persons - who were on Psychiatric Medication. If such victims could have had a little counselling and psychotherapeutic support by a qualified counsellor/Psychotherapist, their lives could have been saved. At the same time in the fields of Counselling and Psychotherapies, there are hundreds of abuses taking place. A young woman brought to light how she was forced to have sex with the so called 'Counsellor' to enable her to have 'mental happiness.' Another so-called Psychotherapist was making huge money by using hypnotism. Some counsellors think, that this is a very good field to earn money and some teachers who teach counselling also encourage their students to make this a good way of earning. The results will be, that deserving counsellees, will soon lose their confidence in this field. Broadly speaking, 'mental health' is 'happiness'. Happiness varies from
person to person, Situation to situation, culture to culture, country to
country. But, universality of mental happiness cannot be denied. To deny
mental happiness is to abuse mental health. Health brief : Morning dialysis more effective - study Certain Cancer drugs seem to work better and have fewer side effects when taken in the morning. Now a study suggests that dialysis patients who get the kidney treatment in the morning may live longer. Researchers at Emory University in Atlanta tracked the welfare of 242 people aged 60 and older who in 1988 were on dialysis. By July 1999 nearly all had died. But patients who'd been receiving treatment before 11 a.m. survived longer - over a year longer, on average - than those on an afternoon schedule. While more study is needed, one theory is that morning therapy meshes better with the body's cycles of sleep and hormone production. |
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