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| Sunday, 10 August 2003 |
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Features |  |
| News Business Features Editorial
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The risk of having an... Induced Abortion Illegal abortions have taken a steep rise in recent years with an average of 2,000 abortions a day taking place in Sri Lanka according to informed sources. The majority of women who have these abortions are unwed teenagers or between the ages of 20-30 years. Abortions can have serious repercussions on the health of the mother, causing infertility and associated illnesses. Dr. R. A. R. Perera who has done extensive research on the subject discusses different aspects of induced abortions. Induced abortion, at any period of gestation, exposes a woman to the risk of complications that can vary considerably, depending on the circumstances under which the abortion is performed. The severity of complications also varies widely from very minor complaints to the occasional fatal outcome. Complications can be divided into two categories - early, that are within around one month after the abortion, and late, those occurring more than one month after the procedure. Early complications may be subdivided into immediate, defined as those occurring (although not necessarily discovered) during the procedure or within a few hours after it's completion, and delayed complications, those developing later but still within one month. Serious immediate complications are rare with abortions performed in medical settings. They include perforation of the uterus by one of the instruments used for instrumental evacuation, sometimes combined with injury to the intestines or other organs; major haemorrhage; laceration of the cervix (opening to the uterus), sever disturbances of blood coagulation (clotting of blood), and due to anaesthesia local or general. Delayed complications The most frequent delayed complications include: retention of fragments of the placenta resulting in post-abortal bleeding; infection, and various clotting problems. Post-abortal depression has been reported but is rare, and guilt feelings are usually of short duration. Known late somatic complications or sequelae of induced abortions in medical settings are sensitization of Rh-negative women by red blood cells from Rh-positive fetus, preventable by injection of Rh immune globulin, and endometriosis. Other less common ones are subsequent pregnancies of lower birth weight, and second trimester (3-6 months) spontaneous abortion. Secondary sterility and ectopic (outside of the uterus) pregnancy can be the late result of pelvic infections. Sterility could be a result of hysterectomy following a major haemorrhage due to an induced abortion. Psychological Adverse psychological sequelae of induced abortion have been a matter of concern. Some doctors, including some psychiatrists, have expressed the view that every abortion is a stressful experience involving major risks to mental health. Others have pointed out that most women undergoing abortion continued to lead essentially normal lives and that an adverse psychological reaction to an unwanted birth may be far more common and more serious than an adverse reaction to having an abortion. Scientific studies on psychological responses to legal, nonrestrictive abortions suggest that severe negative reactions are infrequent in the immediate and short-term aftermath, particularly for first trimester abortions. Women who are terminating pregnancies that are wanted and personally meaningful, who lack support from their partner or parents for the abortion, or who have more conflicting feelings or are less sure of their decision beforehand may be at relatively higher risk for negative consequences. Case studies have established that some women experience severe distress or psychopathology after abortion and require sympathetic care. Such responses can be overwhelming to a given individual, but the development of significant psychological problems related to abortion is 'minuscule from a public health perspective.' Despite methodological shortcomings of any single study, in the aggregate, research with diverse samples, different measures of response, and different times of assessment have come to similar conclusions. The time of greater distress is likely to be before the abortion. Severe negative reactions after abortion are rare and can best be understood in the framework of coping with a normal life stress. ###### Is it safe to have an egg a day? asks Dr. D.P. Atukorale There were several newspaper articles advising people to 'consume an egg a day to keep the doctor away'. Two prospective studies have shown that there is no risk of heart attacks or stroke of healthy people consuming one egg a day. The researchers have recommended consumption of one egg a day for healthy people i.e. those who don't have risk factors for heart attacks (such as high blood cholesterol, smoking, hypertension, obesity, diabetes, lack of exercise and unhealthy eating patterns). It has also been found by researchers that people who ate eggs were more likely to eat bacon, whole milk, red meat and less likely to consume skimmed milk, vegetables and fruits. According to researchers, there is no definite evidence that an egg a day is safe for healthy women. In case of people with diabetes, there is a definite increased risk of heart attacks if they consume one or two eggs per day. The Us Dietary Guidelines and American Heart Association has recommended an average daily intake of not more than 300 mg of cholesterol and this level of 300 mg of cholesterol per day has not yet been challenged by any authority. An egg yolk contains 212 mg. of cholesterol more than a day's ration of cholesterol for people at high risk. But egg white does not contain saturated fat or cholesterol. You may consume two eggs per week if you have not yet checked your serum cholesterol level and one egg per day if your serum cholesterol is normal. So if you have a tooth for eggs it is advisable for you to get your serum cholesterol checked and if it is high you must get advice from your family physician regarding egg consumption. ###### Diabetes and your feet Diabetes is on the increase in Sri Lanka. For people with diabetes even the smallest injury especially on the feet can be dangerous. Here are some useful tips for diabetics with foot problems. Infections that don't heal, poor circulation and numbness in your feet are some of the secondary effects of diabetes, a disease characterized by faulty sugar metabolism. Because an infection that doesn't heal can lead to serious complications (gangrene, for instance, is the death of the deep tissue in the area of the infection), it's especially important that diabetics prevent infections with careful foot care. Poor sugar metabolism will affect circulation, and feet usually show the first symptoms of poor circulation because they're farthest from the heart. Your feet might develop ulcers that don't heal, brittle nails, dry skin, tingling and even numbness when the arteries narrow, starving peripheral nerves and causing permanent damage. High blood sugar makes the skin a perfect breeding ground for bacteria, a dangerous situation if you can't even feel injuries to your feet. Women develop diabetes more frequently than men. If you're a middle-aged adult, you're ten times more likely to develop this disease than you were at twenty-five or thirty. Once you're over sixty, your chances of becoming a diabetic triple. If you are a diabetic patient, professional foot care is a must. Ulcers An early symptom of diabetes, ulcers are breaks in the skin that cause disintegration of underlying tissue and grow progressively deeper when not treated. Usually caused by irritation or injury, ulcers develop most often on the ball of the foot because of foot imbalance causing abnormal pressure points on the feet. They also develop at the sites of neglected corns and calluses and under toenails that have either been trimmed improperly or subjected to tight shoes. Diabetic ulcers should be treated immediately. Untreated ulcers are easily infected and, in the diabetic foot, an infection can quickly become life-threatening. Incurvated nails Another result of diabetes and other circulatory disorders, incurvated nails are among the most common nail problems. Their effect is similar to that of ingrown nails; they grow into the toe's soft tissue and cause a great deal of pain if cut improperly. Incurvated nails can't be prevented by cutting your toenails properly. Caused by an inadequate blood supply to the nail bed, the sides of these nails actually begin to curve down into the skin and the undernourished skin may begin to thicken. Eventually, these nails may need to be removed. Less radical treatment isn't always effective because the problem is the inadequate blood supply and, if it isn't corrected, the nail will continue to emerge distorted. Always have your podiatrist trim these nails; it's dangerous to attempt trimming them yourself. Caring for the diabetic foot If you are a diabetic, there are certain cautions you should observe: See your podiatrist at least once a month. You should always have your podiatrist trim your nails because an ingrown nail or even the slightest nick in the skin from nail scissors can cause a serious infection. If your nails are brittle, you can soak and cream them at home, but don't try to cut them yourself. And never try to treat the simplest foot problem, even a corn or callus, on your own. Don't use any over-the-counter medications on your feet (corn or callus medications or antiseptics, for example) unless they are prescribed for you. They can cause ulcers on the feet even if you don't have circulatory problems. Wash your feet daily with soap and warm (never hot) water. Gently pat them dry with a towel paying special attention to the area between your toes. Use a lotion to massage your feet morning and night to keep the skin soft. You can use a lanolin-based moisturizer or body cream. Don't walk barefoot. It's easy to step on splinters and, if you've lost sensation in your feet, you won't feel them. Inspect your feet daily for any injuries or abnormalities. Wear only soft leather or cloth shoes. Shoes made of reptile skin, plastic or patent leather aren't porous or flexible enough. Your shoes should fit with no points of irritation. Never wear constricting boots. Women's high, tight-legged boots can cause circulatory problems even in otherwise healthy feet. If your feet perspire excessively, ask your podiatrist or family doctor to prescribe a safe foot powder or soak. Get plenty of exercise to stimulate circulation and don't smoke or drink coffee. Nicotine and caffeine impair circulation. (Courtesy: Foot Care) ###### Similar benefits in Coconut oil and mother's milk - says researcher NAYANA FONSEKA Do you know that coconut oil has the same benefits as mother's milk? Recently a group of American scientists found that coconut oil is a wonderful food, which helps to protect the health of infants in the same way as mother's milk. It also protects the health of pregnant mothers. Mother's milk is unique; because of its perfect blend of vitamins, minerals, proteins and fats for optimal growth and development of the infant and also antibodies and other substances which are necessary for their health protection. It helps to protect the infant from infectious diseases and allergies. Mother's milk has special characteristics of improving nutrient absorption and digestive function. The secret of mother's milk is mainly due to two oily substances it contains. One is "Lauric Acid" and the other is "Capric Acid." Lauric and Capric acids represent a big portion of the milk fat content of the breast milk. Coconut oil also contains "Lauric acid" as the biggest part of its composition, except that, "Capric acid" and other oily parts are also there. This is the similarity in breast milk and coconut oil. These two acids in coconut oil can have similar benefits for human health. It protects the human body from a large number of infectious diseases caused by viruses and bacteria. Coconut oil can fight and destroy the lipid coated viruses and bacteria listed in the table. Not only that, it will improve the digestibility and palatability of the food also. Breast feeding mothers In Breast feeding mothers it has been found that mothers in the eastern countries are richer with Lauric and Capric acids in their milk, than western mothers. This is due to their dietary habits; especially as they consume Lauric rich foods such as coconut oil. Daily intake Normally a healthy mother needs 2-4 tablespoonful of coconut oil per day, to keep the Lauric and Capric acids to the needed level for the baby. Mothers with AIDS Even mothers who are suffering from dangerous infections, can feed their babies without transferring the infection to the baby, if they take the right amounts of coconut oil per day. For ex: An AIDS mother (HIV infected) can feed her baby without transferring the disease through her milk, if she takes 4 table spoonful of coconut oil per day. If it is difficult to take such a dose of coconut oil per day, she can consume fresh coconuts in order to meet the right amount of oil content. Coconut as an infant formula Today, the infant milk formula producing multinational companies are also careful to add Lauric acid to their formulas. Therefore they use coconut oil to fill the gap between natural milk and the artificial infant formulas. Editor's Note: What do other health authorities have to say on this controversial subject? Please send in your views C/o Editor, Health Page, Sunday Observer. |
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