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| Sunday, 31 August 2003 |
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Features |  |
| News Business Features Editorial
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Compiled by Carol Aloysius Roundworm infection The clinical picture of the heavily infected child in whom there may be hundreds of worms, is the undernourished, underweight child with a protuberant belly, constant gastro-intestinal discomfort, frequent diarrhoea, often visible peristalsis, blue rings around the eyes, convulsions and complications associated with ascariasis. In Sri Lanka infection rates have reached 70-80 per cent of the population, the victims being mostly children. by Dr. A. M. Aboobucker Roundworm infection (Ascariasis) caused by Ascaris lumbricoides or giant roundworm which has a general resemblance to earthworm is the most common intestinal worm disease in humans with children being at greatest risk. The adult female is 20 to 40cm long; the male 15 to 20cm. This worm, the largest of the parasitic roundworms which infect man, apes, pigs and sheep, usually inhabits the lumen of the small intestine from duodenum to the ileocecal valve. It can live for a year or more, lying free in the lumen. After fertilization the mature female worms daily lay about 200,000 fertilised eggs in the host's intestine. The eggs which are passed in the faeces have brownish-yellow granular contents. Having passed in the faeces from the intestine, the eggs containing embryos are deposited in soil. Upon being deposited in the ground, a fertilised egg begins to develop to the larval stage within its thin filmy shell. At least 10 to 14 days are required for an egg to develop into an active, infective larva. Therefore, newly discharged faeces are not infective. When the embryonated eggs are swallowed by a man, usually with food and water, they reach the small intestine where the eggs hatch and the cycle of larval development of the worm begins. The motile rehabditiform larvae are released as the confining shells of the eggs are digested by the intestinal enzymes, and penetrate the mucosa of the small intestine, migrating through the mesenteric lymphatics and portal system into the liver, from the latter through the inferior vena cava to the right atrium, and from there to the lungs. The larvae lodge in the pulmonary capillaries for a short time, and then burrow the capillary wall passing into the alveoli, bronchioles, bronchi and trachea. During their passage through the lungs, some four to sixteen days after the infection, the larvae may damage the capillary and alveolar walls causing pneumonitis or pneumonia, with signs and symptoms, including fever, crepitations, cough and blood stained sputum in which larvae may sometimes be found. It is at this invasive stage that a peripheral eosinophilia with allergic manifestations and other symptoms (Loeffler's syndrome) occurs. Later, the larvae enter the mouth with sputum during coughing and are swallowed. On their re-entry into the intestine they develop into the adult worms and begin egg production. The mature females lay their fertilised eggs which are passed out with the faeces of the host. This is the usual cycle of the ascaris larvae, but occasionally they may pass to the left side of the heart from the pulmonary capillaries or enter the systemic circulation reaching any part of the body including brain, eye, spinal cord and myocardium. The entire cycle from the larval stage to the adult lasts 70 to 75 days. Parasitation continues from 8 to 12 months and then they die. Symptoms When a person is infested with the worms in large numbers he complains of occasional gastro-intestinal discomfort with epigastric or umbilical pains, especially after a meal. Loss of appetite, aversion to certain foods (most commonly fats) and nausea and vomiting (usually in the morning) are also observed. The patient may also complain of frequent loose motions or constipation, salivation (particularly at night), and unpleasant sensation in the substernal region. Nervous symptoms are manifested by an early fatigue on exertion, irritability, forgetfulness, headache, dizziness, twitchings, hysterical or epileptoid convulsions (usually at night) and night terrors. If the infection is very heavy, during the invasive stage of the larvae, pneumonitis or pulmonary pneumonia which is usually associated with eosinophilia and allergic manifestations may occur. Often the patient, particularly the child, grits his teeth in sleep and bores at nose. In very severe cases, ascaris may cause intoxication of the central nervous system, manifested by meningeal or encephalitic symptoms, producing the clinical picture of tuberculous meningitis or encephalitis. The clinical picture of the heavily infected child in whom there may be hundreds of worms, is the undernourished, underweight child with a protuberant belly, constant gastro-intestinal discomfort, frequent diarrhoea, often visible peristalsis, blue rings around the eyes, convulsions and complications associated with ascariasis. In Sri Lanka infection rates have reached 70-80 per cent of the population, the victims being mostly children. Complications If the worms become irritated due to digestive disturbances or fever, they may pass down the bowel and be spontaneously evacuated per rectum, or they may enter the stomach and vomited up, or they may ascent the oesophagus and pass through the nasopharynx or obstruct the air-passage causing death by asphyxia (particularly in children). Sometimes the worms enter the common bile-duct and cause obstruction associated with cholangitis and jaundice. The pancreatic duct may also be invaded in the same way and pancreatitis may ensure in children. In some cases the adult ascaris may block the entrance to the appendix and cause obstruction and inflammation. Perforation of the intestinal wall may also result as a complication. Intestinal obstruction (commonly in the lumen) and intussusception due to an aggregation of worms may occur in children with heavy infection. With a high parasite load and a low protein intake, malnutrition may be a complication. Treatment In Homoeopathic system of medicine there are many wonderful remedies for roundworm infection. If one of those remedies is given in suitable potency according to the totality of symptoms it can exterminate the worms with their eggs and cure the symptoms. Among the useful remedies Antim.crud, Chenopodium, Chelon, Cicuta, Cina, Ferr.phos, Ignatia, Ind., Lyc., Mag.sul., Savad., Sant., Spig., Stann., Sul., Tereb., and Teuc.m.v. are very effective. The infection can be prevented by strict observance of the rules of personal hygiene. Children as well as adults must have clean hygienic toilets and must be taught to use them habitually. All other systems of stool disposal should be avoided. They should be advised to wash their hands thoroughly with soap and water every time after using toilets and before eating anything. Children should be taught not to put their hands or play things in their mouth. It is necessary to explain the dangers of eating unwashed raw vegetables and fruits which may be contaminated with the eggs. Finally people should be instructed to protect their foods and drinking water from flies, cockroaches, rats and insects which are likely to transmit the ascaris eggs. ########### What is Happiness ? asks Dr. RANIL JAYASENA Every person in this world wants to lead a happy life and it is considered a basic human need. This is in fact irrespective of their power and position. When you experience bad periods during which something happens which is out of your control and not to your liking, you feel unhappy. It may be a bad news regarding your job, a demotion, dismissal or it may be the discovery of a fatal disease you have, it may be the illness or death of a loved one or it may be a divorce or the discovery that your spouse is cheating on you. Most people in this world only want to experience success and are addicted to it. In these circumstances even a simple failure at something, a bad business decision, losing a political election, someone else getting what you deserved, your child eloping or loss of your job can create great misery in your mind regardless of how much wealth, prestige and power you have. How can you deal with these periods of unhappiness ? To answer this question first you should understand what is real happiness. To have a lasting stable happiness you have to dig deep into your mind and get rid of all the unhappiness stored in the depth of your mind. If you have a misery in the depth of your mind, your attempts at feeling happy at the surface level prove futile, then this stock of unhappiness keeps multiplying building negativities thoughts such as anger, hatred and animosity. The law of nature is that the negativity and peace cannot coexist as just as light and darkness cannot coexist. You should not be addicted to happiness and expect everything to go the way you want always. When things do not go your way or when you do not get the return of your happiness the misery becomes greater and unbearable. Therefore it is advisable to behave in a balanced and equanimous manner. Some people react with aversion towards this misery resorting to take alcohol, sleeping pills to cope with these situations of disappointment and depression. This is of no use because by these means you cannot get rid of the unhappiness at the depth of your mind. ########### Calling all parents... : Measles immunization for school goers The Health Ministry will commence its Measles Catch Up Campaign, giving your child a second chance to be immunised against this life- threatening disease, on September 5. The campaign which is being conducted in two phases , will initially target school going children between the ages of 10 -14 years who fall into the group that is most susceptible to getting measles. All children in this age group will receive a supplementary dose of the measles vaccine during the next two months, regardless of previous disease and vaccination history, Health Ministry sources told the Sunday Observer. They said that Catch-up campaigns were one time events targeting multiple groups in which susceptible children have been accumulated." If coverage exceeding 95 per cent is achieved, this is the most effective means of controlling measles tramsmission", sources explained. The first phase of the campaign will target over 94,000 schoolchildren in Colombo and other districts. "All parents have been informed through their schools and asked to be present when their children were being vaccinated." We request them to give us their fullest co-operation in making Sri Lanka a measles free country", a health spokesman said. ########### If you have short memory don't despair. There are... Psychological methods for improving memory by Dr. R. A. R. Perera Memory is as much a skill as an innate (genetic) ability. There are three processes how a person acquires memory. They are Encoding, Storage and Retrieval. Difference in memory is largely due to encoding skills. We get our memory from unprocessed stimulation from the environment. It is first stored in the sensory memory (one sensory store for each sense; iconic or visual, echoic or hearing etc.) Sensory memory lasts only for about 1/20th of a second and it is replaced by new traces and this is an ongoing process. The contents of the short-term memory are processed and some are stored in the long-term memory. The short-term memory has a memory span of 7-8 items (capacity) Memory span is the minimum number of stimuli that can be recalled in perfect 50 per cent of time. Short-term memory is also known as "working memory" and it contents are, input from long term memory, from perceptual processing and attention and consciousness. From short-term memory, forgetting occurs very rapidly immediately after learning, and then declined gradually. Short-term memory last for 2-20 seconds and forgetting in short-term memory is due to decay (with time) and interference from new information. Long-term memory has unlimited capacity and it is more or less permanent. Methods to improve memory: * Rehearsal In improving memory by rehearsal it maintains information longer in short-term memory and establishes new memory traces in long-term memory. Better recall of a beginning and the end of a long list is due to serial position effect. Here the first few items are in the long-term memory and the last few item are in the short-term memory. * Elaborative rehearsal or rehearsals with more description is important for long-term memory. * Dual coding as a picture and as words is a better encoding system. * Try to associate new material with the ones already in the long-term memory. * Try to understand what you are studying for better conceptual processing e.g. Remember ice cube as a picture and a word (dual coding) and as putting to a drink (conceptual processing). * When studying for an exam, space your studying. Don't study the same subject for long hours. * Mnemonics or remembering the first letter of a word and making it, as a 'poem' is another way of remembering. * Combing strong visual imagery (eidetic memory) with mnemonic techniques helps in maintenance of long-term memory. * Arranging items in a system of order makes it easier to remember. Difference in memory is largely due to encoding skills. The types of memories person possesses can be derived into many parts. Remembering how to ride a bike or drive a car is called procedural memory. Remembering who helped you learn and where you learn is or what you ate for breakfast is episodic memory. Understanding a news story as we read is semantic memory. Flashbulb memories are clear and vivid memories of where one was and what one was doing when a special event occurred (dramatic, emotional events). In the so-called eyewitness memory we add new information (which could be true or false) to the gaps in the memory. Eyewitnesses make errors because they include elements of both the original event and subsequent events in their recollection. They fill in memory gaps with inferences and information in the questions, which are asked by the lawyers, that are incorporated into the recollection. How we forget One way how we keep out unpleasant memories is called repression. Repression helps us keep unpleasant memories out of awareness so that we can function without anxiety or being sad. Another way how we forget is due to decay of the information. In decay it is due to passage of time. In Interference two similar items compete each other (Spanish and French), Interference can be divided into two (proactive and retroactive). Proactive interference is old material competing for new ones. Retroactive interference is new material competing for old ones. Tip of the tongue effect is due to cue dependent forgetting. (If you forget something coming out of a room, go back to the same room to remember it or if you want to pay a bill keep it with the checkbook.) In vit B deficiency (Korsokoff's syndrome) there is memory loss. When you take alcohol in excess the Explicit memory (conscious recollection of the past) is reduced but implicit memory (performance on memory relevant tasks without awareness of involvement of the memory (e.g. driving) is normal. Forgetting in short term memory-is due to decay and interference. Forgetting in the Long term memory - is due to repression, decay, proactive/retroactive interference, amnesia, and cue dependent Even though people think that memory is power is a genetic ability it is a misconception. Any one can improve their memory power by practising these above methods. ########### Say no to soft drinks! by S. Ardneham from Switzerland Look at the wrapper on a Cola 1.5 lit. bottle and in the ingredients you will find phosphoric acid in it. Minute quantities of ethylene glycol is also used which is acknowledged in the soft drink world for making it really chill. This is popularly known as anti-freeze which prevents water from freezing at 0 deg. C and instead drops it by 4, 5 degrees with minute quantities. This chemical is a known slow poison of the calibre of arsenic. So, if you manage to drink about 4 litres of Coke within an hour so, you can die. Guess what's the pH for soft drinks, e.g. Coke? pH 3.4! This acidity is strong enough to dissolve teeth and bones! Our human body stops building bones at the age of about 30. Soft drinks do not have nutrition value (in terms of vitamins and minerals). It is high in sugar content, carbonic acid, chemicals, i.e. colourings etc. Some like to take cold soft drinks after each meal. Guess what's the impact? Our body needs an optimum temperature of 37 degrees Celcius for digestive enzyme functioning. The temperature of cold soft drinks is very much below 37 degrees or even close to 0 degrees Celcius. This will dilute the enzymes and stress the digestive system. The food taken will not be digested. In fact it will be fermented! The fermented food produces gasses, decays and becomes toxin, gets absorbed by the intestine, circulates in the blood stream and is carried to the whole body, developing into various diseases. Have you ever thought what happens when you drink an aerated drink? You gulp down carbon dioxide, when nobody in the world would advise you to drink CO2. Imagine what it would do to your soft intestines and stomach lining!! |
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