|
|
|
  |
| Sunday, 31 October 2004 |
 |
|
 |
Features |  |
| News Business Features Editorial
|
The 'pain' in your brain by Sharmila Jiffrey Medical scientists, who have agonised over the mystery of pain and the ways we can control it, believe they have found the key to man's suffering. Their findings could lead to revolutionary new ways of preventing pain by triggering the body's natural defence mechanisms and that could make the use of addictive pain-killers, such as morphine, a thing of the past.
For seven years Dr. Anthony Jones of the Manchester Rheumatism Centre, has been working on the puzzle with researchers at Hammersmith Hospital, London. "Opioids are the body's own method of dealing with pain", he said, but it has been difficult to show how they achieve this. "That's what gave me the idea of scanning changes that occur in the brain when pain is felt." Using radioactive traces, they monitored arthritis patients as they went in and out of pain and revealed which areas of the brain responded most. "We think the receptors on the front of the brain are responsible for the pain itself", said Dr. Jones. "It seems that the opioids are more concerned with modifying the emotional response to pain rather than abolishing it." "We know this is what happens with drugs like morphine. If you take it, you can still feel the pain but it no longer seems to bother you." The result is that he has found patients' responses can be very different. "It seems that pain with a physical basis is often withstood better than pain which may have a psychological cause." Previous research has concentrated on drugs that help prevent pain signals reaching the brain. Little was known about what happened within the brain itself. The key lies in opioids: the secretion by the brain of neurotransmitters serotonin and endorphins. Serotonin induces relaxation and pleasurable impulses; endorphins block the transmission of pain signals from the body to the brain and stimulate the pleasure centres. Through the network of the nervous system, these neuro-chemicals work the same way as the opiate drugs. The team of British scientists believes that rather than preventing the pain, these natural pain killing chemicals that are secreted by the brain merely change the way people respond to it. The success of hypnotherapy as a means of pain management comes from its ability to program the subconscious mind to secrete and distribute these natural brain chemicals then and where and to the extent it is needed. In the United States of America and in the Western World women give birth under hypno-anaesthesia; surgery conducted under anaesthesia induced by hypnosis; and, without artificial or chemically based anaesthesia. Seventy five per cent of pain emanates from emotional factors eg. fear of what can happen (Anticipatory anxiety). There are now substantial ways of hypnotherapy to block the pain from the body. In other words, the neurological message can be blocked by using hypnosis therapy. With hypnotherapy the mind can cause the secretion of chemicals like endorphin and serotonin which facilitate relief of pain. New options for heart patients Heart defects can now be treated without surgery or drugs. Dr G.R. Constantine, Consultant Cardiologist, National Hospital colombo, a specialist in Interventional Cardiology discusses this procedure with Carol Aloysius.
A: It is a method of diagnosing and treating heart disease without using drugs or conventional surgery, with the help of catheters sent through the arteries or veins to study the structure of the heart and coronary arteries. Q: Once you have detected the heart defect, how do you treat it, if you do not use conventional surgery or drugs? A: After studying the structure of the heart, we institute the necessary treatment via the catheter itself instead of resorting to surgery. Q: How is that possible? A: Take for instance a Coronary artery disease. What we do is to send the catheter to the coronary arteries and then inject dyes to get a good picture of the arteries. Next we try and locate the exact position of the narrowing and send a balloon to dilate the narrow area. We then fix the narrow area with a piece of metal called a Stent. For Atrial Septal defect (i.e. hole in the heart) we can close the hole with a disc like device. Abnormal vessels too can be blocked by coils again by using an intervention method. Q: Are these permanent remedies? Will these defects re-emerge after some time? A: In most cases they are permanent remedies that do not require intervention. Q: What is the advantage of this invasive procedure without surgery? A: Young people usually come to us with one to two isolated narrowings. for this type of defect, This procedure is ideal and besides, it avoids by pass surgery which can cause complications especially when done for a second time. With this method there is less risk of a by pass at a later stage if the disease progresses.This is also a good procedure for those who have had a by pass since it is less traumatic and less risky. Q: What about people with multiple lesions as in the case of diabetics? A: Usually for people with 2-3 isolated lesions this procedure can be used safely and successfully. The success rate is low in the case of others i.e. diabetics and those with multiple lesions. For such persons, by-pass surgery may be a better option because complete re-vascularisation is not always possible by interventional methods. Q: Once the intervention procedure is completed, what is the next step? Does the patient have to be on medication as he does after surgery>? A: If he is taking drugs for cholesterol lowering, he should continue to take them. An aspirin and other drugs will also have to be taken. Q: Has there been a new breakthrough in this technique in recent years? A: Now we have drug eluting stents i.e.stents that are coated with certain drugs which prevent reoccusion of the arteries. Q: What is the advantage of using such stents? A: The re-narrowing of stents which occur in about 20 per cent to 25 per cent of normal stents can be reduced by five percent by this drug eluting stent. Q: Are these stents available in Sri Lanka? A: They are available in the National Hospital and other hospitals as well. Q: What do you see as a new trend in the kind of heart patient being admitted to hospitals? A: We are now seeing more young patients being brought in with heart ailments. About thirty per cent are less than fifty years. Q: Why is this? A: Mainly because of their lifestyle; because of heavy smoking and poor diet combined with little exercise. Furthermore in recent times patients are coming to us with severe diseases like angina or severe angina which require early imaging and interventional procedure. Q: How can they prevent developing these severe heart diseases in the future? A: If people adhere to a healthy diet, quit smoking and take exercise on a routine basis, there would be less heart disease in this country. Curing diptheria - the homeopathic way Diptheria is rare in Sri Lanka. nevertheless a few cases still do occur. Dr. Y. M. Mousoom discusses the disease and the homeopathic treatment for it. Diptheria is known as a most dangerous disease of children. The membrane of diptheria is liable to form on any part of the mucous membrane of the mouth, nose, pharynx or trachea and particularly in the region of the tonsils. The causative organism is coryne bacterium diptheria; it can be identified on a direct smell and its pathogenicity determined by bacteriological examination. There are three varieties known as Mitis, Gravis and Intermedius. These organisms tend to be arranged singly or in groups at angles forming shapes like English letters L or V. The incubation period is 2 - 7 days. The tonsils and the fauces are most often the site of the infection, and next in frequency is the nose occasionally the pharynx, larynx or trachea are affected without obvious infection of the fauces. The onset is gradual over one or two days, with malaise, headache, anorexia, mild fever and sore throat. In some cases the sore throat may be inconspicuous. The diagnostic feature is the pearl-grey elevated membrane of variable extent with a well defined edge and surrounded by a zone of inflammation. The membrane is comparatively firm and is adherent. It can be swabbed off only with difficulty in contrast to the ease with which the purulent exudate of streptococcal tonsillitis can be removed. On occasion the membrane may be dirty -grey or even black due to admixture with blood. There may be swelling of the neck and tender enlargement of the lymphglands. In the mildest infections, especially in the presence of a high degree of immunity, membrane may never appear and the fauces are slightly infected. In these circumstances, diagnosis can not be made clinically but depends up on obtaining a positive culture from a throat swab. Anterior nasal diptheria is invariably mild, but the disease is important from the point of view of the spread of infection. The chief feature is the nasal discharge, which is thin and serious at first, but is frequently blood stained. (A similar discharge may result from the presence of a foreign boody in the nose). In addition to the local signs, tachycardia develops in association with a soft compressible pulse, the blood pressure fails and the heart sounds become faint. The gravity of the prognosis is proportional to the extent of these changes. Sudden heart failure is responsible for most of the fatalities, and it is associated with degenerations change in the myocardium which result from the action of diptheria toxin. There is no permanent damage to the heart. Involvement of the nervous system sometimes occurs, and after faucial diptheria it usually commences with palatal palsy on about the tenth day of the illness. The voice assumes a nasal quality, while regurgitation of fluids through the nose and elluggishness of palatal movements may be observed. Paralysis of accommodation soon follows and may be inferred from the patient's complaint of difficulty in reading small print. Such paralysis may occur irrespective of the site of infection. In myopia it may pass unnoticed. A week or two later, the symptoms and signs of multiple neuritis may develop. Recovery from such neuritis is always ultimately complete. In exceptional cases paralysis of the diaphram and respiratory muscles may necessiate the use of mechanical respirator. Prophylaxis-(Treatment) Diptherinum is given by homoeopathist as anti-toxin remedy. Diptherium is prepared according to homeopathic pharmacophia, and like all homeopathic remedies is given to the sick patient. Diptherium will cure every case that crude anti-toxin will and is not only easy to admister, but safe and entirely free from dangerous sequellae, as it is homeopathic. Note- In Allopathic system Anti-Diptheric serum is given (ADS) and as a prophylactic DPT (Triple Antigen) is given to children. |
|
| News | Business | Features
| Editorial | Security
| Produced by Lake House |
Using revolutionary new techniques, the team produced startling colour
scan images which showed sections of the brain which are dealing with
sensations felt by the body respond when a patient is in pain. Scientists
have always been baffled from the wide range of responses from those
undergoing trauma. Frequently, bomb victims, for example, who lost their
legs or other limbs in blasts say they did not feel instant pain, nor did
they even realise they had lost a limb.
Q: What is the role of Interventional Cardiology in treating heart
defects?
