Balanced diet during pregnancy leads to healthy births -Dr. Jayasiri
Dr. Jayasiri Jayawardena
Revealing a pearly white smile, baby Bandula was loved even before he
was born and was the apple of his family's eye. Little did they know
that when he became a toddler, he wouldn't be able to walk, run or play
with other toddlers.
It was later that he was diagnosed with a condition known as
hydrocephalus referred to as 'water filled in the brain'.
Speaking to the Sunday Observer was one of Sri Lanka's leading
Ayurvedha specialists and consultant of the National Hospital,
Dr.Jayasiri Jayawardena who said, "A deformity happens when a baby is
born with a major difference in the traditional shape of the human
body." In toddler Bandula's case, his condition was where an abnormal
expansion of cavities (ventricles) inside the brain caused the
accumulation of cerebrospinal fluid. The doctor said, "Before he came to
me, Bandula had a big head, problems with walking, couldn't control his
bowels or his bladder and he was on the verge of being mental impaired".
One in 500 children are estimated to be stricken with hydrocephalus
but often the ones that are reported are very rare. Dr. Jayawardena
Bandula, before he was
treated, and walking after
"The causes of hydrocephalus are still not well understood as it
could be due to various unexplained reasons but in Bandula's case it was
a complication of premature birth. I believe that if Bandula wasn't
cured at this age, he would have grown into a mentally-imbalanced
A deformity can also be termed as dysmorphism or a dysmorphic feature
where a part of the body can have unusual appearance. "In Sri Lanka, a
major cause of deformity in children are due to complications during
birth which can be easily prevented. Some can be due to hereditary or
even a sort of under-development of the foetus during the pregnancy," he
said. He said that a good pregnancy and a healthy delivery determines
the overall well-being of a child.
According to the doctor, a growth or a hormone disorder can also be
the cause of a deformity and so can conditions such as arthritis and
rheumatoid disorders, but in Sri Lanka, the focus must be placed on good
labour techniques during childbirth.
"There have been cases where pregnant women have given birth to
children with deformities after being poisoned by Carbon Monoxide or
Barbiturates," he said. In fact, certain drugs administered in
therapeutic dosage to the mother during the first three months of
pregnancy may also be responsible for foetal malformation.
"Most babies who have severe deformities where they can't be cured
die quickly due to a missing vital organ but in cases where they have
survived it is the simple fact that a baby wasn't delivered properly
where a deformity has occurred," said Dr. Jayawardena.The phenomenon of
deformities have been in existence since humankind first walked the
earth but for many sufferers who are born with it, shouldn't ashamed.
International celebrities who, in our minds, are the perfect example
of beauty and handsomeness do actually have their own stories of
childhood or adult deformities. From Bollywood heartthrob Hrithik Roshan
to Hollywood's leading lady, Jennifer Garner, some of the world's
beautiful people are in fact physically deformed.
While surgery can rectify a majority of deformities including the one
Bandula suffered with, it is basic principles that can prevent such
"My advice to pregnant women is to make sure that they are not
stressed and live comfortably. If they have a little mental strain, it
is likely to cause an impact for the unborn child. In addition to this,
make sure the delivery will be done at a reputed hospital where measures
are in place should something problematic happen to the baby," said the
He also said that pregnant women should breathe fresh air, shouldn't
be near dangerous factories exuding toxic fumes and should be careful
with what they eat.
"We can't change or control the environment we live in but we can
ensure that we live in a healthy environment by relocating ourselves to
a nicer location.
It would make a world of a difference to not only your baby but to
your whole family," he said.
Dr. Jayawardena has the cures of deformities in his Ayurvedha
treatment and has extensively practised in the sector for nearly 50
A skin specialist and a therapeutic Ayurvedha practitioner, Dr.
Jayawardena believes that the food we consume has much to do with our
"Eat a balanced and healthy diet with less salt and less sugar. I've
seen many pregnancy complications arising because of poor diet and not
eating the right nutritious foods," he said.
If we want to have healthy families who are not a burden to society
and have better lives, be careful and take your pregnancy seriously.
Proteus syndrome - It is a rare congenital disorder with highly
variable manifestations, including partial gigantism of the hands and
feet with hypertrophy of the palms and soles, nevi, hemihypertrophy,
subcutaneous tumors, macrocephaly and other skull abnormalities, and
abdominal or pelvic lipomatosis. The cause is unknown, although a
genetic origin, possibly of autosomal-dominant transmission, has been
conjectured. Although symptoms can be treated, there is no known cure.
Maxillofacial Multiple Fibrous Dysplasia - Patients with typical,
relatively limited facial bone disease have this condition.
Craniofacial fibrous dysplasia is present where there is extensive
involvement of facial bones and bones of the skull.
Micromelia - It is the abnormal shortness or smallness of limbs and
it is also called nanomelia.
Mongolism or Down's Syndrome - It is the abnormal condition of a
child born mentally deficient, with a flattened skull, narrow slanting
eyes, and a short, flat-bridged nose and it is usually known as Down's
Hydrocephalus - This is the result of an imbalance between the
formation and drainage of cerebrospinal fluid (CSF).
Hydrocephalus comes from two Greek words: hydros means water and
cephalus means head. There are two main varieties of hydrocephalus:
congenital and acquired. An obstruction of the cerebral aqueduct
(aqueductal stenosis) is the most frequent cause of congenital
Acquired hydrocephalus may result from spina bifida, intraventricular
hemorrhage, meningitis, head trauma, tumors, and cysts.
(References from www.medical-dictionary.thefreedictionary.com)
Obese patients and airway problems
A major UK study on complications of anaesthesia has shown that obese
patients are twice as likely to develop serious airway problems during a
general anaesthetic than non-obese patients. 'The airway' means the air
passages from the outside world to the lungs, which must be kept open to
keep the patient alive. The study also shows that the use of a simple
breathing monitor, called a capnograph, could significantly reduce
deaths and brain damage from such problems in intensive care units
(ICUs); it found that absence of a capnograph contributed to 74% of
deaths from these events in ICUs during the study.
The report, which is published in two parts online in the British
Journal of Anaesthesia, is the result of a yearlong prospective study by
the Royal College of Anaesthetists (RCoA) and the Difficult Airway
The full report is available on the RCoA website on the same day. The
project, which identified that 2.9 million general anaesthetics are
given in the UK each year, monitored all major complications of airway
management that occurred in these patients and in ICUs and in emergency
departments throughout the UK in 2008-2009. It studied only events
serious enough to lead to death, brain damage, ICU admission or urgent
insertion of a breathing tube in the front of the neck.
The report has several findings and recommendations; but those on
obesity and the monitoring of breathing are among the most striking.
In addition to the two-fold increased risk of obese patients
developing serious airway problems during an anaesthetic, the study also
found that patients with severe obesity were four times more likely to
develop such problems. In addition, obese patients were more likely to
die if they sustained airway complications in ICU. Some obese patients
died from complications of general anaesthesia whilst undergoing
procedures that could have been performed under local or regional
anaesthesia (where only part of the patient's body is anaesthetised). In
some cases this alternative appeared not to be considered.
Dr. Nick Woodall, Consultant Anaesthetist at the Norfolk and Norwich
Hospital (Norwich, UK), and an author of the report says: "Our findings
show that patients who are obese have twice the risk of major airway
problems during anaesthesia, compared to non-obese patients. In the very
obese this risk is even higher. The report is important for patients and
anaesthetists alike. The information will enable obese patients to be
better informed about the risks of anaesthesia and to give informed
consent. We hope our findings will encourage anaesthetists to recognise
these risks and choose anaesthetic techniques with a lower risk, such as
a regional anaesthesia, where possible, and also prepare for airway
difficulties when anaesthetising obese patients."
Airway problems were more likely to result in death in patients
sedated on ICUs than if they occurred during anaesthesia for surgery.
Half of the reports of events on ICUs described a patient death from
the complication, whereas 12% died when the complication occurred during
anaesthesia. Of the events reported from ICU 61% led to death or brain
damage, compared to 14% of events during anaesthesia.
The most important finding was that the absence of a breathing
monitor (capnograph) contributed to 74% of airwayrelated deaths reported
from ICUs. The authors say that if the monitor had been used it would
have identified problems at an earlier stage and so could have prevented
some of the deaths altogether.
The capnograph, which detects exhaled carbon dioxide, is used almost
universally in anaesthesia but only sporadically in ICUs. Several
authors and organisations have recommended that it should be used
routinely in ICUs but, at present, this does not appear to be happening.
Dr Tim Cook, a Consultant in Anaesthesia and Intensive Care at the
Royal United Hospital, Bath (Bath, UK), and one of the report authors,
says: "The findings of this report indicate that when airway problems
arise in this group of sick patients the consequences are often very
severe. The report makes several recommendations to improve the safety
of airway management in the ICU.
The single most important change that would save lives is the use of
a simple breathing monitor, which would have identified or prevented
most of the events that were reported. We recommend that a capnograph is
used for all patients receiving help with breathing on ICU; current
evidence suggests it is used for only a quarter of such patients.
Greater use of this device will save lives."
Although the poor physical condition of patients needing to be in ICU
possibly accounted for some the difference in outcome, the report
identified several other causes:
* patients on ICU who are at risk of airway problems were less likely
to be identified (and their management changed) than when undergoing
anaesthesia; * the range of equipment available to manage patients with
difficult airways is often less extensive in ICU compared to patients
being anaesthetised in operating theatres; * changes in training mean
that the junior doctors looking after patients out of hours on ICU may
have little experience in the management of difficult airway problems; *
rescue techniques (procedures performed to resolve a problem with the
airway) are less likely to be successful in ICU compared to during
Dr Cook says: "Despite the finding of this project, it is clear that
anaesthesia remains extremely safe. The report estimates that a
life-threatening airway complication occurs in less than one in 20,000
general anaesthetics (0.005%) and death in approximately one in 180,000
anaesthetics. Most patients who had complications that were reported to
this project had identifiable risk factors such as obesity or head and
neck cancer; these patients are at a much higher risk of airway
complications than healthy patients undergoing anaesthesia and surgery."
Dr. Peter Nightingale, President of the RCoA, comments: "I believe
this report highlights areas of critical concern for all doctors
involved in maintaining the airway of patients receiving anaesthetics or
in intensive care units.
The report provides a specific insight into the high risks and
complications associated with airway management and obese patients which
should act as a focus for all healthcare professionals treating such
Dr. Ellen O'Sullivan, President of the Difficult Airway Society,
adds: "The Difficult Airway Society welcomes the publication of this
important study which emphasises the critical importance of high quality
airway management in providing safe care of patients during anaesthesia
and in intensive care.
The report shows that in a small number of cases there is room for
improvement and it is important that as a profession we listen to these
Source: Charlie McLaughlan Oxford University Press
Turning unhealthy dependency into healthy dependency
Think of a dependent person and you think of someone who's needy,
high-maintenance, and passive. That's how many psychologists and
therapists think of them, too; passivity is key. But dependency is
actually more complex and can even have active, positive aspects, writes
Robert Bornstein of Adelphi University, the author of a new article
published in Current Directions in Psychological Science, a journal of
the Association for Psychological Science.
Bornstein was sent towards a different concept of dependency by a
series of experiments he did in graduate school. He paired a dependent
person with a less dependent person and set them to debate an issue they
disagreed on. He expected that the dependent person would give in to
their peer. But the opposite happened; 70 percent of the time, it was
the nondependent person who gave in. So the assumption of psychologists
was wrong; dependent people aren't always passive. The reason, he
realized, was that they wanted to impress the professor running the
"My understanding, based on what studies we've done so far, is that
the core of a dependent personality is a perception of one's self as
helpless, vulnerable, and weak," Bornstein says. He believes this often
comes from growing up with overprotective or authoritarian parents. So
dependent people decide "the way to get by in life is to find someone
strong and never let go." That means they want to impress authority
figures who might help or protect them later; they also want to maintain
relationships at all cost.
The surprising part is that this need to impress can lead to some
very active, non-passive behavior. The reliance on authority figures
explains why dependent people are more likely to see a doctor when they
have an alarming symptom, and more likely to stick to a treatment
regimen or a weight-loss program when a doctor assigns it to them.
This can also make them conscientious therapy patients.
Other studies have found that dependent college students have higher
GPAs than non-dependent college students. "If you're a non-dependent
person, the general feeling is, 'well, I'll have to figure it out on my
own,'" Bornstein says. "Dependent students, who are predisposed to seek
help from an authority figure, will go to a professor and ask for help."
Of course, that's not all good. Seeking medical attention after every
little twinge isn't necessarily useful, and a dependent college student
can drive his professors up the wall. Another surprising finding is that
dependent men are more likely to perpetrate domestic violence; they're
so worried about maintaining the relationship that, "When they get
desperate, they resort to coercive tactics," he says.
Bornstein thinks the new way of thinking about dependency is helpful
to psychological scientists and also to therapists. "I'm trying to move
toward a fundamental shift in the way that psychologists or therapists
deal with dependent patients," he says. Traditionally, the goal was to
make the dependency go away. "My take on it is, the most effective way
to deal with dependent patients is to turn unhealthy dependency into
(Source: Divya Menon Association for Psychological Science)
Tumours use white blood cells to halt treatment
Cancer Research UK scientists have discovered that tumours are able
to recruit part of the body's defence system to protect them from the
effect of a drug designed to block the supply of blood to the tumour.
The research, published in The Journal of Clinical Investigation,
showed that white blood cells called macrophages, normally a key part of
the body's defence mechanism against disease, are recruited in large
numbers by tumours and reduce the effects of an experimental drug called
This is a type of drug called a vascular disrupting agent (VDA) as it
rapidly and selectively blocks blood vessels in tumours causing
widespread tumour death.
Research groups in Sheffield, led by Professors Claire Lewis and
Gillian Tozer - working with Professor Michele De Palma and colleagues
in Milan - showed that after treatments with CA4P, tumours in mice begin
to release a protein called CXCL12. This recruits these white blood
cells from the bloodstream into the treated tumour where they then help
to block the effect of the drug on the blood vessels and to encourage
tumour growth.But this effect can be stopped. By blocking the receptor
for CXCL12 on these white blood cells, so stopping their recruitment by
the tumour, treatment with CA4P was significantly better at slowing
tumour growth than when the VDA was used alone.Professor Claire Lewis, a
Cancer Research UK-funded scientist at the University of Sheffield,
said: "We know that drugs that block blood vessels in tumours have a
really damaging effect on the cancer, but this is often only short-lived
and tumours start to re-grow.
"By expanding our research into what prompts macrophages to drive a
tumour's re-growth after therapy we should now be able to find ways of
blocking their effects and making such treatments more effective."
Professor Malcolm Reed, Head of Surgical Oncology at the University
of Sheffield, commented: "This exciting work provides valuable insights
into the possible mechanism which may result in a cancer becoming
resistant to treatment with chemotherapy. This has the potential to help
develop new approaches to improve treatment for patients."
CA4P is an experimental type of drug that targets only the blood
vessels that supply cancer cells. It is currently in trials for a number
of cancers to find out the best dose and how effective it is.
Dr Julie Sharp, senior science information manager at Cancer Research
UK, said: "This exciting area of research provides a critical insight
into how cancers are able to use the body's own defences for their own
survival. Cancer Research UK is funding further research into how these
white blood cells are helping to resist anti-cancer drugs. By tackling
this challenge of treatment resistance we will help more people beat
(Source: Cancer Research UK)