Fever fits

    Common condition in young children

By Nilma Dole

      Parents should be cautious and mindful when their children have fever fits because not all are related to epilepsy. More often than not , we tend to worry about it confusing it with epileptic fits but for any problem , a medical consultation is vital to determine what exactly is the cause. President of the college of paediatricians , Dr.Deepthi Smarage spoke about a particular type of fainting attack called fever fits.
      Q : What are febrile convulsions (fever fits) ?
      A : Febrile convulsions (also called fever fits , fits with fever or febrile seizures) is common condition in children , in the age group of six months to six years. They occur in 3-4%of all children.
           The child loses consciousness briefly and may develop jerky movements coupled with a bout of fever.
           This is not a prolonged fever because it is nothing to worry about but parents should ensure that the child is safe and not in harm's way.
      Q : Do fever fits need prompt treatment if there are repeated fits ?
      A : No. Since it is an age-related condition , it will pass when the child becomes older , after six years.
            Long-term medications have their own side effects because it can be harmful later on in the individual's life. As febrile convulsions are self-limiting , ensure that the child is in a safe environment when such a fit occurs.
      Q : In what way can parents or the guardians help the child when a fit occurs ?
      A : Unwanted manoeuvres during the time of the fit can endanger the child's health and will have dramatic consequences. This can lead to chocking and difficulty in breathing so parents/guardians should be educated on what to do. The important thing is not to panic and bring the child to a position lying down (horizontal) in a foetal position.
            No external substances should be administered by mouth during the time of the fit as it can have a dangerous impact. If the fit doesn't subside after about five minutes , the child should be taken to the doctor immediately.
      Q : Is there a particular drug which the parents/guardian can administer at home ?
      A : Yes , if the fit doesn't resolve spontaneously within five minutes , the parent/guardian can administer a medicine called diazepam which is given through a vial through the rectum.
            The child should be kept under observation and consult the doctor on a fre-quent basis.
      Q : Do febrile convulsions develop into epilepsy later in life ?
      A : This is very rare but if febrile convulsions prolong for more than 20minutes then the chances of developing epilepsy can be more.
            Even though febrile seizures are quite benign , every episode should be fully evaluated by a doctor. A child may have had three febrile seizures from which they recovered quickly and easily , but the fourth episode of convulsions and fever may be a serious illness , not febrile seizures. So it really depends from each child as it can trigger different reactions in children.
      Q : Do children with febrile convulsions need EEG (Electroencephalography) and CT (Computed axial Tomography) scans ?
      A : Not at all. If the diagnosis of febrile convulsions are very clear these investigations are not really necessary.
            Best is to talk to a doctor first before doing any sort of investigations.
      Q : Do febrile convulsions affect the development of the child ?
      A : No. A child will develop normally and achieve their full potential even if they have had febrile convulsions when they were small

Mano Roga or Ayurveda Psychiatry

OCTOBER 10 -   WORLD MENTAL HEALTH DAY

By Ayur. Psychiatrist
  Dr.Saman S.Hettige

      Mental illnesses are increasing day by day. According to the WHO there are 450 million phychiatric patients around the world.
      Mano Roga is classified into twenty two psy-chopathologies. It emphasizes how important the biological predisposition is to amalgamate with the environmental factors to develop psychiatric disease in human beings. This system is still being practiced in its original form at Manasa Hospital Boralesgamuwa (Sri Lanka) , Neelammahara by generations of traditional psychiatrists , which is endemic to them.
      Ayurvedic medicine is a system of traditional medicine native to the Indian sub continent and practiced in other parts of the world as a form of alternative therapy.
      Ayurveda remains an influential system of medicine in South Asia. The earliest literature on Indian medical practice appeared during the Vedic Period in India.Over the following centuries , Ayurvedic practitioners developed a number of medicinal preparations and surgical procedures for the treatment of various ailments and diseases and the first plastic surgery was done by Ayurvedic surgeon Susrutha 3500 ago and the blood circulation was exactly described in earliest ayurveda literature exactly as William Harvey described in 17th century.
      According to Ayurveda , "Nidrava" or sleep factor plays a vital role in one's mental health. One needs to have a sound sleep for at least 7 to 8 hours a day for the well-being of one's mental heath. It is stressed that breaking rest at night and sleeping during the day time are factors detrimental to the well-being of one's mental heath.
      The food we consume has an impact on our Mano dhosa and Kaika dhosa (Mental and physical heath). If consuming harmful food influences the mano Dhosa , it can effect the kaika dhosa and Manasika dhosa as well as in the end cause the malfunction of the brain.


Treatment
      This also indicates that physical conditions also effect the psycological state of and individual and vice versa. In Sankaya dharshanaya this bond is known as "Samavai Sambandathavaya" if broken there will be losses in the bond between the body and mind. Environment plays a vital role in one's mental health. If the individual id frequently exposed to stress induced environment or if a person is addicted to substance such as alcohol , heroin or even betel leaves they are vulnerable to mental illness. hereditary factor is also mentioned in the classical text as Nija Roga.
      In ayurveda the treatments are mainly divided into three. Ukththi Viyapashra (Rational therapy) , Daivap Viyapashra (Spiritual therapy) and Sathvawviyapashra (Phycological theraphy).
      Treatments are conducted according to the severity of the individual's condition.
      If the patients are aggressive , hostile and if the treatment cannot be conducted at home , we admit them to hospital for indoor treatments.For patients who are aggresive and hostile , special treatments such as Nasna (Nasal draining) , Hisagalvum (head packs) , Werechana (Purgatives) and Sheerodara are administered. If their condition is critical , counseling would have no effect. Therefore we are using these special methods to sedate the aggressive patients in the initial stage.
      October 10 is World Mental Heath Day. Boralesgamuwa Neelammahara Manasa Ayurveda Hospital the first ayurvedic mental hospital in Sri Lanka would be conducting a mental health campaign at the hospital the hospital premises today from 10a.m to 4p.m to raise public awareness about mental health issues. We want to make people aware of three conditions.
      Most often patients' guardians fail to recognize these conditions. And bring them to us only after the situation becomes worse. Once the disease becomes Nidangatha or chronic , it is very difficult to handle than during acute phase.   

Prostrate cancer

     

      The prostrate gland that contributes to form seminal fluid which provides nourishment to sperms when you are young. In old age it can become bigger and it could be benign or malignant , the latter being caused by cancerous changes. As the prostate gland enlarges , the layer of tissue surrounding it stops it from expanding and blocks the urethra. The bladder wall becomes thicker and irritable and contracts sending little urine , causing more frequent urination.

    * Prostate problems such as pain in the genitals , difficulty in passing urine and
       erectile dysfunction make people consult a doctor for a check-up.
    * There are symptoms like walking up in the middle of the night to pass urine and
       slow unsteady urine flow which is also part of prostate problems.
    * First a physical examination is done and then tests are checked to see if the
       biopsy is cancer cancer-causing.
    * A prostate-specific Antigen (PSA) Blood Test and a Urine Flow Study might
       also be done.
    * In young men , a prostrate problem called prostatitis can occur in which the
       prostrate gland can be infected due to an unknown reason.
    * Advance in medical science help produce drugs to relax and reduce the size of
       the prostrate.
    * Minimal Access Surgery including transurethral microwave thermotherapy
       (TUMT) can be used.
    * Seek advice from a qualified urologist or physician.
    * There is no way of preventing benign prostate enlargement since it occurs in
       old age but the best way to prevent complications is to submit yourself to a
       medical checkup early and seek treatment before the worst happens.
    * Neglecting prostrate problems can cause much discomfort and disruption in the
       quality of one's life. It may occasionally be life threatening if one fails to detect
       a cancer in time or wait till the bladder and kidneys are affected.

 

Cervical cancer

      "Studies have shown that if you are addicted to smoking and taking strong drinks at the same time , the chances of getting cancer are more.
      Also there are other forms of cancers that spread sexually like the human papillo-mavirus which causes cervical cancer" , She said. We should be careful and not indulge in bad habits , Dr.Perera said. "With a country having a history of oral cancer due to betel-chewing , the odds are heavily weighed against us with more cancer cases like lung cancer , colon cancer , ovarian cancer and even esophagus cancer becoming common".

      At present , some men may feel that prostrate cancer won't effect them and it's only a western disease. But in the future , the major cause of cancer in men in men would be prostrate cancer. She said , "Firstly , I would advise people to drink kola kenda at least three times a week , consult a qualified doctor if you are taking any form of medicine and have a healthy lifestyle with plenty of exercise and good food".

Breast Cancer

  Cancer is preventable

       Although breast cancer is the commonest form of the cancer in females , it is controllable in most women. They can live a near normal life if properly treated in the early stages of the disease. It is most common among women in the West. Breast cancer is a form of cancer which originates from the breast tissue , usually from the inner lining of milk ducts or the lobules that supply the ducts with milk.
      There are many different types of breast cancer and different stages depending on the spread  and genetic make-up.

    * Most breast cancers depend on hormones , estrogen and progesterone to grow and therefore women
       using oral hormonal contraceptives for long periods (usually over five years) may be at a risk of
       developing breast cancer.  
    * Screening for breast cancer before the symptoms are detected will help to identify the disease.
    * If you are above 50 years , have a mammogram done every year.
    * You should undergo a physical examination and seek medical sdvice.
    * Be careful of breast abnormalities.
    * Research has shown that women with certain risk factors are more likely to develop breast cancer those
       over 60 years , a personal history of breast cancer , family history  , gene changes  , re-productive and
       menstrual history and certain breast changes.
    * Women at risk should be concerned about their weight and have a balanced diet and do regular exercise.
    * Radiation therapy the chest , early menarche , late menopause  , lack of exercise and smoking can
       increase a woman's risk of having breast cancer . 
    * Treatment options include surgery , radiation therapy , chemotherapy , hormone therapy , and biological
       therapy and usually these are combined.
    * Mastectomy is done when the breast cannot be saved.
    * Most patients respond well to chemotherapy and hence there is hope.

   

Cancer

Cancer is preventable

      Some people wrongly think that cancer has something to do with karma and destiny , but it is preventable in most cases. According to Maharagama Cancer Hospital (Sri Lanka) consultant and secretary of the college of Oncologist Dr.Kanthi Perera , "Cancer is a one-hundred percent treatable disease but people die due to bad habits and ignore the warning signs". She said that there are patients who take treatment but do not heed advice and continue the habit of smoking and drinking. The doctor said that when cancer is diagnosed , it is often too late. Hence , it's not just detecting it early but changing your lifestyle and attitude.

breast cancer cells

      "We always advice them to take an example from other patients but they don't pay heed to it. Is it worth spending Rs.3 lakhs for treatment when your life is wasted by smoking a pack of cigarettes worth Rs.100 ?
Dr.Perera queried.
       Cancer occurs when different conditions cause cells to multiply uncontrollably. One such condition is the division beyond normal limits , invasion or intrusion on and destruction of adjecent tissues and sometimes metastasis which means spreading these cells to other parts of the body via lymph or blood. These three malignant properties of  cancer differentiate them from being  tumours , which are self-limited and do not invade or metastasis. In most cancer cases , causes a tumour but others do not.
         A survey conducted in Sri lanka , revealed that 20.4 percent of major cancer cases were due to oral cancer which was commonly in men. "There was a high incidence of oral cancer in men and women but with changing behavioral patterns and education , betel-chewing is now less prevalent among youth" , she said. The doctor who counts nearly 20 years experience as a consultant said that today , 25.4 percent of women have breast cancer which has become the number one cancer in women.
      "Modernisation and urbanisation has made it convenient for women to delay pregnancy , marry late and take various types of contraceptive pills" , she said. Even though breast cancer is common in the west , many Sri Lankan women get it quite early in life and this is a dangerous sign , she said.
      "The problem is that many people are stressed out and don't check themselves which is vital in detecting cancer in its early stages" , said Dr.Perera. She said that if someone uses a certain type of contraceptive pill or a medicine , she generally gives it to others and explains that it is beneficial. "What's good for one person doesn't mean it's good for another", she said. Nutrition levels among people were very poor. "With junk food freely available and the habit of not having meals time , make people sick. People should eat greens , yellow vegetables , a variety of fruits and drink plenty of water. "It is often due to negligence on the part of people that they fall victim to cancer at an early stage in life , she said.

               

Arthritis and its effects

International ARTHRITIS DAY - Oct 12

      Arthritis is not a single disease - it is a term that covers over 100 medical conditions. Osteoarthritis (OA) is the most common form of arthritis and generally affects elderly patients. Some form of arthritis can effects people at a very early age. In order to better understand what is going on when a person suffers from some form of arthritis , let us look at how a joint works.
      Basically , a joint is where one bone moves on another bone. Ligaments hold the two bones together. The ligaments are elastic bands , while they keep the bones in place your muscles relax or contract to make the joint move.

      Cartilage covers the bone surface to stop the two bones from rubbing directly against each other. The covering of  cartilage allows the joint to work smoothly and painlessly.
      A capsule surrounds the joint. The space within the joint - the joint cavity - has synovial fluid. Synovial fluid nourishes the joint and the cartilage. The synovial fluid is produced by the synovium (synovial membrane) which lines the joint cavity. If u have arthritis something goes wrong with the joint(s). What goes wrong depends on what type of arthritis you have. It could be that the cartilage is wearing away a lack of fluid , autoimmunity (your body attacking itself) , infection or a combination of many factors. There are over 100types of arthritis. Here is a description of some common ones , together with the causes :

      Osteoarthritis - Cartilage loses its elasticity. If the cartilage is stiff it becomes damaged more easily. The cartilage , which act as a shock absorber , will gradually wear away in some areas. As the cartilage becomes damaged tendons and ligaments become stretched , causing pain. Eventually the bones may rub against each other causing very severe pain.
      Arthritis sufferers will find there are good and bad days. Most patients with arthritis will suffer from discomfort , pain , stiffness and/or fatigue.
      You may also feel frustrated that you are no longer able to grip things so well or get around like you used to. It is important to remember that if you suffer from arthritis this does not mean you have to give up having and active lifestyle. With some changes to your way of  life there is no reason why you cannot continue being active.
     Physical therapy : Physical therapy and occupational therapy help maintain joint mobility and range of motion. How much therapy you need and what kind of therapy will depend on many factors, such as the severity and type of arthritis you have , your age and your general state of health. This has to be decided by you with your physician and physical or occupational therapist.
      People with arthritis will often avoid moving the effected joint because of the pain. A physical therapist can help the patient work out the joint stiffness without damaging it. In order to perform your daily activity the physical therapist will help you achieve a good range of motion. This may involve building strength in the muscles that surround the affected joint-stronger muscles help stabilize a weakened joint. You will also be taught the best way to move from one position to another , as well as learning how to use such walking aids as crutches , a cane or a walker , if you need one.
      Occupational therapy can teach you how to reduce the strain on your joints as you go about your daily activities. The occupational therapist can help you modify your home and workplace so that your movements do not aggravate your arthritis. You may need a splint for your hands or wrists , as well as aids for dressing , housekeeping , work activities , driving and washing/bathing yourself.
      An occupational and/or physical therapist can make an enormous difference to your quality of life if you suffer from arthritis.
      He/she will help you learn more about your arthritis , devise a dietary plan if you are overweight and over-stressing the joints as a result , help you make better decisions about what shoes to buy if that part of the body is affected. You will learn how and when to rest a therapist will most likely devise and exercise program. Exercise is a crucial part of effective arthritis therapy.