|
|
 |
 |
 |
| Friday, 26 March 2004 |
 |
|
 |
Features | |
| News Business Features Editorial Security Politics World Letters Sports Obituaries
|
Ponder points on conceiving by Dr. P. A. Denagama, Obstetrician and Gynaecologist, General Hospital Trincomalee
Preconception counselling is not routinely done in Sri Lanka although it is done so in the developed countries. It is a known fact that the babies born tomorrow will father the nation. So we have the inescapable responsibility of making sure that the babies born be intelligent and healthy. In this sense it demands some planning before the conception. Preparation 1. To make sure that the mother is healthy enough to bear the pregnancy 2. Making sure that the baby is free of defects 3. Acquiring sufficient knowledge needed to nurture the baby. In making-sure that the mother is suitable for conception, we have to see that the mother is fertile enough too. This is of concern if she has been on oral contraceptive pill or injections (Depo-Provera). Usually it may take about three months before the woman regains her ability to ovulate, once these hormonal contraceptives were stopped. So it is wise to omit either the pill or the injection at least 3 months prior to the planned time of conception. Having done so, the couple should be using ideally condoms until they are hundred percent prepared for the conception. When condoms are used the couple should make sure that they depart immediately after emission of seminal fluid for there is a chance of conception with the back-flown fluid if they wait long. Mothers Health The health of mother should warrant a conception. So ideally the mother should undergo a medical examination to see whether she has got any medical problem to be corrected. Some mothers already know that they have some medical problem - for example some heart disease, epilepsy, severe bronchial asthma, kidney diseases, high blood pressure or diabetes. In these circumstances she should go to her relevant medical specialist and get herself suitable for conception. There a few instances where the mother is advised against a conception for a conception might endanger her own life - in fact they better undergo permanent sterilization. The simplest way to assure the health of the average Sri Lankan mother is to see that her blood is thick enough - or in other words, her haemoglobin level is satisfactory. If the haemoglobin level - commonly called Hb - does not prove to be satisfactory, the medical officer has to do two things. One is to do further investigations to see that the low Hb level is not because of a disease in the blood. Secondly, the medical officer has to see that the deficit is corrected before the conception. Iron therapy to correct low haemoglobin levels is not usually done within the first three months of pregnancy because of two main reasons. First three months of pregnancy is associated with nausea and vomiting and iron therapy usually aggravates that condition. There are some schools of thought that iron in early pregnancy may be associated with malformations in the baby. Congenital Anomalies It is essential that the baby is made sure of no or minimal congenital anomalies. This is done by sticking to a diet as natural as possible exposing herself minimally to the environmental hazards. Drugs may play a very important role. Mothers who are routinely on drugs should go to the respective medical specialists and trim their prescriptions to get the safest drugs in optimum doses. If any mother is already suffering from diabetes mellitus she has to get her sugar levels hundred percent controlled since at least one month before the conception. This can be done with diet control alone or in combination with insulin therapy. They should not be using sugar controlling pills for they themselves may bring about some defects in the baby. Folic Acid Deficiency Folic acid is a vitamin of the B vitamin family. The deficiency of this vitamin during conception may bring about serious defects in the brain and spinal cord of the baby. Folic acid is naturally available in green leafy vegetables. The fact that the urban Sri Lankan diet does not include fresh leafy vegetables alarms the possibility of folic acid deficiency in the urban Sri Lankan women. Once one gets deficient in this vitamin it takes about three months to get the stores replenished. So, I recommend that every woman should get folic acid therapy since three months prior to the time of conception. Rubella is a simple viral infection that one might even get unnoticeably, but if the conception in its early stages gets this infection it leads to severe defects in the babies eyes, brain and heart. So any woman should be immune to rubella infection well before she conceives. This immunity is made sure of by Rubella immunization which is given through MOHs. After the Rubella immunization the couple is advised to wait for three months before conceiving. Excess of vitamins Here it should be mentioned that certain vitamins in excess can lead to defects in the baby. So vitamins should not be taken without medical consultation around the time of conception. Knowledge-wise the mother should be prepared before the conception. This knowledge should enable her not only to know how to behave around and after conception but also to know how to feed the baby and how to nurture the baby. Behaviour Behaviour means her eating, moving, sleeping, resting and even reading (including viewing the TV). She should gather scientific knowledge to understand what to be eaten in what quantities and what not to be eaten. How she should move her body especially just after conception is worth knowing before hand. This is also a good time to read and understand or gain knowledge in other way about the advantages of breast feeding and the disadvantages of artificial feeding. This kind of knowledge will create a strong determination on how to feed the baby. The technique can probably be known in the pregnant period. Information on how to bathe, feed and look after the baby can be collected during this period of preparation. There is increasing concern over the fact that what the mother reads views and thinks may be inculcated in the future behaviour of the child. So during the pre-conception the mother can collect information on this aspect too. *************** What is Cancer? Cancer is a group of many related diseases that begin in cells, the body's basic unit of life. It can occur in any part of the body and is named after the organ or type of cell in which it begins. Normally cells grow, divide in an orderly manner, with new cells replacing dead cells. This process is regulated by the body in order to maintain the correct shape and size of organs and tissues. It is when this system fails that a cell becomes cancerous. Cancer cells continue to grow, divide in an uncontrolled fashion and accumulate forming a lump or mass called a tumour. Tumours can be malignant (cancerous) or benign (noncancerous). Cells from a cancer can invade surrounding tissues or break away and travel to other parts of the body, where they continue to grow. This spreading process is called metastasis. Benign tumours do not grow and spread the way cancer does and are usually not a threat to life. Cancer-the scope of the problem According to WHO statistics 6 million people will die of cancer in the world every year. By 2020 there will be 20 million new cases of cancer in the world and 20% of these will be in developing countries. In Sri Lanka it is estimated that there will be 4000 deaths from cancer and 12000 new cases of cancer each year. Recent data indicates that more than 50% of cancers in the USA are linked to unhealthy lifestyles. 30% of cancer deaths are caused by poor diet, while tobacco use accounts for another 30%. Evidence suggests that atleast 70% of cancer related deaths could be prevented by early detection (Screening) and education. What causes Cancer? Cancer usually develops gradually over many years. The exact cause of cancer is yet unknown, but it is thought that cancer is a result of complex mix of factors related to lifestyle, heredity and environment. Several Risk Factors, that is anything that increases a persons chance of getting a disease, have been identified. However not everyone with risk factors will get cancer, while others who get cancer may not have any known risk factors. Some Risk Factors can be avoided but others cant be changed. Cancer is not contagious; you cannot catch it from another person. Risk Factors Associated with Cancer * Tobacco Cancer can result in a variety of symptoms but having any of these does not mean that you have Cancer. How is Cancer diagnosed? Your doctor will take your medical history, perform a physical examination and run a series of tests to confirm the diagnosis. These include blood and urine tests, imaging procedures (X'ray, MRI, CT and Ultrasound scans) A Biopsy where a sample of tissue is removed for examination under a microscope is necessary to confirm a diagnosis of cancer. How is Cancer treated? Treatment depends on the type, location and stage of the tumour, your age and overall health. Currently available methods include surgery, radiation therapy, chemotherapy, hormone therapy and immunotherapy. Prevention and early detection of Cancer Just 50 years ago, diagnosis of cancer meant inevitable death. Today in the developed world, more than 50% of cancer patients are cured and the disease can be prevented in many others. This is in part due to the improved techniques for treatment and also because of the emphasis on prevention and early detection (screening) as important and effective strategies in diminishing suffering and saving lives lost from cancer. What is prevention? Prevention includes measures that stop cancer from developing and can be achieved by identifying and avoiding risk factors and by actively taking steps to reduce one's risk. Making lifestyle changes such as stopping smoking, reducing alcohol intake, eating a healthy diet and getting regular exercise, can dramatically reduce risk. What is screening? Screening involved testing apparently healthy people who do not necessarily perceive themselves to be at risk of a disease, to try and identify those that have very early stage disease. Screening tests are done when you have no symptoms, to reduce the risk of a disease and its complications. Whilst screening has the potential to save lives or improve the quality of life, it is not a fool-proof process and does not guarantee diagnosis and cure. Screening tests are available for: Breast Cancer A screening Mammogram which is a special kind of x-ray picture is the best tool available to find breast cancer before symptoms appear. Breast cancer screening has been shown to reduce the risk of dying from this disease. Doctors recommend that women in their forties and older have mammogram, every 1 to 2 years. Cervical Cancer Doctors use the Pap Smear test, to screen for cancer of the cervix. For this test, cells are collected from the cervix and examined under a microscope to detect cancer cells or changes that may lead to cancer. Colon and Rectal Cancer A number of screening tests are used to find colorectal cancer. If a person is over the age of 50 years, has a family medical history of colorectal cancer, or has any other risk factors for colorectal cancer, your doctor may suggest one or more of these tests. Sometimes tumours in the colon or rectum can bleed. The Faecal Occult Blood Test checks for small amounts of blood in the stool that isn't visible to the eye. A thin, lighted tube called a Sigmoidoscope may be used to examine the inside of your large bowel. A barium enema is a series of x-rays taken following a solution containing barium, which outlines the colon and rectum on the x-rays. A Digital Rectal Examination is an exam in which the doctor inserts a lubricated, gloved finger into the rectum to feel for abnormal areas. Although it is not certain that screening for other cancers actually saves lives, doctors may suggest screening for cancers of the skin, lung, oral cavity, prostate, testes and ovaries. Doctors consider many factors before recommending a screening test. They take into account factors related to the individual, the test, and the cancer that the test is intended to detect. The doctor pays special attention to a person's age, medical history, general health, family history, lifestyle to estimate a persons' risk for developing specific types of cancer. In addition, they will assess the accuracy and the risks of the screening test and any follow up tests that may be necessary. Doctors also consider the effectiveness and side effects of the treatment that will be needed if cancer is found. You may want to discuss any concerns or questions you have about screening with our doctors, so that you can weigh the pros and cons and make an informed decision about having screening tests. (Courtesy: Ceylinco Cancer Detection Centre) *************** The wonder of Human Touch The human hand has a particularly refined sense of touch. According to Smithsonian Magazine researchers found that our hand can detect a dot just three microns high. However by using a texture rather than a dot, the researchers found the hand can detect roughness just 75 nano-meters high - A nano metre being one thousandth of a micron. Such remarkable sensitivity is attributed to about 200 touch receptors in each fingertip. Our sense of touch also plays a key role in our health and well-being. The caress of another person releases hormones that can ease pain and clear the mind says US news and World Report some believe that when a child is deprived of the loving touch of others, its growth will be impeded. (Courtesy Awake March 8, 2003) |
|
News | Business | Features
| Editorial | Security
Produced by Lake House |
