Two Colombo Faculty Medical students produce:

Asia Pacific region's first compact disc on poisons information

Two final year medical students in the Colombo Medical Faculty are being credited with producing the first compact Information CD on poisons in the Asia Pacific Region.

The two Medicos, Kelum Pelpola and Taraka Perera presented their diskette at the 5th Asia Pacific Toxicology Conference held in Colombo last month (August 6) where the chief guest was Health Minister Nimal Siripala de Silva.

Prof. Ravindra Fernando head of the National Poisons Information Centre in Sri Lanka writing to us on this event states;

A 'poison' can be defined as any substance that impairs health or destroys life when ingested, inhaled or absorbed by the body in relatively small amounts.

In Sri Lanka, over 80,000 patients are admitted to State hospitals for poisoning every year. In 2000, 2666 patients died of poisoning, and it is the fourth leading cause of death in State hospitals. Sri Lanka has one of the highest rates of suicides in the world, as a result of nearly two thousand deaths caused by ingesting liquid pesticides.

Being more informed about poisons and the management of poisoning is essential under these settings. Physicians or any doctor for that matter should find information about poisons and its management handy to use in the emergency setting.

A book on 'Management of Poisoning' written by me is available and it is freely distributed under the patronage of the National Poisons Information Centre, among doctors.

However, with the dawn of the new millennium, 'e-knowledge' has become a buzz word. Addressing this issue, Kelum Pelpola and Taraka Perera, two medical students of the A/L 2000 batch of Faculty of Medicine, University of Colombo, have designed a compact disc which was geared to greet the new information age with accuracy, efficiency and cost-effectiveness.

The compact disc brings to light some innovations:

The opening menu - the main menu is divided into five different sections namely, animal poisons, plant poisons, household and industrial chemicals, drugs and agro chemicals. This enables easy access from the opening page. It also enables the users outside the medical field to access data in a more systematic way.

Detailed and emergency sections - Two sections on 'emergency' and 'detailed version' for every entry of poisoning have been introduced. The 'emergency' section includes the clinical features and management only, while the detailed section has more information about the poison including research articles whenever possible.

Search page - The search page contains basic instructions of how to perform a search. After doing the search, the pages are indexed according to priority, where the first entry denotes the most relevant page for the searched word.

Image gallery - this contains images of related animals and plants currently. It would be further updated in the future.

This compact disk could be used as an excellent learning and reference tool by undergraduates as well as medical professionals. It would also enable the medical professionals in Sri Lanka to refer the information on poisons and its management with efficiency and ease. It could also be reproduced easily and updated with minimal hassle.

The cost will not be an issue since a compact disk can be produced with a total cost of around Rs. 40. Another advantage is that it could be used with minimum technical requirements, specially in the Sri Lankan setting.

The compact disk was created in a format that could be converted into a website. That website was created recently and can be accessed at www.npid.tk.

The website functions as the official site of the National Poisons Information Centre. It is a comprehensive website which deals with management of poisoning, and is the first of its kind in South Asia.

The site is also has a 'forum' where anybody who is interested in the topic of management of poisoning can have discussions about the major issues, newest developments etc. Registration at the site and forum could be done by visiting www.npid.tk.

The registered members would be constantly updated regarding the new developments and other major important issues in management of poisoning in Sri Lanka.

The compact disk and the website were launched as the 'National Poisons Information Database' at the inauguration of the 5th Asia Pacific Toxicology conference held in Sri Lanka on August 6, 2006 where Minister of Health Nimal Siripala de Silva was the chief guest.

World Heart Day tomorrow:

'How young is your heart?'

Dr. S. Pradeep Chand

Consultant Cardiothoracic Surgeon

HEALTHY HEART: World Heart Day is the World Heart Federation's most important advocacy event aimed at increasing public awareness and promoting preventive measures to reduce cardiovascular disease.

Since 1999, the World Heart Federation (WHF) and its 189 cardiology societies and heart foundations in more than 100 countries have celebrated World Heart Day; celebrated annually, on the last Sunday of September.

Each year it is focused on a specific theme and activities around the world including walks, runs, jump rope and fitness sessions. This year's World Heart Day theme is 'How young is your heart' and it will take place on September 24, 2006.

To enjoy life fully, you need a healthy heart. The World Heart Federation organises World Heart Day in order to make everybody aware of the importance of lifestyle to maintain a healthy heart. Controlling the major cardiovascular risk factors, by choosing a healthy diet, being physically active and by not smoking can prevent 80 per cent of heart attacks and strokes and may help the heart to age more slowly.

That's why this year's World Heart Day, under the theme 'How young is your heart?', will encourage people around the world to adopt a heart-healthy lifestyle to help maintain a young heart for life by controlling the major cardiovascular risk factors, by choosing a healthy diet, being physically active and by not smoking can prevent heart attacks and strokes.

If we put as much effort into keeping our hearts young, we would see a dramatic decrease in the number of premature deaths from heart disease and stroke each year. Heart disease and stroke are the world's greatest killers, claiming 17.5 million lives a year which represents nearly one third of all deaths in the world. Most of us aren't so very conscious of this. The general thinking is that 'this can never happen to me'.

By asking everyone to think about the age of their hearts on World Heart Day we're encouraging the world's population to adopt a heart-healthy lifestyle."

Controlling major risk factors such as physical inactivity, an unhealthy diet and tobacco use could prevent 80 per cent of heart disease and stroke and help keep the heart healthy. This is why this year's World Heart Day campaign asks: "How young is your heart?"

Physical activity and heart health

Physical activity is vitally important to maintain a healthy heart. Running for one hour or more each week could reduce the risk of heart disease by 42 per cent. A moderate exercise such as a brisk walking of 30 minutes each day has been found to reduce the risk of heart disease by about 18 per cent and stroke by about 11 per cent. Commuting to work by foot is a practical way of achieving this level of physical activity.

Physical inactivity increases the risk of obesity and overweight, diabetes and hypertension which made heart age run faster. Failure to exercise is as bad for health as smoking a packet of cigarettes everyday, experts have warned.

The World Heart Federation said physical inactivity doubles the chances of developing heart disease and increases the risk of diabetes and high blood pressure. Doctors estimate that between 65 per cent and 85 per cent of the world's population fail to take enough exercise.

The heart needs regular exercise to keep it pumping blood efficiently with every heart beat. Regular activity and its impact on associated risk factors helps to slow down the narrowing of the arteries to the heart and brain, encourages the body to use up excess stored fat, can help to reduce high blood pressure, improves 'good' cholesterol levels (HDL cholesterol) and maintains normal blood glucose levels.

A healthy diet

The famous age-old proverb 'The way to a man's heart is through his stomach' is unfortunately leading to serious health problems. For many, a sumptuous, sizzling meal could be more damaging to the heart than the pleasure derived from eating it.

It is also important to balance calories consumed with calories burned to help maintain a healthy heart for life. A balanced diet includes plenty of fruits and vegetables, whole grain products, lean meat, fish and pulses, alongside low-fat and fat-free products. Unsaturated soft margarines and oils such as sunflower, corn, rape-seed and olive oil are preferred to saturated fats.

Eating for a youthful heart - antioxidants

Research indicates that some of these foods, ass part of an overall healthful diet, have the potential to delay the onset of many age-related diseases including cardiovascular disease and strokes.

A diet rich in antioxidants is also beneficial in improving and maintaining health, thereby slowing the aging process. Through naturally occurring processes within our bodies, reactive substances known as free radicals that cause damage to our cells are produced.

Research suggests that there is a link between these free radicals and a number of degenerative diseases associated with ageing, such as cardiovascular disease and strokes. Antioxidants neutralise free radicals before they can cause harm.

Antioxidants are present in foods in many forms including vitamins, minerals, carotenoids, and polyphenols, and others. Many antioxidant-rich foods can be identified by their bright, distinctive colours - the red of cherries and of tomatoes; the orange of carrots; the yellow of corn, mangoes, and the blue-purple of eggplants and grapes. Some of the most well-known antioxidants are vitamins A, C and E; minerals such as zinc and non-essential compounds such as lycopene and resveratol.

Say no to tobacco

Tobacco use is one of the most important risk factors to control. Quitting will help to keep the heart young as it helps maintain 'good' cholesterol levels, reduces the levels of blood clotting and overall, decreases the chance of a sudden blockage of a blood vessel.

According to the Framingham Heart Study, life duration is substantially shortened by tobacco users. Non-smokers may live about 8 years longer than smokers. With passive smoking increasing the risk of coronary heart disease by 25-30 per cent.

A healthy heart is vital for living life to the full, regardless of age and gender. Unhealthy diets, physical activity and smoking are the leading causes of heart disease and stroke.

These unhealthy behaviours are increasingly common among children and teenagers and are being adopted at an alarmingly early age. That's why World Heart Day this year is focused on how important it is for children, in all parts of the world, to have a heart for life, a special focus this year on childhood obesity.

With the growth in childhood obesity and the lack of physical activity, increasing numbers of children are at risk of heart disease. In response, the American Heart Association is dedicating 2006 World Heart Day to kids' heart health.

"Overweight adolescents have about a 70 per cent chance of becoming overweight adults - increasing their risk for heart disease," he said. "An investment today in the world's children can secure a healthy tomorrow."

Physical activity is virtually important to maintain a healthy heart. Running for one hour or more each week could reduce the risk of heart disease by 42 per cent. A brisk walking of 30 minutes each day has been found to reduce the risk of heart disease by about 18 per cent and stroke by about 11 per cent.

Our own health habits influence our children's. By taking a long-term approach to our own health and well-being through regular physical activity and eating a healthful diet, we are setting a clear example for our own children and helping them build a healthier future for themselves.

Enabling Environments for better health

Perhaps for the first time here, awareness was created on how health, the most precious gift to us, could get affected through marginalisation of people resulting from man-designed and built public buildings and places.

It was a distinguished gathering of people in Colombo exceeding one hundred in number. My husband, who is still unable to walk steadily after surgery to his right leg and, I were privileged to get invited here.

What was remarkable about this truly successful and thought provoking programme on such an important subject was that it has been designed and organised almost single-handed with much foresight, by a Paraplegic seated on a wheel-chair, Dr. Ajith C. S. Perera, a tragic victim of a fallen wayside tree in Colombo. Here was a disabled person who won our admiration for his leadership capabilities, in conducting such a programme for over two and a half hours throughout.

Here was Dr. Ajith Perera, giving leadership to IDIRIYA, the organisers of this awareness programme, a not-for-profit group of professionals working voluntarily. Dr. Perera whom most of us in the audience met only for the first time, lead by example from the front with his devotion, dedication and vibrant cheerful personality, fighting for a significant cause of National importance.

In his welcome speech, he reached the hearts and minds of the audience to open our minds to realise that here is a vast sector marginalised due to man-designed public buildings, who need 'Empathy' not Sympathy.

"Human abilities drop for various reasons and that's inevitable. The quality of life then will greatly depend upon how accessible, accommodating and user-friendly the living environments around you happen to be. Denial of opportunities for activities of daily living, leads to physical inactivity which triggers ill-health.

It also brings anxiety, loss of hope, intense sadness, frustration and depression, often enhanced by poverty through loss of employment opportunities. These in return suppress the immune system, place the heart under added strain and become risk factors for mental disorders and physical illnesses", explained Dr. Ajith Perera.

The presentations made by Dr. Samantha Wakista of Kelaniya University and Dr. Neil Fernando the consultant psychiatrist explained why mental well being promotes good health and improves the quality of life of individuals and families and also contributes to enhance productivity.

Ramesh Schaffter of Janashakthi Insurance very effectively made us to realise that this is an unmet health need in our built environment. Charming Maheshi Premasinghe in compering, added luster to the occasion with her eloquent speech.

We realised that my husband and I are amongst tens of thousands of others here, who suffer silently through denial of opportunities in going to the market, cinema or the theatre, which until his mobility difficulties brought us much mental relief and physical well-being. Visiting exhibitions and book fairs even at reputed places such as the BMICH are no more for him.

It is tragic how the Tourist Board and its Ministry continues to give a blind eye and a deaf ear to the urgently needed proper toileting facilities, even at 5-Star Hotels in this country, for the disabled and the elders.

We feel it is the moral duty of the Government and the business community, especially the reputed giants making millions of money as profits, along with the Architects and the Civil Engineers, to open their eyes to the uphill battle we fight silently in attending to crucial activities of daily living at public buildings and places in this country. Let us design to include everyone and it is now or never!

N.W. Gamage

Australia to donate modern Emergency Care Unit to Galle

This gift by the Victorian Government in Australia will be announced at the 39th annual Academic sessions of the Ceylon College of Physicians opening in Colombo at the Cinnamon Grand Hotel on Thursday September 28.

A special Satellite session on this donation is also to be held in Galle at the Galle Medical Association on Tuesday October 2.

Dr. M. K. Ragunathan, President Ceylon College of Physicians, speaking to the HealthWatch on the three day sessions in Colombo said that Prof. Ian Gilmore, President of the Royal College of Physicians in London will be the chief guest at the event with Emeritus Professor Carlo Fonseka as the guest of honour.

Theme

He said sessions theme for this year is 'Managing dual burden of diseases in a low resource setting.' Further elaborating on the event he said;

Unhealthy dietary habits and modern lifestyles

This annual event, which is the academic highlight of the year, will focus on infections and the non-communicable diseases such as Diabetes, Hypertension, Cholesterol etc. Explaining the relevance of the theme, Dr. Ragunathan said that in the early part of the last century, infections were the major killer. "However, unhealthy dietary habits and modern lifestyles are now taking their toll and we hope to focus on this important issue."

Well known Diabetologist from Chennai Prof. A. Ramachandran will be delivering the P. B. Fernando oration titled 'Primary prevention of type 2 diabetes - the Indian experience' Prof. Gilmore will deliver the Cyril Fernando oration titled 'Alcohol as an exploding health hazard'. This year's E. V. Peiris Oration is by Dr. T. P. Weeraratne on 'Redefining the role of metabolic syndrome among Sri Lankans.'

Emergency care as a specialty

The pre and post congress sessions to be held both in Colombo and Galle will give participants a substantial overview of emergency care, a new entity that has not been developed or recognized as a speciality in this country. "Conducted by the Emergency Physicians of Australia, it would focus on sensitizing our physicians and anaesthetists on the need for developing emergency care as a specialty," Dr. Ragunathan said.

Digital eye screening

Matara Diabetes Centre, leader in diabetes care in the South has introduced digital retinal screening and photography using state of the art Topcon digital retinal camera as its latest addition recently.

In keeping with the best diabetes care practices in the world today, digital eye (retina) screening is now included as a standard item in the Diabetes Full Assessment (DFA).

This is the first time this facility is made available to diabetic patients in the South. Speaking to Daily News HealthWatch Dr. Sunil Seneviratne Epa, consultant physician said eye complications are common in diabetes mainly affecting the retina of the eye.

White patches called exudates and small blood vessel changes called micro aneurysms appear as tiny red dots as initial changes. If these changes are detected very early they can now be cured with laser treatment available in Sri Lanka.

Unfortunately, lot of patients go blind due to lack of attention to these changes in early stage. Therefore this new facility will go a long way to prevent blindness in diabetic patients by detecting these changes early.

These retinal pictures taken periodically will also help doctors assess changes occurring in retina and also plan their treatment.