WHO invites Sri Lankan surgeon for two consultations

The WHO has invited Consultant Surgeon Dr Wijaya Godakumbura for two consultations. One was held a month ago in Geneva to formulate ‘A five year strategy on burn prevention’, while the other is to be held in Manila next week in connection with ‘The World Report on Child and Adolescent Injury Prevention’, for which he has been invited as a Temporary Advisor to the Regional Director.

Dr. Godakumbura has been chosen as a participant because of the pioneering burn prevention work he has

 been doing for many years. “The vast majority of burns could be prevented” , says the International Society for Burn Injuries.

“We must ask ourselves what we can do to prevent them”? Burns are of special significance to low and middle income countries (LMICs) like Sri Lanka. This is what the Journal of the Royal Institute of Public Health had stated last year in an article written by Dr Y S Lau of the Oxford University.

“Burns are one of the most devastating conditions encountered in medicine. Yet, burn management in Sri Lanka is fraught with difficulties; the lack of government initiative precludes effective prevention programs.

A successful prevention campaign is conducted by the Safe Bottle Lamp Foundation, which has justifiably received international acclaim. It was founded by Sri Lankan General Surgeon, Dr. Wijaya Godakumbura....”.

The international acclaim Dr. Lau is referring to, is the winning of the Rolex, Reader’s Digest and Lindbergh Awards and publicity in several prestigious magazines, CNN and Voice of America.

Nearly 30 per cent of the population in Sri Lanka still use kerosene due to lack of electricity and many use

make shift unsafe lamps that topple easily and cause serous burns, which often result in severe scarring and some times in death.

The Safe Bottle Lamp Foundation has replaced 750,000 unsafe lamps with their ‘Sudeepa’ safe lamps, while giving valuable advice to the public on first aid etc.

During his stay in Geneva Dr. Godakumbura was able to visit two institutions. One was to the SL Embassy to make a presentation on his work to a group of Sri Lankans in Geneva, who later made a donation to his NGO.

The other was to the Rolex Awards Headquarters for an interview, as they wanted to know the recent state of his project to publish another article in the Rolex Journal.

The Safe Bottle Lamp Foundation would be grateful for donations to maximize their humanitarian work. Their web site is www.safebottlelamp.org and the e mail address is [email protected]. The tele/fax number is 286 4847.

Three Cancer Specialists from Singapore to attend College of Oncology Scientific sessions in Colombo

Edward Arambewala

COLOMBO:Three cancer specialists from the Parkway Cancer Centre, and the National cancer Centre Singapore will be in Colombo from June 27 to July 1 to attend this year’s annual scientific sessions of the Sri Lanka College of Oncology starting in Colombo from June 28.

The three specialists are Dr. Lion Hong Liang a member of the Medical Oncology Advisory committee of the Ministry of Health Singapore Dr. Kei-siong Khoo Deputy Medical director, Senior Consultant Medical Oncologist and phisian.

Parkway cancer centre, Singapore and Dr. Anselm Chi-wai Lee, consultant Paediatric Haematologist -Oncologist East shore Hospital, Singapore. Daily News Medical page Health watch in association with Parkway group Healthcare (Singapore) representive in Sri Lanka shuvo Hridayesh is making arrangements for some of our cancer patients who wish to consult them to do so at a talk on cancer we are organising in Colombo for the benefit of Health Watch readers.

Those interested please write to Health watch cancer talk c/o Features Editor Daily News Lake House D. R. Wijewardene Mawatha Colombo.

Replies to readers queries

Dr. D.P. Atukorala (Consultant Cardiologist) and a member of the health watch medical advisory panel has sent in this reply to a question.

Sent by Maduri de Silva of Kitullamptiya, Galle.

What symptoms there could be on person after a heart attack!

Most patients are free of major symptoms after a heart attack, but some complaints are quite common.

The symptoms depend on so many factors and those who have been admitted within the first few hours after the heart attack to Intensive Care Units (ICU) and given treatment e.g. thrombolytic drugs (such as streptokinase), oxygen, anti-platelet agents (such as soluble aspirin), heparin, betablockers and nitrates have less cardiac symptoms such as angina than those who have been treated in medical wards or in patients’ homes.

Angina is a discomfort in the chest due to insufficient blood reaching the heart muscle. It is situated mainly in the center of the chest but may be felt on either side of chest or in the arm, jaw or between the 2 scapular blades at the back of chest or in upper abdomen (epigastrium).

It is usually a tight or heavy feeling which is provoked by exercise or stress but can sometimes occur at rest.

When angina a occurs at rest in spite of medical treatment, the patient should be admitted to a hospital and should be investigated and treated without delay.

Many heart attack patients have experienced angina previously and they are more likely to have it again than those who have never had it before. Angina is evidence that there is till a narrowed artery supplying blood to the heart muscle.

It can usually be treated with medicines such as nitrates, beta-blockers, calcium channel blockers, anti-platelet agents (such as soluble aspirin or clopidogrel) and ACE inhibitors.

If a patient who recently had a heart attack gets angina again (post-infarction angina) the patient should be referred to a cardiologist even if the resting ECG does not show any fresh ischaemic changes, for a stress test (exercise ECG). If the exercise ECG is negative, the patient should be subjected to a stress echo.

If either the stress test or stress echo is positive, the cardiologist will arrange for a coronary angiogram with a view to subjecting the patient to angioplasty (P.T.C.A.) or coronary artery surgery (C.A.B.G.)

There are few patients who refuse angioplasty or C.A.B.G. through fear or due to poor financial situation and pleads with the doctor to give medical treatment. (An angioplasty procedure with stenting costs anything between Rs. 400,000 to Rs. 1,000,000 or more whereas C.A.B.G. procedure costs about Rs. 350,000.

I usually refer these patients for chelation therapy which relieves angina in majority of those patients undergoing chelation, Exercise ECG when repeated after the complete course of chelation therapy (C.T.) shows improvement compared to exercise ECG done before chelation.

Reply to query on iodised salt

Dr. D. D. Wanasinghe (Dip AG, DVM, Phd. former Senior Lecturer Vet. Faculty, University Peradeniya)

Last week we had a few questions on use of iodised salt in our food, and in the livestock industry. L. U. de Silva from Battaramulla in his letter stated:

Salt

Some years ago, the Government laid down by statute that all salt - in loose or packeted form - sold in the market for consumption should be iodised. But this was observed in the breach. About two years ago, the Government re-activated this statute and consequently all salt sold should necessarily be iodised.

A few problems come to my mind.

1. Has the Government got the necessary machinery and manpower to ensure quality control in this iodisation process?

2. How reliable is the iodisation done by various firms in this particular trade? Iodised salt produced by Lanka Salt Ltd and by Puttalam Salt Ltd. May be reliable. But what about the others?

3. Is iodised salt good for all people? Earlier iodised salt was sold only in goitre prone areas, like Gampola.

4. What about livestock? Is iodised salt good for animals?

I would like someone in authority in the Medical and Veterinary departments to enlighten the people on these points.

Dr. Wanasinghe replies: Thank you for raising this salt matter, in the HealthWatch which they have referred to me for a reply.

I agree with you that the Government should enforce the regulations gazetted on this product, for quality, by getting the industry to state in the packets the percentage of iodine in the salt.

This is essential as you say that while the people can depend on the quality of the product marketed by Puttalam Salt and Lanka Salt Ltd., the same reliance cannot be placed on most of the other brands in the market, which do not carry quality assurance stamp.

Use of iodised salt in the livestock farms, improves the growth of the animals, and doesn’t cause any problems to man in the consumption of milk and meat.

Readers who wish to ask any questions on veterinary issues, relating to cattle, poultry, pets etc. could write to Dr. Wanasinghe direct, with a copy to the HealthWatch sent separately.

Address: Dr. D. D. Wanasinghe, C/o NAC, No. 503, Jayawardenapura Mawatha, Ethul Kotte, Kotte.

Harmful effect of excessive laptop use

MUMBAI: Corporate hi-fliers who rarely step out without their data-loaded laptops will hate this, but doctors in Mumbai believe the device is a growing source of ill-health.

Tingling sensation in the fingers, strained tendons and sore shoulders are the price young and ambitious are paying for clicking non-stop on their laptops, according to a study done by occupational therapists in Mumbai.

“Busy office-goers are using laptops way over the recommended two-hour period,” says S R Pingle of the Indian Association of Occupational Health, studying the habits of executives in two leading corporate houses.

The laptop craze is growing at an amazing pace in the Mumbai, especially after the advent of affordable brands a couple of years back.

Corporate or self-employed persons can be seen glued to the LCD screen not just in airports, but even in crowded first-class compartments of trains.

Hep B-schoolers, jet-setting executives and self-assured corporate honchos refuse to step out to work — or even that cursory chotta sa break — without the convenience and connectivity of a laptop.

In the West, the dependence has grown even further. An international survey carried in Time magazine last week showed that one in five holidayers usually take their laptops along even on vacations.

The favourite excuse as the Mumbai study found was that essential office data is stored on the laptop. “Laptops are meant to be used for a short-time period, but executives are using them instead of their desktop computers in offices as well as homes,” adds Pingle.

While the erudite crowd that logs on to laptops understand ergonomics (the science of fitting workplace equipment to maximise a worker’s productivity), few seem to understand the damage done by excessive laptop usage.

Take Navi Mumbai resident Vijay Habbu (50), who is self-admittedly “laptop dependent”.

A senior executive in a corporate house, Habbu says he uses his laptop for over nine hours every day.

“I had developed a ganglion (bunching of nerves) on my wrist, working on the computer, which got further aggravated when I shifted to regularly using the laptop,” says Habbu. Nailing the diagnosis wasn’t too difficult for him.

“There was a clear correlation. When I was on leave and didn’t use the laptop, I had no complaints,” he says.

The problem is that laptops are not ergonomically designed to be used for prolonged hours.

“The keys in a laptop are cramped. Moreover, most computer users haven’t learnt typing and tend to use one or two fingers which puts pressure on the hand,” explains Pingle.

Those who slouch over their laptops for long hours particularly complain of back and neck spasms or posture-related problems, says consultant and upper-limb surgeon at Bombay Hospital Parag Munshi.

“Many also come in with strained tendons as their wrists are flexed in extreme positions,” he says.

The Cornell University Ergonomics website has a basic explanation as to why prolonged use of laptops can be tough on the body.

“The reason is simple — with a fixed design, if the keyboard is in an optimal position for the user, the screen isn’t and if the screen is optimal the keyboard isn’t.”

Hearteningly, timely interventions can bring a lot of relief. “Since I can’t work without my laptop, I always carry an external mouse which I attach to my system,” says 45-year-old managerial executive Karunidhi.

Habbu, too, agrees that the move to an external mouse has given him 20% relief, though he still occasionally pops in pain-killers.

Doctors say preventive measures can keep away pain. “Such problems are usually caused by recurrent movements for prolonged periods.

People should try and maintain the position of neck and back in neutral position,” advises KEM Hospital’s head of orthopaedic department Dr V J Lahiri. Munshi, who calls the laptop-related ailments “transient and temporary”, says frequent users need conservative management which includes rest as well as “correct posture”.

Times Of India