Compiled and coordinated by Edward Arambewala

Dr. Viraj Peramuna speaks on:

Avoiding - 'burn out' in stressful life

The physician who sees a person beginning any new career including marriage or parenthood with an over-enthusiastic, over-involved approach and the expectation that this role will bring incredible feelings of satisfaction and self-esteem, may be looking at a potential burnout.

Most of us living in a stressful society today, are confronted with stresses in life both in our work places and in home life and unless we know how to face them and prevent them we get depressed and reach the state of what is medically called 'Burn out'.

As doctors I feel it is our duty to health educate people on this. That is why I decided to talk on this to the Health Watch on this topic this week.

I am basing my talk on an research article carried on this in a publication the Canadian Family Physician Dr. M.L.S. Vachon a research scientist who is an Associate Professor in the Department of Psychiatry and Behavioral Sciences at the University of Toronto, Canada.

This article based on his research findings gives lot of material useful to all of us professionals and the public in meeting the stresses of life, in work places and in family life as well.

He writes - "The basic concept behind the term-burnout, is that most of one's energy has been focused on one area of life in the expectation that this would bring great satisfaction. The expectation of rewards are unrealistic. Gradually the individual begins to lose energy, enthusiasm and commitment, and becomes increasingly cynical and bitter, the lack of rewards.

Women

Burnout may also be increasing for women because of changing societal expectations and the role conflicts involved in fulfilling multiple career and family roles with little time for oneself or for enjoying family relationships.

Some of the Burnout symptoms listed are

Physical:- General malaise, Sleep disturbances, Physhosomatic complaints.

Psychological:- Excessive impatience irritability, Detachment conflict laden dreams, lack of enthusiasm about work and life in general feelings of hopelessness and helplessness.

Depression Boredom and Cynism, sense of omnipotence with a sense of being unappreciated, Denial of feelings. Alcohol and drug abuse, Marital problems.

Occupational:- Guilt over taking time off, Inability to detach from work, Dehumanization of clients, Impaired performance.

Burnout-Prone Individual

Burnout is often the disease of the over-achiever-one who cannot burnout unless one has been on fire! Frendenberger uses the analogy of a building which has been burned out.

Where once there was a throbbing structure, pulsating with energy, now there are only crumbling reminders of energy and life. While the outer shell may seem to be intact, if you go inside you will be struck by the force of desolation.

Decent Individuals

Attributed to Frendenberger on burning out of decent individuals:- The people who fall prey to (burnout) are for the most part decent individuals who have striven hard to reach a goal. Their schedules are busy whatever the project or the job they can be counted on to do more than their share.

They are burning out because they have pushed themselves too hard for too long.

Executives

Levinson found that burn out in executives occurred in situations where in they were exposed to repetitive and prolonged stress which engendered enormous burdens on them As with so many other diseases, the best treatment of burn out is its prevention.

It is imperative at this stage to point out the reality that no single aspect of life can provide all rewards.

The person should be helped to discuss some of the potential difficulties this new role may entail, and to realise that should he/she experience such problems, it will not be a reflection of inadequacy but rather a response to factors inherent in the role.

Talking with others who have had similar experiences and exploring useful coping techniques to change the situation provides the individual with social support and a feeling of mastery.

Your comments on this article is welcome, please write to Health Watch

Edward Arambewala

Stem cell and liver transplant specialists from Singapore in Colombo

Two doctors from the Asian Centre for Liver Diseases and Transplantation and the Stem Cell Transplant programme and Haematology Services of Mount Elizabeth Hospital in Singapore will be attending this year's Annual Scientific Sessions of the College of Physicians Sri Lanka taking place in Colombo next week (from September 27 to 29).

The two doctors are Dr. Wai Chun Tao (Desmond) Consultant Transplant Hepatologist and Gastroenterologist from the Asian LDT Centre and Dr. Patrick Tan from Mount Elizeth Hospitals Stem Cell Transplant programme.

The Parkway Group Healthcare Centre's Marketing Manager in Sri Lanka informs us that he has arranged the media here to meet these two specialists for a special discussion on the liver and Stem Cell Transplant Services in Singapore, which are not available here at present.

The meeting is to be held on September 28th at Cinnamon Grand Hotel, Colombo. HelathWatch readers who would like to get any issues clarified on the two topics from the two doctors, please sent them to reach us - Health Watch, Daily News by September 27 the latest.

Implantable hearing aid solutions for deafness

HealthWatch in association with the Colombo Apollo Hospital is organising a talk on the above topic by the Indian ENT Consultant surgeon Dr. Devanand Jha at the Apollo auditorium at Narahenpita shortly.

Dr. Tha who has done over 40 hearing aid implants so far in an interview with HealthWatch on this topic last week, said that he would like to hear from parents who have children with hearing defects as to how they are coping with this children's problem, and also any questions they would like to ask from Dr. Tha on the latest implantable hearing aids' solution to this problem.

Those interested are invited to send their questions addressed to:

Questions on Implantable Hearing Aid Solution,
HealthWatch
C/O "Features Editor"
Daily News,
Lake House,
No. 35 D.R. Wijewardene Mawatha,
Colombo 10.

Daily anti-HIV pill could save millions from infection: study

Providing healthy people with an antiretroviral drug to protect them against HIV infection could drastically slow the spread of the virus in sub-Saharan Africa, US researchers said Tuesday.

In a best-case scenario, the drug could prevent three million new HIV cases in this part of Africa over a 10-year span, even if it was only made available to the most sexually active individuals, the investigators said.

"This could represent another tool in our arsenal against HIV infection," said Ume Abbas, an assistant professor of medicine at the University of Pittsburgh School of Medicine and lead author of the paper.

The drug in question is tenofovir, one of the cocktail of antiretroviral medications given to HIV patients.

In studies on monkeys, the drug has been shown to be very effective in protecting them against the simian version of the human immunodeficiency virus that can lead to AIDS, and it is now being tested in humans.

US health authorities are funding five separate trials involving high risk groups such as gay and bisexual men, sex workers and intravenous drug users, on four continents.

The earliest results of those trials will not be available until early 2008, but US and British researchers decided to use computer modeling to project ahead to evaluate just how useful the drug treatment might be in reducing HIV transmission rates in the context of the HIV/AIDS epidemic of southern sub-Saharan Africa if and when it is approved for that purpose.

The researchers looked at three different scenarios. In the first they assumed that the drug was effective 90 percent of the time, and that 75 percent of the sexually active population (15-49 year-olds) could be persuaded to pop a daily pill to protect themselves from HIV.

If that rosy scenario panned out, the strategy could potentially cut new HIV infections by a whopping 74 percent over a decade, according to the computer projections.

If the drug was only effective 60 percent of the time and used by just 50 percent of the sexually active population, the reduction fell to about 25 percent over the same time period.

Finally, the researchers modeled a scenario where the drug was effective 30 percent of the time and only a quarter of the target population used it, yielding a reduction in new cases of a mere 3.3 percent.

Even assuming that the drug does prove as effective in humans as it was in monkeys in protecting healthy individuals from infection, it is "never going to be feasible to treat the entire population," Abbas noted.

But even if governments or aid agencies were able to find the funds to supply the drug to the most sexually active individuals - an estimated 18 percent of the population - it could still make a big dent in the problem, slashing the infection rate by almost 30 percent over a decade.

That translates to 3.2 million cases.

"Our data highlights the enormous potential public health benefit of pre-exposure chemoprophylaxis against HIV, provided the regimen is efficacious and used consistently daily for a number of years," said John Mellors, a professor at the University of Pittsburgh.

Sub-Saharan Africa is the epicenter of the global HIV/AIDS epidemic, with more than 22 million adults infected with the virus.

The study appears in PLoS One, a journal of the Public Library of Science.

AFP

Medical Crossword No. 27

The list of prize winners

Prize winners being picked up by Prasangika Willatgamuwa - Customer Service Officer - Nestle Health Care Nutrition	Consolation prize winner of Crossword No. 26 getting his prize Asitha Meemaduma (left) - Field Manager - Nestle Health Care Nutrition
Prize winners being picked up by Anushka Wickremaratne (Medical Education Coordinator CME Nestle Healthcare Nutrition)	Prize winners being picked up by Madhu Siriwardana - Country Manager - Sri Lanka & Maldives

Here’s the list of prize winners in (Novartis Medical Nutrition) sponsored Health Watch Medical Crossword No. 27 drawn on September 5th at Lotus Lounge, Galle Face Hotel, Colombo

First Prize Rs. 3,000 - Entry No. 60 Imran Fouze 18 A, Perera Avenue, Kohuwala.

Second Prize Rs. 2,000 - Entry No. 40 Antonett Ferdinand 25, Dharmaratne Avenue, Rawathawatta,Moratuwa.

Third Prize Rs. 1,000 - Entry No. 32 Srimathie Epa Senadeera Laboratory, Sulaimans Hospital, Colombo 14.

Consolation Prizes of Nutrition packs - 1. Entry No. 23 S. Samaranayake 146/4, Havelock Road, Colombo 5.

2. Entry No. 33 Mrs. P. L. Padmalatha No. 1 Wanduramba Road, Sandawawala Junction, Baddegama.

3. Entry No. 22 Lakshmi Samaranayake 146/4, Havelock Road, Colombo 5.

Three consolation prizes of Rs. 1,000 each from:- Parkway Group Healthcare, Singapore.

1. Rs. 1,000 Entry No. 26 S. Sri Kantha General Hospital, Chilaw.
2. Rs. 1,000 Entry No. 35 S. Cadiramanpulle 64/2 B, Centre Road, Colombo 15.
3. Rs. 1,000 Entry No. 3 Ms. Billy Esufally 76/14, Flower Road, Colombo 3.

Our congratulations to all the winners Health Watch, Daily News Features Department, Editorial and the sponsors.