Having a healthy baby

Advice for those getting married this year:

Consultant paediatrician Base Hospital, Mawanella Dr. R.M. Mudiyanse (MBBS, DCH, MD, MRCP) gives the following advice for those getting married this year in having healthy babies.

Having a healthy baby is the dream of any married couple. The nature has taken all the necessary precautions to prevent a birth of abnormal babies. The chance of having a healthy baby is very high as much as 95%. But there are unfortunate stories where babies are born with various types of birth anomalies. How can we minimise this chance?

The causes for birth anomalies have been recognised birth defects could be prevented. Many of these preventive measures could be carried out at personal level.

* Marry when you are between 20 and 30 years of age

* Avoid marrying a close relative

* Check blood for thalassaemia carrier state when teenagers

* Get vaccinated against rubella when you are young

* Plan your conception

* Start taking folic acid vitamin before the conception

* Avoid drugs, chemicals, and x-rays

* Make sure young girls are getting an adequate diet

* Avoid pets, or make sure that you pets are not harbouring toxoplasmosis a disease that can cause birth defect in your baby

Why marry when you are between 25 and 35 years

Epidemiological studies have shown that the optimum age for marriage is between 20 and 30 years. Babies born during this period have the best chance survival and being healthy.

Mothers of younger age tend to have smaller babies and the chances of those bobbies to have complications in early neonatal period are very high. Teenage mothers are still growing. During this period their systems in the body is diverting its functions and energy for growth.

Additional demand of growing a baby will be a challenge. Similarly mothers above 35 have a higher chance to deliver bobbies with congenital anomalies. The best example for this is Downs Syndrome well-known as Mongolism.

Mothers above 35 have 1-2 per cent chance of having Down Syndrome while the mothers below 25 have only 0.1 per cent chance of having down baby. There are many other similar diseases that can have higher incidence with age of the mother.

The advice is that it is better to marry during this age group because the chances for having a healthy baby and successful pregnancy outcome are high. Don’t delay the marriage unnecessarily. Postpone having children until about 20 years of age even if you are married.

Avoid marrying a close relative

Genes that are embedded in the 23 pairs of chromosomes of our cells, control almost all the functions in the body directly or indirectly. These chromosomes are very important. They come in pairs (duplicates), one from mother and the other from father.

This happens at the time of conception; when a sperm from the father joins with the ovum of the mother. This important event takes place 14 days prior to the first miss period of a mother in pregnancy. This means two weeks before they knew that they are pregnant.

Babies can inherits a bad gene from one of the parent, and still avoid malfunction of the body because genes provided by the other parent could compensate for it. This system of compensating by one of the parent works most of the time to minimize inherited diseases.

However this will break down when both parents are having defective gene for the particular function. The chances of this happening are high when both mother and father are relatives. Closer relatives have even a higher chance of bad genes for the same function.

Therefore it is better to avoid marriages between close relatives because both of them have a higher chance of having an affected baby than a randomly met couple. Thalassaemia, blindness, deafness, and cardiac malformations are few out of many examples that can be given.

This type of genes that can be compensated by having one gene is called Autosomal recessive genes. Whereas other type of genes that will cause disease even if it is inherited from one of the parents is called Autosomal dominant genes.

There are some genes that are bound with X Chromosome called X linked genes or sex linked genes. Males are having only one X chromosome. Therefore if the problem is related to the X chromosome boys will get the disease unless the mother provides them with a good X chromosome.

Prevention of thalassaemia

In Sri Lanka about 60 bobbies are born with thalassaemia every year. This disease leads to premature destruction of red cells in our blood. Treatment available is palliative and expensive.

A child with thalassaemia will have to have blood transfusions every month for lifetime while taking injections to remove excess iron that is accumulating in the body daily everyday.

Lifetime cost is about 10-20 million rupees. Therefore prevention is the best/only option for this illness. Prevention of this illness is possible.

This can be achieved by adopting simple principals of genetics. Both parents have to be careers to give a birth to a child with Thalassaemia.

Both the parents of all thalassaemia patients in our country are thalassaemia carriers. If one of them was not a thalassaemia carrier, baby wouldn’t have got thalassaemia.

When the mothers are checked at antenatal clinics so many of them are thalassaemia carriers, but all of them have healthy babies if the husband is not a thalassaemia carrier. Thalassaemia carriers will produce babies with thalassaemia only if they marry another carrier.

Just three nights of bad sleep raises diabetes risk: Study

Just three nights of bad sleep is enough to dramatically reduce the body’s ability to process glucose and raise the risk of diabetes, a study released Monday found.

Suppressing deep sleep for three nights in a row decreased the glucose tolerance of young, healthy adults as much as if they had gained eight to 13 kilos (20 to 30 pounds), researchers at the University of Chicago’s medical school found.

And while it is possible that the body’s ability to process glucose would adjust to chronic sleep deprivation, it is likely that poor sleep patterns in the elderly and obese play a role in the development of diabetes, the authors concluded.

Deep sleep, or “slow wave sleep,” is considered the most restorative form of sleep and has been shown to be important for mental clarity. This is the first study to show its significance for physical well-being.

“Previous studies from our lab have demonstrated many connections between chronic, partial, sleep deprivation, changes in appetite, metabolic abnormalities, obesity, and diabetes risk,” said study author Eve Van Cauter.

“These results solidify those links and add a new wrinkle, the role of poor sleep quality, which is also associated with aging.”

Nine lean, healthy volunteers between the ages of 20 and 31 spent five nights in a sleep laboratory where they went to bed at 11 pm and got out of bed at 7:30 am.

They were undisturbed for the first two nights but on the following three nights, speakers near the bed emitted low-level sounds whenever their brain patterns indicated they were drifting into deep sleep.

While not loud enough to wake them, the sounds reduced deep sleep by about 90 percent by shifting them out of the onset of deep sleep back into a lighter sleep.

This mimicked typical sleeping patterns of those over the age of 60 who generally get only 20 minutes of deep sleep a night compared with 80 to 100 minutes for young adults.

When tested after having had their sleep disturbed, the insulin sensitivity of the volunteers had decreased by 25 percent, which meant they needed more insulin to dispose of the same amount of glucose.

But insulin secretion did not go up in eight of the subjects and, as a result, they showed a 23 percent increase in blood glucose levels.

“Since reduced amounts of deep sleep are typical of aging and of common obesity-related sleep disorders ... these results suggest that strategies to improve sleep quality, as well as quantity, may help to prevent or delay the onset of type 2 diabetes in populations at risk,” Van Cauter added.

The study will be published Wednesday in the Proceedings of the National Academy of Sciences. AFP

Happy and a peaceful New Year for all from the SLMA

Sri Lanka Medical Association Headed by Prof. Lalitha Mendis wishes a Happy Peaceful and a Healty New Year for all in Sri Lanka.

The newly elected Councils of the Association comprise - President - Prof. Lalitha Mendis, President Elect - Prof. Rezvi Sheriff, Vice President - Dr. Udaya Ranawaka, Dr. Ananda Wijewickrema, Secretary - Dr. Indika Karunatilleke, Assistant Secretaries - Drs. Priyadarshani Galappatthy, M.R. Haniffa, Pubudu de Silva, Treasurer - Dr. Gamini Walgampaya, Assistant Treasurer - Dr. Rohan Chinniah.

Sri Lanka Medical Association Council 2008

At the annual general meeting of the Sri Lanka Medical Association held on the 15th of December 2007, the following members were elected to the Council for the year 2008.

Council members - Dr. Sunil Seneviratne Epa (Southern province), Dr. G.C.D. Abeywickrama (Central Province), Dr. N. Jeyakuamran (North Province), Dr. Eshanth Perera (North Central Province), Dr. Suriyakanthie Amarasekera, Dr. Dennis Aloysius, Dr. Vajira H.W. Dissanayake, Dr. Malik Fernando, Prof. Colvin Goonaratna, Dr. N. Ganeshanathan, Dr. M.M. Ismail, Dr. Lucian Jayasuriya, Dr. P.G. Mahipala, Dr. R.W.T.W.A.M. Olupeliyawa, Dr. Anuruddha Padeniya, Dr. K. Sri Ranjan, Dr. S. Sivapriyan, Dr. D.W. Weerasooriya, Dr. M.C. Weerasinghe, Dr. K. Wickramasinghe, Public Relations Officer - Dr. Nalinda Andraweera, Social Secretaries - Dr. Thiwanka Wijeratne, Dr. Preethi Wijegoonewardene, Past President’s representative - Dr. Lakshman Ranasinghe, Ex-officio members of the Council - Prof. Gita Fernando (Immediate Past President), Dr. Chandanie Wanigatunge (Outgoing Secretary), Dr. Anuruddha Abeygunasekera (Co-Editor CMJ), Prof. Janaka de Silva (Co-Editor CMJ).

Five Star Doctors

Doctors play the major role in building up a healthy society. To carry out this work properly they have to follow five principles and work accordingly thus becoming “Five Star Doctors”.

Dr. W.A. Fedrinand writing in the IMPA (Independent Medical Practitioners Association) news bulletin Vol. II on this topic under profile of a “Five Star” Doctor describe these Five Stars (Principles) as follows:

The Profile -

The “Five Star” Doctor has the desirable profile for a healthcare professional in a system that is based on responding to people’s needs. The Five Star Doctor role includes.

1. Care provider who considers the patient holistically as an individual and as an integral part of a family and the community, and provides high quality, comprehensive, continuous and personalised care within a long-term trusting relationship.

2. Decision maker who makes scientifically sound judgements about investigations, treatments and use of technologies that take into account the patient’s wishes, ethical values, cost effective considerations and the best possible care for the patient.

3. Communicator, who is able to promote healthy lifestyles by effective explanation and advocacy thereby empowering individuals and groups to enhance and protect their health.

4. Community leader, who having won the trust of the people among whom he or she works, can reconcile individual and community health requirements, advise citizens groups and initiate action on behalf of the community.

5. Manager, who can work harmoniously with individuals and organisations both within and outside the health system to meet the needs of individual patients and communities, making appropriate use of available health data.

Partnership pentagon

This partnership pentagon if progressively strengthened and activated can effectively motivate our doctors to try and achieve the “Five Star” status. This will ensure the health and the wealth of the nation.

Wisdom of drinking black tea

Dr. D.P. ATUKORALE

There is scientific evidence

(a) that black tea reduces that risk of heart attacks and stroke;

(b) that drinking black tea helps to control blood pressure;

(c) that drinking black tea protects against a range of cancers;

(d) that black tea helps to prevent cavities, gum disease and halitosis;

(e) that drinking black tea prevents diabetes;

(f) that drinking black tea boosts immune system and mental alertness;

(g) that black tea soothes away stress;

(h) that black tea helps to stop excess iron, damaging the body in iron overload disorders.

Effect of Milk On Tea

According to Lorenz et al who did a research project at University of Berlin in Mitte, it has been shown that adding milk to tea will block all the above healthful effects of tea, as casein from milk binds to molecules of tea that cause arteries to relax especially E.G.C.G. Adding milk to tea also blocks tea’s effect on other things such as prevention of cancer.

It is noteworthy that plant-based milks such as soy milk do not contain casein and is quite nutritious and does not cause any allergies.

Laughter is the best medicine

The best doctor in the world is veterinarian.

He never asks his patients, “what’s wrong?”

Sent by: H.M. Gunatilake, Hospital Secretary, Base Hospital, Marawila