Health watch

Giving flu free of charge!

Another flu has already hit us. Flu is everywhere nowadays and whenever you inquire about a friend who is missing for few days or about your neighbour who you did not see for days, you get to know that they had been hospitalized with flu.

Nadira GUNATILLEKE

Many people had to be hospitalized due to flu because it was a little bit more than an ordinary flu. Many people had to seek specialized medical treatment for this flu and the people who had other health problems were badly affected when they got infected with the flu which came with fever, cough, vomiting and loose motion.

But here we are not going to talk about that flu, how and why it hit our people, its impact or treatment. Here, we are are going to talk about how some people are distributing it among others free of charge without any problem! We know people distribute various things and donate things while engaged in social services and social welfare programs. They spend money on donations and people are willing to accept anything that come their way free of charge! But there are some people who are happily distributing flu among others no matter whether they accept it or not!

"Oh I have high fever. But I came to work. I have to finish my work, have to give it to X and Y is waiting for the document, please give me two paracetamol tablets, I can't keep my head up."

"My son had fever and sore throat this morning but I sent him to school. He is having a special science lesson today and in the evening he has a maths class which he cannot miss."

"My daughter had a bad cold and sore throat today but I sent her to school because she cannot stay at home alone and my husband couldn't take leave. I have to come to office. The servant lady did not turn up today saying that her child is sick."

These above statements are some of the things we hear during our day to day life. All of such statements have a direct connection with distributing flu in the public.

Nowadays people are engaged in a rat race and they don't care about others at all. There are people who are prone to infections than others and who should avoid infections as much as possible. But it seems our society is not thinking about such people at all. Not even some hospital staffs. Giving flu to friends and colleagues is nothing for some persons. Taking medicine and resting at home is something useless and funny for them because other people do not exist for them.

They never care about others and laugh at the persons who care about themselves and others. It is same when it comes to other diseases such as sore eyes. Some people report to work just after one day before contagious period ends and distribute the disease among others!

Usually we are very kind towards pregnant women and our society is very caring for them. But it is very pathetic to see how some pregnant women behave. Majority of pregnant women do not take medications for minor sicknesses and it is completely all right to avoid swallowing extra tablets during your pregnancy.

But how about distributing flu? Some pregnant women report to work no matter what type of sickness they are suffering from or with whom they work with. Sometimes the persons who are trying their best to avoid getting infected with viruses get affected through them. But no one can say a word against the culprit!

Wearing masks is something that is never done in Sri Lanka. You can see a person who wears a mask rarely in a high class private hospital. Still wearing a mask is something strange for the majority of people in Sri Lanka. Taking some medications and rest for a cold is something hilarious for them. But they do not know that their attitude can bring death for some innocent people who try their best to avoid infections and communicable diseases.

Please, please do not send your sick kid to school to get rid of him or her and carry out your work as usual. Please do not report for work if you have flu or suffering from some type of infectious or communicable disease.

If you need to be in a public place or attend to your work do not be selfish, think about others and at least wear a surgical mask. Take medications and rest when you get flu or any other disease. It does not destroy your child's education or your entire career. Taking medical leave is not a crime but distributing diseases is a crime.

Sufficient Sleep

Essential component in good health:

Dr. Shantha HETTIARACHCHI

She has come to the clinic to get her backache cured since it affects her daily routine. She is in her early thirties and runs a small restaurant with take away facilities to earn and save some money for her future.

"When are you going to rest and sleep", the doctor asked her after collecting the relevant facts and examining her.

"It is usually around midnight after finishing the routine work," she replied. I have to get up early in the morning, at about 4 o' clock, as there are so many preparations for the following day. There is only one employee in the restaurant to assist my work.

According to this schedule her sleep is limited to four hours a day. There is no difference in this pattern even in the weekend as it is not possible to close this restaurant due to financial constraints. She has to save a little money for the future while paying the assistant and the rental for the place.

The causative factor for her backache has been already disclosed through this conversation. Sleep deprivation comes first in the list of differential diagnosis in her case but she is totally unaware about this possibility. She has to take pain killers as a remedy temporarily while continuing her day-to-day activities till she fulfills the difficult task in finding an alternative.

Health is reflected as the state of physical, mental and social well-being in a person. Perfect functioning of the body, ability to respond to the varied experiences of life with flexibility and a sense of purpose, quantity and quality of an individual's interpersonal ties and the extent of involvement with the community are the basic requirements for healthy living.

The people who are keen on their health may concern about healthy food, pure water, regular exercises and hygiene but most of the time forget the importance of sleep. The sleep is a common requirement for humans, other mammals, birds and even for the fish. It is a state in which restoration of the immune, nervous, skeletal and muscular systems and growth accentuation occur in ensuring good health.

The need for the sleep varies according to the age and also on personal basis. It is considered adequate if there is no sleepiness in daytime. Children require more sleep than adults. The average amount of sleep in a day could be mentioned as 18 hours for the newborn, 14 to 18 hours up to one year of age, 9 to 10 hours for adolescents and 7 to 8 hours for adults. Transitions between sleep and wakefulness will occur with the control through the circadian rhythm or sleep wake homeostasis.

Sleep is divided into two types: REM or Rapid Eye Moment sleep and NREM or Non Rapid Eye Moment sleep. REM sleep is the stage in which characteristic eye movements can be seen.

Sleep begins with the four stages of NREM sleep in which there is some activity of skeletal muscles but no eye movement. The person gradually loses muscle tone and conscious awareness of the external environment while going through the four stages of NREM sleep. They have the chance in experiencing night terrors, sleep talking and even sleep walking in the final stages of NREM sleep.

REM sleep is taking 20 to 25 percent of sleep time in adults. The muscular tone disappears in this stage as it is needed in protecting the subject from self damage due to a result of reactions to vivid dreams.

Studies indicated that sleep is essential in maintaining metabolic and caloric balance, thermal equilibrium and immune competence of the body. The possible effects of sleep deprivation includes, irritability, impairment of memory and judgment, hallucinations or experiencing audio visual perceptions which are not there in reality, impaired immunity, decreased temperature, risk of obesity, type 2 diabetes and heart diseases and more commonly body aches and pains.

Tiredness is a common symptom in our life. This feeling may be due to sleep deprivation as the sleep debt can cause mental and physical fatigue. Recent studies have reported that short sleep causes weight gain. Secretion of two hormones called ghrelin and leptin, is influenced by the duration of sleep. Insufficient sleep affects the balance of these hormonal actions.

The main site of ghrelin synthesis and secretion is the stomach but it is also produced in the hypothalamus. It appears to be involved in the control of the food intake, in addition to stimulating secretion of growth hormone. The blood levels of ghrelin are reduced on eating and increased during fasting. The hormone ghrelin increases the food intake through the stimulation of a site, called arcuate nucleus in hypothalamus in brain.

The hormone leptin acts on the hypothalamus to decrease the food intake and increase energy consumption. It is produced primarily in fat cells in the body. The hormones ghrelin and leptin are having opposite actions on food intake. When this controlling mechanism is disrupted with insufficient sleep, a person feels less full and tends to eat more to reach the stage of weight gain easily.

It is worth to make a habit in having sufficient sleep to avoid physical and psychological effects in sleep deprivation. Relaxed mind, regular exercise, well balanced diet with fresh fruits and vegetables are the main components that keep this healthy habit in life time. It should not be forgotten the fact that the good sleep is essential in maintaining physical and psychological well-being.

Vitamins and Food supplements:

Haphazard ingestion to be avoided

Dr. Shantha HETTIARACHCHI

Billions of dollars are spent to purchase vitamins and food supplementations. Messages on nutritional supplements are disseminated through print and electronic media frequently. People are entangled with myths related to vitamins and nutrition supplementation on seeing and hearing them.

Currently, the media has become the most important single information source on health and nutrition for the public. An enormous influence, has created by media on everyday decisions of the people, with the time.

The vitamins are a group of organic substances which are needed in very small amount to ensure the normal metabolic activities of the cells in our body. They are divided into two main groups according to their solubility in fat or water as it determines transportation, storage and excretion of the vitamins in the body. When taken in excess, the water soluble vitamin B and C are excreted through the kidney but fat soluble vitamin A, D, K and E are get trapped in the tissues and organs of the body to cause adverse clinical problems as they are not excreted through this pathway.

Generally, there is no need to pump the vitamins to the body as the tablets, capsules or suspensions while taking a diet with balance, variation and moderation. A variety of foods in the diet is essential to suit the growing body needs. Balance in diet will provide calories or energy and nutrients for proper growth and development. Moderation is another important fact in nutrition as it should not make a habit in using too much of any one type of food in the diet.

The food pyramid provides an important and simple guidance in ensuring variation, balance and moderation of the diet. A pyramid consists of larger space in the lower part and smaller space in the upper part. The food pyramid is divided into four parts from the base to top to include four varieties of food there according to the body needs.

The large lower part represent the foods containing carbohydrates, include rice, bread, cereals, roots and others. The adjoining second part above that having considerable space too, represent the fruits and vegetables of the diet. The third part which is fairly smaller than the second part represent the foods of animal origin such as meat, fish, eggs and milk. The foods rich in fats and sugar are confined to the smallest upper triangular part of the food pyramid.

Everyone must have the ability to understand this clearly and easily in selecting the type and amount of food varieties for optimal nutrition. There is no need to buy food supplements or vitamins in different forms while adhering to these healthy food habits except in some circumstances in which nutritional deficiencies are encountered.

Decreased intake and decreased absorption of the food can cause vitamin deficiencies in a person. Alcoholism, vegans, elderly with poor diet and loss of appetite in any cause are the common examples for the decreased intake of food. Alcoholics could develop vitamin deficiencies, mainly B vitamins. Vegans who do not take any foods in animal origin could reach deficiencies in calcium and vitamin B 12 after sometime when the body storage was depleted.

Intestinal, liver and biliary diseases are the common causes of decreased vitamin absorption. Vitamin B 12 is mainly absorbed in the lower part of the small intestine called ileum. A person could develop vitamin B12 deficiency in ideal diseases as the absorption get impaired in these circumstances. Bile salts are essential in digestion of fat in the diet. In liver and biliary tract diseases specially when the biliary tract was obstructed bile salts does not reach the small intestine adequately. The absorption of fat soluble vitamins namely, vitamin A, D, K and E is severely impaired in these disease states. Also, long-term use of some antibiotics drugs could cause vitamin K deficiencies due to decreased absorption. Vitamin D is produced in the skin as cholecalciferol or vitamin D3 through the photo activation of dehydrocholesterol by sunlight. This vitamin D3 undergo changes in the liver and kidney to become biologically active vitamin D. As a result of this mechanism vitamin D deficiencies could occur in kidney and liver diseases. Elderly people who are immobile and not exposed to sunlight may also develop vitamin D deficiencies.

Vitamins and food supplements are required in those circumstances, according to the medical advice to correct the relevant deficiencies but it should not be taken haphazardly as a routine. Vitamin alone does not supply energy even though this misconception is appearing repeatedly through advertising in time to time. Vitamins and minerals such as calcium, iron together called as micro nutrients.

The fats, carbohydrates and proteins are the food components that supply the energy through the process of metabolism. The protein can be considered as the main food component, involving in growth and repair of the tissue. The control and regulation of the metabolic and biochemical processes which are concerned with energy production and tissue growth is mediated by micro nutrients. Actually, these metabolic processes are catalyzed by enzymes of the body. The actions of the enzymes are assisted by vitamins as they contain important constituents, called co-enzymes. It is clear that all the food components must be included in the diet to ensure the energy production and growth.

The provisions to approve the food supplements including vitamins for safety and efficacy before they reach the consumers are minimal, when compared to the accepted drugs. Therefore, it important to have a sensible attitudes for self protection. When someone think to spend on vitamins or any food supplements, must find the answers for two main questions, "What is in this?" and "What effect will this really have on me?".

It should not be forgotten the fact that vitamins and minerals are widely available in natural foods. While taking these organic vitamins from natural foods, fiber and many more nutrients are entering the body at the same time unlike the synthetic vitamins in different colours and different forms. The loading of these multi-coloured items into the body should only be done when there is a necessity.