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Health Watch
The ‘family doctor’
Nadira Gunatilleke
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Trusting a doctor like a family member |
Who is a family doctor? Do we need family doctors? Do we have family
doctors here in Sri Lanka ? This is one of the issues that we need to
discuss today. It is not all about family doctors. Consultants who treat
patients regularly for long periods become a sort of `family doctor’.
Family doctor has a medical specialty devoted to comprehensive health
care to people of all ages. This medical specialty is a form of primary
care that provides continuing, comprehensive health care for the
individual and family across all ages, sexes, diseases, and parts of the
body.
It is based on the knowledge of the patient in the context of the
family and the community, emphasizing disease prevention and health
promotion. He provides personal, comprehensive and continuing care for
the individual in the context of the family and the community.
 We
need family doctors because all of us fall sick and all of us need
medications. We also need them to get some relief for minor sicknesses
and for primary consultation for a major sickness. It is the family
doctor who guide his or her patients to the correct type of consultant
(depending on the sickness) after doing the basic diagnosis.
We hardly have family doctors in Sri Lanka. There are only handful of
family doctors who really care about their patients and remember what
type of body, sickness and problems his or her patients have. Some
doctors even remember patients by their names and keep records on them
in their memory or in their notebooks/computers. These are the dedicated
doctors who really serve patients. They care about providing a genuinely
great service as payments are not their main criteria.
There are some other doctors who do not remember patients even after
they visit him many times. These doctors do not have any type of record
on their patients. This is all right when it comes to minor sickness or
a sicknesses that do not need continuous or long term consultation or
medical treatment. But then what about patients who need continuous
consultation and medical treatment?
Even some consultant doctors do not have any record on such patients.
They have no idea about previous treatment or history of the disease
diagnosis unless the patient relates it to him. This is unfair by the
patient because not all patients are capable of remembering history of
the disease and treatment. The only way to remember such important facts
is by maintaining records. But some consultants do not spend their
valuable `consultation time’ even to scribble a few lines about the
disease and treatment plan. Therefore the guardian of the patient has to
relate the story every time they consult the doctor. This problem does
not arise when there are relevant and updated medical reports of the
doctor available with the patient.
Patients are also responsible for this situation because they visit
numerous doctors at different times and visit several doctors for one
sickness. Therefore doctors have no way of keeping records or treating
them properly.
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Checking for a good beat |
Such `patients’ take valuable time of actual patients who wait long
hours to meet the doctor.
Sometimes some patients take an assortment of medications prescribed
by various doctors for the same sickness with the intention of getting
cured quickly. Some patients are addicted to drugs.
There was a person who took a handful of pills after every meal and
died of overdose. It was discovered that he had in his collection many
prescriptions issued by various doctors. But then there are patients who
always visit one doctor closer home, for minor sicknesses and one
selected consultant for major sicknesses which is a better practice
because it is easy for one doctor to understand the patients actual
health state and treat him accordingly.
Patients have to do justice by themselves, their families and the
doctors by selecting and helping one doctor keep family health history
on record for future reference in order to be of service to his regular
patients.
AH1N1 lifting its head, again!
 What
can I do to protect myself from catching pandemic AH1N1? The main route
of transmission of the pandemic influenza virus seems to be similar to
seasonal influenza, via droplets that are expelled by speaking, sneezing
or coughing.
You can prevent getting infected by taking the following measures:
keep your distance from people who show symptoms of influenza-like
illness, such as coughing and sneezing (trying to maintain a distance of
about 1 metre if possible);
clean hands thoroughly with soap and water, or cleanse them with an
alcohol-based hand rub on a regular basis (especially if touching
surfaces that are potentially contaminated);
avoid touching your mouth, nose and eyes as much as possible; reduce
the time spent in crowded settings if possible;
improve airflow in your living space by opening windows; practice
good health habits (including adequate sleep, eating nutritious food,
and keeping physically active); and getting yourself (or family members
age 6 months and older) vaccinated against the pandemic influenza, if
possible.
What about using a mask? What does WHO recommend?
If you are not sick you do not have to wear a mask. If you are caring
for a sick person, you can wear a mask when you are in close contact
with the ill person and dispose of it immediately after contact, and
cleanse your hands thoroughly afterwards.
If you are sick and must travel or be around others, cover your mouth
and nose. Using a mask correctly in all situations is essential.
Incorrect use actually increases the chance of spreading infection
How do I know if I have pandemic influenza ?
Today, since the H1N1 pandemic virus is now the dominant influenza
virus circulating worldwide, most cases of influenza-like illness are
likely pandemic influenza.
Typical symptoms to watch for include fever, cough, headache, body
aches, sore throat and runny nose. WHO advises health care providers to
treat people with influenza-like illness based on their symptoms and the
progress of their illness, and not to wait for laboratory confirmation
of pandemic influenza. The pandemic H1N1 virus has already spread
worldwide.
Regarding laboratory testing of cases, public health authorities and
WHO partners continue to do selective testing of samples from patients
with influenza-like illness to characterize outbreaks, monitor the virus
and identify disease trends.
What should I do if I think I have the illness?
If you feel unwell, have a fever, cough or sore throat: stay at home
and keep away from work, school or crowds; rest and take plenty of
fluids; cover your coughs and sneezes. If using tissues, make sure you
dispose of them carefully. Clean your hands immediately after with soap
and water or cleanse them with an alcohol-based hand rub; if you do not
have a tissue close by when you cough or sneeze, cover your mouth as
much as possible with the crook of your elbow.
Use a mask to help you contain the spread of droplets when you are
around others, but be sure to do so correctly; inform family and friends
about your illness and try to avoid contact with other people; If
possible, contact a health professional before traveling to a health
facility to discuss whether a medical examination is necessary.
Source World Health Organization
(WHO) website
Pig cell insulin treatment approved
Australian biotechnology firm Living Cell Technologies Ltd has won
approval from Russia to sell its Type 1 diabetes treatment using
insulin-producing cells from pigs, the company said on Friday, sending
its shares up by a quarter.
Russia was the first major industrialised nation to approve the sale
of the new treatment, said LCT.
“This is a major step toward global commercialisation of this
important advancement in the treatment of diabetes,” LCT chief executive
Dr Ross Macdonald said in a statement to the Australian stock exchange.
Type 1 diabetes is a genetic condition in which the pancreas stops
making insulin, requiring a person to inject it several times a day
while keeping a close eye on their blood glucose levels with regular
finger-prick tests.
LCT’s Diabecell treatment takes insulin-producing cells from a breed
of pig and encases them, so they can be transplanted without the need
for immunosuppressant drugs, said Professor Bob Elliott who heads the
LCT laboratory in New Zealand.
“This is not a cure for type 1 diabetes, but it will make it easier
to control,” Elliott told local media.
“Their diabetes becomes easier to control with fewer highs (in blood
glucose), fewer lows, and if they have unaware hypoglycaemia we can
pretty much guarantee to get rid of that. It makes a huge difference to
their lives.”
Hypoglycaemia is a condition responsible for many diabetes-related
deaths, as blood glucose can drop quickly and not be detected until a
person loses consciousness.
Elliott said two out of eight trial patients in Russia were able to
cease insulin injections altogether for eight months.
He said further clinical trials were under way in New Zealand and the
therapy may be available there in 2013.
Shares in LCT jumped 26 percent to A$0.17, valuing the company at
around A$48 million ($47 million).
Reuters
Major US breast cancer drug trial disappoints
A major trial that aimed to see if a common bone-strengthening drug
could help prevent recurrences of breast cancer found it did not benefit
most patients, doctors said Thursday.
The five-year study, known as the AZURE trial, followed 3,360 women
with advanced breast cancer who had already undergone surgery.
The study randomly assigned some to take the osteoporosis drug Zometa,
also known as zoledronic acid, in addition to standard therapy. Zometa
is made by the Swiss pharmaceutical giant Novartis.
The hope was that it would prevent cancer from resurfacing, as it
often does, in a survivor’s bones.
But the American Association for Cancer Research said the drug was
found to have no impact on “disease-free survival” for the group as a
whole.
“In the larger population, we did not see a difference,” said Robert
Coleman, professor of medical oncology at the University of Sheffield in
England, who presented the results at a conference in San Antonio,
Texas.
He added, however, that there was a slight difference across age
groups, with older patients faring slightly better on the drug.
The 30 percent of the group who were post-menopausal by at least five
years, 1,101 in all, saw a 29 percent improvement in overall survival,
which was “unlikely to be a chance finding,” Coleman said.
2010 AFP
Medical Crossword No 43 winners
Edward Arambewala
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First Prize Rs 3,000 Entry No 42: Basma Azard, No. 20,
Palmyrah Avenue, Colombo 3.
Second Prize Rs 2,000 Entry No 18: V C Jayasuriya, Sirisetha,
Mawila Rd, Katuneriya.
Third Prize Rs 1,500 Entry No 40: Tarik Mass (undergraduate)
65/365 Crow Island, Colombo 15.
Consolation prize winners of Rs. 1,000 each
* Entry No 45, Maniza de Croos 251/2B, Kurunduwatta Rd, Kochchikade
* Entry No 39, D U K L de Silva 16/5, Pallewela, Gampola.
* Entry No 29 Nayana Kanthi, 16/5, Pallewela, Gampola.
Special prize of Rs 1,000 each was awarded to Entry No 32 Alstair
Gerreyn, 142/4 Jensonwatta, Dehiwala and Entry No 6, Anusha Samarasuriya,
Henpitagedara Rd, Marandagahamula.
******----
Prizes were drawn (at the Audiology seminar of the Crossword Sponsors
Wish Institute held on this day) by Borne Anchored Solutions of the
Australian Cochlear Ltd Asia Pacific Director Campion Fernando. The Wish
Institute head Mihira Wickremarachchi Rev. Fr. Nihal Fernando of the
Vicarage, Colombo 15 (special invitee, who had also sent an entry for
the Medical Crossword No 43) and Abdul Gaffar a consolation prize winner
in Crossword No. 42, who had come to collect her cheque.
Daily News Editorial, Medical Crossword sponsors Wish Institute
congratulates all the winners and wish them good health and good luck.
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Blood Donation Campaign December - 2010
Date Place Town Telephone
13 Kithal Ella - Temple Badulla -
14 Gamidiriya Hall, Sooriyawewa Kamburugamuwa -
14 Ketawatta Temple Badulla -
14 Navy Hospital, Col-1 NBC 114856213
15 Sri Lanka Telecom Head Office, Col-1 NBC 112433480
15 4th Ela Temple, Kaduruwela Polonnaruwa 272223133
16 Digana Sport Society, Digana Kandy -
16 Samurdhi Bank, Thelulla Badulla -
16 Manning Market, Col -1 NBC 776190434
17 Henegama Maha Vidyalaya, Horana NBC 728043313
17 Kaludawala Church Mathale -
17 MRC Garment, Boralesgamuwa NBC 112519800
18 Community Hall, Mattegoda NBC 112845477
18 Mahamewnawa, Kundasale Kandy -
18 YMBA, Hatton Nawalapitiya -
18 Temple – Perahattiya Badulla -
18 Wilson grounds, Homagama NBC 112855760
18 Pasgoda Maha Vidyalaya, Kamburugamuwa -
18 Sri Sumana Pushpikaramaya, Kahathuduwa NBC -
19 Tharunasewa Mawatha, Moronthuduwa NBC 718253538
19 Mahanagapura Maha Vidyalaya, Kamburugamuwa - Lunugamwehera
19 Daliwala Temple, Daliwala Kandy -
19 Doowa Temple Badulla -
19 Raddoluwa Abinawaramaya NBC 112290242
19 Handapangoda Kanishta Vidyalaya NBC 724763410
19 Millana, Dimbulagala Polonnaruwa 272225745
20 Panadura Gangula Temple NBC 387237158
20 Thalathu Oya AG/Office Kandy -
20 Highland School, Hatton Nawalapitiya -
20 RH/Mirahawaththa Badulla -
20 Bowala Temple, Bowala Gampola -
20 Boyawalana, Aluwa Kegalla -
20 Rohana Gems, Kahawatta NBC 773065377
20 Baberyn Ayurvedic Hotel, Gurubewila, Kamburugamuwa - Weligama
20 Habarakada Nursing Home NBC 112752943
20 Kaluthara Bodhiya NBC 773112582
21 Siksil Company, Peters Place, KohuwalaNBC -
21 Sri Pushparamaya, Pattiya Junction, NBC 772916684
Kelaniya
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