Health Watch

Justice for Achala!

Ishara Jayawardane

The story of Achala Priyadharshani is a wake up call for all of us. Daily News readers would have read Broken Angel Achala Priyadharshani's heart rending story on February 7.

It is a case that has caused many untold suffering. The fact that this kind of situation took place is an outrage.

This is not the end of a story that has left Sri Lankan public aghast; A story that has been given maximum news coverage. There are lessons to be learnt here.

All those involved in the Health sector must take steps to ensure that something like this never happens again.

An inquiry into the case of Law Student Achala Priyadharshini has ruled that the amputation of her hand was the cause of medical negligence by the Matara Hospital. However this is too little too late. The horse has bolted and now the stables doors have to be shut.

Inquiry committee

On the instruction of the Minister of Health, Health Secretary Nihal Jayathilake established an inquiry committee comprising of four members. The hairperson was Health Ministry, Director Medical Service, Dr. Lal Panapitiya, Consultant Physician Dr. Narendra Pinto, Consultant Physician Dr. Tilak Kollure and Consultant Physician Dr. Ratnasena.

“In the course of two weeks they covered all sectors and recorded information and collected evidence. In a very short time the report was submitted. The report was reviewed and discussed by the Health Minister and Health Secretary along with a panel and made some recommendations. According to those recommendations certain facts were made evident. One, in the Matara Hospital the persons who were responsible for the ward had seriously delayed the treatment. There were also weaknesses in administration. They have also identified the people responsible for this. Firstly there was medical negligence and administrative lapses,” said a Health Ministry Source.

“As the Health Ministry the problem we face is that we cannot take any disciplinary action against these people. There are four categories of people involved: Consultants, Doctors, Interns and Nurses. The Public Service Commission is the disciplinary authority concerning the officers identified in the inquiry and therefore the Ministry of Health will seek legal advice in this regard and submit the report in due course to the Public Service Commission for disciplinary action.”

Lessons for the future

“In order to prevent something like this happening again we convened a meeting with Directors of many hospitals and discussed what measures must be taken to prevent recurrence of such events. There is an allegation that when the Plaster of Paris was attached , the staff had not checked her pulses, when she cried out in pain they administered her with Pethidine. They should have immediately removed the POP. But they had not removed the POP. That was medical negligence. The question was why did this happen? It was something that could have been prevented.

They were informed of this treatment protocol,” said the Health Ministry Source.

The other side of the coin is that doctors and nurses are human and have successfully treated many other people. Perfection is good but it is human to err.

Broken Angel Achala has already told her tale. She has relived the memory of fracturing her arm time and again.

She now lies in bed without a limb; without a wing. Yet let us hope that with the loss of a limb she has gained a new found strength.

Don't die, diet

Timing your meal:

S. Rahanan

When I logged on to my Facebook profile recently, I found that I had been tagged in a note by my foreign friend.

The title of that note grabbed my attention instantly “Do Sri Lankans really care about their diets?” Since it is related to my field, I became interested and read it thoroughly. In that note, common dietary malpractices prevailing in Sri Lanka were discussed.

After reading it, I realized that although most of us have proper knowledge of nutrition, we don’t really apply them into our own lives. So in this article, I will share my views on some of those nutritional issues existing in our country.

The first and foremost issue I want to focus is skipping meals. Usually we as Sri Lankans don’t care much about eating meals on time. Skipping regular meals can be generally seen among people in all life stages including school children, university students, working adults and housewives. You may think if you don’t eat food, body fat will be used up for energy production and will be reduced.

But it is hard to believe that skipping breakfast can cause excess fat storage or obesity in our body.

It is true because skipping breakfast can lead to over-eating. If you don’t eat your breakfast, you will feel much hungrier and tend to eat a lot. This out-of-control eating leads to excess energy storage in body in the form of fat.

Obesity risk factor

Consequently this excess fat storage in body can promote obesity. In addition, snacking can be often seen among people who skip their regular meals.

They will eat more convenient foods such as high saturated fat and trans fat (types of ‘bad’ fat which promote obesity) containing fast foods. Ultimately they will end up with chronic diseases such as diabetes, heart diseases and cancer. In order to avoid those adverse health effects, don’t skip any major meals.

Even though you don’t have plenty of time to eat a big meal in your office, at least you can eat a sandwich instead of skipping lunch.

“If there is a will, there is a way.”You don’t have to worry about variety of food groups if that particular sandwich contains a fish piece/egg, tomato/carrot slices, salad leaf and a cheese piece. Especially children must have their breakfast on time every day or else it can undesirably affect their performance at school.

Balanced diet

Next nutritional issue is balanced diet. Do we really understand the true concept of balanced diet and follow it? As it goes in the famous song “the answer my friend is blowing in the wind.”

Nowadays we live and work in a fast paced world. So we eat whatever foods those are convenient for our lifestyle. We don’t pay much attention towards nutrients or balanced diet. There is no “magic food” that can provide all essential nutrients in required amounts to us.

So we have to eat a variety of foods to compensate our metabolic needs. Balanced diet consists of all essential food groups such as grains/tubers, vegetables, fruits, fish/meat/egg/pulses, milk products, nuts and oils in required amounts. You don’t have to include all food groups in single meal which is impractical; thus you can incorporate all of them in one whole day menu.

Then how can we measure the efficiency of a balanced diet? The simple answer is just count how many food groups are present in your daily menu.

Another method of measuring the efficiency of balanced diet is calculating serving sizes.

Serving sizes

Generally serving sizes represent amount of foods in household measurements. For example, 1 serving size of cooked vegetable is 3 tablespoons (45g) whereas 1 serving of cooked fish is one “matchbox size” piece (35g).

The number of servings needed for each day can be varied among individuals depending on their age, sex, body size, exercise, diseases and the stage of the lifecycle. Do you know that we have to eat more than 5 servings of fruits and vegetables per day to prevent chronic diseases? According to Food based dietary guidelines for Sri Lankans published by Nutrition Division Ministry of Health in 2011.

“The golden rule is “be sure to eat some food from each of food groups daily.” It is important to include some items from each group rather than a large quantity of one or two groups.

This will ensure variety in your diet and thereby give you the nutrients required by your body every day”

Moderate consumption

The last issue I want to emphasize is moderate consumption. Most of our people eat for pleasure than nutrition. So they will eat high quantity of their favorite foods even if it is high in salt, sugar or saturated fat.

This can ultimately lead to obesity and other chronic diseases. Therefore they have to check how much and how often they are eating them to prevent those unfavorable health effects. Never eliminate any foods from your diet; always go for moderate consumption.

The truth there is no any single food in the world that can be considered as entirely “good” or “bad”; it always depends on amount and frequency.

Can you believe that you have to eat fatty foods to reduce your body fat level? Yes, the fact is you have to eat more unsaturated fat (one ‘good’ type of fat) rich foods to reduce your saturated fat level in body.

Good sources of unsaturated fats are fish, soya, ground nuts, avocado and sunflower oil.

So patients with obesity or heart diseases should eat adequate amounts of those fatty foods!

As the conclusion, I want to highlight that prevention is always better than cure. Definitely you have to eat regular and balanced diet in moderate amounts to live healthy. Life moves at such a fast pace that it seems to pass us by before we can really enjoy it. Enjoy and experiment with your food rather than fulfilling your stomach. So eat for pleasure as well as nutrition.

(The writer is a third 3rd year student, Department of Applied Nutrition, Faculty of Livestock, Fisheries & Nutrition, Wayamba University of Sri Lanka.)

The benefits of exercising outdoors

While the allure of the gym - climate-controlled, convenient and predictable - is obvious, especially in winter, emerging science suggests there are benefits to exercising outdoors that can't be replicated on a treadmill, a recumbent bicycle or a track.

You stride differently when running outdoors, for one thing. Generally, studies find, people flex their ankles more when they run outside. They also, at least occasionally, run downhill, a movement that isn't easily done on a treadmill and that stresses muscles differently than running on flat or uphill terrain. Outdoor exercise tends, too, to be more strenuous than the indoor version. In studies comparing the exertion of running on a treadmill and the exertion of running outside, treadmill runners expended less energy to cover the same distance as those striding across the ground outside, primarily because indoor exercisers face no wind resistance or changes in terrain, no matter how subtle.

Advantages

The same dynamic has been shown to apply to cycling, where wind drag can result in much greater energy demands during 25 miles of outdoor cycling than the same distance on a stationary bike. That means if you have limited time and want to burn as many calories as possible, you should hit the road instead of the gym.

But there seem to be other, more ineffable advantages to getting outside to work out. In a number of recent studies, volunteers have been asked to go for two walks for the same time or distance - one inside, usually on a treadmill or around a track, the other outdoors. In virtually all of the studies, the volunteers reported enjoying the outside activity more and, on subsequent psychological tests, scored significantly higher on measures of vitality, enthusiasm, pleasure and self-esteem and lower on tension, depression and fatigue after they walked outside.

Latest study

Of course, those studies were small-scale, short-term - only two walks - and squishy in their scientific parameters, relying heavily on subjective responses. But a study last year of older adults found, objectively, that those who exercised outside exercised longer and more often than those working out indoors. Specifically, the researchers asked men and women 66 or older about their exercise habits and then fitted them all with electronic gadgets that measured their activity levels for a week. The gadgets and the survey showed that the volunteers who exercised outside, usually by walking, were significantly more physically active than those who exercised indoors, completing, on average, about 30 minutes more exercise each week than those who walked or otherwise exercised indoors.

Studies haven't yet established why, physiologically, exercising outside might improve dispositions or inspire greater commitment to an exercise program. A few small studies have found that people have lower blood levels of cortisol, a hormone related to stress, after exerting themselves outside as compared with inside. There's speculation, too, that exposure to direct sunlight, known to affect mood, plays a role.

But the take-away seems to be that moving their routines outside could help reluctant or inconsistent exercisers. “If outdoor activity encourages more activity, then it is a good thing,” says Jacqueline Kerr, a professor at the University of California, San Diego, who led the study of older adults. After all, “despite the fitness industry boom,” she continues, “we are not seeing changes in national physical activity levels, so gyms are not the answer.”

The New York times

Over two thirds of Sunbed users concerned they are aging their skin

Over two thirds of Sunbed users concerned they are aging their dkin Results of a survey by the charity Cancer Research UK show that more than two thirds (68%) of people who use sunbeds are concerned that the practice is aging their skin.

The research, which polled 2,500 UK adults in January, was released to coincide with the charity's R UV UGLY sunbed awareness campaign.

The results also reveal that over two-fifths (43%) of UK's sunbed users are using anti-aging products compared with only one-fifth (20%) of non-users.

Plus, nearly a fifth (19%) of people who use sunbeds are already using anti-aging products by their 25th birthday, while among non-users this figure is just 5%. In a statement to the press, Caroline Cerny, senior health campaigns manager at Cancer Research UK, blames our “image obsessed culture”, and says many people continue to use subeds because they think they looked better with a tan.

A survey done in Germany that was published in October 2012 also found that one of the main reasons people use sunbeds was because they thought they looked more attractive with a tan. Another reason was because they found it relaxing.

Catharine Paddock PhD, Medical News Today

Prize Winners of Medical Crossword Draw No 55

Healthwatch Medical Crossword Draw No 55 was held on February 14, Valentine's Day, at the Crossword sponsor's Wish Institute at Delkanda Nugegoda amidst a youth group of the Institute in keeping with the Valentines Day.

Following are the prize winners of Rs 3,000 Rs 2,000 and Rs 1,500 picked by the youth group.

Housewives category

1st prize: Entry No 14 Mrs Maya Weerasuriya 67 yrs. No 17, Sangabo Mawatha, Ratmalana.

2nd prize: Entry No 19 Miss P A Siriwardena 67 yrs No 7, 7th Lane, Jambugasmulla Nugegoda.

3rd prize: Entry No 16 Mrs M Lilani 65 yrs 77 Davidson Rd. Colombo 4

Professional category

1st prize: Entry No 5 T Mass graduate 65/365 Crow Island, Colombo 15

2nd prize: Entry No 11 Mrs N D Jayasuriya, Teacher, 35 Mirihana Rd. Nugegoda.

3rd prize: Entry No 12 Mrs S Mass Nurse 65/365 Crow Island, Colombo 15

Retired category

1st prize: Entry No 3 D P W Karunatilleke 84 yrs No 8 Devale Rd Makola

2nd prize: Entry No 7 R P de Soysa 72 yrs. Rt. Principal 19/321, Perakumba Mawatha, Udugampola.

3rd prize: Entry No 1 G R E C Perera 66 yrs, Pensioner 56/9 Morawatta Rd. Kandana.

Daily News Editorial, Wish Institute, the sponsors congratulate all the winners and wish them good health, peace and happiness.