HEALTH WATCH/ DAILYNEWS.LK: In the early days they were called `prostitutes’. No matter what you call them, they don’t wait doing nothing.!!!

HEALTH WATCH

A shock of your life
‘Seven Colombo sex workers HIV positive!’ Now we can call them ‘commercial sex workers’.

Nadira Gunatilleke

In the early days they were called `prostitutes’. No matter what you call them, they don’t wait doing nothing.


A child who is HIV positive

They have hundreds of `clients’ who provide them sufficient money to live. The clients also have hundreds of other `service providers’!

Who are these clients? They are either single or married men. How about their innocent wives/girlfriends who know nothing about their husbands’/boyfriend’s HIV positive `entertainer’. According to findings, over 50 percent of Sri Lankan married women get HIV/AIDS from their husbands!

May be you are fit and fine. May be you are well protected against all STDs and HIV due to your good sexual behaviour or fear for life! May be you are very enthusiastically reading news just to learn what is happening around you.

At the same time may be there are persons who faint after reading the above news item and who are dying inside about the safety and future of himself and his innocent wife/girlfriend!

Maybe you are not too late to think about it. That is why we need to discuss this issue. It is all about Sexually Transmitted Diseases (STD) and HIV.

According to Health Ministry Media Coordinator W.M.D. Vanninayake, Sri Lanka’s HIV prevalence rate has gone up from 0.1 to 0.5. since the discovery of first HIV infected person from the country around two decades ago. This is a fact that all of us should take into consideration. Although records say that only around 1323 HIV positive persons are there in the country, the actual number can be much more higher than this recorded number. Maybe there are a thousand more male and female HIV carriers in Sri Lanka who are in good health and have casual sex with other partners other than their wives/girlfriends.

According to the scientific findings, antibody tests may give false negative (no antibodies were detected despite HIV being present) results during the Window Period, an interval of three weeks to six months between the time of HIV infection and the production of measurable antibodies to HIV seroconversion.

Most people develop detectable antibodies approximately 30 days after infection, although some seroconvert later. The vast majority of people (99 percent) have detectable antibodies by three months after HIV infection; a six-month window is extremely rare with modern antibody testing. The most dangerous fact is during the window period, an infected person can transmit HIV to others although their HIV infection may not be detectable with an antibody test.

Therefore if a person had unprotected sex, very worried about his/her safety and health, runs into a lab and gets tested for HIV within few days of the incident, it will give no relief to him/her. The test may say negative but the person can be HIV positive!


The world making an awareness

The best thing that can be done by a genuine husband/wife who had unprotected sex is, protecting his/her spouse until the window period ends and get himself/herself tested for HIV. It will ensure the safety of the innocent husband/wife who does not know a thing about his/her spouse’s `sex adventures’. But the question is whether he/she is (really)worried about the health and safety of his/her spouse. If one really loves and care for another first of all he or she will love himself/herself and protect himself/herself first!

The worst possible situation arises when a husband brings HIV home, gives it to his wife and the wife gives birth to their HIV positive child ! There is no need to describe the pathetic situation of such a family which is proceeding towards a huge tragedy. The innocent child may lose both or one parent in an early age of his life and then die from AIDS once his/her immunity gives up.

The sex worker found positive for HIV has nothing to do with any of these tragedies because she was earning a living selling her body without knowing her HIV positive status, and the mother is helpless without knowing anything about her husband’s behaviour.

The innocent child is paying the price for the sins of his/her father who seek some ‘thrill’ outside home!

After hearing or reading this breaking news you may start thinking twice of the safety of your family. It increase your blood pressure and take away your mental peace. The other fact is you do not have any right to infect your pregnant spouse with HIV. So why worry about breaking news? Live your life according to the nature and religion.


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Adolescent hearing loss on the rise in US
Do you ever get the impression your teen is just not hearing you? Well, maybe he’s not. Literally. According to a new study, more American adolescents may be suffering from early signs of hearing loss than previously estimated.


Listening to
music through
earphones for
a long period
of time is not good

Researchers looking at hearing loss in people ages 12 to 19 found that when compared with data from the mid-1990s there has been a 30 percent increase in the development of minimal levels of hearing loss, and a 77 percent increase in more serious hearing problems – those where obvious communication difficulties can be observed. About one in 20 children experienced hearing loss in 1994, and that number jumped to about one in 5, or an estimated 6.5 million adolescents, by 2006.

“What we’re seeing is a big jump in the prevalence of hearing loss in a very short period of time, in less than one generation,” an author on the study Dr. Roland Eavey said. “That means we’re on the front edge of an epidemic.” The results were published today in the Journal of the American Medical Association. Hearing loss is a serious problem that can lead to developmental delays for school-aged children.

Even though the condition is common, getting to the root of the problem remains a challenge.

The authors of the JAMA article conclude that more studies are needed to determine the ex

act cause of the increase.

“We see smoke,” Eavey explains. “We’re not sure where the fire is yet, but we know it’s not good for the woods to be burning.”

An otolaryngologist with the National Institute on Deafness and other Communication Disorders Dr. Gordon Hughes, agrees that the findings are significant and says the next step is moving beyond epidemiological analyses.

“You’re taking a cross section of the population in certain age groups, and then comparing what you see from then to now,” he explains. “You cannot prove cause and effect with that.”

Both Eavey and Hughes say future studies should probe more specifically into questions about noise and music.

Even though the 2005 – 2006 survey included a question asking participants whether they had been exposed to loud noise or music for five hours or more a week, Eavey says adolescents may simply reply ‘no’ to a question either because they don’t understand the significance, or because to them a loud rock concert might be the norm.

Asking “have you experienced ringing in your ears in the last three months,” could really help pinpoint the cause, he suggests.

Despite the absence of a causal link, experts say technological trends popular among adolescents can’t be ignored.

CNN health


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The doctor of tomorrow
Dr Sujatha Liyanage - Health Education Bureau

An era of acute diseases with straight forward causes is gradually being replaced with chronic diseases of complex and multifaceted causation, most of which are man made.


Chronic disease epidemiology

Chronic non communicable diseases in Sri Lanka reaching epidemic proportions, pose a severe threat to the people- resulting in premature death and disability. Moreover, by diminishing the productivity of the nation and huge health care costs, NCDs (diabetes, cardiovascular and respiratory diseases and cancer) play out a huge economic burden to the Government.

Around the world 60 percent of all deaths are due to NCDs, and four-fifths of these occur in low and middle-income countries. But fortunately, nearly all chronic diseases are preventable. Four factors contribute to three-quarters of the risk for NCDs: physical inactivity and poor nutrition (which lead to overweight and obesity), tobacco use and alcohol use.

All of these can be effectively targeted. The World Health Organization (WHO) recommend multi-faceted multi-institutional’ responses to eliminate the global chronic disease burden.

With regard to the responses a three-point approach that merges epidemiological surveillance, primary prevention (preventing chronic disease in lay healthy communities through health promotion) and secondary prevention (preventing complications and improving the quality of life of people with chronic disease through medical, psychosocial and/or economic interventions) is suggested.

Considering the structure and agents of responses, (1) interdisciplinary research that addresses the multi-faceted causes and consequences of chronic disease; and (2) innovative interventions that efficiently use existing economic and human resources are further recommended by professionals.

Educational curricula of medical schools should introduce the higher level of reasoning and assessment. The habitual view of the patient from linear cause and effect, symptom and diagnosis to a broader real life viewpoint. The role of the future doctor should undergo a shift from today’s traditional practice. In a way it should be a multidisciplinary, patient centered and also inclusively concern body, mind and spirit.

The future doctor should be much more capable of working smoothly with partners of various allied health and non health professionals. This novel doctor should consistently be updated with new evidences of best practices to ensure that patients under his care receive high quality services and best available treatment options. High technology is not the sole hope for medicinal achievement; it must be coupled with a ‘high-touch’.

It is because of the natural healing powers of the human body and mind that we continue survival. Subsequently an ideal doctor should not compromise this capacity, but facilitate patients towards self healing. They should be empowered to adopt healthy life behaviors. In other words, health promotion, which emphasizes community empowerment for their optimal well being within supportive environments, must be the primary idea of future medicine . Accordingly the doctor should be where the community is, but not in a ‘in- the- clinic practice’. The delicate and inborn healing process is not to be compromised with robust interventions and drugs. Rather than fostering drug dependence and its adverse effects, the safest and mildest drugs should be used in the first instance.

It is important to utilize high technology and curative wisdom with utmost care and patience. The battle against complex chronic diseases cannot be solved solely by prescribing a drug or an intervention which is at the same time valuable in acute ill health and emergencies. In most chronic conditions such approaches will only temporarily relieve the patent’s current symptoms , with the threat of returning symptoms from the underlying problem.

In the management of chronic diseases the patient should be the navigator of a multidisciplinary team of care providers, not a passive recipient.

The empowered patient plays a giant role in controlling his/her own health and well being through adopting healthy life styles, involving in formulation of healthy public policies and advocating for supportive environments.

In short, to tackle the multifaceted nature of chronic disease causation the future doctor should have the ability to advocate for optimal supportive environments and be actively involved in the formation of policies conducive to the overall well being of communities.

Such a role of a doctor is urgently required to reduce risk, morbidity and mortality for a growing number of Sri Lankans affected by chronic diseases. It will be the inimitable solution to reverse the escalating health expenditure on chronic disease burden and to enhance the quality of lives of our nation.


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An Illegal Abortion:

Murdering in a point of secured living
Dr SHANTHA HETTIARACHCHI

A love affair of a matching young couple had been going on for several years. They were able to obtain the consent from their parents very recently after passing through a long period of opposing .

Both of them were willing to discuss their problem openly in the session of counseling .


A baby inside the womb

As the marriage was registered a few months back, they were preparing for their wedding ceremony in the near future. An unexpected problem had been encountered by them while waiting to see this happiest day in their life. The girl had developed ulceration in the genital region and later diagnosed as genital herpes. Though it was a sexually transmitted infection, it had come through another hidden route in this instance.

The girl had to undergo a termination of pregnancy in an illegal abortion center in finding an urgent but incorrect answer to an unexpected problem, before appearing as a bride in front of their relatives. The genital ulceration was apparent two weeks after this unpleasant experience and it was evident that such a gift had been received through the usage of unsterilized instruments in this illegal place.

The gift they received could not be discarded from their life. There is a possibility to recur the disease in time to time even after subsiding the relevant clinical manifestations with treatment. They were counseled and reassured how to reduce this burden from their mind while living with this recurring illness.

It is true that the word abortion is very familiar to people nowadays, irrespective of their religious or racial differences. When they see or hear this word the mind of the majority get struck with the term, illegal abortion. An increasing number of unwanted pregnancies which are occurring in the country, has invariably created this situation.

It is evident that abortion could happen spontaneously in 10 to 15 percent of pregnancies. Abortion is defined as the termination of a pregnancy before the fetus is capable of extra uterine life, prior to 28th week of gestation.

The causes for the spontaneous abortion include, malformation or defective development of the fertilized ovum or zygote, general diseases of the mother such as rubella, syphilis, malaria, toxoplasmosis, diabetes, hypertension, renal disease, acute emotional disturbances and high fever, certain hormone imbalances like increased or decreased activity of thyroid gland, low level of progesterone and trauma, irradiation exposure or abnormalities of the uterus.

When the abortions take place intentionally, they are said to be induced. An induced abortion may be legal or illegal according to the law in the relevant country. The existing legislation in Sri Lanka, has been implemented in the year 1883.

There is a legal provision for induced abortion when the mother’s life is in danger due to her pregnancy. There are no other indications to allow an induced abortion, according to this law in our country.

The grounds on which abortion is permitted are different in countries. Saving the life of the mother, preserving physical or mental health of the mother, medical problems or birth defects of unborn fetus, economic or social reasons , rape or incest and demand or request are among the indications that has been selected differently in those countries.

In Sri Lanka section 303 of the Penal Code provides that anyone voluntarily causing a woman to terminate her pregnancy is liable up to three years imprisonment and/or payment of a fine, unless the miscarriage was caused in good faith in order to save the mother’s life. A woman who induces her own miscarriage is also liable to the penalties. If the miscarriage is caused without the consent of the woman, the person causing it is liable up to 20 years’ imprisonment and payment of a fine according to section 304.

The same penalty is imposed if the woman’s death results from any act carried out with intent to bring about a miscarriage, whether or not the offender knew that the act was likely to cause death according to section 305.

Currently, a vast number of illegal abortions are being reported while such tough legislations are existing in the country. It has been estimated through various researches that around 700 to 1000 illegal abortions are occurring in a day.

It must be emphasized that exact incidence of illegal termination of pregnancy could not be measured as many patients who are admitted to hospitals with symptoms of abortion deny any attempt in disturbing pregnancy. The suggestive evidence of manipulation can be detected in some of the cases during the examination.

The complications that arise as a result of abortions will endanger the life of the woman.

In addition to the acute complications of nervous shock, hemorrhage, infection, injury to genital tract and internal organs, chronic pelvic inflammatory diseases could occur as a long-term sequel of unsafe abortion. Sometimes drugs or other chemicals which are used to induce abortions, may cause adverse toxic or chemical reactions.

Unsafe illegal abortion could act as a path in transmission of sexually transmitted infections. No one can guarantee that operators of these hidden places adhere to proper sterilization techniques in induction and completion of relevant procedure. There is a possibility in sharing sexually transmitted infections through the use of improperly sterilized instruments when someone is having this type of disease, among the waiting group of women who are in the queue to get terminated the pregnancy.

The majority of deaths in illegal abortion are attributable to infection. The patient can develop septicemia as a result of multiplication of the germ, which has entered the bloodstream in these circumstances. Apart from this, nervous shock or excessive hemorrhage may be a cause for sudden death following these procedures.

The resultant infection may lead to chronic pelvic inflammatory disease, involving the genital tract. It can manifest clinically, with fever, lower abdominal pain, menstrual irregularities and vaginal discharge. Sub fertility may be another additional problem due to this condition.

The number of women, who undergo illegal abortion, represent group of married as well as unmarried.

The lack of proper knowledge on family planning is the common reason in considering both groups. There is an necessity in providing correct sex education to all, with different proportion to suit for the different age groups.

The good attitudes must be built among them while improving the knowledge on this context, in avoiding problematic circumstances. It should be emphasized that destruction and disintegration of socio cultural norms are the unavoidable results with delay in providing this knowledge to our society.

courtesy:dailynews.lk
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