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Hey there, mental health warriors! Are you ready to embark on an exhilarating quest to boost your mental well-being and unleash your inner superhero? In this action-packed article, we’re diving deep into the realm of mental awesomeness, armed with 10 mind-blowing strategies to supercharge your mental health.

Rock Your Self-Care Game:

Time to treat yourself like the mental health royalty you are! Embrace activities that tickle your fancy and bring you pure bliss. Whether it’s jamming to your favorite tunes, basking in the great outdoors, or simply snuggling up with a good book, make self-care your number one priority. Remember, you deserve all the love and care in the world, so give yourself permission to indulge in activities that light up your soul.

Your Vibe Attracts Your Tribe:

No hero is complete without an awesome squad by their side. Surround yourself with positive, uplifting individuals who have your back. Build meaningful connections by hanging out with friends, bonding with family, or joining clubs that align with your interests. Together, you’ll form an unstoppable force that boosts your sense of belonging and provides unwavering support when the going gets tough.

Power Up with Physical Activity:

Time to unleash your inner fitness warrior! Engage in exhilarating physical activities that make you feel like a superhero in training. Whether it’s joining a dance class, mastering yoga poses, or becoming a sports champ, get your body moving and grooving. As those endorphins flood your system, you’ll experience a natural high, bid stress goodbye, and unlock your mental potential.

Snooze and Win at the Sleep Game:

Sleep like a champion, wake up like a boss! Establish a sleep routine that would make even Sleeping Beauty envious. Set the stage for a night of sweet dreams by creating a cosy sleep sanctuary, bidding adieu to screens before bed, and practising relaxation techniques. With quality shut-eye as your secret weapon, you’ll wake up refreshed, recharged, and ready to conquer the day.

Zen Out with Mindfulness and Meditation:

Get your Zen on and become the master of your mind! Dive into the world of mindfulness and meditation, where tranquillity and mental resilience await. Carve out a few moments each day to be present in the here and now. Embrace your breath, let thoughts flow without judgement, and feel the calm wash over you. With regular practice, you’ll become the Zen warrior you were always meant to be.

Unplug and Recharge Your Soul:

In a world buzzing with digital noise, it’s time to unplug and reconnect with the real world. Set limits on screen time and embark on regular digital detox adventures. Break free from the digital chains and savor the joy of offline activities. Connect with loved ones, rediscover your hobbies, and revel in the simple pleasures that life has to offer. It’s time to be fully present and embrace the magic of the moment.

Feed Your Mind with Yummy Brain Food:

Supercharge your mental powers with a diet fit for a mental health champion. Load up on delicious fruits, veggies, whole grains, lean proteins, and healthy fats. Ditch the mood-zapping processed foods and excessive caffeine. Stay hydrated and let your inner nutritionist shine. Your mind will thank you for the nourishing feast!

Crush Goals, Smash Stress:

Unleash your goal-crushing powers and show stress who’s boss! Break down big tasks into bite-sized chunks, prioritise like a pro, and celebrate every step forward. Manage stress like a Jedi master by deep breathing, journaling, or diving into your favorite hobbies. As you conquer stress and achieve your goals, you’ll level up your mental well-being and feel like the true superhero you are.

Call in Reinforcements When Needed:

Remember, even superheroes need a little help sometimes. If you find yourself battling persistent feelings of sadness or anxiety, don’t hesitate to seek professional support. It’s a sign of strength and a game-changer on your mental health journey. Reach out to trusted mental health professionals who can provide the guidance and support you need to soar to new heights.

Harness the Power of Gratitude and Positivity:

Tap into the immense power of gratitude and positive thinking. Take a daily mental adventure by reflecting on the things you’re grateful for. Keep a gratitude journal and jot down three things that make your heart sing each day. Watch as your mindset shifts from negativity to a radiant, positive glow. Embrace the magic of gratitude, and a more fulfilling, balanced, and vibrant life awaits you.

Congratulations, you’re now armed with 10 mind-blowing strategies to level up your mental health game. Remember, this journey is yours to own, so keep nurturing your mental well-being with love, care, and a healthy dose of adventure. You’re destined for greatness, so unleash your inner hero and soar to new heights of happiness and fulfilment!

Sources:
Mental Health Foundation. (2021). How to look after your mental health. Retrieved from [https://www.mentalhealth.org.uk/explore-mental-health/publications/our-best-mental-health-tips ] Mayo Clinic. (2021). Exercise and stress: Get moving to manage stress. Retrieved from [https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469#:~:text=Exercise%20in%20short%20bursts.&text=For%20instance%2C%20if%20you%20can,do%20some%20squats%20or%20pushups ] National Sleep Foundation. (n.d.). How Much Sleep Do We Really Need? Retrieved from [https://www.sleepfoundation.org/how-sleep-works/why-do-we-need-sleep ] National Center for Complementary and Integrative Health. (2021). Meditation: In depth. Retrieved from [https://www.nccih.nih.gov/health/meditation-and-mindfulness-what-you-need-to-know ] Harvard Health Publishing. (2021). Nutritional psychiatry: Your brain on food. Retrieved from[https://www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626 ]

Good mental health means being generally able to think, feel, and react in the ways that you need and want to live your life. Mental wellbeing describes your mental state, including how you are feeling and how well you can cope with day-to-day life. Our mental wellbeing is dynamic.

Types of Mental Health Conditions:

  • Anxiety
  • Depression
  • Eating problems
  • Schizophrenia
  • Phobias
  • Obsessive-Compulsive Disorder
  • Bipolar disorder
  • Personality disorders
  • PTSD

What are mental health problems?

Mental health problems can affect any of us irrespective of age, personality, or background. They include a wide range of experiences and can affect the way people think, feel, or behave. They can appear as a result of experiences in both our personal and working lives, or they can come about without any easily identifiable cause. Some problems may be mild or moderate, while others may take on a more severe form, affecting a person’s ability to cope with day-to-day living.

Your mental wellbeing can be affected by work-related factors like:

  • Repeated exposure to traumatic events
  • Workload pressures
  • Lone working
  • Long working hours
  • Shift work
  • Dealing with people who may be physically or verbally abusive

Your mental wellbeing can also be affected by other things in your life, for example, if you:

  • Suffer some sort of loss
  • Experience loneliness
  • Have relationship problems
  • Are worried about money

Sometimes, there is no clear reason why we experience a period of poor mental health. It’s important to look after your mental wellbeing on a day-to-day basis, and not just after experiencing big traumatic events. Staying mentally well by building resilience can reduce your chances of developing mental health problems like depression, anxiety, and post-traumatic stress disorder. 

How can one look after your well-being?

  1. Keep physically active: Regular exercise can be very effective in lifting your mood and increasing your energy levels. It doesn’t have to be very strenuous or sporty to be effective. The important thing is to pick something you enjoy doing, so you’re more likely to stick with it.
  2. Identify mood triggers: Keeping track of your moods in a mood diary can help you work out what affects your mental wellbeing and recognise changes in your mood that would be difficult to spot otherwise. For example, you may realise that seeing a certain person has an effect on your mood. Knowing what affects your moods can help you take steps to avoid these situations or mitigate against the negative impact a certain situation may have on you.
  3. Sleep: There is a close relationship between sleep and mental health. If you’re finding it difficult to sleep, don’t try to force it. Get up, go to another room, and try to relax there. Do something soothing, such as listening to music, until you’re tired enough to go back to bed. If you are awake for long periods, repeat this process as many times as you need to.
  4. Relax: It is important to make time for yourself and relax. In order to look after others you need to first care for yourself. Self-care is not self-indulgent, it’s essential. Do something you like, or even just take a five-minute break to look out of the window. Learning a relaxation technique, such as yoga, meditation or mindfulness can also help you relax and reduce stress levels.
  5. Diet: Explore the relationship between the food you eat and your mood. Improving your diet can help give you positive feelings, clearer thinking, more energy and calmer moods. Think about how regularly you eat. If your blood sugar drops, you might feel tired, irritable, and experience low mood. You need to eat regularly to keep your sugar level steady and choose foods that release energy slowly, like protein, nuts and seeds, oats, and whole grains.

Are you having too much caffeine? Caffeine is a stimulant. Having too much can make you feel anxious and experience low mood, disturb your sleep, or give you withdrawal symptoms if you stop suddenly. Caffeine is found in tea, coffee, chocolate, cola and other manufactured energy drinks. You might feel noticeably better quite quickly if you drink less caffeine or avoid it altogether.

  • Accept yourself: One of the most important steps in maintaining mental wellbeing is to learn to accept yourself. If you value yourself, you are more likely to have positive relationships with other people and find it easier to cope with difficult times in your life.
  • Use self-help books and websites to help you change your beliefs
  • Be assertive
  • Spend time with supportive people
  • Try not to compare yourself to other people
  • Acknowledge your positive qualities and things you are good at
  • Learn to identify and challengeunhelpful thinking patterns
  • Engage in hobbies that you enjoy
  • Be realistic.

Dr. K.A.H.L. Fernando
MBBS(SL) MBA (Healthcare Administration)
APG Dip. Pharmaceutical Medicine (Ind/SG)
Head of wellness and clinical services
Kings Hospital Colombo

Your fury friend is better than any pharmacological drug. Most, or at least many, have had a friendly companion in their life in the form of a pet. Dogs have integrity sometimes lacking in humans. They are loyal, loving, caring furry beings. There are numerous health benefits of having a dog. They are, in their own right, four-legged psychiatrists.

Dogs are known to:

  • Bust stress
  • Boost memory in dementia patients
  • Enhance cardiovascular fitness
  • Reduce high blood pressure

They are extremely well trainable, loyal, and trustworthy companions to humans. Dogs are used as service companions to patients with anxiety, Parkinson’s, Alzheimer’s dementia, and patients with disabilities/rehabilitation, assisting them with long-term care and activities of daily living.

Patients with Alzheimer’s disease have shown increased calmness and improved social interactions when they receive visits from dogs. These four-legged canines boost dopamine and endorphin levels in the human body, leading to feelings of happiness. Furthermore, they help decrease cortisol levels, which are responsible for stress. Early exposure to pets during infancy in humans helps reduce allergies, wheezing, and asthma.

The symbiotic relationship, to a certain degree, between humans and dogs causes humans to exercise more, as dog themselves require exercise. This helps to build better cardiovascular fitness and immunity. The array of health benefits of caring for and raising a pet dog is substantial to the wellbeing and wellness of any human. These pawed beings have helped extend the lives of the sick as well as the healthy.

In conclusion, a dog, or any pet for that matter, can derail your unhealthy habits and enhance your health. The commitment to caring for a dog is enormous, while having them can bring many health benefits that will reflect in your own well-being. Therefore, your four-legged friend is a life savior.

Not just a best friend but your personalized health advocate!

Dr. K.A.H.L. Fernando
MBBS(SL) MBA (Healthcare Administration)
APG Dip. Pharmaceutical Medicine (Ind/SG)
Head of wellness and clinical services
Kings Hospital Colombo

HIV/AIDS and sexually transmitted infections are topics that are not openly discussed by many people. As a result, most of us do not have enough knowledge about them. I am sure you would like to know what HIV/AIDS and sexually transmitted infections are, how they can spread from one person to another, how to identify them, whether there are any treatments for them, and how we can prevent getting HIV and STIs.

Let’s talk about HIV first. Up to now, Sri Lanka is one of the few countries in our region with a very low number of HIV cases. But during the last 2 years, we have seen an increase in the reported number of cases. Therefore, it is better for all of us to be aware of these diseases.

HIV is caused by a virus that can weaken our immune system. It spreads from one person to another mostly through unsafe sex. The virus can also spread through blood by sharing needles and equipment contaminated with infected blood. If a woman gets infected with HIV, she could pass it on to her baby if she is not on treatment.

Once someone gets infected with HIV, they could experience flu-like illness 2-3 weeks later, but some may not show any symptoms. This flu will get better without any treatment, and thereafter, most people remain without any symptoms for 8-10 years where they look healthy from outside but could spread HIV to others. Once their immunity gets weakened due to the virus, they will start getting infections and diseases like skin rashes, fever, weight loss, TB, pneumonia and sometimes cancers.

HIV-infected people may not show any symptoms for a long time, and even if they show symptoms, they are not specific to HIV/AIDS. Therefore, the only way to accurately identify HIV is by a special test called an HIV test. You could consult a doctor and get an HIV test done at a government or private hospital. The test is available in most government and private hospitals. If HIV is identified early, there are very effective medicines to control the virus through special drugs called Antiretroviral Therapy (ART). If an HIV-infected person takes ART as recommended and controls the virus, they can live a normal, healthy life and carry on with their day-to-day activities without any issues, and the medications need to be continued lifelong. Therefore, what is important is to go to a qualified doctor and get tested for HIV without delay and, if HIV positive, to start treatment as soon as possible and continue treatment for the rest of your life.

I believe you would also like to know how one can stay away from HIV. HIV mostly passes on from one person to another through unsafe sex; therefore, limiting your sexual relationships to a faithful one partner is the best way to protect yourself from getting HIV. Using condoms correctly can also protect you from getting HIV. It has also been found out that those who take medications according to medical advice have the number of HIV viruses in their body reduced to undetectable levels after 6 months, and HIV transmission will not happen through such people. We call it U = U; Undetectable equals Untransferable.         

Not only HIV, but other sexually transmitted illnesses can also be passed through unsafe sex. Discharge, wounds, or warts in the genital area are some of the common symptoms of STIs. Many STIs may not show any symptoms but can affect your health in a bad way later if not properly treated. If identified early, many STIs can be effectively treated and cured.  Therefore, if you have had any unsafe sex, it is best to consult a qualified doctor and get yourself checked for sexually transmitted diseases and receive the correct treatment. Through correct and quick treatment for STIs, we can also reduce the risk of getting HIV.

Difficulty in having sex or sexual dysfunction is another condition that many people are reluctant to seek medical advice for, and some are suffering a lot with these problems. Now there are many successful ways to treat such problems. Some go to pharmacies and buy medicines without recommendations from a doctor. It is always important to go to a qualified doctor, undergo a proper assessment to identify the underlying problems, and then get necessary treatments to minimize the risks and enjoy a healthy sex life.

Most people are reluctant or embarrassed to talk about their sexual behaviors with a doctor, and some think the doctor will judge them based on their sexual behaviors. But the doctor will never judge you and will use that information only to help you, and the doctor will always protect the confidentiality of the information that you provide.

If we are to prevent the spread of HIV in society, it is important not to stigmatize infected people or treat them differently. The stigma will prevent people from getting tested for HIV, seeking treatment, and ultimately lead to increased deaths and facilitate the spread of infections in society.  Therefore, it is very important for all of us to come together and fight against sigma and discrimination against HIV and ensure the human rights of people living with HIV. By doing so, all of us can contribute to ending AIDS in Sri Lanka by 2030!

Therefore, I invite all of you to educate yourselves about HIV, STIs, and sexual problems and seek medical advice when necessary and play your role for a better Sri Lanka!

Dr. Geethani Samaraweera
MBBS, MD(Ven),
Consultant Venereologist and Sexual Health Physician,
National STD/AIDS Control Programme,
Sri Lanka

You’ve heard about channelling your doctor through the internet or your phone. But what if, you could actually talk to your doctor and get your diagnosis without ever having to visit the hospital?

TeleChanelling allows you to do just that! Gone are the days where you would have to go through the process of channelling and then, physically visiting a doctor. Now, with only a stable internet connection and the eChannelling app, you’ll be able to make your phone do all the work for you!

TeleChanelling is the newest service offered by medical professionals over at eChannelling. With it, you will be able to connect one on one with a doctor through a video call and then the doctor will be able to diagnose you wherever you may be!

All you need to do is:

  1. Download the app.
  2. Take a look through the list of doctors registered for Video Consultation Services.
  3. Select your preferred doctor and make a reservation after paying the service fee.
  4. Enter your Name/NIC/Contact number which is mandatory for the reservation.
  5. You will receive a confirmation SMS with the consultation time and transaction reference number.
  6. Then all you have to do is wait till you receive a video call once the doctor dials you!

And that’s not all, TeleChannelling also includes a chat feature that can be used to communicate with your doctor through text before and after the appointment. This will allow you to share any issues you have much more clearly before the call. And to add to that, you will also be able to upload any prescriptions that you have to the chat.

As the leading software provider for the medical industry in Sri Lanka, eChannelling has expanded its services within the digital world by connecting the doctor and patient directly through this video consultation service. And with it, you will be able to experience the best medical care in Sri Lanka regardless of where you live or if you are traveling.

Overall, Telechannelling is a service that breaks the traditional method of physically meeting a doctor and conducting the entire process from channelling to payment to consultation online. So the next time you need to see a doctor, don’t worry, you’ve already got the best care you could wish for on your own phone!

As dermatologists, one of the most common questions that comes our way is about the excessive hair loss you see when you simply brush your hair, on your bathroom floor, or on your pillow when you wake up.

Are you someone who can relate and is concerned about what is causing this? 

Here is what you should know:

First, we call this occurrence “hair shedding.” Losing 50 -150 strands of hair a day is quite normal, so you have nothing to worry about! Every single strand of hair will fall off between 3 and 5 years, and in relation to this, one will grow back in the same exact place. The density or the thickness of the hair will not change.

After the age of 25, the amount of hair on both men and women’s heads gradually decreases. Even so, due to the estrogen hormone in women, during the ages 20 – 40, the thickness of their hair may increase slightly. Nevertheless, after 40, they too will usually undergo a decrease in the amount of hair and hair strand density.

You may have experienced excessive hair loss due to side effects from certain illnesses. A most commonly known situation is iron deficiency, especially experienced by young women who menstruate heavily. Identifying that and treating the deficiency accordingly would be valuable for good hair growth.

Similar to iron, vitamin D plays a significant role in hair growth. You might know that when we are exposed to the sun, our skin produces Vitamin D, and even though we experience sunlight abundantly, it is not unusual for people in our country and countries similar to ours to be subjected to Vitamin D deficiency, which can cause hair loss.

At times, due to illnesses such as hypothyroidism and hyperthyroidism (an underactive or overactive thyroid gland producing less or more of the thyroid hormone, respectively), your hair may fall. If you are showing symptoms of such instances, it is advised to do the recommended hormone tests.

Dandruff and seborrheic dermatitis, which is very similar to the former, are two more commonly known scalp complications. These result in minuscule flakes coming off the scalp, leading to hair fall. It is important to diagnose these conditions and treat them appropriately. Use a doctor-recommended and accepted dandruff shampoo a few times per week as a treatment to some extent.

Not to mention, chemical products used to style your hair and heating tools such as hair dryers, curlers, and straighteners would weaken your hair and prompt hair shedding. Particularly, using high levels of heat on damp hair might create air bubbles in the hair strand, known as the “Bubble Hair Syndrome,” that would damage your hair further.

Immense physical or mental stress your body goes through will also negatively impact your hair, and we call this Telogen Effluvium. For example, if you were someone who suffered from Covid or Dengue fever, you may have observed excessive hair loss after 2 to 3 months, or even if you have been subjected to a great mental stress. It can be any type of physical or mental stress, but the good news is that it will all be alright in a few months.

Moreover, an effect from the combination of your hormones and genes would result in hair loss, known as Androgenetic Alopecia, a common form of hair loss seen mostly in men but also occasionally among women.

In closing, if you think that your hair is falling excessively or that it is thinning rapidly, it is important that you meet a suitable doctor and conduct proper diagnostics.

Dr. Dulini Liyanagama
Consultant Dermatologist/MBBS,
MD (Dermatology), MRCP (UK), SCE Derm MRCP

Breast cancer is one of the most common types of cancer in the world. There are significant numbers of women losing their lives to this. Considering the number of deaths in the world, the 5th place is due to cancer, in particular breast cancer. Taking the context in Sri Lanka, it is very similar to what it is in the rest of the world. Around 12 women a day are reported with breast cancer, and each day 2 women lose their life because of this. Unfortunately, the type of cancer associated with breast cancer is not something that can be prevented.

If so, what can we do about this?

If we are able to diagnose breast cancer, before it shows external signs in the breast, then we are able to cure it completely. Up till the 1980s, the quality of the treatments for breast cancer did not see any significant improvement, which meant as much as there were attempts to advance the cure, there was no way to save their life or heal them fully. However, after that once the treatments were improved in such a way to diagnose breast cancer head on, the rate of curing increased substantially. The biggest role played in this is the introduction of the Mammography Testing. After this, women had the opportunity to identify breast cancer even before they observed or felt any physical signs in their breasts and at the very beginning stages of the cancer. They were able to cure it completely through the standard treatments. From this we can avoid situations of removing whole breasts or going for treatments such as chemotherapy.

Which ages of women should do this Mammography? 

Women over 40 years old should do this testing yearly, or as the recommendation from a doctor here from Sri Lanka, at least once every 2 years. However, Sri Lanka does not have that privilege to do so. 

Then what can we do?

Even though it is not as effective as Mammography, we advise all women to self-diagnose the status of their breasts if they are above the age of 20. They can do so when 7 – 10 days have passed after their monthly period. Here, they should observe their breasts in front of a mirror by themselves, feel for any irregularities in the surface, unusual discharge from the nipple or other signs for   breast cancer, and seek immediate medical attention if needed.

There is the option of clinical diagnosing as well, where a professional would examine the woman’s breast. It is recommended that women in the ages of 20 -39 should get these clinical examinations done at least once every 1 – 3 years, and those above 40 should conduct these at least once a year. This is all relevant to women who have a normal risk of having   breast cancer. 

Nevertheless, there could be women with high chances of having breast cancer because of maybe the history of their mother, sister or a close relative who has undergone breast cancer before. We consider them as people with extremely high odds of having breast cancer, and through a proper assessment of the risk we may prescribe the Mammogram Testing even before 40. It should also be known that we do not recommend Mammography to women under 30 because the sensitivity of the test declines gradually under the age of 40. For them we conduct the Ultrasound scan and an MRI scan for the breasts. If we have a suspicion, then we take a small sample and diagnose accurately if it is a cancerous condition. In an instance that shows it to be true, we quickly check if it has spread in any way to the rest of the body, particularly by the PET-CT scan. This also can only be conducted for a very limited number, because there is only one machine each in the private and governmental sectors.

We go ahead with the CT scan and Bone scan testing to decide on the best treatment for this breast cancer patient based on the outcomes. We recommend surgery if cancer has not spread to distant organs yet. If it is in the early stages, we have the option to remove only the cancer without removing the breast completely – Breast Conservation Surgery. After such a surgery we proceed with radiation therapy for that breast. However, if the cancer is very large compared to the breast, then we will have to opt for removing the breast completely. Regardless, now there are ways to reconstruct the breast through maybe prosthetics or using their own tissue.

After all this, taking into account all the tests conducted and the related reports, we decided that, even though there were no signs that it had spread to the rest of the body, it has the potential to reach the insides microscopically. We would then continue to recommend more treatments. Chemotherapy, Immunotherapy, Targeted therapy for cancer, Hormone treatments and many others are such treatments. There are stories of women who have undergone these treatments and are fortunate to live a long and healthy life as a regular woman. But also we meet women who were unfortunate and who had this cancer spread throughout their body. Through standard methods of nursing, we do have the ability to give these women a long, healthy life. In addition to these standard procedures, there is also a vital type of treatment known as Palliative Care. There is a grave misconception that it is for people who are in their death beds. This Palliative Care should go hand in hand with the disease directed treatments when a cancer is diagnosed. The advantages for people in their very last stages of life, the effect of this care is priceless, and especially for someone who is at a point of incurable cancer, going through it without such comfort care is quite awful. The physical, mental, spiritual and social suffering that they and even their family members go through, could be benefited a lot through this care.

Being educated and aware of breast cancer is important because it could be your mother, sister, grandmother or someone very close to you who could be at risk. If women are attentive towards their breasts and will conduct regular testing to get to know this well ahead, they would be in luck to heal breast cancer fully!!

Dr. Shama Goonatillake
MBBS (Colombo) MD (Colombo) SLMC Reg No. 17334,
Consultant Clinical Oncologist
Head of Clinical Department
Asiri AOI Cancer Centre

Lower back pain is a common medical condition that affects about 80% of the population at some point in their lifetime. Sri Lanka is not immune to back pain and there are as many cases as you would see in the West where it is also a very common medical problem.

The main causes of lower back pain are disc bulges and facet joint arthropathy. The two joints on either side of the vertebrae are known as facet joints.

In addition, muscles that go into spasms and ligaments that join the vertebrae can cause back pain.

There are different ways to treat back pain:

  1.  Simple analgesics which is very common.
  2. Complementary therapy consists of Physiotherapy, Acupuncture, Hydrotherapy, etc.
  3.  Interventional treatment is done by carrying out procedures. Examples of interventional treatment include:
    • Trigger point injections
    • Facet joint injections done under X-ray guidance (fluoroscopy).
    • Spinal root blocks
    • Dorsal root ganglion blocks
    • Epidurals with epidurogram
    • Radio frequency denervation
    • Pulse radio frequency denervation

Epidurals

Can be a Lumbar, Caudal or Cervical Epidural. However, it is important to remember that Epidurals should always be carried out under X-ray while putting a contrast (Epidurogram). If someone would proceed to have an epidural, there should be an MRI-proven disc bulge that is pressing on the nerve roots. 

It is nevertheless crucial to stress the necessity of an MRI scan before administering an epidural and to provide evidence that there is in fact a nerve disruption because of a disc bulge.

In the UK, 5 million days are lost each year due to back pain, which has a serious impact on the economy.

Unfortunately, Sri Lanka lacks adequate referral systems, and patients select their own consultants, which might lead to overlap and at times, the inability to identify patients with back pains.

In England, there is a musculoskeletal pain unit consisting of a team of pain medicine consultants, neurosurgeons, and orthopedic surgeons specializing in spines, and patients are referred to the appropriate consultant by the general practitioner.

In Sri Lanka, patients are not always educated or informed enough to choose the right consultant for their disease. This system needs to change so that patients can make more informed decisions based on their condition.

Dr. Namal Senasinghe
MBBS, FFARCS, Dip in Pain Med, FFPMCA, CCST(UK),
Consultant in Pain Medicine
United Kingdom (GMC – 4498708 in the specialist register)
Sri Lanka (SLMC – 10475 in the specialist register)

The Dengue fever which spreads rapidly in the rainy season, is an illness caused by a virus. As there are four types of this virus, there is a fair risk of a person falling ill with dengue more than once. It has been found that the dengue virus is spread by two mosquito types called Aedes Aegypti and Aedes Albopictus.

Let us talk about the symptoms we can observe in someone who is subjected to dengue fever. As the dengue virus enters our body, we may experience a high fever, severe headaches, pain under the eyes, nausea, fatigue, and, at times, red spots on the skin. One of the main problems is that all these symptoms are quite common in many other viral illnesses. Truth be told, there are instances where even doctors have difficulty in identifying it right! So, if you do not have any other symptoms, such as throat pain, cough, flu, etc., but only the previously mentioned symptoms, you should most definitely conduct a blood test as soon as 24 hours have passed to confirm if you have dengue fever or not. With that confirmation, you have the responsibility of getting proper medical consultation from a doctor and hospitalizing or resting well at home under good supervision and care.

Between all these, there are things you should do and not do. Most importantly, apart from Paracetamol, you should strictly avoid other painkillers. Especially medicine with Aspirin should not be consumed. You should give adequate amounts of fluid to your body under the guidance and instructions given by doctors. We especially recommend fluids that do not have color in them.

During dengue fever, there comes an instance where the permeability of the blood vessel increases and the blood fluid will begin to seep out through the vessel wall, and with that, the blood pressure will decrease. In a situation like this, if we have given too much fluid to the patient, in about two days when it will be reabsorbed to their system, they may experience a few complications.

Taking all these into consideration, it is important that you do not take this lightly but take the advice given by doctors and act accordingly to get well soon and even be saved from near- death cases. Something we see often is that people die of dengue fever because of the delay in hospitalization. Therefore, it is important that you consult the doctor at the right time and take the necessary action.

Let us talk about preventing this illness altogether. There, the important thing is that we should not always be heavily reliant on chemically induced methods such as smoke or disinfectants, but know that there are simpler ways. The lifecycle of a dengue mosquito only being 7 days is a big challenge in dengue prevention, and even though it is only 7 days, the mosquitoes select places created by humans themselves where water has been collected.

A mosquito can lay eggs between 200 and 800, and the female dengue mosquito places them strategically in several places. We cannot be happy by just destroying one place where water has gathered, which shows how severe this challenge is. We should be observant and check for such places daily and disrupt them, which is when we would have successfully prevented the spreading of these mosquitoes.

Especially if you understand and work according to your social responsibility and do your part to prevent this deadly dengue fever, we will be able to see less and less people passing away. We should acknowledge that, even though we call this illness deadly, it is a problem created by us that can be prevented by us so that we witness fewer deaths from it. In conclusion, I would like to remind you that with your help, we can prevent this, and it is our social responsibility and duty to take the next steps in the right direction.

Dr. Dammika Adikariwattage
MD (MBBS), MBA, MSc, SLMC Reg No. 19696,
Medical Officer of Health
Colombo Municipal Council

Not only do we hear more about cancer today than in the past, but the harm caused by cancer to humans is increasing more and more. However, throughout recorded history, cancer has been recorded not only in humans but also in other animals. Among the earliest evidence of cancer are bone tumors found in ancient fossils, cancer found in mummified human corpses in Egypt, and cancer written in ancient records. Thus, it is clear that cancer is not a new disease.

In the year 2020 alone, 19.3 million new cancer cases were diagnosed worldwide, and the number of people who died from cancer in that year is around 10 million. Breast cancer in women has become one of the most common cancers in the world. Previously, lung cancer was the first, and now it has been pushed to second place in terms of cancer prevalence. After that, colon and rectal cancer, prostate cancer and stomach cancer occur in descending order. However, lung cancer still accounts for the highest cancer deaths worldwide, accounting for 1.8 million in 2020. The next leading causes of cancer deaths were colon and rectal cancer, liver cancer, stomach cancer and breast cancer.

How cancer develops is a big question for many people. Some people think that cancer is caused by a fault in the genes they inherited from their mother and father. It means that they got the cancer-causing genes directly from them. Cancers that occur like this are less than 10%. One reason for people thinking that way is that cancer is a genetic disease. However, about 90% of cancers are caused by changes or mutations in genes that happen after conception.

Many factors contribute to the development of cancer-causing genetic mutations. Most mutations can occur randomly. When the cells of the body divide to make daughter cells, random mistakes can happen in this manner as the DNA is divided and given to the daughter cells. But cells have a very complex system of correcting these mistakes. As you age however, this process weakens. Another cause of genetic mutations that leads to cancer is the exposure of genes to certain factors in the environment outside the body or in the body’s internal environment. Accordingly, about 1/3 of all cancer deaths are caused by some form of tobacco use (cigarettes, use with betel leaves, etc.), obesity, alcohol use, eating fewer fresh fruits and vegetables, and less exercise. About 30% of cancers in the world’s poor countries are caused by cancer-causing viruses, bacteria, fungi and protozoan infections.

There is a chance to avoid cancer. There are two main methods for that. One is to follow good health habits to prevent cancer. Not consuming tobacco and alcohol, maintaining a body weight appropriate for the height, exercising regularly, and eating more fruits and vegetables are some of them. The other method is to prevent the development of cancer by identifying the initial changes in the body when cancer occurs and treating it properly.

In addition, 1/3 of other cancers can be detected and treated properly before they spread. Unfortunately, the last 1/3 of the cancers are not curable. The reason for this is sometimes the form of cancer being dangerous or the difficulty of proper treatment due to factors such as the age of the cancer patient, other medical conditions, etc.

වෛද්‍ය ශාමා ගුණතිලක
MBBS (කොළඹ) MD (කොළඹ) SLMC ලියාපදිංචි අංක 17334,
උපදේශක සායනික ඔන්කොලොජි
සායනික අංශයේ ප්‍රධානී
ආසිරි AOI පිළිකා මධ්‍යස්ථානය