Zika by Zita

Zika- another virus playing havoc?

It’s been around since 1947 with outbreaks in South East Asia, Africa and the Pacific Islands but now this virus has turned up in South America and neighbouring islands with 1.5 million cases confirmed.

The present episode is associated with microcephaly in children born to women who contract the disease. Except in the odd case, no association was noted but a definite relationship has been noted since 2013.

What is it really? It is a viral illness caused by an RNA virus which has as its vector the Aedes mosquito mainly egypti but albopictus and polynesiensis have also been mentioned. Patients present with mild fever, sore eyes, headache, joint pain and a red, bumpy rash. The illness lasts from a few days to a week.

The only treatment advised is rest, painkillers and drinking of plenty of fluids. Only one in five infected show symptoms but all can transmit it via the vector. Other modes are transplacental and from an infected mother during delivery. There is potential risk of transmission by transfusion of contaminated blood. Diagnosis is by detection of viral RNA. Viraemic period seems to be short but the virus has been detected in the urine for up to 10 days.

There is no vaccination or preventive drug yet. Differential includes dengue fever, chikengunya and malaria. Treatment is symptomatic but aspirin and NSAIDs are discouraged because of increased risk of haemorrhagic syndrome as well as Reye’s syndrome in children and teens.

Prevention: Public Health control measures of vector management and reduction of breeding grounds i.e. stagnant water, pots, used tyres, tree holes and rock pools are highly recommended and also keeping drinking water stoppered is important. Other simple measures are wearing of long sleeved clothes and use of mosquito nets and insecticides.

Microcephaly as the dreaded new complication has been suggested after its incidence in babies born to infected mothers significantly rose since 2013. Pregnant mothers are advised not to travel to affected areas. Mosquito control in air crafts which is already been done is a simple but important measure. Has Sri Lanka got lessons to learn from this new threat?

Sent by Zita Perera Subasinghe

References:

http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/Pages/index.aspx#sthash.Do0V9a3e.dpuf

http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/factsheet-health-professionals/Pages/factsheet_health_professionals.aspx#sthash.h73kNIbW.dpuf

Visitors from abroad

A record number of batch members from abroad have visited Sri Lanka in the past few months.

Among them
1.Rohini Abhayaratne,
2.Indra Anandasabapathy,
3.DSC Attale,
4.K. Balachandra,
5.Haris Boralessa,
6.Chittamparanathan Thiagarajah,
7.Sanath de Tissera,
8.Cyril Ernest,
9.Srianee Fernando Dias,
10.Mahendra Gonsalkorale,
11.Nihal Goonetilleke,
12.Kumar Gunawardene,
13.Suren Iyer,
14.Lakshman Jayasinghe,
15.Nalin Nanayakkara,
16.Cecil Saverimutto,
17.Ranjan Wattegedera,
18.Lakshman Weerasooriya,
19.Jimmy Wickramasinghe.

These are only the visits that I have been aware of. It is possible that some others may have come in and left without making their presence known.

News from Sanath Lama

Sanath has sent me this important message. As you can see, he is raising funds for a worthy cause.

Dear friends,

I am involved in three important health related charitable ventures.

Thalassaemia

You may remember reading in the newspapers about bone marrow transplants (BMT) for thalassaemia. So far, 9 BMTs have been carried out successfully at Central and Nawaloka Hospitals. Very soon it would be done at LRH also. However, that is not the answer. We should try and prevent the birth of such babies. To do so, we have to identify the carriers of thalassaemia by community screening and counsel them not to marry a fellow carrier. The Ministry of Health spends about 5% of its health budget for the care of these patients. During the last 15 years, Sir David Weatherall (Emeritus Professor of Medicine, University of Oxford ) and Professor Nancy Olivierri (Professor of Paediatrics, University of Toronto.) have being coming here  many times for work in this field. Nancy recently came here for the 76^th time!

They have raised funds abroad for a charity named Haemoglobal and established centers in Kurunegala and Kelaniya. Two of our academics have been trained in Oxford and returned with PhDs’. At Anuradhapura where I am a visiting professor, there are over 300 thalassaemics who are being followed up. We need funds for various activities such as community screening, counselling, iron chelation studies, BMTs etc,

Meththa Rehabilitation Foundation

A good friend of mine Dr. Panagamuwa, started a limb fitting facility in Mannar few years ago. He is a surgeon and was a colleague of mine for many years in Galle. He went to the UK in the early nineties, gave up surgery and specialised  in limb fitting and rehabilitation work.The beneficiaries in Mannar were the civilian victims of the war because the soldiers were cared for by the government. He got down container loads of equipment from the UK, trained local personnel and treated many hundreds of patients and thereby changed their destiny. He has cleared that reservoir in the North.

Later he set up similar facilities in Mankulam and Maho and attends to amputees, majority of whom are victims of road traffic accidents and diabetics. He has sent prosthetic technicians to the University of Salford in UK and one of them has already returned and is working in Maho. Initially, he used funds donated by expatriate Sri Lankan doctors and Tamil diaspora. He used his personal funds as well at times of need. His project is called the Meththa Rehabilitation Foundation (MRF). He fits an average of one artificial limb a day and has acquired a fully equipped bus to conduct mobile clinics. Already he has visited Batticaloa and other areas in the North. He will be visiting Galle in early February. The monthly expenditure for the project is about Rs, 900,000.00 and is dependent on donors and I am one of them.

If you wish to contribute, I could send you details of the bank account and contact details of Dr. Panagamuwa. 

Chronic Kidney Disease of Unknown Aetiology  (CKDU)

This project involves patients afflicted with Chronic Kidney Disease of Unknown Aetiology (CKDU). It affects farmers in the Polonnaruwa area but is spreading to other areas in the deep South as well. In spite of extensive studies, its causes are unknown as yet. Mr Ranjith Mulleriyawa is helping the people of this area in different ways. He is an old Royalist (49 group) and his contemporaries had been Brendon Gooneratne, JB Peiris et al. He is providing water storage tanks of 5000 litres capacity to harvest rain water. He is in need of a social worker very badly to visit houses and educate people. I have started supporting his project financially in a small way. His project is called the Kandy Kidney Protection Society. You may have read his articles in the Island and Sunday Island newspapers. If you wish to contribute I could send you further details.

Kind regards,

Sanath

Creative Spot - Mahendra (Speedy) Gonsalkorale

Suwanda Rosa Mal Nela

https://www.youtube.com/watch?v=hiQYrJGAeFc

Speedy says- "This is a Sunil Santha favourite of mine. Played on the incomparable Tyros 5 and sung by me"

From the Sunday Times

This appeared in the Sunday Times of 10 January, 2016.

Many important lessons in Prof. Ratnatunga’s fight against stroke

I was touched and impressed to read the article titled ‘My Story’ by Professor Channa Ratnatunga, a skilled and dedicated surgeon, in the Sunday Times of January 3, 2016.

His recent illness was unfortunate but we can draw important lessons from the way he has come through this illness.

Lots of lesser mortals afflicted with a sudden massive stroke of this nature may have become bitter over their misfortune and said ‘why me?’. Some others may have become depressed.

However Prof. Ratnatunga has borne this misfortune with great courage and fortitude. He has cooperated well with his doctors and therapists. He blames no one.

What is more important he tries to make use of his misfortune to canvas for the setting up of more stroke units in the country so that in future people who are afflicted with strokes of this nature would be able to make a recovery as good or better than he did.

He tries to make a triumph out of adversity. Similarly we should always try to learn a lesson and do something good of any unfortunate occurrence we may undergo.

I hope he continues to make further progress in his recovery.

Dr. V.P. H. Rajapakse
Kandy

For lovers of literature

Srianee (Bunter) Fernando Dias has sent in this.

Dear Lucky,

While reading an article by Jhumpa Lahiri (one of my favorite authors) in The New Yorker magazine,  I came across this passage.  She expresses skillfully what we have all experienced in our lives.  The twists and sharp turns are what become indelibly etched in our memory.  I would like to share this with my friends on the blog and get their comments.

As an aside, she has mastered Italian in her adult life over the years, and her latest book is written in Italian and translated back into English by someone else.

Srianee/Bunter

From Jhumpa Lahiri's article "Teaching Yourself Italian" in "The New Yorker," December 7, 2015.

 "One could say that the mechanism of metamorphosis is the only element of life that never changes.  The journey of every individual, every country, every historical epoch - of the entire universe and all it contains - is nothing but a series of changes, at times subtle, at times deep, without which we would stand still.  The moments of transition, in which something changes, constitute the backbone of all of us.  Whether they are a salvation or a loss, they are moments that we tend to remember.  They give a structure to our existence.  Almost all the rest is oblivion."

The beloved Vespa scooter

By Mahendra Gonsalkorale

It is impossible to trace the history of the Vespa scooter without some reference to World War 2. Most of our batch colleagues were conceived during this period but most fortunately, in relative terms, Sri Lanka or Ceylon as it was then called, escaped the terrible hardships of War. It is sobering to reflect that estimated thirty six and a half million Europeans died between 1939 and 1945 from war related causes (equivalent to the total population of France at the outbreak of the war). No other conflict in recorded history killed so many people in so short a time. Something we tend to forget is that of these European casualties of war, at least 19 million (approximately half) were non-combatants. The non-combatant deaths outnumbered the military losses in all European countries with the exception of UK and Germany.

The post war period was devastating with massive material destruction and shortages of everything. The migration problems we see now are minute compared to the massive movement of people that happened in the post war period. Europe became much more homogenised as a result. The word “ethnic cleansing” was first used around this time. It is the hope of all civilised people that we will never ever witness such a human catastrophe.

The need for mobility is basic and in the early post war years, most people relied on public transport where available. Travelling for leisure was restricted to the small number of economically well off people. The motor car was invented many centuries ago but the first mass produced, conveyor belt production car, was the American Ford Model –T produced in 1908. Other early pioneers were Karl Benz in Germany and Nicholas Cugnot in France who is credited with the first powered road vehicle. The development of the motor car which began earlier in the century was interrupted during the war but by the early 1950s, had been revived by the production of small cars with small engines capable of delivering more miles per scarce gallons of petrol. The Citroen CV2 in Italy, the Renault 4 in France, the Morris and Austin early models in UK, the VW Beetle in Germany were typical examples. But in the post-war transport revolution in Europe, the supply of cars could not keep up with demand. This encouraged the growth of bikes, motor cycles and the new brand of motor scooters. The first National motor scooter rally was held in Rome on November 13th 1949 and was followed by a massive growth in the market for these reasonably priced and convenient means of transport which were symbols of urban freedom and mobility.

 Under such circumstance was the Vespa born.

The word Vespa means Wasp in both Italian and Latin. Up to 138 different versions of the Vespa have been built since production began. When Vespa celebrated its 50th anniversary in 1996, more than 15 million of the scooters had been sold worldwide, making it the most successful scooter of all time.

This picture shows the early M6 model with a central section. This was replaced by the more familiar one without the central bar with room for placing the feet behind the shield (wings) housing the handgrip  controls.

Vespa is an Italian brand of scooter manufactured by Piaggio.Piaggio was founded in1884 in Genoa by 20 year old RinaldoPiaggio as a luxury ship building company that expanded into producing rail carriages, automobiles, marine craft and later aeronautics.    Enrico Piaggio and his brother Armando inherited the family engineering business on their father’s death in 1938. Enrico decided to move the business from aircraft to scooter production after the end of the war as there was a need for low cost transport.

Upon seeing the first Vespa (MP6) for the first time, Enrico Piaggio exclaimed: "Sembraunavespa!" ("It resembles a wasp!"). Piaggio effectively named his new scooter on the spot. If he was a Sri Lankan, he would have uttered the immortal words “YakomekaBambarek wage!” and Vespa would have been known as “Bambara”.

The move to scooter production proved to be a prudent one as the company would eventually become one of the biggest manufacturers of two-wheeled vehicles in the world and in fact the Piaggio group is now Europe’s largest manufacturer of two-wheeled vehicles and the world’s fourth largest motorcycle manufacturer by unit sales. The group own 7 companies. Piaggio, Aprilia, Moto Guzzi, Derbi, Vespa, Gilera and Ligier

From their inception, Vespa scooters have been known for their painted, pressed steel unibody which combines a complete cowling for the engine (enclosing the engine mechanism and concealing dirt or grease), a flat floorboard (providing foot protection), and a prominent front fairing (providing wind protection) into a structural unit.

In 1950 Piaggio opened a factory in Germany and a year later in the UK (Douglas of Bristol). The Vespa was soon manufactured in 13 countries and sold in 114.

As a result of the MOD subculture that developed in the 1960s, the United Kingdom became Vespa’s second largest global market.

When Vespa celebrated its 50th anniversary in 1996, more than 15 million of the scooters had been sold worldwide

Sadly, in its country of birth Italy, Vespa popularity is declining. According to data published by ANCMA, moped sales in Italy have declined from a peak of 600,000 in 1980 to 26,727 in 2014 - a vertiginous fall of 97 percent. Economic crisis, demographic shifts, and the changing habits of the younger generation are all conspiring to end the moped culture widely associated with Italian life since World War II."The younger generation is just not as interested in mopeds as it used to be," Claudio Deviti, head of the motorcycle unit of ANCMA, the National Association of Motorcycle, Bicycle and Accessories, told Al Jazeera.

The great rival for the scooter owning fraternity in the Medical Faculty was the Lambretta, made in Milan by Innocenti, but that is another story.

I would like to refer readers to a previous post by Lucky,"Two Wheelers" of the Batch,  25th November 2015. In this post, he named some of our Vespa owners. I hope readers would add to this list.  Those who owned the newer Vespa models (the handle in particular was different) were: SanathLamabadusuriya (I think it had registration number 4 Sri 955), MahendraCollure and the late LGDK Herath. Douglas Mulgirigama owned an older model Vespa. Rajan (Patas) Ratnesar was the other who used an older model of Vespa.

Lucky, and the comments, cover the Vespa. Lambretta, BSA.MotorGuzzi and Honda.

Does anybody know a lady Medico who owned a Vespa? I would have thought it was very suitable for a lady who would like to avoid straddling for reasons best known to her!