Many research studies were done by local as well as foreign experts on how they affected people, some in collaboration with local experts, some independently and a few actually tried to exploit vulnerable tsunami survivors for research not applying even the mandatory set of ethics with the help of  the so called local professionals who also supported them in turning Sri Lanka into a ‘free trade zone for easy and cheap research’. Looking at the positive side, many good quality research studies were done in Sri Lanka by local and foreign experts that we could incorporate into development programmes for the benefit of the country.

One such articlewas published in Science direct on “Sri Lankan children affected by War, Tsunami, Daily stressors” on July 15 2010. Two studies done on Sri Lankan children who survived the 2004 tsunami and the war found that they were not the only stressors affecting their psychological health but also the ongoing daily stressors such as domestic violence that are actually exacerbated by traumatic events and continue after the disasters. It further states that even though war and tsunami have a direct effect, unsafe housing and povertythat arose from the War and Tsunami are continuing stressors that affect these children’s psychological health adversely.

“By making sure not to miss the importance of ongoing stressors in youths’ daily lives, our study highlights the need for holistic policies and programsthat focus on reducing these current stressors,” notes Gaithri A. Fernando, associate professor of psychology at California State University, Los Angeles, who led the study.

Children are amongst the most vulnerable group to the harmful long term consequences of violence and destruction.Children are an invaluable resource to a country and its best hope for the future. The results of research studies as above can be used when developing programmes to help these traumatized youngsters as issues such as the ones discussed in the article needs prompt action and should come in the top of any priority list for a better future for Sri Lanka.

A rather interesting phrase. I loved it the moment I heard it as it built a vivid picture in my mind of the deeper meaning it possess.

Quite surprisingly I heard this in a workshop on qualitative ethics and this the name of a classical qualitative research done by Victoria J. Baker, an idealistic teacher and an anthropologist who took residency in a remote area belonging to the Monaragala district situated in the dry zone of  Sri Lanka during 1984. Her research was named as the “Blackboard in the jungle: formal education in disadvantaged rural areas.A Sri lankan case.”
Bringing into notice what she has found in her research, even though more than two decades ago is still applicable to the education system in Sri Lanka. She separates into three broad categories based on the research findings the inhibiting forces for the effective functioning of village schools as poverty, traditional and /or negative attitudes and weaknesses in the system. She further says that “these three categories penetrate all levels of education network.Some areas overlap one another and work together to intensify or frustrate the situation”.

 In her article on “Schooling and disadvantage in Sri Lankan and other rural situations”she explains precisely the education system from her popular research  “Blackboard in the jungle” which comprised of  three stages of field research carried out in Sri Lanka, how disproportionately the resources are distributed as in many a occasion ‘the best is for the city and the rest for the village’.

photo: Ministère Travail Solidarité Fonction Publique

A cup of tea not only boosts your mental alertness it also boosts your memory. In an article published in the BBC says that this may lead to the development of a new treatment for Alzheimer ’s disease. This is good news to all the tea drinkers out there and more so to the patients suffering from Alzheimer’s disease and their carers. Developing a medicinal tea as treatment for Alzheimer’s disease for which there is no cure found yet, sounds very interesting.

The above study says that both green and black tea work in two ways towards combating the disease. One way is by inhibiting the enzyme acetylcholinesterase which breaks down acetylcholine. (Alzheimer’s disease is associated with a reduced level of acetylcholine). The other way is that both teas are found to inhibit the activity of a second enzyme butyrylcholinesterase (BuChE), which has been discovered in protein deposits found in the brain of patients with Alzheimer’s.

Green tea works in another way, in the article it says that green tea obstructed the activity of beta-secretase, which plays a role in the production of protein deposits in the brain which are associated with Alzheimer’s disease. This action is mainly due to the antioxidant epigallocatechin-3-gallate (EGCG) which is present in high amounts in green tea. The research article in Webmed says that EGCG prevents the development of plaques in the brain. EGCG also has anti-cancer properties.

An e-mail has been circulating around with the article containing the false information with no external references to back up its claims. The article says that, the cold water will solidify the oily stuff that you have just consumed. It will slow down the digestion. Once this “sludge” reacts with the acid; it will break down and be absorbed by the intestine faster than the solid food. It will line the intestine. Very soon, this will turn into fats and lead to cancer. It is best to drink hot soup or warm water after a meal.

Logically the body’s internal temperature which is found in the stomach will bring the contents you take in with meals to a uniform temperature and it is therefore unlikely even ice-cold water to stay cold long enough inside the stomach to actually solidify the oily stuff.

The other fact is that the stomach lining releases enzymes (e.g.:- pepsinogen which gets converted to pepsin within the acidic medium found in the stomach due to secretion of hydrochloric acid) causing chemical digestion of food. In addition to the chemical breakdown of food by the enzymes there is also a mechanical breakdown of food by the muscular contractions of the stomach wall. This breaks down food into smaller parts and also enables better mixing with the enzymes.  This semi-liquid mass is called chyme and it is released in small amounts into the duodenum (first part of the small intestine). It is important noting here that this normally occurs within four hours of eating a meal, but can take six or more hours if your meal has a high fat content.  Thus, even if cold water did solidify oily substances in the stomach contents (highly improbable), the resulting “sludge” would soon be converted into chyme and it would not enter the duodenum more rapidly than any other material.

However there is another concern that cold water can slow digestion. Even if this slowing did occur, it would certainly not fundamentally disrupt digestion in the way described in the message nor would it lead to cancer.

Therefore make sure what you read with your eyes or hear with your ears goes through your brain before you start believing in them!

However if anyone comes through more information on this let us know, so far the news is that it is safe to drink cold water with or after meals and the warning should be disregarded.

Considering the amount of tea drunk around the world especially here in Sri Lanka every day, the news that the drink can be good for you is welcome indeed!

Tea is made from the plant Camellia sinensis and there are at least about 6 varieties of tea  white, yellow, green, oolong, black and pu-erh of which the most commonly found on the market are white, green, oolong and black. Important noting that herbal teas are not actually from tea leaves but a blend of herbs and spices. The leaves for black tea are fully oxidized while those for green teas are lightly steamed before being dried. Ceylon White tea can fetch much higher prices than black tea from the area. To those who haven’t heard of white tea it is described as having a delicate very light liquoring with notes of pine & honey and a golden coppery infusion. Important noting that herbal teas are not actually from tea leaves but a blend of herbs and spices.

Historically, tea has been served as a part of various ceremonies and has been used to stay alert during long meditations. A legend in India describes the story of Prince Siddhartha Gautama, the founder of Buddhism, who tore off his eyelids in frustration at his inability to stay awake during meditation while journeying through China. A tea plant is said to have sprouted from the spot where his eyelids fell, providing him with the ability to stay awake, meditate, and reach enlightenment. Turkish traders reportedly introduced tea to Western cultures in the 6th Century.

A tea plant was brought to Ceylon by the British from China and was planted in the Royal Botanical Gardens, Peradeniya for non commercial purposes in the 1824 and in 1867 tea was first grown commercially on 19acres at Loolecondra by James Taylor and since then how Sri Lanka became one of the biggest exporters of tea  producing the best of it to the world, which is well known as Ceylon tea is a story by itself. 

There are many proven benefits of tea and mostly of green tea as vast majority of studies have been of green tea. Green tea has been claimed to be helpful for atherosclerosis, LDL cholesterol, cancer, inflammatory bowel disease, diabetes, liver disease, weight loss, neurodegenerative diseases, and even halitosis . In hot weather, it seems refreshing to have a cup of tea as it raises your body temperature and momentarily cause an increase in perspiration cooling your skin.

Article in Wikipedia claims following as benefits of drinking tea:

• Anti cancer properties – An article in New Scientist magazine mentions that numerous studies suggest that green tea protects against a range of cancers, including lung, prostate and breast cancer attributed towards the antioxidant present in it which is known as epigallocatechin gallate (EGCG) .Antioxidants prevent the oxidation that damages DNA and turns normal cells cancerous and those  present in tea are called as flavanoids and catechins are one kind of flavanoid and are categorized as tannins by doctors in general. It should not be mistaken with tannic acid as tea extracts have been reported to contain no tannic acid. EGCG levels are high in green tea.

Several case control studies suggest an inverse relation between green tea consumption and gastric cancer. Further evaluation is needed to assess the role of green tea and gastric cancer reduction. A study at Taiwan‘sChung Shan Medical University found that people who drank at least one cup of green tea per day were five times less likely to develop lung cancer than those who did not.

Studies show that 150 milligrams of flavanoids – the amount in an average cup of tea – produced immediate health effects on the heart, while 500 milligrams – or roughly three-and-a-half cups of tea – produced a more sustained effect.

• Increases metabolic rate
• Possible anti-diabetes effect drinking at least three cups of tea a day is linked with reduced risk of type 2 diabetes, according to a new Dutch study published
• Boosts mental alertness – amino acid L-theanine, found almost exclusively in the tea plant affects the brain’s neurotransmitters and increases alpha brain-wave activity. The result is a calmer, yet more alert, state of mind.
• Boosts immune system
• Lowers chances of cognitive impairment
• Lowers stress hormone levels - 4 cups of black tea daily for 6 weeks
• Effects on HIV
• Effects on inflammatory bowel disease
• Effects on bad breath
• Iron overload disorders
• Effects associated with caffeine - positive effects of caffeine consumption has been linked with greater athletic performance, healthy weight loss, reduction in duration and severity of headaches and is effective in treating the symptoms of asthma.

Caffeine content in tea is half to one third as much caffeine content in coffee when you compare cup to cup and black tea has the most content out of the teas. Extensive research shows that up to 300 milligrams of caffeine (about eight cups of tea) is not a health risk Drinking four cups of tea is rehydrating unless the amount of tea consumed at one sitting contains more than 250mg of caffeine (the equivalent of five cups of tea) which will cause diuresis. However in dry form, coffee actually has less than tea in dry form.  Next time you brew that pot of coffee, consider how much less your brewed cup of tea will have.  Unless of course you consume your tea dry. It is also important noting here that the amount of caffeine in tea depends on a number of things,  the variety of tea leaf, where it is grown, size and cut of the tea leaf, and how you brew or steep as well as how long. Studies from the Caffeine Institute also show that caffeine levels can vary depending on the location of the tea leaf on the plant.

• Effects on obstructive sleep apnea related brain deficits.
• Effects on bacterial and fungal infections white tea more than green tea
• Anti-venom effects melanin extracted from black tea (MEBT)
• Stroke Research presented at the International Stroke Conference in February 2009 found that drinking three or more cups of tea per day can reduce the risk of suffering a stroke by as much as 21%. The research, conducted at the University of California, Los Angeles (UCLA), found that drinking green and black varieties of teas has a significant impact on the risk of stroke.
• Cardiovascular health Research published in April 2009 by the University of L’Aquila and funded by the Unilever-owned Lipton Institute of Tea suggests that drinking just one cup of regular, black tea per day may help to protect against cardiovascular disease. The research showed that black tea consumption does – depending on dose – improve blood vessel reactivity, reduce both blood pressure and arterial stiffness, indicating a notably better cardiovascular health profile.
• Anogenital warts
• Antidepressant properties

Benefits of tea are found to be increasing as more research is being done on tea.

• Bone – recent research is now suggesting that drinking tea can actually have a positive effect on bones
• Fluoride is known to protect teeth from dental caries.  Tea contains fluoride, which has a well-established link to dental health. Studies have shown that tea can provide up to 70% of the fluoride you need. It’s also thought that antioxidants in tea may help inhibit the growth of the bacteria that cause plaque.

Well the list is a long one even though many are yet to be proven with time the list will undoubtedly be longer.

However there are drawbacks and as the saying goes too much of anything is good for nothing.

• Carcinogens in tea bags – epichlorohydrin, in the casing of some tea bags are carcinogenic. The problem can be avoided by using loose-leaf tea or tea bags which do not use the coating.
• Effects of fluoride Compounds found in black tea leaves fight cavities and can reduce plaque
• Effects associated with caffeine mostly insomnia and nervousness
• Oxalates –too much of oxalates can cause damage to the kidneys as well as increasing the risk of kidney stone formation and taking up calcium. However it is important to note that the bioavailability of oxalate in tea is low and for effects to develop large amounts of tea has to be drunk.
• Tannin -   may increase one’s risk of developing oesophageal cancer but this again is controversial as some studies show that drinking tea reduces the risk of oesophageal cancer.
• Drinking tea very hot or hot is linked with oesophageal cancer. A study published in the advance online edition of BMJ says that “It’s Not the Tea; It’s the Temperature — Scalding Hot Liquid Could Injure Cells in Esophagus”. Knowing this will be helpful to Sri Lankans as we are used to having tea very hot!

• Can stain teeth therefore have tea in one or two sittings rather than sipping it throughout the day. And brush after drinking tea. If this is a problem to you shift to green tea or add milk to your black tea.

A 1984 study concluded that “tea is a potent stimulant of gastric acid, and this can be reduced by adding milk and sugar.

The effects of adding,

• Milk - Tea without milk and sugar has virtually no calories. A study at the Charité Hospital of the Berlin Universities showed that adding milk to tea will block the normal, healthful effects that tea has in protecting against cardiovascular disease. This occurs because casein from the milk binds to the molecules in tea that cause the arteries to relax, especially EGCG. Milk may also block tea’s effect on other things, such as cancer. However some studies have found little effect or no effect on the antioxidant levels after adding milk. A 1984 study concluded that tea is a potent stimulant of gastric acid, and this can be reduced by adding milk and sugar.

Plant-based “milks”, such as soy milk do not contain casein and are not known to have similar effects on tea.

• Citrus -Drinking tea, particularly green tea, with citrus such as lemon juice is common. Studies have found that adding citrus to the tea lowers the pH in the small intestine and causes more of the catechins to be absorbed.

According to the Harvard Women’s Health Watch tea provides a few tips to get the most out of tea-drinking:

• Drinking a cup of tea a few times a day to absorb antioxidants and other healthful plant compounds. In green-tea drinking cultures, the usual amount is three cups per day.
• Allow tea to steep for three to five minutes to bring out its catechins.
• The best way to get the catechins and other flavonoids in tea is to drink it freshly brewed. Decaffeinated, bottled ready-to-drink tea preparations, and instant teas have less of these compounds.
• Tea can impede the absorption of iron from fruits and vegetables. Adding lemon or milk or drinking tea between meals will counteract this problem.

• Tanin in tea prevents absorption of iron and proteins therefore you should not take iron tablets along with tea it is advised that those who have a poor iron status or are at risk of iron deficiency should avoid drinking tea with meals, and instead to wait one hour after the end of a meal before enjoying a cup of tea. Those not at risk of iron deficiency can enjoy drinking tea at any time of the day

It is important to know how to make a cup of tea to get the best taste and maximum health benefits.

Many people don’t know that different kinds of teas — from black to green to herbal — require different preparation methods

To properly steep a tea bag you need hot water. Dip the tea bag in the hot water letting it sit for a few seconds at a time then lift it back out of the hot water.

When boiling water for tea, always use cold water and bring to a boil; then, let it set for 30 to 60 seconds to allow it to cool so it does not cook the tea leaves this would help to steep tea to get the most out of it. If tea is steeped too long it becomes bitter.

To all the ladies out there looking out for beauty tips :

• Don’t toss your morning tea bag, put them in a plastic baggy in the refrigerator and use them on your eyes to relieve puffiness or freshen them up after a late night.
• After washing your face use a cool tea rinse to help with acne.  Tea has great astringent properties.

Have a cup of tea and boost your taste buds as well as your well being.

However as a medical oncologist says in Mayo clinic if you have any concerns regarding a possible connection what’s best is to limit your cell phone use cutting down on the duration and number of calls or use a headset that places the cell phone antenna farther from your body as all this will reduce the level of exposure to radio waves emitted via the cellular telephones.

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TMR (Targeted Muscle Reinnervation) is a method which helps amputees to use their prosthetic arms effectively to do their daily activities. This method was developed in the rehabilitation institute of Chicago and the Northwestern University. In Wikepedia (they describe TMR as a method by which a spare muscle (the target muscle) of an amputated patient is denervated (its original nerves cut and/or de-activated), then reinnervated with residual nerves of the amputated limb. The resultant EMG signals of the targeted muscle now represent the motor commands to the missing limb, and are used to drive a motorized prosthetic device.
Research done at the rehabilitation institute of Chicago reports that TMR gives the patients much better control over their prosthetic arms.

In simple terms what they do in TMR is that in a patient whose arm is amputated the residual parts of the  motor and the sensory nerves that went down the arm carrying the information that is needed to give motor commands and sensation are transferred ( the process of reinnervation)  to spare muscle and skin in the patient’s chest which are no longer attached to the amputated arm,  therefore when the patient thinks about  making a fist the muscle reinnervated with the motor nerves which used to do that in the hand will contract . The reinnervated muscle then provides a myoelectric signal to make a fist which acts as the control input for a motorized hand. With regards to the sensation, when you touch the chest in the area reinnervated the patient will feel her hand.

Dr. Kuiken who along with Dr.Gregory responsible for developing this method says that he’d like to see the technique be brought into wider use in other centers.”I think we’ve had successful enough results that we’re ready to say this is no longer experimental, and we can start doing this just for the clinical benefit to people, without big grants and studying it from top to toe. We want it to be tried in other places by other people so that patients get the advantage of it and we learn more.”  This may also mean that the way amputation surgeries are done will also be changed leaving nerves a bit longer than cutting them as short as possible

Vit C is necessary for the body to form collagen which is found in skin, bones, cartilage, muscle and blood vessels. It is essential for wound healing and maintenance of healthy skin, cartilage and bone. It is not naturally produced in the body therefore you need to take in a good supply of adequate vit c through your diet. Best sources are fresh fruits and vegetables.  

It is also important to note that vit c is heat labile which means it gets destroyed when exposed to heat. Food processing may destroy some of the vitamins. For example, exposure to air, drying, salting, or cooking (especially in copper pots), mincing of fresh vegetables, or mashing potatoes may reduce the amount of vitamin C in foods. Freezing does not usually cause loss of vitamin C unless foods are stored for a very long time.

The Food and Nutrition Board at the Institute of Medicine recommends the following amounts of vitamin C:

Infants and Children

• 0 – 6 months: 40 milligrams/day (mg/day)
• 7 – 12 months: 50 mg/day
• 1 – 3 years: 15 mg/day
• 4 – 8 years: 25 mg/day
• 9 – 13 years: 45 mg/day

Adolescents

• Girls 14 – 18 years: 65 mg/day
• Boys 14 – 18 years: 75 mg/day

Adults

• Men age 19 and older: 90 mg/day
• Women age 19 year and older: 75 mg/day

For pregnant/breastfeeding women and smokers the amounts are higher. Vitamin C is a water soluble vitamin therefore excess amounts will not be stored in the body however amounts greater than 2000mg/day are not recommended.

Too little vit C can lead to 

• Dry and splitting hair
• Gingivitis (inflammation of the gums)
• Bleeding gums
• Rough, dry, scaly skin
• Decreased wound-healing rate
• Easy bruising
• Nosebleeds
• Weakened tooth enamel
• Swollen and painful joints
• Anemia
• Decreased ability to fight infection
• Possible weight gain because of slowed metabolism

 Scurvy is a severe form of vit C deficiency.

Vitamin C has many other uses. Scientific evidence has suggested that high doses of vitamin C can help treat cancer. As a matter of fact, in some areas of the world, some alternative physicians use IV sodium ascorbate, the injected form of vitamin c, to treat cancer and result in better prognosis. However it has been found that Vit C has no effect on prevention of cardiovascular diseases.

It is common practice among us to take about 500mg/day of Vit C to prevent getting a cold when we think we are at risk of getting one. But research done to see whether it has a benefit of that sort doesn’t say so!  According to the article in Mayoclinic, more than 30 clinical trials including over 10,000 participants have examined the effects of taking daily vitamin C on cold prevention. Overall, no significant reduction in the risk of developing colds has been observed, no change of severity either but there is a small significant reduction in the duration of colds! I guess this is good enough news for most of us.

Most of us may or may not have heard of preconceptual folic acid supplementation which is the intake of folic acid at least a month before you get pregnant. This prevents the development of neural tube defects in   the baby.

What is the neural tube? It is the precursor to the central nervous system, which is the brain and spinal cord. Defects in the neural tube also known as NTDs (neural tube defect) is an opening in the spinal cord or brain and is one of the most common birth defects resulting in severe morbidity and mortality.

In addition to prevention of NTDs recent research done by the RCOG (Royal College of Obstetricians and Gynaecologists) reports  on how folate  supplementation, during the pre-conception period, may reduce the risk of spontaneous early preterm birth by 50 – 70% for women taking folic acid a year before becoming pregnant.

Folic acid is a vitamin found naturally in leafy green vegetables, fruits and dried beans. For pregnant mothers folic acid supplementations are given in addition to the dietary intake to prevent the above defects. NICE (national institute for health and clinical excellence) guidelines recommend that pregnant women supplement their diet with 400micrograms of folic acid a day during the first trimester of pregnancy( first twelve weeks of pregnancy).

According to the above research done by the RCOG for the prevention of preterm birth (baby born before 37 completed weeks)  they have compared with women who had no supplementations of folic acid to women who had preconceptional folic acid for 1 year or longer with a 70% decrease in the risk of spontaneous preterm delivery between 20 and 28 wk…

In Sri Lanka all mothers are given a prophylactic dose of folic acid one tablet (5mg) orally per day during the first twelve weeks of pregnancy (1st trimester) which should have been started 2months prior to conception. Therefore ideally all women should plan their pregnancy well ahead and sought pre-pregnancy medical advice not only for you to start on preconceptional folic acid but also to exclude other medical conditions like Diabetes which needs to be in optimum control before you conceive to prevent complications during pregnancy. Once the pregnancy is diagnosed (e.g. urine pregnancy test) make the booking visit as early as possible in the hospital or village clinic/MOH clinic.

It is in your hands to give your baby the best start and the journey begins before you conceive!

If it’s a heavy bleed which is more than just a few patches on your handkerchief and also if you have palpitations and turning pale its best to go to a doctor as soon as possible because this calls for urgent intravenous fluid replacement .

Netdoctor gives us a good explanation of what to do during a nose bleed, it’s safe to sit in an upright position allowing the blood to trickle down and don’t forget to breathe through the mouth otherwise you have a risk of aspirating blood which can be fatal.
It also says that “Do not swallow the blood. It can cause you to become nauseous and vomit, or could conceal a greater blood loss.” In addition to the above swallowing could also dislodge a clot and cause more bleeding.

Bleeding is most commonly from the anterior part of the septum of the nose which is also called as the ‘little’s’ area as it contains a rich plexus of blood vessels, therefore during a nose bleed if bleeding is from this area it is advisable to apply direct digital pressure on the lower nose for about 10 minutes to arrest bleeding. Applying pressure over the root of the nose is useless.

Go to your doctor if you have,
• Heavy bleeding, palpitations turning pale and is feeling weak.
• If the bleeding doesn’t respond to above measures.
• Frequent episodes of nose bleeds.