for the childless
The scanned image of the male reproductive structure showed
the manner in which blood supply to these organs was functioning.
It was found that the drainage of blood through the venous blood
vessels was affected. "Such impairment of blood flow could
affect the movement, count and even the normality of the structure
of sperms," Prof. Harsha Seneviratne, Consultant Obstetrician
and Gynaecologist says.
in question was being investigated for infertility. Initial tests
indicated that both husband and wife required further testing.
One of the
tests that was required before a plan of treatment could be designed
was an ultrasound scan of the abdomen/ reproductive system of the
Since it was
possible to quantify the extent to which the blood flow had been
affected, a decision had to be made; whether or not the patient
required a surgical option offering medical treatment.
(ultra sound scan with colour Doppler) is now available at the Vindana
Reproductive Health Centre, an added facility in their whole range
It is at Vindana
that the first local team performed In Vitro Fertilization (IVF)
and successfully delivered two babies in the last two years. In
addition there are several more ongoing pregnancies.
of technologies have been added over the years in IVF and further
introduction of newer techniques continues by collaborating with
a reputed team from the UK.
services include: basic investigations and treatments at Level 1,
stimulating the ovaries with medication and placing the husband's
sperm directly in the womb of the wife at Level II and test tube
babies at Level III.
male infertility clinically and by lab tests is done by their latest
addition, the ultrasound scan assessment.
such problems by way of more advanced technology such as the separation
of sperms of best quality, storage of sperms for future use and
intra-uterine insemination followed by the most advanced technologies
in assisted reproduction such as IVF and Intracytoplasmic Sperm
have thus been enhanced, providing for reproductive health from
adolescence to the menopausal years, and in particular the management
of infertility, high-risk pregnancies and a range of gynaecological
disorders. "In the whole process," Dr. Harsha Seneviratne
adds, "we are only promoting or giving a better chance for
the sperm and ova to meet, thereby assisting nature.
The final fertilization
takes place according to the natural phenomenon. All advances in
fertility treatment, when you go beyond the basic level, involve
fine tuned biological techniques.
material have to be invariably imported. The cost of such techniques
is an ever-present barrier to expanding the facility to all who
scan is an indirect assessment of a structure living within the
body. "Therefore however advanced the machine is it has its
limitations whereby all abnormalities cannot be detected. It cannot
be used to replace other forms of assessment, as it remains a tool
for study," the doctor reiterates.
One in five
couples have fertility problems. This could be attributed to social
changes - People are driven to advancing their career prospects
and status, causing stress that has affected lifestyles and the
whole bio-system. Further, there is a marked change in the type
and quality of food consumed.
smoking, alcohol and ever-present pollution, life has deteriorated,
especially in the urban society, causing all kinds of health complications,
even in reproductive health.
is heartening to note that men are coming forward voluntarily for
that this is due to better awareness and education, Dr. Seneviratne
says that the blame that was previously shifted to women is very
subtly changing. "Couples seem to support each other much better
Vindana conducted a workshop for
medical staff (radiologists and gynaecologists) on January 8 and
9, providing an opportunity for them to gain knowledge and guidance
in using the ultrasound scanning machine with colour doppler. Dr.
S. Suresh, Director of Mediscan Systems: Diagnostic Ultrasound Research
and Training Centre, Chennai was their resource person.
An applications expert from the Hitachi Ultrasound Company also
fine-tuned the machine to the needs of the scanning practices of
doctors and trained them in the use of this machine. The entire
workshop had very active interaction between resource persons and
Ultrasound scans are images of
the internal organs created from sound waves.
The images are produced when the sound waves are directed into the
body then reflected back to a scanner that measures them.
Ultrasound scanning is used to help monitor and diagnose conditions
in many parts of the body, including the kidneys, the liver and
the heart. It is often used to examine conditions affecting the
organs in a woman's pelvis - the uterus, fallopian tubes and ovaries.
It is not dangerous and has no side effects, so is considered safe
to use during pregnancy.
The ultrasound scanner looks like a small paint roller.
As it moves back and forth over the body, it sends sound waves through
the skin and muscles.
These waves are then turned into an image that appears on a TV screen.
The scanner can be used externally on the skin, or through the natural
openings of the body, such as the vagina.
It has revolutionized the care of women during pregnancy. The scan
can be copied onto paper or an X-Ray film.
anaemia in Sri Lanka
Lanka, hundreds of residents are taking an unusual taste test. They're
sampling a variety of local breads and bread products to see whether
they can detect anything unusual in any of the items. Do the testers
notice a flavor of rusty nails in a sample of flat bread, for instance?
Do they smell anything peculiar in a particular cookie?
test may seem like a challenge for epicures, its ultimate goal is
to conquer anaemia among Sri Lanka's 18 million residents.
that half the women in Sri Lanka and throughout Southeast Asia have
the disorder, the most common nutritional disorder in the world,
says Rebecca Stoltzfus, assistant professor of nutrition at the
School of Public Health. "Southeast Asia is probably the worst
area in the world for iron deficiency," she says. Anaemia lowers
a person's ability to think, decreases productivity, and increases
the risk of infection.
with anaemia have a greater risk of dying in pregnancy or childbirth.
anemia can retard growth and mental development. "As countries
develop and get rid of other nutritional problems, anaemia hangs
on," says Stoltzfus, particularly in places where people consume
few animal products, which supply iron.
hookworm also contribute to anaemia by eating blood, which stores
most of the body's iron.
With the United
States Agency for International Development and the Sri Lankan government,
Stoltzfus is developing a program to reduce anaemia by fortifying
all Sri Lanka's wheat flour with iron.
Step one are
the taste tests, to see whether volunteers can taste or smell iron
in various breads, pastas, crackers, and cookies prepared with iron-fortified
fortification is a good intervention," says Stoltzfus. "It's
extremely inexpensive. The cost-benefit analysis becomes meaningless."
wheat is a prime food to fortify in Sri Lanka, she says, since it
comprises about 40 percent of the nation's staple calories.
All the country's
wheat is imported from the U.S. and processed at one mill.
to the nation's wheat would be relatively simple.
So why hasn't
it been done already?
block is that scientists first need to find out how much iron and
what type of iron should be used. "We'd like to pack in as
much iron as we can without it tasting like rust," says Stoltzfus.
too much iron won't be palatable, and consumers won't buy it. So
the products in the taste test contain varying amounts.
The bread products
also contain five different forms of iron, ranging from ones that
are highly bio-available (more likely to be absorbed by the blood
supply) to those that are of low bio-availability (thus more likely
to be excreted).
Stolzfus, "we'd like to pick the highest level of bio-avail-
But when you use iron that is more bio-available it can react with
the fats in the bread," she says.
ends up tasting like nails, or the color changes to green, or the
bread doesn't rise as well."
For phase two
of the project, Stoltzfus and her colleagues are designing a study
to monitor the levels of haemoglobin (the iron-carrying molecule
found in red blood cells) and rates of anaemia in people who are
eating fortified flour.
The study seeks
to make sure that fortification really does increase their blood