Life style
Why Arthritis more common among women
Senior Consultant Orthopaedic Surgeon at Mount Elizabeth Novena Hospital and Parkway East Hospital Dr. Gurpal Singh was in Sri Lanka on the invitation of Parkway Patient Assistance Centre Colombo to deliver speeches on Evolution of Orthopaedic Oncology and development of Musculossketal Oncology, This lecture was organised by Parkway Cancer Centre, Singapore and the Sri Lanka College of Oncologists and Sri Lanka Orthopaedic Association. He was the guest of honour at the 14th Annual Academic sessions inaugural ceremony and delivered the oration on ‘’How Evolution of Advanced surgical techniques have enabled complex nervous and vascular reconstruction’ Excerpts
(Q) Do you think joint replacements is a successful method?
Materials used in joint replacements underlie strict quality testing and are well characterised
It is a fact even the best joint replacement is not as good as a young and healthy joint. once a joint replacement fails, a repair surgery is needed to remove the failed implant components and introduce new implants This is a complex surgery than the primary surgery. One of the factors limiting the life span of joint replacement is implant wear/ coupling of bearing surfaces. As a result the companies around the world are constantly working on improving implant materials. Only the test of lime will be able to confirm the success of new techniques and materials.
(Q) Your lecture on Development of Musculosketal Oncology as a sub-speciality in Sri Lanka at the College of Surgeons Auditorium? What is Musculosketal oncology?
(A) Musculosketal oncology is a field within Orthopaedic surgery that is focussed on diagnosis and management of benign (non cancerous) and Malignant cancerous tumours of bone and soft tissues. This also includes patients who have cancer that has widely spread all over the bones.
(Q) Arthritis is common in Sri Lanka. What are the key causes?
(A) Osteoarthritis is very common form of arthritis ‘wear and tear ’ of the cartilage covering joint surface and basically refers to degenerative changes in the whole joint pain stiffness and limb deformity
(Q) What is the exact cause of osteoarthritis?
(A) Despite being so prevalent among men and women the exact cause is still not known. Some of the risk factors include advanced age, females, obesity, previous joint injures, repeated stress on the joint, genetic, limb deformities and some causes are due to metabolic diseases.
(Q) How to overcome these risk factors?
(A) X-rays are usually sufficient in advanced Osteoarthritis. In early stages MRI is strongly recommended – (MRI is Magnetic Resonance Imaging).
(Q) Are there any surgical treatments for arthritis?
(A) Yes there are several non surgical treatments for arthritis. Surgery is the only last resort. Less invasive measures such as activity modification, physiotherapy and medication are recommended. Injections recommended if symptoms do not improve or if pain becomes worst surgery is the only alternative.
(Q) Why Arthritis more common among women?
(A) Yes medical history suggests that women are affected by oesteoarthritis than men This might be due to sex specific differences in both the presence and relative risk of other several risk factors. (Body mass index) a modifiable risk factor impacts women more strongly.
(Q) Early signs of Osteoarthritis?
(A) Stiffness of the joint, pain, climbing up and down staircase, getting up from a chair. Some also experience joint swelling.
(Q) Is there any evidence to prove haphazard use of exercise machines or vigorous workout led to more Orthopaedic injuries?
(A) Exercise has many health benefits. If haphazardly carried out it can entail exercise related injuries. Better to get a health check up done by a good doctor prior to an exercise regime.
(Q) Common Orthopaedic sports injuries?
(A) Sport injuries are very common in the Orthopaedic clinic. People suffer from meniscus and ligament injuries. In fact physiotherapy has a very important role to play for all patients with sports injuries. Surgically there are various techniques that can be used to fix sports injuries.
Dr. Gurpal Singh has a long standing connections with many Orthopaedic surgeons from Sri Lanka. He has visited Sri Lanka for teaching purposes for more than ten years.
The Annual Meeting of the Sri Lanka Orthopaedic Association has a focus on training and an it is also an exchange programs and Dr. Singh is truly impressed by the commitment of young Orthopaedic surgeons in Sri Lanka to enhance their knowledge and surgical skills.
The latest treatment methods available at Singapore Parkway Hospital for Orthopaedic conditions include robotic surgery for patients suffering from arthritis of state of arts imaging facilities, computerised scan is another popular method For tumour patients, proton beam therapy, a novel mode of radiation therapy is now available.There is strict auditing to ensure sthe quality of drugs used. Most importantly doctors from various specialities work closely as to allow decision making for patients on a case by case basis.
Life style
A nation comes together: Business, compassion and public service unite to protect Sri Lankan women from cervical cancer
In an emotionally charged and inspiring gathering that brought together business leaders, healthcare professionals, philanthropists and community organisations, Sri Lanka, this week, reaffirmed its determination to defeat one of the country’s most preventable yet devastating diseases—cervical cancer.
The event was more than a formal announcement of financial assistance. It was a story of legacy, compassion, partnership and hope. It was also a reminder that when private enterprise, government institutions and civic organisations stand together with a shared purpose, lives can be saved and futures protected.
At the centre of the initiative was a renewed commitment by Dilmah and the Fernando family to continue funding cervical cancer screening programmes, in partnership with the Ministry of Health and Rotary.
The programme, which has already helped thousands of women through early detection, will receive a further Rs. 50 million this year, enabling 20,160 additional screenings.
This follows an earlier Rs. 75 million commitment made in January 2024 under a Memorandum of Understanding signed between Dilmah, Rotary and the Ministry of Health.
A Son Honours a Father’s Vision
Delivering one of the most moving speeches of the event, Dilmah Chairman/CEO Dilhan C. Fernando reflected on the values of his late father, Merrill J. Fernando, founder of Dilmah, whose philosophy continues to guide the company.
Fernando said his father began his journey in 1950 not merely to create a successful tea business, but to build a company that would improve lives and protect nature.
“My father started on a mission to make the world a better tea,” Fernando said. “Now, better tea is always welcome because it implies good taste, but his vision was quite different. It was about tea that would have an impact on the lives of people and on natural ecosystems.”
He said he and his brother Malik were blessed to steward a business that values kindness to people and the environment as much as profit.
“Businesses do not exist to make profit. Businesses exist to create value,” he said. “Value begins with people and livelihoods. It continues through nature, which is an inextricable part of welfare. And if you get those two right, then you have the right to secure economic value.”
Fernando said learning that hundreds of Sri Lankan women were dying annually from cervical cancer—an entirely preventable disease—was deeply disturbing.
“It was something that was really quite abhorrent to us,” he said. “An entirely preventable form of cancer should not be taking so many lives.”
He said the contribution was not about publicity or recognition.
“We announce this not to boast, but in appreciation of all those who made it possible, particularly my father, because that is how it is possible for us to make this assistance.”
Thousands of Lives Already Touched
Fernando said the true value of the investment could not be measured in rupees alone.
“That value may seem like a big number, but it is insignificant when you consider that it has saved thousands of women from the scourge of cancer and in many cases helped them avoid late-stage disease.”
He praised Sri Lanka’s healthcare system for maintaining an admirable record, despite national hardships.
“Whatever anyone may say about systems or governance, the fact is Sri Lanka’s healthcare system has an enviable track record,” he said.
Rotary’s Promise of Early Detection
Representing the Rotary Club of Colombo, former Rotary International President K.R. Ravindran delivered a powerful message on the life-saving power of partnerships.
“This is not a discussion. This is a promise of early detection,” Ravindran said. “Cancer, especially cervical cancer, does not arrive with a bell ringing or a warning. It whispers, and so often by the time it is heard, it is too late.”
He spoke emotionally of the grief caused by delayed diagnosis.
“For millions of women, that whisper is a devastating reality. Families left grieving—that is the reality.”
Ravindran recalled how Rotary had earlier established a stand-alone early detection centre offering free screening for breast, cervical and oral cancers. Through those efforts, more than 120,000 women had access to screening.
“During that journey, we learned something profound,” he said. “Early detection is not just saving lives. It transforms fear into hope, into possibility.”
That experience led Rotary to intensify efforts against cervical cancer, supported by overseas partners who introduced expertise and advanced screening technology.
A Crisis That Nearly Stopped Progress
Ravindran revealed that Sri Lanka’s financial crisis nearly derailed the programme when funds for HPV testing kits became unavailable.
“Without the money, the whole thing would have gone awry,” he said.
It was then, he said, that Dilmah stepped in.
“They did something far greater than simply giving money. They made scale possible. They made continuation possible. They made impact possible.”
He paid tribute to Merrill J. Fernando’s values.
“He believed business was a matter of human service. It was not just about making money. He did not just speak it. He lived it.”
He added that Dilhan Fernando had strengthened that legacy through direct leadership and compassion.
Sri Lanka Can Lead the World
Ravindran said Sri Lanka has every reason to believe it can become one of the first countries in the world to eliminate cervical cancer by 2030.
He cited the country’s literacy, school vaccination programmes, far-reaching public health system and highly respected midwife service.
“One thing we have to be proud of is our public health service,” he said. “And we have an excellent midwife system. If you involve the midwives, you are effectively empowering the community.”
He concluded with a message of hope.
“I think this country can become one of the first countries to be rid of this disease. Perhaps one day no woman in Sri Lanka will ever again hear the whisper of cervical cancer.”
Science, Prevention and Public Health
Consultant Community Physician Dr. Nadija Herath, of the Family Health Bureau, explained that cervical cancer is caused mainly by persistent infection with the Human Papillomavirus (HPV), which can take years to develop into cancer, if left untreated.
She said this makes screening especially important because pre-cancerous changes can be detected and reversed.
“The most important thing about this cancer is that it is preventable,” she said. “If identified early, women can be fully cured and live normal lives.”
Sri Lanka’s Well Woman Clinic programme, introduced in 1996, currently focuses on women aged 35 and 45.
Dr. Herath said the country is now expanding the use of HPV DNA testing, which offers much higher sensitivity than traditional methods.
She added that outreach clinics in factories and underserved communities would be strengthened, ensuring women can access services close to where they live and work.
Cancer Society Calls for Social Change
President of the Sri Lanka Cancer Society, Anoja Karunaratne, said awareness and stigma remain serious barriers.
“We need to take this message beyond hospitals and clinics—into schools, workplaces, religious institutions and community groups,” she said.
She stressed that women should view screening as a normal and responsible part of healthcare.
“Women must not fear screening. They must see it as routine care that can save their lives.”
A Partnership with Purpose
Throughout the event, one theme stood above all others—the power of unity.
Government institutions brought infrastructure and expertise. Rotary brought leadership and international support. The private sector brought resources and purpose. Civil society brought compassion and outreach.
Ravindran summed it up simply:
“This is not just institutions coming together. It is values coming together.”
“When governments, civil society, global networks and responsible businesses all come together, we do more than fight disease—we change destiny.”
Hope for Every Woman
As Sri Lanka moves toward the World Health Organisation goal of eliminating cervical cancer as a public health threat by 2030, the gathering offered more than policy announcements. It offered confidence that progress is possible.
It reminded the nation that some of the greatest victories are won not in boardrooms or conference halls, but in clinics where disease is detected early, in families spared grief, and in women given the chance to live healthy, full lives.
And in that shared effort, Sri Lanka may yet become a global example of what compassion, courage and collaboration can achieve.
By Ifham Nizam
Life style
Rheumatoid Arthritis doesn’t stop at your joints; And neither should your treatment
By Dr. Aruna Caldera, Consultant Rheumatologist MBBS, MD, MRCP (UK), MRCP (Rheumatology)
The word arthritis comes from ancient Greek. “Arthron” means joints; “itis” means inflammation; so, arthritis means inflammation of joints. Arthritis is one of the commonest disease categories which effect man. Some forms of arthritis may not even require any form of specific treatment, whereas some may even kill you.
Among long-term arthritis conditions, the most serious is rheumatoid arthritis. This disease occurs due to genetic variations that cause the immune system to malfunction and produce antibodies against the joints, leading to joint damage. We call this process, auto immunity; in simple words, your immune system which is supposed to protect you, starts to work against you.
If proper treatment is not started on time, the progression of the disease will be extremely difficult. Without proper treatment, it can make life miserable and may even lead to premature death.
Rheumatoid arthritis is a chronic, systemic inflammatory disease. Joint involvement is only one part of it. In simple terms arthritis is not limited to the joints. This is why relying only on ointments or topical treatments can lead to extra-articular (other organ) damage some of which could be catastrophic and lead to premature death.
If untreated, inflammation damages the joints—causing deformities, cartilage loss, and involvement of more joints over time. Complications usually appear after 10–15 years. Those who don’t understand, or refuse to believe this, often rely on short-term fixes and, unfortunately, will suffer later.
Eventually, joint deformities can become so severe that a person may not be able to walk without aid, button clothes, dress themselves, go to the toilet independently, open a bottle, or even open a door.
There are several types of rheumatoid arthritis:
Classical rheumatoid arthritis:
Affects small joints (fingers, wrists) and large joints (elbows, ankles, knees). Symptoms include morning stiffness, joint pain, swelling, weak grip, and fatigue.
Palindromic rheumatism
: Sudden joint pain (and swelling) that disappears within hours or days. Many of these patients may later develop classical rheumatoid arthritis. However, treatment can reduce this risk of progression to classical type. Medication may be needed even when symptoms are absent.
Monoarticular rheumatoid arthritis:
Affects a single joint. It is often mistaken for other conditions like gouty arthritis or osteoarthritis. Without proper treatment, it can destroy the joint and later progress to classical rheumatoid arthritis. Commonly affects larger joints, like knees, ankles, hips, and shoulders.
Polymyalgic onset (proximal) rheumatoid arthritis:
Seen in older individuals and even could be missed by clinicians. Patients usually complain of stiffness in both shoulders rather than joint pain or swelling.
Most patients experience morning stiffness (difficulty moving joints after waking) and joint “gelling” (stiffness after rest). Stiffness can last from minutes to hours and is caused by inflammatory substances accumulating in joints during sleep and rest.
Other symptoms may include whole-body pain, fatigue, weight loss, mild fever, depression, fibromyalgia (generalised wide spread pains)
Rheumatoid arthritis affects the whole body. The effects on other organ systems are identified as” extraarticular manifestations”. Most organs can get involved in poorly controlled disease. Some of the common manifestations include,
Skin vasculitis rashes and skin nodules
Lung disease (interstitial lung disease)
Heart disease (ischemic heart disease)
Osteoporosis
Eye problems which can even cause blindness (uveitis, scleritis)
Nerve disorders (polyneuropathy, mononeuritis)
Dry mouth (Sjogren’s syndrome)
About 40% of patients may develop such complications. The only way to reduce them is timely treatment.
In addition to joint swelling, the whole hand may swell like wearing a boxing glove. Swelling in the wrist can compress the median nerve, causing carpal tunnel syndrome (numbness in fingers). Surgery should not be rushed—arthritis must be treated first.
The disease can even affect the upper spine (neck joints). Neck pain along with other joint pain should not be ignored. In simple terms, rheumatoid arthritis can affect almost any joint except most parts of the spine.
No blood test is required to suspect or even diagnose rheumatoid arthritis. In some patients the rheumatoid factor antibody test will never be positive (seronegative rheumatoid arthritis). Waiting for lab confirmation before starting treatment is an unwarranted delay.
Some tests may show abnormalities:
Rheumatoid factor antibodies, Anti-CCP antibodies, ANA may be positive
ESR and CRP may be elevated
Haemoglobin may be low (anaemia of chronic disease)
Platelets may be high
Blood tests are more useful for monitoring treatment and medication safety rather than initial diagnosis. One important fact we must realise is the titre of the antibody test positivity has no correlation to disease activity and we cannot use the antibody titres to evaluate the response to treatment.
There are treatments that can even bring the disease into remission in no time at all. However, patients who delay treatment, take insufficient doses of medicines, stop medication early, follow inconsistent treatment, or rely on unscientific treatment methods are unlikely to achieve this.
Proper treatment involves starting with stronger medications and gradually reducing it as the disease improves. Simply controlling symptoms, without addressing the disease progression, is not enough; that is why using pain killers and prednisolone only cannot prevent extraarticular manifestations.
The first goal is on-drug remission. After that, patients should continue medication for more than 12 months without symptoms before gradually tapering. Stopping/tapering medications too early often causes relapse, which is a major reason why many patients fail to recover. Some patients may relapse even after stopping medication, but modern treatments allow long-term control without harm and sustained, drug-free remission in other patients. Most novel therapies are available in Sri Lanka as well.
The medications used are called DMARDs (Disease-Modifying Anti-Rheumatic Drugs). These do not just control symptoms—they change the course of the disease. Most patients respond to conventional DMARDs, but if not, biologic or targeted synthetic DMARDs should be started early—not after joint damage occurs. These treatments are available in Sri Lanka. Without consulting rheumatologist, patients may not receive these advanced forms of novel treatments.
Having rheumatoid arthritis is like being trapped in a room with a venomous snake. As long as you stay alert, you can avoid harm—but if you ignore it, it will strike. The disease must be treated at any cost. The choice is yours. With proper treatment initiated early, you can live a normal life. Ignoring the disease will not make it go away. Misinformation by people who aren’t aware of the severity of the disease and medications used often causes patients to avoid ideal treatment, leading to worse outcomes.
There is no point worrying after diagnosis; see a specialist early and seek treatment. You can live a normal life. Even pregnant or breastfeeding mothers can be treated safely without harming the baby. The precious time you waste starting a DMARD will definitely impact the final outcome.
Life style
Avurudu spirit comes alive
The Sinhala and Tamil New Year stands as one of Sri Lanka’s most significant cultural observances, marking not only the transition of time but also a collective moment of renewal, reflection and togetherness. The Sinhala and Tamil New Year is deeply rooted in age old customs that continue to shape both domestic life and wider social culture across the island. Priyanthi Fernando brought the spirit of Sinhala and Tamil New Year to life, hosting a thoughtfully curated Avurudu celebrations that brought together elegance, culture and the timeless spirit of togetherness. The Sinhala and Tamil New Year festivities were held at Colombo City Centre, followed by a strong service of cultural authenticity. The event unfolded with traditional observances carried out in glamour and style. The atmosphere was warm, yet distinctly elegant, with carefully curated details. Priyanthi embraced tradition in a striking reddai hatta, even the invited guests embraced the occasion in equally colourful ensembles that added a rich, cultural vibrancy.
The food presentation added to the charm of the evening, with a beautifully arranged spread of Avurudu delicacies.
The gathering blended festive decor with familiar Avurudu touches, games sweet meat spreads. and a musical backdrop inspired by local rhythms. Both men and women opted for the national attire, while traditional sweets, such as kavum, kokis, aluwa and mung kevum, were among the food highlights, alongside other savories and contemporary bites.
Adding to the celebrating tone were the traditional Avurudu games which brought moments of laughter and friendly competition. As the Avudu Kumari was announced, the evening reached its natural clima, filled with smiles photographs and applause. The gathering captured the true essence of Avurudu with warmth and celebrations.
- Zarina
- Onitha Gurugalle
- Sujeewa Nelson
- Guest in national attire
- Sheila
Pix by Thushara Attapathu
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