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Facilities for infected pregnant women inadequate – SLCOG

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By Rathindra Kuruwita

The distribution and availability of high-flow oxygen machines to treat Covid-19 infected pregnant women were not adequate, President of the Sri Lanka College of Obstetricians & Gynaecologists (SLCOG,) Dr. Pradeep de Silva said yesterday.

Dr. de Silva said that while they had not yet faced any lack of oxygen in treating Covid-19 infected pregnant mothers, things could change rapidly given the limited availability of equipment. “Having an adequate supply of oxygen alone is not enough. You need high flow oxygen machines, and 50 litres of oxygen per minute is needed to operate a high flow oxygen machine. I do not know how many machines we have in this country but where I work, Castle Street Maternity Hospital has about four. We need to estimate the number of these machines we require and how much oxygen we want. From my understanding, the distribution and availability of high flow oxygen machines to treat Covid-19 infected pregnant mothers is not adequate.”

Dr de Silva said that Sri Lanka needed about 50–200 high-dependency unit (HDU) beds per district, based on the population, 10–50 high flow oxygen machines per district, four for ten ICU beds and two dedicated Extracorporeal Membrane Oxygenation (ECMO) machines.

“If we get this, we will be able to deal with pregnant women who develop complications from COVID-19 for the next four to five years,” he said.

Dr de Silva said that currently one pregnant woman who has been infected with COVID-19 is receiving ECMO treatment. There is also a shortage of beds at the Mulleriyawa Base Hospital, which has the largest ward dedicated to COVID-19 infected pregnant women. On Thursday, Obstetrician & Gynaecologist, Dr Mayuramana Dewolage, who heads the ward that treats COVID-19 infected pregnant women at the Mulleriyawa Base Hospital, said that they only had 37 beds were dedicated to pregnant women with COVID-19. They didn’t have any HDU or ICU beds dedicated for their use, he said.

“We share HDU and ICU beds with other patients at Mulleriyawa Base Hospital,” Dr Dewolage said.

The President of the SLCOG also urged all hospitals to find a separate space for pregnant women who were receiving treatment at their institutions. When COVID-19 pandemic started, the Health Ministry instructed all hospitals to do so but it was now obvious that those instructions had not been followed, he said.

“When the second wave started people got ready but later, they just stopped getting ready and now we are unprepared to meet the challenges of the third wave. We need to find a way to manage this. If the Ministry of Health has not prepared a plan, we are ready to help formulate one,” the President of the SLCOG said.

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Those who had AstraZeneca first jab, should take Sputnik V with adenovirus 26 – Specialist

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By Rathindra Kuruwita

If those who have taken the first dose of AstraZeneca are to receive a second jab of Sputnik V, they should take the first Sputnik V vaccine with adenovirus 26 (Ad26), Consultant Immunologist and head of the department of Immunology-MRI, Dr Nihan Rajiva de Silva says.

Dr. de Silva said that the first dose of Sputnik had Ad 26 and the second had adenovirus-5. “Adenovirus-5 is common. We may have been exposed to that and we may have developed antibodies. Adenovirus-26 is rarer and we will better respond to that. That is why the vaccine-maker has used adenovirus-26 in the first vaccine. So, if you had a first jab of AstraZeneca and you are to get the second dose from Sputnik-V remember to get the first jab,” Dr. de Silva said.

He added that any vaccine has the chance of reducing the severity of the virus and that the general public should get vaccinated when the opportunity is available.

Dr. de Silva said that there was a shortage of AstraZeneca vaccines because the Serum Institute of India could not deliver shipments as promised.

“However, we are now getting Sputnik V vaccines and we are looking at mixing them. There is a study in Russia about the efficiency of mixing Sputnik V with AstraZeneca and the results should be out soon. I can say that theoretically mixing the two vaccines should work,” he said.

Dr. de Silva added that the AstraZeneca vaccine should work against the new variant spreading in the country.

Consultant Cardiologist at the National Hospital of Sri Lanka, Dr. Gotabaya Ranasinghe said that those with heart issues, non-communicable diseases and were obese must get vaccinated to minimise the complications of Covid-19.

Dr. Ranasinghe said that those in the above-mentioned categories were at risk of contracting, getting complications and dying of COVID-19 and research had proven that vaccination would reduce the chance of such eventualities.

“If you worry about getting vaccinated, talk to your doctor. Don’t seek advice from friends and family,” he said.

Dr. Ranasinghe added that they had limited the number of heart surgeries they do due to COVID-19. ICU beds used for heart patients too were being now allocated for COVID-19 patients. “We only do the most pressing cases. But this means that the waiting list keeps on growing. Now, the waiting list is over eight months. If we limit the surgeries more and keep taking away ICU beds available for those who have had heart surgeries, the waiting list will grow further,” he said.

The Consultant Cardiologist also advised the public to eat healthy food and engage in moderate exercises, at least five days a week. This will reduce the mental stress as well as boost the immune system. ‘We recommend moderate exercises like jogging and brisk walking, for 30 minutes, five days a week. Being healthy is as important as wearing masks or adhering to physical distancing,” he said.

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When a wonderful human being crosses the great divide

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Sarasaviya took this picture of Punya and Milroy at their home after the “Abhimani” Legendary Award was conferred on Punya, during their last visit to Sri Lanka to attend the Sarasaviya Festival in 2016.

“There are friends,
There is family,
And then there are friends
That become family”

Such a friend was Milroy, whose passing away a few days ago, we learnt with heavy hearts and deep sorrow.

To those who didn’t know him, he was the husband of Punya Heendeniya, the actress who captivated the hearts and minds of a nation by her portrayal of Nanda in the film classic “Gamperaliya”; Nanda was the quintessential Sinhala upper class village maiden who valued tradition over love.

To MBS (Siri) he was a lifelong friend “who stayed forever, beyond word, beyond distance, beyond time”.

To me (Kumar Gunawardane) who came to know him through Siri and also through his brothers, he was a pleasant companion, and good friend.

PUNYA:

“He loved music, sing songs and kalawaa (art) in all its forms. That is why he married me. He went out of his way to help the needy in whatever way he could. He did everything for me and the children.

“In the last year or two he took to understanding what real Buddha Dharma was.

“May he attain the supreme bliss of Nibbana!”

SIRI:

“We met on the very first day in the “Block”; alphabetically we were next to each other, Milroy de Silva and MBS de Silva. That day, wearing our white jackets and ties back to front, we had to march to the Anatomy laboratory, jeered by serried ranks of haughty seniors. The naked bodies lying on marble slabs was nauseating. I was directed to the appropriate cadaver by a tutor and paired with a brilliant student JBC De Silva, to dissect the upper limb. Confused and bewildered I could only gaze at the colleague carving the other arm. He looked equally nonplussed wielding a scalpel nonchalantly, while another student recited the instructions from Cunningham’s manual of Anatomy. Our eyes met and that was the start of a beautiful friendship; a coming together of the high-spirited and full of joie de vivre. We immediately downed tools and scampered to the canteen to revive ourselves with a cup of tea, laced with condensed milk, and the cheapest available cigarette ‘Peacock’. Our interests were similar; studies took a back seat, larking around taking precedence. The friendship was sealed further when we joined Bloemfontein the formidable male medical student hostel alternatively feared and lauded.

“I remember our first Block dance at the King George’s hall. He was smartly dressed in black tuxedo pants and a cream jacket; only missing element was a lady companion. I, who wore a black shirt and a white tie, had a beautiful girl on my arm. I asked Milroy where he came by his tuxedo and he disdainfully replied I have two brothers who are doctors and one tuxedo for the whole family and now it is my turn to have it!!

“Our bonds strengthened during our intern year. Milroy returned to his roots in Galle and I joined him a few months later at Mahamodara, the hospital by the sea. It was a year of back breaking work, but also a year of fun and frolic.

“Milroy was then posted as chief (District Medical Officer) of the Moneragala hospital. But “I was left high and dry, Milroy, thoughtful as ever arranged for me to work with his brother Dr A.S.H De Silva, who had a thriving general practice just down the road from the hospital. Three months later, I got a posting to Buttala, which was then a mostly elephant and serpent infested jungle. It was classed as a ‘punishment’ station by the Health Department. The attractions however were the proximity to Milroy, and also the predecessors who included medical giants such as Professor Rajasooriya and the distinguished surgeons Dr Bartholomeuz, and R. L. Spittel the Surgeon of the Wilderness. In this pastoral outpost Milroy was bowled over by the image of Punya. He was at a loss to reach her. I advised him to write and he did so with panache. She invited him to visit them at Mirigama, her hometown to meet her folk. They teamed up in Punya’s own words for 52 years seven months and 22 days; a match made in heaven.

“As a dutiful father, he wanted to give his son and daughter the best education available and so it was that he and Punya migrated to Zambia. It was here that they demonstrated hidden strengths of character which helped them overcome adversities and even threats to their lives and move over to England. Milroy re-invented himself and rose to top of the ladder to become a consultant psychiatrist. His two children also became consultants in the NHS, the son a gastroenterologist and daughter an endocrinologist. He acknowledged freely Punya’s role not only in all his triumphs, but also in the hazards and misfortunes in their paths.

“Yet, more than all this was his humanity and humility, generosity to those less well endowed especially relatives and also to those medical graduates at the threshold of their careers. They were gracious hosts; Punya was an accomplished cook and less well known, a euphonious singer. I and my good friend Karu had the good fortune to enjoy their hospitality on many occasions in London.

“Milroy my friend, “To live in the hearts of those we love is never to die”

“May your journey in Samsara be short and my you attain the Supreme bliss of Nibbana!”

 

KUMAR:

I first got to know Milroy at Bloemfontein, the medical student’s hostel adjoining Carey College. He was a dapper figure, stylishly dressed with an unceasing gentle smile on his face. His chums, Siri, Gerry, Wicky and others were always friendly with us juniors and never intimidating. Their banter and capers in the dining room and the spacious portico were invariably hilarious.

My friendship with Siri was cemented in the hurly-burly of the Galle hospital, where I too did my internship. When I was unemployed after its completion it was Siri who arranged for me to work with Dr ASH, Milroy’s brother. ASH and Kingsley, another brother became my friends and mentors.

“Punya was a heartthrob of many young bucks of our era. But only one, Milroy, could win her hand and her heart. What a splendid partnership it was.

The Buddha Dhamma teaches that death is natural and inevitable. Yet it is sorrowful and we pray for you and your family’s peace and comfort. Their sadness is soothed by the beauty of your life, a life well lived. As the Buddha said death has no fear to those who fashioned life as a garland of beautiful deeds.

May you attain the Supreme Bliss of Nibbana!

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