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WHY STOP SMOKING?

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By Dr. Rohan Jeyarajah

We all have our vices; mine is chocolate cake. I cannot walk by a chocolate cake and not eat some of it. How can I get on someone for smoking? Surely, this is their vice and are we not allowed one at least? I think about this all the time as I counsel my patients to stop smoking prior to a surgery.

I assure you, I am an equal opportunity abuser: I equally counsel my obese patients on weight loss prior to their surgery or the diabetic on better glycemic control. But what is it about smoking that makes it so bad for you?

Smoking affects so many aspects of the human body: the lungs, heart, blood vessels and on and on. The blood vessel effect is probably the most problematic for what I do as a surgeon. We rely on blood supply to organs to allow them to heal after cutting out a part. The blood vessels bring lifesaving nutrients and oxygen to the area of healing. Without this, there will be limited, or no healing and things can leak or just not heal. This can cause life threatening effects including death.

The heart is critical to life as it pumps blood throughout the body. As with other critical organs, blood needs to supply the heart. This sounds so counter-intuitive as the heart is full of blood all the time – surely it does not need more blood? The heart is a muscle and the blood vessels to the heart itself (called the coronary vessels) can be affected by smoking. Blockages in these vessels can lead to heart attacks and death. This can be a major issue during the stress of surgery. We look at those that smoke as higher risk for surgery in general.

There are so many types of smoke exposure. Those that smoke cigarettes have first-hand smoke exposure. Those that live with smokers have second-hand smoke exposure that can be very harmful. We sometimes see a patient that does not smoke have lung issues attributed to those that smoke. This is from second-hand smoke from being in a household with someone that smokes. Please do not underestimate the risk that second-hand smoke may give.

Vaping (inhaling and exhaling vapor with nicotine and flavoring) has become a big issue, especially in the younger population. This has become a trendy thing to do. The reasons for this increase in use among the younger population is manifold: vaping is thought to be safer than cigarettes. This is not correct. Most vaping fluids contain high levels of nicotine and this can be more harmful than lower-level exposure in cigarettes.

Most agree that the lack of smoke in vape is safer on the lungs than smoke in cigarettes. However, homemade vaping fluids are especially dangerous as they may contain high levels of harmful agents – this has been recently shown in the vitamin E containing vaping fluids that have caused lung injury. Some vaping fluids are mixed with THC and other substances that are thought to aid in the “experience” of vaping.

This mixing can be dangerous and cause lung injury and even death. The preservatives in vape fluid as well as the flavors can be harmful when inhaled. The smell of vape fluids that are flavored with many “fruity” additives make these especially attractive to younger users. The lack of regulation of vape fluids can make this practice very dangerous.

So why stop smoking?

It is bad for you.

It is hard to quit.

It causes proven damage to your vital organs.

I see it every day. I see patients who have had to have their leg cut off because of poor circulation.

Please tell someone you love to stop smoking. You never know if you could be the one who changes their life…

 

Dr. Rohan Jeyarajah, MD FACS,

Chair, Department of Surgery,

TCU and UNTHSC School of Medicine,

Director HPB/AGI Fellowships,

Director GI Surgical Services,

Associate Program Director,

General Surgery Residency,

Methodist Richardson Medical Center – Texas, USA.



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COPE discovers fake documents covering drug imports in 2022/23

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The Parliamentary watchdog Committee on Public Enterprises (COPE) has found that there were fake documents regarding the importing of medicines under the emergency procurement system in 2022 and 2023.

This was revealed during a COPE meeting held at Parliament probing the transactions of the National Medicine Regulatory Authority (NMRA).

NMRA CEO Saveen Semage told the committee that several fake documents have been found due to the lack of registration of medicines.

Stating that six such fake documents were found last year alone, Semage said he had recorded statements regarding each of the documents with the Financial Crimes Investigation Division.

He revealed that, however, no investigations have been conducted yet into the incidents.

“We have documents with confessions from a woman accepting that fake documents had been made. However, a statement has not even been recorded from that woman yet,” he said.

Meanwhile, COPE member MP Asitha Niroshana Egoda Vithana also revealed that the highest number of waive-off registrations (WOR) for medicines had been obtained in 2022 and 2023.

He said 656 such WORs had been obtained in 2022 and 261 in 2023, adding that this proves that discrepancies have taken place during the emergency procurement of medicines during these periods.

Furthermore, Deputy Director General of the Medical Supplies Division of the Health Ministry, Dr. G. Wijesuriya said discussions are underway on allowing the State Pharmaceutical Corporation (SPC) to directly import essential medicines.He pointed out that it was essential to take a policy decision in this regard as a solution to mitigate such discrepancies.

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Batalanda report tabled in parliament, forwarded to AG

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Bimal Ratnayake

The Batalanda Commission report was tabled in Parliament on Friday by the Leader of the House and Transport Minister, Bimal Ratnayake.

Minister Ratnayake announced that the government has decided to forward the report to the Attorney General for legal advice. Additionally, a Presidential Committee will be appointed to provide guidance and recommendations on how to proceed with the findings of the report.

Ratnayake said that the Cabinet of Ministers, along with President Anura Kumara Dissanayake, has made a policy decision to take necessary action in response to the report. He reassured the public that steps are being taken to ensure that such a dark chapter in the country’s history is never repeated.

Minister Ratnayake said that a two-day debate on the Batalanda Commission report will be scheduled in Parliament at an appropriate time, allowing for a detailed discussion on the report’s findings and recommendations.

The report, which will be printed in all three official languages—Sinhala, Tamil, and English—will be made available to the public in the near future. Ratnayake confirmed that printed copies would be provided to members of Parliament as well as the general public for their review.

The Leader of the House further revealed that there are 28 evidence volumes associated with the commission’s work, which will be submitted to Parliament at a later date for further scrutiny.

Ratnayake said that as entire country concerned of the Batalanda Commission’s findings, the government’s commitment to addressing the issues raised and preventing future atrocities stands clear. The next steps, including legal action and policy recommendations, will be shaped by expert advice and informed parliamentary discussions, he said.

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CB Governor stresses need to assist crisis-hit construction industry

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Governor of the Central Bank Dr. Nandalal Weerasinghe on Friday (14) emphasized the importance of promoting a sustainable and cost-effective construction industry in the country, highlighting key challenges and opportunities in the sector.

Speaking at ‘Construction Expo 2025’, Dr. Weerasinghe underscored the need for Sri Lanka to align with global trends in sustainable construction, integrating cost-effective energy solutions and eco-friendly building practices.

“I must say my views here are not necessarily as Governor of the Central Bank of Sri Lanka, but as a person looking at this construction industry and how this can be developed and what the issues are. Sustainability in construction is essential, not just for new projects but also for existing buildings,” he noted.

Dr. Weerasinghe acknowledged that the construction sector has been one of the hardest-hit industries due to multiple economic pressures in recent years including the decline in public investments, high material costs and the industry being dependent on government projects.

The CBSL Governor, who acknowledged that the government faced fiscal constraints, limiting infrastructure spending and delaying payments to contractors, said that however, the outstanding arrears had now been settled.

“Government did not have space to spend money for public investment, especially construction that had a significant impact on the industry in the last couple of years, plus the government inability to pay the arrears for a long period. That was an issue we all recognize that has been one of the adverse impacts the industry had in the past”, he expressed.

“Also the cost of materials went up significantly, partly because of foreign exchange shortages. As a result, the shortage had shot up the prices of construction materials, as well as depreciation of the currency, high interest rates, finance costs, and other factors. We all recognize that it had an adverse impact on the industry. It’s one of the worst affected industries because of all these factors.”

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