Dilani wife of HE. Nimal Bandara -Consul General of Sri Lanka in Sydney – birthday celebrations

Dilani wife of HE. Nimal Bandara -Consul General of Sri Lanka in Sydney, had her birthday celebrations, at their residence in Strathfield, Sydney, on 3rd January 2020. With the staff of the Consulate Office.

Invited guests: Jaya Jayawardena, his wife and Dr. Harold Gunatillake and his wife Irangani.

It was a private and homely event with traditional foods and lavish home-made dinner.

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

birthday celebrations

 

 




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Video talk on high blood pressure – BY Dr Harold Gunatillake

Dr Harold

Script
Let us discuss today, the importance of checking your blood pressure regularly.When you are 40 and over, it is advised that you check your BP annually.Owning your own BP apparatus would be an impetus for such recordings, regularly When you are a kid, your heart works beautifully with absolute, no strain. This is attributed to the fact that all your arteries -major, minor and minute tributaries to the fingers and toes are expandable, elastic and mobile, and not stiff, causing no resistance to the pumping action of your heart.

With age, the blood vessels seem to harden, become less expandable, becomes stiff and increases the resistance on pumping the blood from your heart.With increased resistance from the thickened blood vessels the heart needs to pump more forcefully.

That creates the higher pressure on the arteries, and that would be the onset of high blood pressure.

This pressure is measured by the sphygmomanometer by your doctor in his office. The upper reading is referred to as the systolic pressure, because that is a measure of how much the left ventricle of your heart is straining to pump the blood to the periphery.

When the left ventricle of your heart which pumps the blood to the periphery now needs to relax to fill with blood from the left upper chamber -called the left atrium.The lower pressure created in the blood vessels is related to the phase when the heart muscle relaxes between beats allowing the chambers to fill with blood. This is referred to as the diastolic pressure

So systolic pressure is when the heart contracts, and diastolic pressure is when the heart relaxes to fill with blood for the next beat, or you could say between beats. Adults should keep their systolic pressure at 120mm. of mercury and the diastolic could vary between 60 to 80 mm. of mercury.

When the diastolic pressure is more than 90 or higher means you have high blood pressure.

There was a time when your doctor would say when the BP is higher, it is okay for your age.

Now, it is believed that all adults at any age should keep the BP consistently at 120/60-70

Both systolic and diastolic blood pressures are important, but for those forty and older systolic is more important than the diastolic. It is the systolic pressure what increases our risk of having a heart attack, stroke or artery disease in the legs. So, remember, that systolic BP is more important and needs to be kept at 120mm of mercury.
No bargaining at all.

When the BP increases with a systolic pressure of 180 mm of mercury or higher or a bottom number of 120mm Hg can damage blood vessels and is referred to as a hypertensive crisis.

In the early stages of rising blood pressure, it happens so slowly over months or years, the body seems to accommodate the increase until such time the vessels cannot tolerate anymore, and the warning signs are imminent.

This is the main reason why you should check your BP at home or with your doctor frequently with every visit to your doctor, to prevent such episodes that can cause instant death.

How can you prevent high blood pressure?
The answer applies to all chronic diseases whether it’s high blood pressure, heart disease, cancer, diabetes among others.

Eat the right foods meaning unprocessed low fat, and low carb in small quantities at a meal.

Avoid animal foods with high saturated fats.
Avoid those foods in the refrigerated section of your supermarket where all frozen foods are saturated with transfat- a killer that is used to maintain the shelf life of foods.

Exercise daily, at least a brisk walk of 10,000 steps.
Control your diabetes with medication and low GI foods.
Eat more oily fish than meat. Oily fish contains omega 3 fatty acids that keep your blood vessels soft and elastic.
Now let’s talk about the pulse rate or heart rate
When you get your BP checked you don’t seem to record the pulse rate which is as important, for deciding on medication for high BP.

If your BP is high and pulse rate is also rapid- more than 80 per minute at rest, your doctor will prescribe certain drugs like betablockers and calcium blocker drugs in addition to slow the heart rate to about 70 at rest.

When you exercise your target heart rate tells you if you’re exercising too hard or not hard enough. Everyone’s target is different, but in general, during moderate or vigorous exercise, you want it to be between 50% and 85% of your maximum heart rate, which is the hardest your heart can work safely. Your maximum heart rate when you exercise should be 220 minus your age.

Using a heart rate monitor can help you get fit.
Wearable electronic heart monitors, and exercise machines with built-in heart sensors, can give you up-to-the-minute information on how hard your heart is working. That can tell you how hard you’re exercising. It can help you pace yourself, too. It may even help keep you motivated.
Summering
Hypertension is the most common condition seen in old people and lead to heart attack, stroke, kidney disease, if not detected early and taken steps to treat adequately.
Blood pressure increase is inevitable as you age, due to the thickening of arteries- a natural event called arteriosclerosis.
The heart becomes strained to push the blood from its left ventricle into the circulatory system.
High blood pressure is avoidable if you take steps to check your BP regularly.
Hope this video has been useful.
Thank you for watching

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Seniors event- Annual Seniors’ Day for expat Sri Lankans in NSW, Australia – Video thanks to Dr Harold Gunatillake

Annual Seniors Day incorporated with The Sri Lankan Community Young Achiever Awards 2019 was held at Community Hall, Thornleigh NSW, Australia. Filming was done by Dr Harold Gunatillake

 




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Keeping your Circulatory system, healthy

There are two circulatory systems: blood circulatory system and lymphatic system in our body, and efficient working of those systems keep us healthy and shapely, too. 

We are only discussing about the blood circulatory system, also called cardio-vascular system, in this article. The central pump (heart) including the receiving pump in thissystem are the central figures most important to deliver nutrients and oxygen to the cells of the body and return the de-oxygenated blood (bad blood) back to the right chambers of the heart be sent to the left chambers of the heart after purification( oxygenation) in the lungs.Just like the circulatory system the pump (heart) needs to be maintained in prime condition to remain healthy.

 The complex system of circulation that supplies nutrients and oxygen can get disturbed and result in diseases detrimental to our health.

 The pipes (arteries) in this system can get damaged. In healthy situations, they are flexible, elastic and expandable, as seen mostly in young kids. In a condition called Atherosclerosis these pipes can get hardened in patches with fatty deposits from your food and other inflammatory processes, may cause partial obstruction to the flow of oxygenated blood and micronutrients, resulting in irreparable harm to your body.

Such pathological changes do occur with age, and lifestyle changes. High blood pressure is one of the commonest outcomes of thickened arteries. High blood pressure may affect your heart, kidneys, eyes, cognitive decline and may lead to stroke through neglect.

There is a difference between ‘Arteriosclerosis’ and ‘Atherosclerosis’. One could say that the latter is a specific type of arteriosclerosis. The former occurs through aging and is a natural phenomenon in all human beings. Over time the walls in your arteries can harden for no definite reasons, other than just aging and genetics may play a part in it.

When you are over forty, you need to check your blood pressure yearly, failing will result being a victim to this silent killer.

According to the American Heart Association under the new guidelines the BP should be below 130/80 from 140/90 millimeters of mercury. Above these figures you enter the criteria for stage 1 hypertension.

Lifestyle changes without pills can lower blood pressure, during this early stage of hypertension. Lose weight, read labels, avoid foods containing very high amounts of sodium (salt) such as breads and rolls, cold cuts and cured meats, pizzas, and Chinese food. Did you know that Chinese and Japanese food includes lot of salt? It is paradoxical why those nations do not show a higher incidence of hypertension and other circulatory problems.

Heart disease: Not only blood vessels supplying the periphery of the body gets affected in hypertension, the coronary blood vessels of your heart can get constricted with hypertension. These vessels get blocked by blood clots and lead to anginal episodes and heart attacks. So, always keep your BP in the normal approved range.

With chronic neglected hypertension your heart valves can prolapse and lead to incomplete closure, leading to leak and back flow of blood (regurgitation). Narrowing of the valves in hypertension can cause stenosis (narrowing) and preventing the free flow of blood from the heart.

Arrhythmias: With uncontrolled blood pressure, the heart muscles get strained and stressed and contractions could become erratic, can cause abnormal heart rates and rhythms. You could always self-diagnose this condition from feeling an irregular pulse rate at your wrist, or a dropped beat.

High cholesterol: You may have read that cholesterol has made a U turn, giving you the idea not to worry about eating foods with high cholesterol. It is partially true that cholesterol in your food such as in eggs may not influence the cholesterol numbers in your blood, but remember most foods have high saturated fats along with natural cholesterol that harms. So, avoid unhealthy diets, and lead an active life with regular exercise to lower your cholesterol in your blood. The bad cholesterol (LDL) do collects in plaques and damage the blood vessels (arteries). If you have high cholesterol due to genetic factors, you need to take statins to control the cholesterol numbers in your blood.

Heart failure: With high blood pressure the peripheral blood vessels tend to get stiff and non-elastic. This leads to back pressure on your pump (heart) and cause additional strain on your left ventricle that pumps your blood to the rest of your body.

Neglecting your hypertension ultimately leads to heart failure. Initially the heart muscles get hypertrophied (expanded). At this stage x rays reveal an enlarged heart. If no remedial action is taken the muscles can get weak and go into failure. At this terminal stage, there is water-logging in your body, lead to fatigue, shortness of breath, coughing, and lead to a miserable life causing much misery to yourself and loved ones.

Stroke: Due to high blood pressure the vessels supplying the brain can rupture, or lead to blockage with blood clots and prevent oxygen from getting to the brain.

Most strokes are preventable. You only need to keep your BP under control with healthy lifestyle changes.

Peripheral artery disease (PAD): With chronic hypertension your peripheral blood vessels could narrow just like the central ones. Uncontrolled diabetes is one of the main culprits that can cause this condition, and ultimately leads to gangrene of limbs needing amputation. Such incidents are rare today, as most people have access to good health care.

Carotid artery stenosis: In addition to narrowing of the limb vessels, it is quite common to see the carotid arteries supplying blood to the brain getting restricted with plaque formation in these main vessels in the neck. The plaques can get dislodged, ulcerate and bleed, causing a condition called Transient ischemic attacks (TIA). This leads to a transient stroke, a warning sign for action to prevent a full- blown stroke.

Aortic aneurysms: Uncontrolled hypertension can lead to ‘ballooning out” at weak points I your blood vessels, as at bifurcations of vessels. These bulges or aneurysms could burst and become medical emergencies.

Other factors: To keep your circulatory system healthy you need to be aware of the consequences of neglect. Smoking can damage your blood vessels. Fortunately, the incidence of smoking among the adults are reducing, whilst it catches on among the young and in third world countries where the cigarette companies still promote through advertising.

Being overweight could be a strain on your heart and circulatory system. However, awareness, keeping your weight under controlled with healthy low-calorie diets and exercise the risk could be reduced.

Inflammation from diseases: There are certain diseases where thickening and narrowing of blood vessels are inevitable, includes arthritis, lupus an autoimmune disease, and inflammation due to unknown causes.

Conclusions: Be aware of circulatory diseases and take lifestyle measures to prevent them. Do not weight to see the doctor until you get a life-threatening circulatory problem, as they are all preventable unless there is a congenital or familial factor.

Eating a healthful diet, checking your BP regularly, exercising, not smoking can avoid these preventable issues in your circulatory system. If you are a diabetic, you need to tightly control blood sugar levels with proper diet and medication.

Hope this article will help you to stay fit and lively.

Dr Gunatillake-Health editor is a member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery. Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery, Member of the International Societies of Cosmetic surgery, Fellow of the International College of Surgery (US), Australian diplomat for the International Society of Plastic, Aesthetic & Reconstructive Surgery, Board member of the International Society of Aesthetic Surgery, Member of the American Academy of Aesthetic & restorative Surgery, Life Member of the College of Surgeons, Sri Lanka, Batchelor of Medicine & Surgery (Cey). Government scholar to the UK for higher studies.

 

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Selecting diets when you are a diabetic –
By Dr. Harold Gunatillake 

Non- diabetics can eat a multitude variety of foods without selection,but when you are a diabetic there are known restrictions you need to follow to keep your blood sugar within the normal range. In brief, the aim of diabetic treatment is to bring blood sugar (glucose) as close to normal ranges as possible through dietetic and other regimes.

During fasting, when you have not eaten any food overnight, should read 70-99 mg/dl  (3.9-5.5 mmol/K) This would be the ranges for non-diabetics. Diabetics should not attempt to reach such low levels, as the chances of going into ‘hypoglycaemia’ may be high. On an average a diabetic should keep the fasting sugar at about 110mg/dl or between 80-130mg/dl (4.4-7.2 mmol/L). If your fasting level is above 126mg/dl falls into the category a‘prediabetic’.

When you plan a diabetic diet, you need to consider the calorie content of each ingredient to get a handle on your weight and feel better, as well. So, in short you need to watch your portion sizes and calories.

There are certain foods high in fat and added sugar you need to avoid, such as sweets,ice cream, puddings, sugar drinks and most fatty food. Also, it is advisable to restrict your salt intake in your cooked foods.

Let’s discuss the staple diet of the Sri Lankans living in Sri Lanka and expats living in other countries.Eating white rice seems to be popular for lunch and dinner, because of its colour, flavour, easy cooking, and easily converted to more palatable dishes like fried rice and so on. Though it is a versatile grain, cheap and easy to cook, contains too much of starchy calories not well recommended for diabetics. In fact, one cup of cooked white rice contains around 240 starchy calories that gets converted into fat in the body, if they are not burnt off.

Sales in supermarkets of polished white rice is much greater than more health and  nutritious red or brown rice, in Sri Lanka.

White rice being minus the outer bran and being polished gets absorbed much quicker than the unprocessed brown or red rice. This causes a problem among diabetics. Being absorbed fast through the gut as glucose, may rapidly increase glucose levels in the blood and even cause spikes. You tend to get hungry sooner than consuming the unprocessed varieties of rice. Further, micro- nutrient content is much less.

Diabetics should avoid white processed rice and always consume unprocessed rice for more glucose control, slower absorption and less spiking.

Resistant rice: You still could enjoy white rice being a diabetic by making the rice grain more resistant to digestion and absorption. This process is naturally created when you enjoy your plate of biriyani lumprai, fried, or pilau styled rice.

It does not mean that you should eat rice cooked in above methods daily, due to the high fat and calorie content. You could make your plain rice more resistant for your daily eating.

Researchers in Sri Lanka discovered a new simple way of cooking the white grain to  dramatically cutting down its calories by as much as 50 per cent and offer some health
benefits.

All you need to do is to add a table spoon of coconut oil into the boiling water before adding your raw rice. Sudhair James, an undergraduate chemistry student from the College of Chemical Sciences in Sri Lanka, who led the research with his supervisor explained this new method of cooking rice. He presented the work at the National Meeting and Exposition of the American Chemical Society on Monday.

The rice after cooked by this method is left to cool overnight in the refrigerator, and next day you microwave to warm the rice and enjoy the fluffy white rice.

The advantage of consuming resistant rice is that our bodies cannot brake down into glucose to be absorbed and increase blood sugar levels. They pass through the large bowel where they act as more like a dietary fibre and provide benefits to the gut microbiota.

This method of producing resistant starch also applies to pasta, too.
You could also try low carb diets which limits your carb content, like Atkins or South  Beach diets. In these diets the carb content is reduced to about 40 grams, which means you could still enjoy two table spoons of starchy rice per meal. The rest of the calories are obtained from veggies, fish and meat. These diets are specifically designed to lose weight and not for diabetics. Research on the benefits of low-carb diets for type 2 diabetes is still mixed.

One of the best diets recommended for diabetics is the Mediterranean diet. It is a heart healthy diet using lots of fruits and veggies, fish chicken, nuts and olive oil,legumes and whole grain.

There is a popular diet for diabetics called the “Zone Diet”. In this diet you keep your blood sugar very low stable levels. (40% carbs, 30% protein, and 30% fat). The food you eat in these diets are selected according to the glycaemic index.

People living in Sri Lanka cannot afford to eat specially labelled diets, and for them rice and curry is the cheapest and most energy producing diet, especially to the out-door working class of people.

Today, diabetes is not uncommon among the poorer class of wage earners, though it was known as a ‘rich-man’s disease’

The low wage earners find it difficult to test their glucose levels frequently, as they cannot spend about rupees 5000 to purchase a glucometer and each testing  stripcosts   approximately  Rs. 80.00.

Visiting diabetic clinics run by the state cannot cope up with the number of diabetics arriving at the respective clinics and may have to spend hours, affecting their job situations.

Due to their inability to control their blood sugars, the public hospitals are full of them with complications, even needing amputations of limbs.

The richer folk gets diabetes due to over-indulgence, eating too much of rich high crab food, stress factors, and obesity.

They need to do 10,000 steps walk daily, reduce their carb content and alcohol use.

Low sugar veggies and fruits: Low sugar vegies include Brussels sprouts and other  cruciferous vegies like broccoli, cauliflower. Other low sugar vegies are: cucumber, kale,carrots, green beans, spinach, rocket, arugula lettuce, tomatoes and radishes.For a diabetic, fresh or frozen vegie are preferable to canned vegies because of added salt. Choose low salt canned vegies instead.

Another factor you need to investigate is those complex carbs containing high fiber. Such vegies take a long time to digest, absorption is slower and blood sugar does not spike. The University of Texas Southwestern Medical Centre found in a study that people who boosted fiber consumption from 24 to 50 grams per day showed drops in their blood sugar levels. The researchers found that, for some, changing to a high-fiber diet worked as well as some medications for diabetes

Whole plant foods are great sources of complex carbohydrates: such as Green
vegetables: whole grains and foods made from them, such as oatmeal, pasta, and whole-grain breads: starchy vegetables such as, sweet potatoes, corn, and pumpkin: Beans, lentils, and peas.

Foods that are high in carbs are: pastries, breads, rice and potatoes

Fruits which are low in sugar include all varieties of berries, mushrooms. Carambola fruit also provides amazing health benefits. It is very low in calories, only 31 in 100g, and is high in antioxidants, vitamins C and B, riboflavin, folate, niacin and minerals such as calcium, manganese, iron, zinc, and potassium. Studies have found it also control diabetes and lowers cholesterol.

Fruits that contain large amounts of sugar should be avoided. A medium sized ripe banana contains 14.4 grams of sugar almost double the amount in a ½ cup of blue berries. Now you know why blue berries don’t taste much in when added to your oatsmeal breakfast. Apples though having high sugar- 18.9 grams in a medium apple are high in quercetin, a nutrient that reduces the risk of diabetes and heart disease and stabilizes blood sugar levels. Raspberries have 2.7 grams of sugar per ½ cup serving. Strawberries have about 3.5 grams of sugar per half a cup. In brief, all berries have low blood sugar and you should eat much of them, also having antioxidant, flavones and other nutrients.

Fruits that have high fructose are pineapples (16 grams), Oranges (17 grams), Grapes over 20 grams, and mangoes.

Most diabetics feel that fruits are nutritious and good for diabetes and they eat with no
concerns about their fructose levels, affecting their blood sugar numbers. All fruits have sugar in the form of fructose and sucrose. Too much of fructose can harm you and even linked to increase belly fat, slows metabolism and gains weight and worst can cause a non-alcohol fatty liver.

Goals:
1. Eat a well-balanced low carb diet, emphasizing fruits, vegetables, whole grains and lean protein, while watching total calories and getting exercise regularly.

2. Eat more vegetable products and fewer animal products.

3. Eat more fresh and homemade foods and fewer processed foods. Avoid fast food and junk food. You know what they are.

4. Choose your fats wisely. Cut down on meat, the skin of poultry, whole-fat dairy products, stick margarine, fried foods, processed snack foods, and commercial baked goods made with trans fats. Think about dressings, sauces, and cooking oil. Use olive or canola oil to cook whenever possible and moisten your bread with olive oil or soft margarine. Get “good fats” from fish and nuts.

5. Choose your carbs wisely. Cut down on simple sugars; remember that sodas, sports energy drinks, and fruit juices are loaded with sugar. Cut down on highly refined products made with white flour. Favor whole-grain, coarsely ground, unrefined products. Don’t be fooled by dark-colored bread or by labels that boast of unbleached flour, wheat grain, or multigrain flour. Instead, look for whole grain as the first ingredient, and read the fine print to learn the fiber content of a portion; more is better.Learn to like bran cereal, vegetables, fruits, nuts, and seeds. Consider fiber supplements if you can’t get enough from foods.

6. Eat more potassium-rich foods, such as citrus fruits, bananas, and other fruits and
vegetables. Eat more calcium-rich foods such as low-fat dairy products, broccoli,spinach, and tofu (but don’t take calcium supplements to boost your daily intake above 1,200 mg).

7. Eat more grain products, especially whole-grain products, aiming for at least 6 ounces a day. Count 1 cup of dry cereal; ½ cup of cooked cereal, rice, or pasta; or one  slice of bread as 1 ounce. Whole grains and brown rice should provide at least half your grains; the more, the better.Hope this article will help you to control your diabetes and for a healthier fruitful life.


Dr Gunatillake-Health editor is a member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery.Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery, Member of the International Societies of Cosmetic surgery, Fellow of the International College of Surgery (US), Australian diplomat for the International Society of Plastic, Aesthetic & Reconstructive Surgery, Board member of the International Society of Aesthetic Surgery, Member of the
American Academy of Aesthetic & Restorative Surgery, Life Member of the College of Surgeons, Sri Lanka, Batchelor of Medicine & Surgery (Cey). Government scholar to UK for higher studies and training.

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A better way to check your diabetes : Written by Dr harold Gunatillake FRCS-Health writer

Most Sri Lankans do ignore a simple test to check for diabetes when required after the age of 40, as they do not realise the serious issues of the disease and the ability to control better when detected early. Those who have a family history of diabetes do check to find out whether they have got high blood sugar levels.

To check for fasting blood sugar finger prick test would do. If you have your own glucose testing monitor, you could check it at home when required. In a normal non-diabetic person the reading would be about 90mg/dl. (6 mmol/l). When it reaches 126mg/dl (6.9mmol/l) you would be considered a pre-diabetic. The complications with pre-diabetes and full blown diabetes are similar. So, it is important at the pre-diabetes stage to nip in the bud by eating low GI foods and exercise daily.

There are other tests recommended like ‘Glucose tolerance tests’ among others to diagnose and confirm diabetes.

Today there is a better test to control blood sugar levels and reduce the long term risks of heart attacks, stroke, blindness and kidney failure associated with diabetes.

One such test is the HbA1c or in short A1c test. This term refers to glycated haemoglobin a protein within each red cell that carries oxygen throughout the body. The glucose that enters your blood stream joins with the oxygen in the haemoglobin to become glycated.

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Health and views – Christmas issue 2017 – By Dr Harold Gunatillake

May I wish all of you who have supported me ‘For the sharing & Caring’ by circulating these collections of Health issues and articles to benefit so many readers over the years. Our readership is over 11,000 world-wide with the support of ‘eLanka web-site’ authored by Neil Jayasekera (Sydney), & by Desmond Kelly & Victor Melder (Melbourne)

Merry Christmas

Cheers with a glass of red wine

Harold

 

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