|
Fall-related injury
Hip fracture can be life-threatening
Dr. Turin Chowdhury
Hip fracture is a serious injury, especially for elderly people. The complications related to a hip fracture injury can be life-threatening, especially in the context of our country where the surgical as well as the medical treatment is mainly Dhaka-based and quite expensive.
Causes of hip fracture injury: In the elderly, falling down is the most common cause of a hip fracture. It is most often a result of a traumatic event and weak bones are responsible for the fracture. In younger people, major trauma to the hip, such as a sports injury or an accident, may lead to a hip fracture.
Risk factors of hip fracture: Some factors are available which increases the risk of injury. A combination of these factors may increase the risk of hip fracture injuries, such as:
Aging: The risk of hip fractures increases with age. With the aging process, bone density starts decreasing. Additionally, vision and sense of balance also decline, and reflex reaction time slows down. These factors increase the chance of fall-related injuries. Among the fall-related injuries the hip fracture is the most troublesome one.
Bone: A bone-related disease, named "Osteoporosis", is one of the major risk factors for hip fracture injury. In this disease, the structure of the bones becomes weaker due to the fact that the bones do not contain enough calcium and other minerals. Thus a weaker structure makes the bones more prone to a fracture, even with relatively minor trauma. Loss of bone strength tends to be greatest in the spine, lower forearms and upper thighbones because these are the weight bearing structures or structures that faces the maximal movement. The upper thigh bones, known as femur, is the site of hip fractures.
Chronic diseases: Other medical conditions also may lead to bone fragility either by slowing bone formation or by speeding up bone loss. These include endocrine disorders, such as type 1 diabetes; gastrointestinal disorders, and rheumatoid disorders. These conditions often are associated with interference with calcium and vitamin D absorption or lead to inactivity and loss of bone mass. Prolonged bed rest or immobility due to disability causing disease condition like stroke also can lead to bone loss.
On the other hand chronic conditions that affect the nervous system can increase the risk of falling, such as Parkinson's disease and multiple sclerosis. Diminished mental attentiveness, such as that caused by dementia or depression, also increases the risk of falling.
Gender: It has been observed that women tend to have more hip fracture injuries in comparison to men. Women lose bone density at a faster rate than men do. The drop in estrogen levels that occurs with menopause accelerates bone loss, increasing the risk of hip fractures as a woman moves beyond menopause.
Heredity: Genetic polymorphism influence bone size, bone mass and bone density. A family history of osteoporosis or fractures later in life is a strong predictor of low bone mass, although not necessarily of fractures themselves.
Malnutrition: A diet which lacks in calcium and vitamin D during the early age lowers the peak bone mass and increases the risk of fracture later in life. Serious eating disorders or malnutrition condition can contribute or damage our body skeleton structure by depriving the body of essential nutrients needed for bone building. Being obese also poses risk by having the body skeleton to bear extra weight causing stress burden.
Tobacco and alcohol use: Smoking habit and excessive consumption of alcohol can interfere with the normal processes of bone building and remodeling, resulting in bone loss. These habits also interfere with the production of estrogen and testosterone, two hormones that contribute to bone mass.
Side effects of some medications: Some medications can accelerate bone loss, thus increasing the risk of osteoporosis and hip fracture. Prolonged use of corticosteroids may lower bone mass. There are some medications that may contribute to bone loss or to calcium or vitamin D deficiencies if used for long periods of time. So no medications should be taken without proper consultation with the health care provider. Some drugs may affect our balance and cause dizziness and increase the risk of fall and thus hip fracture injury.
These medications include certain blood pressure medications, sedatives, tranquilizers, antidepressants, cold and allergy medications, pain relievers and sleep medications. So taking these medications caution should be taken regarding movement.
Environmental vulnerability: Not only disease, physical or medication related factors increases the risk of hip fracture injury. Environmental hazards or men made hazards or situations also increase the risk of hip fracture. Loose carpets, cluttered floors, poor lighting, exposed electrical or telephone cords, stairs with no handrails, slippery floors of house or bathrooms may increase the risk of stumbling and falling. Slippery floors are quite common cause of fall related injuries in elderly people.
Treatment option:In lots of cases the hip fractures are treated by orthopedic surgery, which involves implanting an orthosis or prosthesis. The goal of treatment for hip fractures is to let the patient to do, without pain, most of the things he or she did before the fracture. If operative treatment is refused or the risks of surgery are considered to be too high the main emphasis of treatment is on pain relief.
Surgery: Fortunately, surgery to repair a hip fracture is usually very effective, although recovery often requires time and patience. The most common and almost always the best treatment for a hip fracture is surgery. Surgery helps ensure that the bones are lined up to heal correctly. Most people make a good recovery from a hip fracture. Generally, the better your health and mobility before your hip fracture, the better your chances for a complete recovery from a hip fracture. There are people who have undergone hip replacement and are leaving a quite decent life.
Rehabilitation: Apart from the surgery itself, a well planned rehabilitation is also very important to bring back the patient to near normal mobility. This needs proper planning as well as proper execution. Without a proper implemented rehabilitation programme the benefit of hip replacement can not be fully utilized.
Prevention: Obviously there are some risk factors which we cannot do anything about, such as being women or getting older. Some more in the later years of life also we cannot compensate for the malnutrition issue of the earlier years. But knowing the risk factors and knowing that they exist among one's own self, we can take care avoiding the mechanical risks of fall and minimize the hip fracture probability. We can increase reasonable intake of calcium and mineral supplement to balance the bone strength, or can take necessary minerals to compensate for the bone loss.
Apart from that we can reduce our body weight to put fewer burdens on out skeletal body structure. Also apart from that we should be taking care for eradicating the mechanical hazards for hip injury, such as keep the floors dry and clean, especially if we have an elderly family member residing with us. We should use proper lighting, and proper construction of stairs or other parts of house for being movement friendly.
 ^ TOP OF THIS PAGE ^ MAIN PAGE
Varsity students' access to textbooks
Faisal Hossain
When the idea was floated about twenty years ago (in October, 1989) among the students and teachers of the Applied Physics and Electronic Engineering Department, there were more skeptics than believers. Yet, the protagonist - Dr. Md. Delawer Hossain, Professor of Applied Physics and Electronic Engineering at Rajshahi University - continued toying with the idea of setting up a library with voluntary contribution. When it began, the library was housed in a makeshift cupboard containing only a dozen books and five hundred Taka. Today, the rental library set up with Dr. Hossain's visionary initiative boasts 1225 textbooks in a dedicated library with an average annual revenue generation of 12 thousand taka. This revenue is used to procure an additional 40-50 textbooks each year. This is how it all began.
Textbooks at the university level are never in sufficient quantity for our students. Anyone who has completed a university degree would know that these books, mostly written by foreign authors, can cost more than the annual living expenses of a student. Realising this problem, Dr. Hossain floated the idea of a rental library, where students could 'hire' textbooks against a nominal annual fee. The rent would be funnelled to a money pot that would be used to buy more books at the end of the year. If every student became members of this library, then sufficient revenue could be generated to increase access of textbooks among students.
Apathy and resistance to the idea of becoming a voluntary member of yet another scheme was widespread in the beginning.
'Why care to pay 30 Taka a year when we have the R.U Central library?' was the student response. Dr. Hossain recalls that, "Students would rather spend 30 Taka on 'adda' and photocopying 'chotha' (i.e. notes prepared for exams) than on something that most thought would never be used".
Yet, the journey was not abandoned. In December 1989, there were only 16 books and 2,935 Takas of which Tk. 2000 was obtained as grant from the Chairman of the Department of Applied Physics and Electronic Engineering. The rest came from student fees and personal donations. As students of this department began to realise that the library guaranteed access to many textbooks against a nominal fee (much cheaper than photocopying the whole book), they started to become regular paying members of the rental library. Subscription grew steadily.
Revenue generation was not a great deal during the initial years, but it was enough to ensure purchase of new textbooks each year. As most of the 200 students (50 per batch) of the Applied Physics and Electronic Engineering Department became members, revenue generation started to rise quickly, often exceeding 10,000 Takas.
In the figure below, the impressive growth of revenue from students is shown for this now-popular rental library. In between then and today, the University Grants Commission (UGC) and various independent donors have also helped the library to grow beyond expectations. In this regard, the annual book drive organized by the MIT (Massachusetts Institute of Technology) Bangladesh Student Association (BSA) is noteworthy. The MIT-BSA has donated around 100 books from funds of the MIT student foundation. The UGC grant has also allowed the purchase of 432 books so far. All of this was orchestrated with the enterprising spirit of Dr. Hossain who would often go out of the way to solicit book donations from various sources.
Looking back twenty years, Dr. Hossain has much satisfaction with the implementation of the rental library. He believes the concept's success is analogous to the Grameen Bank. But it is the feedback of the Departmental academic committee and the students that demonstrates the value of the concept in improving student learning.
"Today more than 90 percent of the books of our rental library are in circulation among member students at any given time", said the Seminar Library Assistance, Mrs. Farida Begum with pride. "If there was circulation any less than that, we would have a hard time housing all the books we have! In fact, we now need to place an order for 6 more wall-bookshelves to house the upcoming books".
Similarly, student Mr. Atiar Rahman, now a newly recruited lecturer at the Applied Physics and Electronic Engineering Department, says, "The rental library has been a very valuable asset for us. Our students hardly need to access the ill-equipped R.U central library as they get all their textbooks here. Today, each student member can rent 5 books at a time. Students from other departments often envy our access, which helps particularly before exam times."
We hope that other Departments and Universities in Bangladesh will take of this noble concept of a rental library and take the initiative to set up one of their own for the welfare of our students.
Interested persons may contact Dr. Hossain at ninigorki@yahoo.com for information on ways to procure books cost-effectively.
^ TOP OF THIS PAGE ^ MAIN PAGE
ROAMING RACONTEUR
A Life of Mediocrity
Rayyan Kamal
You have just completed your 300-page autobiography. Please submit page 217.
As I looked over the sales of my latest novel I smiled because I had broken my previous record. 13,453 people had bought my book. I wondered if they had enjoyed it. I certainly thought it was my best work so far. The story was told from the eyes of five brothers, with a different brother narrating each chapter. In many ways, the novel was autobiographical.
Fast approaching fifty years of age, I was content with the rich, fulfilling life I had. But I had to admit that, as an ambitious high schooler, I would never have dreamed of what life had in store for me. No doubt I would have gagged if I could have fast-forwarded to my late forties then.
I have already talked about my teenage years, how I had no idea what I wanted to do for a living. All the same, I wanted to attain some degree of fame and definitely be rich (which adolescent doesn't hope for such materialistic glory?). I wanted to be wealthy enough to be able to travel on business class - maybe even first class - on British Airways, without having to think twice about my bank balance. I also wanted to be married to a worldly, charming, beautiful, sophisticated and settled down with a delightful family life.
Then, forty-nine, ordinary and single, I could honestly say that the fact that none of my teenage wants had come true did not bother me at all. During my thirties and most of my forties, I would often get panic attacks. "What are you doing with your life?! You're single! You're going to die alone and poor," I would say to myself.
However, I went through a sort of transformation during my late forties. I don't know how or why it happened. Maybe it was because I started noticing that of the rich and not-so-rich people that I met, a more or less equal percentage of people in both groups were happy. Maybe it was because divorce rates were rising exponentially. Or maybe I was just deluding myself in order to be content.
Whatever the reason, I started appreciating my single status and my average income. There is a charm to a life of mediocrity that no one seems to talk about. There is no pressure, and with no pressure, no pretence. Instead of those acute explosions of ecstasy (and agony) that punctuate the lives of the rich and famous, I was enjoying a dull but lasting sense of satisfaction. Yet I still worried that I was betraying myself as a young adult.
After getting both his Bachelor's and Master's from Yale, he had no idea he would throw away his six-figure salary and decide to become a novelist - and as time and sales (or lack, thereof) would prove, not such a successful one - at age twenty-nine. No, he probably expected to continue working as an investment banker, his income rising steadily, until it climbed over the million-dollar mark in his forties. But what could I say? It may sound trite, but things happen and people change. I had embraced this fact and sincerely hoped he could too.
Rayyan Kamal is a sophomore at Yale University.
Warid honours schoolboy for act of heroism
Holiday Desk
Warid Telecom on August 5 rewarded schoolboy Rakibul Hasan whose bravery helped avert a train accident in Comilla on August 2. Rakibul was inspired by Warid's TV advertisement that showed a story of a boy who stopped a train on a damaged railway track, says a press release.
The Warid Recognition Award was given in an informal programme at Warid telecom company's Banani head office by it Chief Executive Officer Muneer Farooqui.
Rakibul noticed a track displacement while cutting grass beside the railway track on August 2, and ran to the nearest level crossing to inform the signalman and returned to the spot to stand on vigil. As Noakhali-bound Upakul Express approached the displaced track, he took off his red t-shirt and waved it, signalling the train to stop. The driver stopped the train on Rakibul's red signal much to the relief of the passengers; and this admirable heroism saved hundreds of lives.
Rakibul, a class X student of Chanpur Janata High School under Comilla Sadar South Upazila, later said he was inspired by a Warid Telecom television commercial to do the bravery. He is the son of Ali Newaz Moishaje of Khanpur village.
Muneer Farooqui, CEO of Warid Telecom, and high officials of the company accorded an informal reception to Rakibul Hasan in Dhaka. Farooqui presented him with scholarship worth Taka 50,000 for his education up to higher secondary and all books necessary for his current secondary education. Rakibul also received a gift hamper including a Sony Ericsson W200i handset with Warid connection.
"We salute the bravery of Rakib", Farooqui said and added "What makes us proud is that he did what was needed to be done, not waiting for anyone else to do the job." He also mentioned that while Warid always believes in socially responsible promotions and advertisements, seeing such an ad inspiring young kids like Rakib is a reward in itself.
"The train was approaching to a certain danger and I wanted to do something to prevent it. At that moment the Warid advert came into my mind and I began waving my red t-shirt until the train stopped," the teenager told his breathtaking story to the audience.
Speaking to the media, Rakibul said, "I didn't waste time thinking too much when I saw the train approaching the open slipper; I just did what I thought should be done." Thanking Warid for recognising his efforts, he said, "I hope to make best use of what they are giving me as reward -- this will certainly help me to do better in my studies."
^ TOP OF THIS PAGE ^ MAIN PAGE
|
