Water and Sanitation

WATER AND SANITATION

WATER AND SANITATION

Water and Sanitation

Water-related diseases cause a significant strain on Human health In Kenya and World At large. Most of the diseases occur due to unavailability of clean water either for drinking, cooking or cleaning food substances. Others occur as a result of poor sanitation and personal hygiene. Water-related diseases are largely preventable and affect a significant population in the world apart from being preventable in nature. These exert a toll on the Economy significantly affecting health services provision. The problem is more common in the developing World. Cholera outbreaks have been resulted in millions of deaths every year.

Water-related infectious Diseases can be classified into five main sub-types:

  • Water-borne
  • Water-washed
  • Water-based
  • Water-related insect vector
  • Diseases caused by Poor Sanitation

WATERBORNE DISEASES

Waterborne diseases are acquired when people drink contaminated water or eat food that has been prepared with contaminated water. This forms the bulk of all water-related diseases. The diseases are normally transmitted fecal-orally, acquired when human wastes find their way in water bodies or supplies.

They include:

  • Cholera
  • Cryptosporidium
  • Girdiasis
  • Typhoid fever
  • Amoebiasis
  • Hepatitis
  • Other gastroenteritis causing bacterial infections

Cholera is the most common and deadliest occurring in epidemics in developing world. It’s a bacteria infection caused by Vibrio cholerae bacteria. It causes severe diarrhea leading to dehydration and subsequent mass deaths.

WATER WASHED DISEASES

Water-washed diseases occur as a result of poor personal hygiene resulting from inadequate water availability. Improve water supply and enhanced personal hygiene comes hardy in prevention of these ailments.

THE INEVITABILITY OF CHANGE

THE INEVITABILITY OF CHANGE

THE INEVITABILITY OF CHANGE

We live in a world that is ever changing. Today, everything seems certain and peaceful and then tomorrow throws a spanner at the smooth machinery and our lives turn upside. Many times, we get all confused at this prospect of change that our solid grounds become quick sand and we lose ourselves.

We forget to ride on the wave of change and look for what is right at that particular moment and in that situation. We then fall into misery and wallow in pain and despair forgetting the words that were written by Solomon, the philosopher in biblical times; ”there is a time for everything, and a season for every activity under heaven”.

Seasons come and go. One body cell degenerate and regenerate until it reaches equilibrium, then we start growing old and eventually we die. Life is a series of beginnings and endings. Simple happenings like the passage of time and the changing weather patterns make us realize just how much of an illusion life is, that is, that nothing in this world is permanent, that everything always passes, eventually anyway, no matter how hard it may be to comprehend at the time. Persons pass, ideas pass, things pass, some quickly, others slowly.

Change is the wheel of life. Some change seen good, others bad. And as the saying goes, the only thing that is constant in our lives is change. With change, we are able to grow in many ways, so why do people oppose change so much? It is because we want to stick to our comfortable zones. We love routine, and comfortable routine at that. We forget that everything could happen at anytime. Our comfortable homes can be taken away, can be destroyed, our raging beauty can be snapped, just like that. Our loved ones can leave us, by dying or even by abandoning us. A major illness can leave you minus a body part, even more life changing.

Transitions are times of crossing or traveling from something old and familiar to something new and unfamiliar. Most transitions are small and go by almost unnoticed. Some, however, involve major disruptions in routines and force us to re- examine our values and lifestyle. We are fraught with worry when faced with the prospects of a new position, a new partner, a new home. We find it hard to let go of the past, we feel vulnerable. But we soon realize that change is part and parcel of life and that all of it is synchronized.

The best you can do in your journey through life is to look forward to the good times, at the same time hoping you shall be prepared, resilient enough to survive the tough times that are sure to come, hoping that you can find an oasis that will help sustain you as you pass through the desert. Go therefore, ahead and embrace the transitions that come your way. You never know what is awaiting you on the other side of the fence. See the opportunity in change and grab of it. It might seem scary but the results are ultimately refreshing.

Old age Diet

Old age Diet

Old age Diet

Want to know what to eat in old age? Here are some tips for a healthy Old age Diet!

  • Eat fresh fruit vegetables at every meal
  • Eat small quantity of nuts everyday because it contains protein which help to repair and restore your organisms
  • Bread, potatoes, rice or pasta in every meal aims at representing our body’s preferred source of energy
  • Include calcium rich foods such as milk, yoghurt, cheese and green leaved vegetables in your daily diet
  • Drink plenty of fluids everyday, one to two litres outside of meals. Water is the best drink although you may include some juices, skimmed milk or herbal tea
  • keep to regular meal times
  • Eat brown bread, wild rice, whole meal is recommended if you suffer from constipation due to lack of roughage in your diet
  • Your diet should have enough iron from spinach, cabbage, lentils, beans and eggs in moderation
  • Enough of vitamin D which is found in eggs and dairy product. Sunlight on the skin stimulates the production of vitamin D
  • Eat in moderation so as not to overload your digestive system
  • Avoid high calorie foods such as cakes, biscuits or sweets which do not provide other essential nutrients
  • Make meals a pleasant occasion and have a partner at meal times or if you live alone, occasionally meet up with a friend for a meal

Toxic Effects of Fish Oils

Toxic Effects of Fish Oils

Toxic Effects of Fish Oils

To the digestive System

  • The fish Oils in the form of concentrated supplements may cause Diarrhea in some people.
  • The oils in the form of concentrated supplements may cause temporary Gastrointestinal
    discomfort in some people.

To metabolism

  • The fish Oils may increase LDL Cholesterol ( bad cholesterol) levels after consumption of 12
    grams of Fish Oils per day. This causes an average increase in LDL Cholesterol levels of 8.5%.
    This increase can be negated by consuming garlic concurrently with the oils
    This is presently believed to be the only detrimental effect of Fish Oils and is not a reason to avoid
    consumption of Fish Oils as Fish Oils possess numerous other health benefits.

Fish Oils may Interfere with these Substances

  • The oils when taken regularly may cause the depletion of vitamin E. It is therefore advisable to
    consume additional vitamin E to counteract this depletion

Contamination of Fish Oils

There have been concerns raised that the fish oils do contain contaminated substances such as mercury
and organochlorines. The most contaminated fish include king mackerel, swordfish, shark and tilefish.
Studies have shown that the oils generally do not contain these contaminants as feared.
According to the World Health Organization (WHO) and the Food and Drug Administration (FDA),
concentrations of methylmercury (MeHg) in various species of fish cover a wide range, from less than
0.01 parts per meter (ppm) to over 3.0 ppm fresh weight, depending on factors such as pH, the
redox potential of the water, and the species, age and size of the fish. Human hair analysis for mercury
is a useful biomarker for determining long-term exposure to mercury from fish and non-fish food

Studies

In a study done by Foran, and his colleagues (The measurement of mercury levels in concentrated
over-the-counter fish oil preparations: is fish oil healthier than fish?) They found out that the levels of
mercury in the 5 different brands of fish oil ranged from nondetectable (<6 microg/L) to negligible (10-
12 microg/L). They also concluded that the mercury content of fish oil was that same as that found in
human blood. It was discussed that fish such as swordfish and shark are also a source of exposure to
the heavy metal toxin, mercury. The fish oil brands examined in this manuscript have negligible
amounts of mercury and may provide a safer alternative to fish consumption.

References: Arch Pathol Lab Med. 127(12):1603-1605, 2003.
Division of Laboratory Medicine, Department of Pathology, Massachusetts General Hospital and
Harvard Medical School, Boston, Mass, USA.

Other studies were done by Melanson and colleagues
Ref: Arch Pathol Lab Med. 129(1):74-77, 2005.
Clinical Laboratories Division, Department of Pathology, Brigham and W omen’s Hospital and
Harvard Medical School, Boston, MA, USA.

Cookies ‘n’ Cream Dessert Cocktail

Cookies 'n' Cream Dessert Cocktail

Cookies 'n' Cream Dessert Cocktail

Ingredients (makes 6)

  • 12 (about 130 g) Oreo biscuits
  • 375 ml (1 1/2 cup) pouring cream
  • 125 ml (1/2 cup) Frangelico liqueur
  • 125 ml (1/2 cup) Kahlua liqueur
  • 125 ml (1/2 cup) Baileys Original Irish Cream liqueur
  • 3 tbs honey
  • 2 cups ice cubes
  • 375 ml (1 1/2 cup) pouring cream, extra

Method

  1. Place the biscuits in a bowl. Use the end of a rolling pin to gently pound until coarsely crushed.
  2. Use an electric beater to whisk the cream in a large bowl until firm peaks form.
  3. Place the Frangelico, Kahlua, Baileys, honey, ice cubes, extra cream and half the biscuit in the jug of a blender, and blend until the ice is crushed and the mixture is well combined.
  4. Divide the mixture among serving glasses. Top with a dollop of cream and sprinkle with the remaining biscuit to serve.

Nutrition

Energy
3246 kJ
Fat saturated
34.00 g
Fat Total
53.00 g
Carbohydrate sugars
41.00 g
Carbohydrate Total
50.00 g
Dietary Fibre
Protein
5.00 g
Cholesterol
134.00 mg
Sodium
142.60 mg

All nutrition values are per serve.

Cervical cancer

Cervical cancer

Cervical cancer

Catch that cancer before it catches you

Your 50 year-old auntie has been complaining of severe back pain for 2 months, she is also having difficulty holding her urine on and off. With your busy schedule you have done your best to take her to a clinic in your neighbourhood. She is being treated for lower back pain but the symptoms disappear for a few days and come back in full force. Finally she develops vaginal bleeding and you dedicate a whole day off work to take her to the gynecologist, where she is diagnosed with an advanced cervical cancer. The doctor mentions that the chances of survival are bleak.

Sadly this typical story could happen to any of your female relatives. It could be your sister, your mother, your grandmother or any friend within the child-bearing age. Of course cancer can be a scary ordeal for the patient and family members dealing with the disease. But the purpose of this article is to provide you with guidance and the HOPE that this disease is perfectly preventable. This is especially true if check-ups for cervical cancer are made routine within your medical care.

What does statistics show?

There has been a good deal of media and public health attention on breast cancer and screening programs for it. This is a good thing and should not be faulted. However, World Health Organization (WHO) statistics show that of the cancers affecting Ugandan women Cervical Cancer is the number one culprit, followed by Kaposi’s Sarcoma (an HIV/ AIDS related cancer) with Breast Cancer coming third in total cancer cases within Uganda.

  • In Uganda, Cervical Cancer is the leading cause of female cancer deaths
  • It accounts for 45 – 50% bed occupancy in Mulago hospital
  • Gynecological wards
  • The average woman diagnosed is 47years old

How does Cervical Cancer develop?

Cervical cancer is caused by a group of viruses called Human Papilloma Virus. These viruses are present in some men. Once sexual activity begins, there is exposure to Human Papilloma Virus from the woman’s partner. The lining of the cervix begins to change and grow. When this growth becomes excessive, it becomes what doctors call cancer. Furthermore women who are HIV positive, have a weakened immune system so being infected by HPV means that cervical cancer develops faster in their bodies.

Simple ways to identify Cervical Cancer

  • Vaginal bleeding after sexual intercourse
  • Extra bleeding between monthly periods
  • Foul smelling vaginal discharge
  • Persistent lower abdominal pain and backache
  • Difficulty holding urine or stool (incontinence)

Importance of Cervical Cancer screening

  • 3 years after a woman’s first vaginal intercourse encounter she should have a Pap test or Pap smear done by a trained medical professional
  • If the Pap smear is abnormal your doctor will recommend further testing such as an exam under anesthesia to fully visualize the cervix and to obtain cells for viewing under a microscope
  • If the test is normal the doctor or mid-wife will advise you on when next to make a return appointment based on your individual age and risk factors

Gout: Causes and also Diagnosis

Gout: Causes and also Diagnosis

Gout: Causes and also Diagnosis

Gout is some sort of arthritis. An attack could be due to it of unexpected burning pain, stiffness, and swelling in a joint, the big toe usually. These attacks can occur again and again unless gout can be treated. Over time, they are able to damage your joints, tendons, and other cells. Gout is many common in men.

What causes gout?

Gout is due to too much the crystals in the blood. The majority of the right time, having too much the crystals is not harmful many many people might never get gout therefore. However, when the crystals levels in the bloodstream are too high, the the crystals might form hard crystals in your joints.

Your likelihood of getting gout are higher in case you are overweight, drink an excessive amount of alcohol, or eat an excessive amount of fish and meats that are saturated in chemicals called purines. Some medications, such as for example water pills (diuretics), may bring on gout also.

Read moreGout: Causes and also Diagnosis

Toxic Effects of Fish Oils

Toxic Effects of Fish Oils

Toxic Effects of Fish Oils

To the digestive System

  • The fish Oils in the form of concentrated supplements may cause Diarrhea in some people.
  • The oils in the form of concentrated supplements may cause temporary Gastrointestinal
    discomfort in some people.

To metabolism

  • The fish Oils may increase LDL Cholesterol ( bad cholesterol) levels after consumption of 12
    grams of Fish Oils per day. This causes an average increase in LDL Cholesterol levels of 8.5%.
    This increase can be negated by consuming garlic concurrently with the oils
    This is presently believed to be the only detrimental effect of Fish Oils and is not a reason to avoid
    consumption of Fish Oils as Fish Oils possess numerous other health benefits.

Fish Oils may Interfere with these Substances

  • The oils when taken regularly may cause the depletion of vitamin E. It is therefore advisable to
    consume additional vitamin E to counteract this depletion

Read moreToxic Effects of Fish Oils

INFORMATION & IMPORTANCE OF BLOOD DONATION

INFORMATION & IMPORTANCE OF BLOOD DONATION

INFORMATION & IMPORTANCE OF BLOOD DONATION

The earliest documentation of blood transfusion is found in the religious text of many civilizations.

Karl Landsteener discovered the ABO blood grouping system in 1901, which is one of the most important landmark discoveries in the transfusion medicine. In the 1970s voluntary donors were accepted as blood donors. Blood transfusion lead to the discovery of Hepatitis B transmitted by donated blood. Since then testing for the hepatitis B antigen was implemented. Further studies since then have included tests for Malaria, Syphilis, AIDS, and Hepatitis C to make donated blood as safe as possible to the recipient.

Eligibility criteria for blood donors

  • Both men and women can donate blood.
  • Should be between 18-60 years of age with a weight of 50 kg or above with normal pulse rate, body temperature and blood pressure.
  • Donors with history of epilepsy, psychotic disorders, abnormal bleeding tendencies, severe asthma, cardiovascular disorders, and malignancy are permanently unfit for blood donation.
  • Donors suffering from disease like hepatitis, malaria, measles, mumps, and syphilis may donate blood after full recovery with 3-6 months gap.
  • People who have undergone surgery may safely donate blood after 6-12 months.
  • Women donors who are pregnant or lactating cannot donate as their iron reserves are already on the lower side.

How much blood can be taken during blood donation?

Our body has 5.5 litres of blood of which only 350 ml – 450 ml (one unit) of blood is taken depending upon weight of donor. Majority of healthy adults can tolerate withdrawal of one unit of blood. The withdrawn blood volume is restored within 24 hours and the hemoglobin and cell components are restored in 2 months. Therefore it is safe to donate blood every three months.

What is done with the blood collected?

The blood is collected in sterile, pyrogen free containers with anticoagulants like CPDA (an anticoagulant used in blood collection bags) or CPDA with SAGM (a solution that gives the red blood cells optimum viability). This prevents clotting and provides nutrition for the cells. This blood is stored at 2-6 C or -20 C depending on the component to be prepared. Donated blood undergoes various tests like blood grouping, antibody detection, testing of infections like hepatitis, AIDS, Malaria, syphilis and before it reaches the recipient it undergoes compatibility testing with the recipient blood.

One unit of whole blood is separated into components making it available to different patients according to their requirement. Thus one unit of blood is converted into packed cell volume, fresh frozen plasma, platelet concentrate, cryoprecipitate and granulocytes concentrate.

AAR BLOOD DONOR CLUB

Requirement of safe blood is increasing and regular voluntary blood donations are vital for blood transfusion services.  At AAR we have a blood donors club that was launched last year and has tremendously grown with over 200 registered members. From the clubs membership, we were able to save lives of two patients who critically needed blood.

Membership is free and open to all men and women between the ages of 18 to 60.  Once someone joins they will be grouped according to their blood type and will be issued with a membership card.  Incase of a request for a certain blood group, members with that blood type will be requested to go to the hospital the patient is admitted in and donate blood.

Blood transfusions save lives and this can only be possible if we all volunteer to donate blood. And as said by an unknown author, “Nobody can do everything, but everyone can do something” we should all endeavor to give blood.

Why isn’t my medication working???

Why isn't my medication working???

Why isn't my medication working???

One of the common problems patients, or people in general face nowadays is that they need to consult a doctor repeatedly for the same medical issues they may have…they present with the question that heads this article: “why isn’t my medication working???

I as a medical doctor would like to give a brief overview of the common reasons for this happening and hopefully in the process make most of you say to yourselves “Ahaa…that makes more sense now…”

Its always important to keep some very basic facts in mind when your body shows you any symptom. These include:

A symptoms is the bodies way of communicating with us about a problem that its facing

If you think about it, when you get hurt in your body, Imagine if you couldn’t feel exactly where…you would end up causing much more damage to that area before you can rest it  or treat it. The body needs to make you feel pain in order for you to know which part of you is being damaged. This blessing is sometimes missing in diabetics whose nerves have been effected. Ask any of them the importance of pain, and how it can be used to avoid the amputation of a limb!

Some conditions are not treatable, they’re just manageable

Doctors are not God, and there are quite a few conditions that we cannot treat. In such cases we offer advice and on how to manage the condition that you may have on a long term basis to prevent the severe symptoms that one may be experiencing. In other words we may have to give you tips on how to prevent things from getting worse…this is known as tertiary prevention. The concept is not so easily digested by most patients. There comes a time when our patient come to us and tell us “we stopped the medicines because we saw no improvement”. Ensure you confirm with the doctor if the medicines were meant to prevent worsening, as in osteoarthrtitis, before you decide they are not working!!

Some conditions are self limiting, the medications given just help temporarily alleviate the symptoms while the infection takes its course

The common cold is appropriately named, as the cases are really too common. An important thing to note is that it is one of the conditions that we don’t cure. Our bodies’ immune systems is what we rely on to fight this, we only assist the symptoms that may be quite severe with our medication and allow the disease to take its course. So if the medication is not causing a lasting effect, or if the condition is persistent because of habits like exposing ones self to cold or playing in the rain, don’t think its the medication that is ineffective

As much of a nuisance some symptoms may seem, it may be playing a very important role in limiting the disease that you have… so sometimes its good to bear some of the symptoms rather than get rid of all of them!

It has been proven that the high temperatures during a fever also limit the growth of bacteria causing the infection, and the cough that one may develop in a cold is a very effective way of getting rid of the trapped pathogens in our mucus membranes…so stopping the cough or maintaining a low temperature of 36 degrees Celsius may not necessarily be a good thing all the time

When you feel better because of medication, that doesn’t mean you can resume all the stressful and difficult activities… your body mostly will require some time for recuperation

Out of site, out of mind!!! when people don’t feel their sickness any more they immediately resume their stressful and difficult activities. It’s important to remember that the result of such actions is a slow recovery and a high chance of recurrence of the problem.

The body needs rest so it can focus on rebuilding itself, and combating the remnants of the infection or disease that one has.

If you don’t help you’re body, it will not help you!

As long as you don’t understand the cause of the disease, you will never be able to stop it from recurring

When we fall sick it’s imperative to understand the source of the infection or cause of the illness. It’s not enough to just feel happy that the symptoms have gone after taking medication. Recurrent amoebic dysentery, because some patients take medicines then go back to drink the same contaminated water, has been found in many cases. The medicines may be working after all, but the disease keeps being brought back into your system before you can enjoy the medicines positive effects!!!

With the above tips, it should be clear that treatment consists of more than just taking of pills prescribed by a doctor at the appropriate dose…it’s about understanding what illness you have and how your body works to get rid of it.

I wish all the patients best of luck with their conditions as we pray for their recovery, but I advise them, and everyone in the general population to adopt the informed approach to illnesses and other medical conditions so that they may know what to expect.

Heard about yips?

Heard about yips?

Heard about yips?

Just about everyone has had moments when we get nervous breakdowns especially when we need to rise up to the occasion. School students sometimes exhibit this kind of tension during exams; actors get stage fright before an audience and sportsmen may get the yips when competition is high.

The yips refer to unintentional muscle movements especially when sportsmen need to perform maneuvers that require precision. These involuntary muscle motions occur in little muscles and are known as muscle spasms usually. It impacts players of varied sports like cricket, darts and golf and is grounds that sportsmen eliminate their professional careers sometimes.

In golf, yips are seen as a muscle twitches or spasms when golfers are trying to putt. Due to the distraction due to the shaking in the hands and wrist, this inevitably necessitates even more strokes than are necessary for the average 18 hole rating. That is common when playing big tournaments or playing against extremely competitive or seemingly best players in the overall game. Research has demonstrated that nearly 50 % of golfers have observed the yips. A few of the elements that may boost the possibility of a golfer obtaining the yips are:

  • Excessive utilization of certain muscles: it’s understandable that golfers with an increase of experience are even more at risk than people that have less experience
  • Players with a lesser handicap
  • The elderly: This can be as a result of biochemical adjustments in the brain as you grows older

Although the specific reason behind yips is not ascertained, the etiology is graded to be possibly neurological or psychological:

Read moreHeard about yips?

Osteoarthritis

https://upload.wikimedia.org/wikipedia/commons/9/9c/Heberden-Arthrose.JPG

https://upload.wikimedia.org/wikipedia/commons/9/9c/Heberden-Arthrose.JPG

Osteoarthritis

Osteoarthritis is a degenerative joint disease that involves cartilage destruction.

It usually presents with joint pain, joint swelling due to effusion, limitation on the range of movement and joint deformity.

It increases with age, worsened by weight gain and overuse of certain joints like in athletes.

History of bone fractures across a joint predisposes one to osteoarthritis.

Treatment is both pharmacological and non pharmacological.

Patients must realize that a cure and symptom-free state may not be achievable while physicians must understand the 3 Cs’ i.e. compliance, control and communication.

  • Compliance- patients must take the medicines as prescribed, use assistive devices as advised and exercise
  • Control is better when patients actively participate in the management of their condition and
  • Communication; People remember
    • 10% of what they read
    • 20% of what they hear
    • 50% of what they see and hear
    • 70% of what they articulate
    • 90% of what they articulate, do, or demonstrate

Physical therapy includes weight loss, aerobic exercise and use of assistive devices such as canes.

Pharmacological therapy involves use of drugs such as pain killers and steroid injections.

Ingrown Toe Nail

What is an ingrown toenail?

What is an ingrown toenail?

What is an ingrown toenail?

The right toenail is said to be ingrown, when the sides or corners of the nail curl down and dig into the pores and skin of the toe, leading to swelling, pain and redness.
Sample cases

What causes an ingrown toenail?

  • Spikes that don’t match well – Shoes that are too limited press the sides of the finger nail and help to make it curls into the skin.
  • Toenails and fingernails that are peeled off at the edge or trimmed down your corners are also more likely increasingly ingrown

To avoid ingrown claws, you should cut your nails straight across. The top of the finger nail should make a right model

Read moreIngrown Toe Nail

Fish Oils

Fish Oils

Fish Oils

Fish Oils Contain these Substances references

Lipids

Although the composition of different products can vary, a typical Fish Oil capsule contains:

  • Omega-3 Fatty Acids: 33.44%. The profile of these are:
    1. Docosahexaenoic Acid (DHA): 12.04%
    2. Clupanodonic Acid (Docosapentaenoic Acid) (DPA): 2.25%
    3. Eicosapentaenoic Acid (EPA): 19.15%
  • Polyunsaturated Fatty Acids (Omega-6 Fatty Acids): 3.06%. The profile of these are:
    1. Linoleic Acid (LA): 1.9%
    2. Dihomo-Gamma-Linolenic Acid (DGLA): 0.1%
    3. Arachidonic Acid: 1.06%

Read moreFish Oils