Dental Caries

Dental Caries

Dental Caries

What is dental caries?

This means continuous decay of teeth, eventually exposing the sensitive parts. The hard cover of the tooth s gradually eroded.

What teeth are mostly affected by caries?

The process affects flat teeth in premolar and molar region due to their physical appearance which allows food stagnation.

How does dental caries present?

The symptoms of caries include tooth pain and or sensitivity to cold or/and hot substances. This results from exposure of nerve endings occasioned by the decay. Other symptoms that will come with the caries include the swelling of jaws. Some patients may not have no symptoms except a visible tooth cavity.

What factors favor development of dental caries?

  • Certain foods that favor growth of bacteria
  • There must be bacteria on the teeth
  • A tooth whose surface favors food stagnation

What specific bacteria play a role in development of dental caries?

Certain species of bacteria called the streptococcus break down carbohydrates and release acids that dissolve calcium deposited in the tooth. Food particles left on the tooth also prevent the protective effect of the saliva and other oral secretions.

What are different types of caries?

These can be classified as follows:

  1. Enamel caries: affects enamel only, usually painless
  2. Dentine caries: affects both enamel and dentine, may be painful if pulp is exposed
  3. Caries of the cementum: affects cement, that is, the structure that attaches the tooth to the socket.

What are the complications of dental caries?

  • Pain
  • Spread of infections around the tooth
  • Distant spread of infections
  • Oral abscess and respiratory complications
  • Heart complications: infective endorcarditis, infection of heart valves
  • Worsening of existing medical illnesses such as diabetes.
  • Death may result from complication of dental caries

How are dental caries managed?

The methods used depend on extent of cavitation noted and presence of symptoms as well as complications. Usually, prevention of caries is the best approach. This is done by practicing good oral hygiene habits.

These include:

  • Proper brushing of the teeth after meals
  • Use of right kind of brush and changing regularly
  • Avoiding too sugary foods
  • Regular visits to dentist at least once per year for check up and advice

If dental caries are already established, they can be managed by any of the following methods singularly or in combinations:

  1. Filling
  2. Root canal treatment
  3. Crowns
  4. Tooth replacement
  5. Dentures
  6. Extraction under local anesthesia (XLA)

How can I know what kind of treatment is needed if I have dental caries?

The kind of treatment is determined by the dentist. This puts into consideration the cost of procedure, availability of procedure and materials, the extent of decay, aesthetic factors, other medical or surgical conditions present, and competence of the dental practitioner, and presence or absence of complications. Always consult a qualified personnel for advice.

What is the public health significance of dental caries?

  1. Loss of revenue through absenteeism from work
  2. Decreased quality of life
  3. Death and disability from complications such as spread of infections and respiratory compromise.
  4. Spread of infections due to use of unsterilized apparatus
  5. Increased legal cases against dental practitioners

Hand washing techniques (The beginning of infection control)

Hand washing techniques (The beginning of infection control)

Hand washing techniques (The beginning of infection control)

Introduction

There are hundreds of thousands of bacteria that live on our hands. We keep on adding and removing them with our hand washing methods. We keep adding some from the things we handle, the greetings we get and many more. Most bacteria are harmless but gain entry to the body after a small weakness in our defence systems. If you imagine all the places you visited today, from your office to the washroom, you must have handled many things. By frequently washing your hands the right way you will wash away germs, i.e. bacteria and viruses. Improper hand washing techniques is one of the many ways we breach our immune defence systems. The skin is one of the body’s defence organs against such germs, by washing your hands; you are performing one of the single most important-infection prevention procedures.

What is hand washing?

Hand washing is the removal of dirt, germs or micro-organisms and other organic materials that may be present on the hands by using water.

Why do we wash hands?

By performing this procedure, we are able to remove about 99% of micro-organisms with simple soap, water and friction. This helps to reduce the rate of infection from person to person or patient to patient, patient to health worker. By reducing the rates of transmission of these organisms, we are able to directly influence the rates of infections and complications that arise.

When should we wash hands?

Basically your hands should be washed after you have performed every act or procedure, whether domestic or at the place of work. The most important times are after:

  • After blowing your nose or coughing/sneezing
  • After using toilet
  • Before handling food
  • After handling food
  • Before and after handling patients
  • After handling pets and other animals
  • Before and after procedures
  • Before changing a diaper
  • Before touching newborns (neonates) as their immunity is not well developed.
  • When physically dirty

What to use when washing hands

The three most important things you need are:

  • Water
  • Soap
  • Antiseptic solution

Water is responsible for removing and rinsing all dirt from the hands. Soap helps dissolve some of the particles and materials that cannot dissolve in water and the antiseptic soaps hep I killing the germs.

How to wash hands

The most important thing to remember is never to touch the tap with dirty hands, wash the hands than return to the tap with clean hands to close it. Basically you end up having done nothing. In most health institutions, the types of taps used are different from the taps at home for the purpose of minimizing the risk of transfer of infections. You may use a paper towel to open the tap and let it flow especially if your hands are completely dirty. After doing this;

  1. Wet hands with running water
  2. Apply soap and distribute it over the hands.
  3. Away from running water rub the palm, back of hands, between fingers, back of  fingers, thumbs, finger tips and wrist and remove debris from under the finger  nails if any.
  4. Do this for at least 20 seconds.
  5. Thoroughly rinse and dry your hands using disposable towels or hand dryer
  6. Close the tap to save on water.

The use of antibacterial / antiseptic soaps

What is an antibacterial soap?

Antibacterial soaps are agents used to clean with the aim of removing or killing bacteria that are logged in the skin, nails and hair. The soaps contain the following antibacterial agents:

  • Triclosan
  • polyhexamethylene biguanide
  • benzethonium chloride
  • farnesol

Any benefits antibacterial soaps?

Most antibacterial soaps come with ingredients in combination or as triclosan alone. There may be other kinds of antibacterial agents. Research done in the department of Surgery, Columbia College of Physicians and Surgeons, Columbia University, New York, New York showed that the combination of Triclosan, polyhexamethylene biguanide, and benzethonium chloride-TPB or farnesol polyhexamethylene biguanide, and benzethonium chloride-PB showed superior rapid and broad-spectrum reduction of risk of organisms developing resistance than do soaps containing triclosan alone. Hand washing with TPB and FPB soaps by healthcare workers and the general population may reduce the transmission of germs, with a lower risk of promoting the emergence of resistant organisms.

When are the antibacterial soaps effective?

A study was done in the Dial Corporation, Microbiology Department, in Scottsdale Rd., Scottsdale,  USA ( link Janice.Fuls@us.henkel.com ) and found that the antibacterial soaps effectiveness depend on the following

  • The compliance of the person using them. If used on an on and off basis, the effectiveness is reduced and the chance of bacterial resistance increased. This is because the bacteria get clever and develop mechanisms of resistance or eliminating the antibacterial agents from inside their cells
  • The soap volume. The higher the amount of soap volume the better. Less amounts are more or less ineffective in destroying the bacteria altogether
  • How much time do you spend washing? It has been studied and found that the more time spend (minimum of 15 seconds) significantly reduced the bacteria transmission.

Unacceptable hand washing methods

About the antibacterial soaps

Much has been written about the potential hazards versus benefits of antibacterial (biocide)-containing soaps. A study be the department of epidemiology university of Michigan, Ann Arbor concluded that soaps containing triclosan within the range of concentrations commonly used in the community setting (0.1%-0.45% wt/vol) were no more effective than plain soap at preventing infectious illness symptoms and reducing bacterial levels on the hands. Several laboratory studies demonstrated evidence of triclosan-adapted cross-resistance to antibiotics among different species of bacteria.

Please note the following

  • Triclosan is used in higher concentrations in hospitals and other clinical settings, and may be more effective at reducing illness and bacteria than the home setting
  • There are other soap ingredients that help fight bacteria such as savlon, peroxide hydrogen, povidone iodine or Betadine.
  • A combination of several drug ingredients is far much better than a single ingredient since it leads to faster bacterial resistance.
  • When using the soaps, allow at least 15 seconds or more wash time to be sure of the effectiveness
  • Most soaps contain only one type of ingredient ( always read the insert) and this becomes a problem when trying to reduce hand or skin bacteria
  • Not all that is seen in an advert may be true concerning eh effectiveness of some products. A lot of consumer knowledge and follow up is important

Based on the above details and research findings one should always ask him/herself; how long do I take to wash hands? Most of the time is after the dirt is gone or when the water that comes out of the hands is clear. These are practices that are not effective in removing bacteria and other organisms from the hands:

  • Not washing hands after every procedure
  • Irregular use of antibacterial soaps
  • Washing hands for less that accepted time. It is advised that you wash for at least 20 seconds
  • Using soaps that have not been medically tested and or registered as antiseptics
  • Using soaps that do not contains enough antibacterial ingredients
  • Reusing the water that is already contaminated
  • Using towels that are dirty and not frequently cleaned
  • Using wet towels to dry hands. Wet towels tend to adsorb dirt and accumulated more germs
  • Using the same towels for more than one purpose e.g. one towel for the washrooms being used in the kitchen

This week’s Bachelor Steak

This week’s Bachelor Steak

This week’s Bachelor Steak

Men are good at brunt offerings, from the days of Moses, Elijah, Solomon and David. They all did these especially to cleanse their sins or the sins of their families. In this week you may have had several ‘sins’ committed during the weekend.

But we are not going to help you up the Holy of Hollies, just a steak recipe to help you learn some stuff in the kitchen.

What you need:

  1. 1 sirloin steak, for you and the boys (nuff said)
  2. Soy sauce.
  3. The cheapest red wine available (ha!).
  4. Garlic. By the way did you read about the health benefits of garlic? One more thing, just avoid lots of this in case your spouse is thinking of you 9 months fro now.
  5. A garlic-smashing tool.
  6. Propane gas grills, if you have one.

Read moreThis week’s Bachelor Steak

Nail maintenance tips

Nail maintenance tips

Nail maintenance tips

Introduction

Nails are an important part of the body. The nail is one of the hardest parts of the human anatomy, and a durable and potent weapon. Although there are differences between fingernails and toenails, they are also quite similar

In many aspects. The fingernails growth at 3 mm/month compared with toenails at 1 mm/month. One of the reasons is because of poor blood flow to the toes compared to the fingers.

There are advantages of nails such as:

  • Protective coverings. They help protect the tips of the fingers and toes from injury or inflammation.
  • They may serve as effective weapons as anyone who has been scratched by sharp nails can confirm.

The nail anatomy

  • Nails are made of basically keratin, a fibrous protein that grows out of the front part of the top of the toe and slides forward over the nail bed. The same keratin is found in hairs.
  • The root of the nail is also called the matrix, or the growth plate.
  • The whitish area at the bottom of the nail is the lunula (half-moon), and the fold of skin lying directly over the root is the nail fold.
  • A skin layer next to the root is called the eponychium also known as the cuticle.

Keeping your nails healthy

Nails show many different indications of systemic diseases or conditions. For example in patients with anemia, the nails appear as whitish patches called apparent leuconychia which is spurious whiteness. On the other hand the nails are alive and need to be taken care of. The following are some of the facts on healthy nails:

  • A healthy nail is clear, with no discoloration on any part. There should be a normal growth pattern that follows the follows the contour of the toe or finger.
  • The nails have no nerve endings, meaning that there is no pain directly associated with damage to the nail itself. The pain that may arise may be due to the damage to the underlying tissue that has been traumatized.
  • The toenail serves no useful function to modern humans except for beauty especially in many women
  • The fingernails growth at 3 mm/month compared with toenails at 1 mm/month. One of the reasons is because of poor blood flow to the toes compared to the fingers.
  • Nails do not breathe. The nail plate is made of dead keratin and does not require oxygen. The nail bed, cuticle, and matrix do require oxygen because they are composed of live skin cells. These areas are supplied with oxygen rich blood from numerous capillaries.
  • Nails do not sweat since the bed does not contain sweat glands, so it can not perspire. While the nails do contain a lot of moisture the moisture does not build up under the acrylic nail. The moisture that causes problems under artificial nails occurs when the product lifts and moisture gets trapped underneath; most commonly caused by waiting to long between rebalances.
  • Nails do not eat and they do not need vitamin or minerals. Because nails are made from dead protein, they cannot be strengthened by vitamin or mineral supplements, or topical vitamin treatments. While severe vitamin, mineral, or protein deficiencies do affect the nails, healthy people rarely suffer from a deficiency severe enough to affect their nails.
  • The most common cause of nail  problems is an accidental or intentional, damage to them, and in most cases it is the big toe that is affected, just because it happens to be a bigger, better target than other nails
  • Some nail disorders are caused by ill-fitting shoes or erratic nail-cutting. When cutting nails, it is important to follow the contour of the cuticle

How to Give Yourself a French Manicure

This is a fairly difficult job, but after some time you easily get used to it. You must practice this. It will give you some attractive appearance from daytime denim to evening elegance. The white-tipped look will never leave you wondering whether your polish complements your outfit.

So if you want to look good, consider a French manicure.

Continue reading Tips for Nail Maintenance.

How to bleach your teeth

How to bleach your teeth

How to bleach your teeth

Tooth discoloration is the change in color from the normal white enamel to the darkening or brownish discoloration. Persistent tooth discoloration can also occur as a result of the gradual thinning of the enamel layer of the tooth.

This thinning allows for more yellow -brown dentin formation underneath becoming visible. This is called amelogenesis imperfecta

What causes tooth discoloration?

Several factors play a role in this process. Exposure to some chemical s can also promote tooth discoloration in some individuals.
In amelogenesis imperfecta, the enamel is often absent and the exposed dentin has a yellowish-brown discoloration. This condition is an inherited disorder with defective tooth enamel formation caused by various gene mutations. The condition is treated with resin veneers and jacket crowns for anterior teeth, as well as steel crowns for posterior teeth
Tooth discoloration may be due to substances such as Fluoride. Excessive exposure to fluoride from drinking water, tooth pastes, supplements, and infant formulas results in fluorosis a condition of excess fluoride in the system. The excess fluoride interacts with mineralizing tissues, causing alterations in the mineralization process especially in the teeth. fluoride in the drinking water in excess of 1.5 parts per million causes coloration

  • Color disturbance may also be due to secondary to inflammation
  • Vitamin deficiencies can also cause color changes in teeth
  • Trauma to the enamel leads to the exposure of denting that shows a yellow-brown coloration
  • An isolated tooth with a grayish – blue hue may indicate the presence of a necrotic pulp, often due to prior trauma.
  • A tooth that appears pink (pink tooth of Mummery) indicates an internal tooth resorption.
  • Yellow to violet staining that fluoresces under ultraviolet light is normally due to exposure to tetracycline. It is advisable to avoid these drugs during pregnancy and up to 18 years of age as the teeth are growing and developing. Tetracycline also destroys the calcium deposits
  • It has been shown that regular use of Mouthwashes that contain Chlorhexidine as their active ingredient increases the incidence of tooth discoloration.
  • Tobacco smoking may lead to tooth discoloration.
  • Excessive consumption of coffee may cause tooth discoloration.

There are various methods now in use for bleaching teeth.

The home based Bleaching Kits

This is a do-it-yourself method that you can use at home. The kit contains diluted dentist approved hydrogen peroxide (1% – 10%). Other kits may have carbamide Peroxide (at 10% – 20%) gel. The gel is applied topically to the teeth and left for some minutes. The gel is a good whitener for teeth that acts by breaking the stains. It also enters the enamel and dentin of the Teeth where it bleaches the stained substances.

Steps in bleaching the teeth include:

  1. Step one; Rinse the teeth with a mouth wash containing citric Acid. The acid helps to remove the pellicle, an enzyme layer that dental plaque clings to.
  2. After cleansing the teeth, use a cotton swab and dip in the hydrogen peroxide solution provided. Remember, it has to be in a concentration of 10% to 20%. You may also use the carbamide peroxide gel.
  3. The kit comes with the whitening substance such as titanium dioxide paste. After the gel application, allow a few minutes then apply the paste and polish to the surface clearly.
  4. Allow a few minute then rinse your mouth with distilled water

Please note that due to the lesser contact time of your teeth with the bleaching agents, the treatment results may not be displayed immediately. You may have to repeat this again till you get the result. If you are not comfortable with the kit, you may consult your dentist.

Dentist Supervised bleaching

This is a three step procedure that involves:

  1. Cleaning of the Teeth by the dentist to remove superficial stains. He may use the dental equipment to do this unlike what you use at home.
  2. Application of the gel to the teeth to allow bleaching and removal of the plaque. The carbamide Peroxide concentration used is about 35% – 44%. references
  3. The dentist will then provide a dental tray that is to be worn for approximately one hour everyday. This can be done at night while sleeping or during the day, which ever is comfortable to use. Note that the tray does not interfere with your speech.

Studies show that the dentist supervised bleaching is effective in about 90% of patients.

How diet helps to prevent or Treat Cervical Cancer

How diet helps to prevent or Treat Cervical Cancer

How diet helps to prevent or Treat Cervical Cancer

Diet has become an important component in fighting different types of cancer. In fact, it is recommended, for example, that you eat at least five servings of fruits and vegetables daily and eat the right amount of food to stay healthy. Here are some of the foods and or ingredients that are important in fighting and helping in treating cervical cancer.

Vegetables

Cruciferous vegetables such as broccoli, cabbage, cauliflowers and kales are known to contain substances such as diindolylmethane (DIM) which has been show to inhibit the development of cervical cancer. The DIM acts by inhibiting the growth of the cancer cells of induce a programmed cell death (apoptosis) of the tumor cells. Other compounds that help in killing the cancer cells include the Indole-3-Carbinol (I3C) which also acts by preventing the papilloma virus-initiated cervical cancer. This is an important factor in managing cervical cancer.

Mushrooms

Karawatake Mushrooms and other compounds that contain PSP have been proven to improve the quality of life in patients suffering from cancers especially cervical cancer.
PSP is a type of Proteoglycan / Peptidomannan found in Japanese medicinal mushrooms.

Fruits

Carotenoids are an important component in inhibiting the development of cervical cancer cells. Fruits that are rich in carotenoids such as carrots, mango, cantaloupe melon, apricot, papaya, banana, apples and straw berry come in handy. Foods rich in beta carotenoids include the above mentioned in addition to water melon, grapes, spinach, Spirulina, garlic and corn.

Selenium

Selenium is an essential micronutrient with extended benefits in improving e immune system, preventing blood clotting, preventing arthrosclerosis and helping to lower blood pressure. Selenium deficiency has been found in patients with cervical cancer. Studies in lab animals have proven the same and an increase in the selenium in water given to the animal reduced the incidence by a significant amount. Foods that are rich in selenium include

  • Cereal Grains such as wheat Germ, whole grain bread, wheat Bran, barley, brown rice, oat Bran, rye, rice bran and white rice
  • Dairy foods such as cow milk and butter
  • Poultry foods  such as  chicken liver, turkey and egg yolk
  • Fungi such as dried shiitake mushrooms
  • Legumes such as kidney Beans
  • Meats including beef, liver, lamb, kidneys rabbit meat and ham
  • Nuts including brazil nuts, peanuts, almond, cashew, walnuts, hazelnuts and macadamia nuts
  • Sea foods like herring, tuna , crab , oysters, lobster, cod and prawns
  • Seeds like sunflower Seeds and mustard Seeds

Vitamins

There is a correlation between vitamin deficiency and development of cervical cancer in some patients. Vitamins such as Folic acid, vitamins B1, 2, 6 and B12, Vitamins C, D and E are important in preventing and treating cancer. Folic acid is important I development of cell DNA and deficiency of folate increases the risk of cancer development. This happens during the weak chromosomal stage when the HPV virus is incorporated into the cells.

Quinones

Coenzyme Q10 has a similar molecular structure to the vitamin E and K. It is a fat soluble compound that has been shown to help to prevent cervical cancer. The compound helps to prevent cancer cell growth and leads to rapid death of the cancer cells (apoptosis).

The sources of this compound include:

  • Dietary Oils including rape seed, soybean,  sesame, and cottonseed oil
  • Chicken eggs
  • Grains such as rice bran, wheat germ
  • Legumes including soybeans
  • Meats
  • Nuts such as hazelnuts, walnuts, chestnuts, almonds. Pistachio, and peanuts
  • Vegetables such as cabbage, broccoli, spinach, cauliflower, potato, garlic, onion, eggplant and carrot
  • Commercially available supplements

Cervical cancer is a public health problem. Early diagnosis and treatment is important in reducing the incidences and complications. More over diets management is also important in prevention and treatment. Patients who are over weight are also at a higher risk of developing the cancer. This underscores the importance of having a proper diet in management of cancer among women.
Get tested.

Minor Complications during Pregnancy & management

Minor Complications during Pregnancy & management

Minor Complications during Pregnancy & management

There are a few minor complications that can occur during and after childbirth.  Many of these last the whole pregnancy and are accompanied by other problems.

Morning sickness:

The condition, which can range from feelings of nausea to continuous vomiting, can occur at any time of the day or all through the day.

For some women it lasts throughout the pregnancy, but for most that have it usually fades after the third month.

Management

  1. Healthy eating – fruits and vegetables
  2. Exercise.
  3. Taking Sips of hot Water before walking up form bed or biting some biscuits between meals
  4. Eat small amounts of food regularly, drink lots of fluids, and avoid foods that make you feel nauseous.

Constipation

  • The bowel absorbs more fluid during pregnancy and food moves slower down the intestines.
  • This can lead to constipation which can in turn trigger haemorrhoids – protrusions from the anus which bleed and can be painful and itchy.

NOTE Pregnant women with constipation are discouraged from taking laxatives.

Management

  1. Eating lots of fruit and vegetables, and drinking plenty of fluids
  2. Exercise regularly,
  3. Avoiding standing still for long periods.
  4. There are also creams and suppositories on the market which lessen the irritation caused by hemorrhoids.

    Management

    • regular exercise
    • avoid long periods standing still, sitting with crossed legs and wearing tight-fitting underwear
    • sit and sleep with your feet up
    • avoid excessive weight gain during pregnancy
    • use ice packs

Cramps

Sudden muscle spasms it mostly occurs at night and can be extremely painful.

Management

Massaging the affected area – often the feet – can help, as can flexing the foot and regular exercise.

Indigestion and heartburn

Indigestion can be due to hormonal changes in the early stages of pregnancy.

In the later months, it is likely to be a result of the foetus pushing the stomach upwards.

Management

  • Eat little and often, instead of big meals, avoiding fatty and spicy food and sitting up straight when eating.
  • Heartburn is as the result of the relaxation of muscles at the stomach opening which  causes excess acid in the stomach.
  • It is most likely to occur when lying flat so sleeping with feet propped up and avoiding food for two or three hours before going to bed.

Backache

Ligaments become looser during pregnancy in preparation for labour, but this can put more pressure on the lower back and pelvis, causing backache.

This is likely to increase in the later stages of pregnancy as the foetus gets heavier.

Management

  1. Avoiding lifting heavy objects,
  2. Keeping the back straight when lifting objects,
  3. wearing flat shoes and sitting with the back well supported.
  4. Exercises which involve arching the back can also help.

Other complications include:

  • faintness
  • needing to urinate often (caused by the baby pressing on the bladder)
  • bleeding gums (due to hormonal changes)
  • stretch marks, swollen feet (due to water retention)
  • vaginal discharge
  • Headaches.

Lung Health

Lung Health

Lung Health

How can I hold my lungs healthy?

Your lungs do amazing work every day. Healthy lungs supply large amounts of oxygen to your blood and enable you to work, play and live well. They also remove the carbon dioxide and other waste gases that your body doesn’t need.

There are many things you can do to keep your lungs healthy and disease-free:

1. Stop smoking

Lungs are influenced by using tobacco which causes respiratory diseases collectively called chronic obstructive pulmonary disease or COPD including emphysema (lung rot), chronic bronchitis and asthmatic bronchitis. Smoking tobacco offers been linked to an increased risk of respiratory symptoms including coughing, phlegm, wheezing and hard or labored breathing (dyspnea).

Read moreLung Health

Intrauterine devices (IUD)

Intrauterine devices (IUD)

Intrauterine devices (IUD)

What is IUCD?

IUCD is an acronym for intrauterine contraceptive device. Intrauterine products (IUD) have been in use since early 60s but due to side effects of septic abortions and infections, they were withdrawn and only one type of Intrauterine devices (IUD) was in use by 1988. Today, IUDs continue to be the most popular reversible method of contraception and currently the choice of more than 1000 million women worldwide

What types of IUCDs are available?

There are many types like the:

  1. The 380 mm2 copper T intrauterine gadget (TCu380A, marketed as ParaGard)
  2. Levonorgestrel intrauterine program (LNG-IUS, sold as Mirena

How will an IUCD work?

Evidence suggests that IUCD impacts events before egg implantation and fertilization to allow a pregnancy. Listed below are mechanisms of the way the IUCD or IUD works. Once implanted by the gynecologist, the IUD prevents uterine pregnancy by

Read moreIntrauterine devices (IUD)

Everyday Tips To Keep The Dr Away:

Everyday Tips To Keep The Dr Away:

Everyday Tips To Keep The Dr Away:

My son was unwell for several days and for the first time I felt like a mechanic who couldn’t fix his own car. Every time I thought ah! I have this figured out something else came up. Until I met a Doctor friend who said sometimes kids get bugs that are unexplained. During this period I learnt a few things I’d like to share.

  • Regardless of child’s age all his/her utensils should be properly sterilized. Studies have shown that Rota virus infection in older children is worse than the younger ones.
  • Cold drinks e.g. water, soft drinks do affect the child because they act as a media for infections viral or bacterial especially upper and lower respiratory tract.
  • Immediately you remove your baby’s pamper especially one with stool wash your hands thoroughly before fitting him/her with new pamper.
  • Be prepared when you come to the doctor. If your child is having vomiting or diarrhea carry the stool and urine sample. These can be brought to the lab at most ONE hour after collection.
  • Make sure your child is warmly dressed especially at night since the child keeps tossing and turning chances of staying under covers are minimal. Please don’t judge by the way you feel children are more sensitive to lower temperatures than adults.
  • An important sign that your child could be feeling cold is if they start to have running nose, sneezing or coughing. Dress him/her up give warm fluids and you will see the change.
  • Reassure the child and be honest with them on exactly what is going on regardless of age. Let then know everything is being done to make them feel better but don’t over do it. It’s not the time to buy that toy or game or sweets just make it look like part of life.
  • Oh! Don’t scare the child about doctors. Many a time I’ve heard parents tell kids to ‘behave or the doctor will inject you!!’ This just makes it harder for the child to cooperate with the doctor/health profession. Also chances that your child may not say when he/she is ill are high for fear of injections. As for dentist visits, well even I, am still afraid.
  • Don’t panic regardless of what your child is going through. This just makes them worry too.
  • Do not be afraid to ask for or accept help from partner/spouse or whoever is available. You need rest and fresh mind to handle whatever comes tomorrow.

A Devastating Monster

HIV, A Devastating Monster

HIV, A Devastating Monster

Many diseases are caused by germs (microorganisms) which invade the body and alter the normal body functioning. These germs differ from one another and are thus grouped as viruses, bacteria or fungi. The most devastating and difficult diseases to treat are those caused by viruses, due to their uniqueness from other microorganisms. Viruses are very small in size (minute) and have no cellular structure, little wonder, they are called infectious particles.

The most outstanding feature of viruses is their inability to grow (replicate) outside living cells and because of this, fewer drugs are available to treat viral infections. More confounding in their ability to cause diseases is a group of viruses called retroviruses and in particular, Human Immunodeficiency Virus (HIV).

So what makes HIV more confounding than other viruses?

A clearer understanding of the uniqueness of HIV can be achieved by understanding how viruses cause diseases. Viruses can only grow inside a living cell outside of which they are inactive (metabolically inert), and this is why unlike other microorganisms which invade tissue surfaces, viruses invade the cells. Following entry into a cell, a virus shuts down all the activities of the host cell, then it directs the cell to produce the materials (proteins and nucleic components) required to make new viruses (virions) during its growth.

The new (daughter) viruses then grow and mature inside the host cell and are eventually released through rupture of the cell membrane(unenveloped viruses) or by budding(enveloped viruses).Either way, both processes of release lead to the death of  the host cell whereas the new viruses infect more cells and the process continues. This process is devastating considering that most drugs cannot act against germs within the cells (intracellular pathogens). The viruses can therefore hide causing more and more infections without being destroyed and the high number of cell death eventually lead to the death of the whole organism.

In the case of HIV, what distinguishes it from other viruses and makes it a monster of sorts is the type of human body cells it invades and the subsequent weakening of the body’s immune system leading to AIDS. Within the body of an infected individual, HIV is mainly present in semen, vaginal/cervical secretions and blood. It may also be present in saliva, tears, urine, breastmilk, cerebralspinal fluid and infected discharges. The virus can be transmitted from infected person to uninfected person through sexual intercourse, from mother to child during birth, blood transfusion and use of contaminated syringes and needles.

Once inside the body, HIV infects the very cells which are meant to defend the body against germs that cause diseases. Worst of all, the virus readily infects the type of cells (CD4 T-cells) which control and regulate almost the entire body’s defense system in addition to infecting other cellular components involved in the body’s defences.As was described earlier, this state of affairs leads to massive destruction of immune cells hence leaving the body vulnerable to all kinds of disease – causing organisms which in essence would not have caused any disease had the immune cells not been depleted. The depletion of the body defences continues over a long period of time and the resulting immunosuppression paves way for opportunistic infections such as pneumonia, tuberculosis, typhoid, dysentery and meningitis. These diseases further weaken the body’s immune system resulting into immunodeficiency which eventually leads to full blown AIDS.

Indeed, the devastation caused by HIV may be compared to a nation whose armed forces have been killed and so its citizens are attacked from all sides by foreign aggressors eventually leading to the demise of that nation.

Who is a good doctor

Who is a good doctor

Who is a good doctor

The definition of a good athlete, a good prosecutor, or a good artiste is fairly easy. It’s the one who scores most goals, the one who puts most criminals behind bars, and the one who sells millions of albums. The best soccer team is the one that takes home the most trophies. Having said that however, I must point out that arsenal in my opinion still remains the better team albeit it’s poor goal record.

On the other hand, what makes a good doctor is more difficult to define. Using specific parameters to measure how good a doctor is, is one of the biggest challenges for health managers. The best doctor is not the one who heals most patients, because in many specialties, cure is not the goal of patient management. In fact some of the best doctors I know are in specialties that take care of patients with terminal illnesses.

It’s not the one whose patients live the longest, because in many situations we need to add life to our patients’ days rather than adding days to their lives. In fact in some circumstances prolonging/sustaining life may be considered undesirable by the patient and his/her loved ones.
It’s not the cleverest or most knowledgeable one since there’s still so much we don’t know in medicine, that if that were the only parameter we’d all fall short.

Not the one with the best people skills, because that’s not enough in the craft of medicine. It’s definitely not the one who rakes in the most money for their practice. In my opinion however these are parameters we can’t trash wholesome when we attempt to define the attributes of a good doctor. Enough of what a good doctor is not.

To different people a good doctor means different things but there are some key attributes that most people agree on.

  • A good doctor is humane, a good person. He is a friend, compulsively compassionate, respectful, patient, a good listener and available. He takes interest in the patient as a person and not as a constellation of symptoms.
  • A good doctor appreciates and admits their limitation.
  • A good doctor has a high tolerance for ‘not knowing’ and knows when to consult. I’ve seen a many professors learn from junior students. One of the most elusive diagnoses I’ve seen made, was by a fourth year student. The professor leading the team was humble enough to pursue that possibility. Because it’s all about what’s best for the patient and not polishing our personal egos.
  • A good doctor must be knowledgeable, scholarly and in touch with current trends in medical practice. He or she must demonstrate respect for the body of science, must use evidence as a tool to optimize patient care but not merely to justify a certain course of action.
  • A good doctor must also be a critical thinker, always questioning every decision he/she makes. He/she makes decisions that add value to the task at hand. Costly investigations that confirm only what history and physical examination have discovered have no place and neither have investigations that would not change patient management.
  • A good doctor is gentle yet firm. He educates, counsels and informs the patient’s decision making. He recognizes that the ultimate responsibility for health decisions is the patient’s.

That’s the summary of who I want my doctor to be. What’s yours?

The Top Seven Sexual Fantasies

The Top Seven Sexual Fantasies

The Top Seven Sexual Fantasies

The Top Seven Sexual Fantasies

The common myth that men have at least sexual thoughts seven times an hour may come to your mind. But think about this, women are also catching up very fast. By the way research shows that about 55% of men studies are visual creatures.

This means that everything that passes by is quickly internalized that the brain to produce a need to act on it. Women have been known to the kinesthetic. This means that you have to caress them by all means, physically, mentally what ever the means. So buying those flowers, chocolate, saying those nice words, all these tend to go down well with what women want. Bearing in mind these two groups of people, when ever they go through a kinesthetic or visual experience with the opposite sex, certain things start running through their minds. These end up as being fantasies when they persist. These are some of the sexual fantasies;

  1. Making love with someone other than one’s regular partner. This is very common at your place of work, at the regular club, your neighbor name it. Every time you encounter this person this is the commonest fantasy that comes up.
  2. The commonest myth in some African communities is that after the rights of passage, boys were told to go out and ‘test’ their potentials. This normally ends up being overrated and may persist in some. You end up having thoughts of trying our in all sorts of class of people including those from another race or class, a relative, a friend’s spouse.
  3. The three some syndrome. This is becoming very common especially among men. It is their fantasy to have sex with one’s partner and another person.
  4. The romantic fantasy. Every one wants to have the TV movies experience – sex in idyllic surroundings such as the Caribbean beach. Women have this kind of fantasy all through. Thanks to the TV soaps.
  5. Forced sex – also called the “rape fantasy”. This is very common among both sexes where one has fantasies of being forced into or forcing someone into a sensual position. This comes especially when one fantasizes about a certain person he or she has a strong sensual urge to meet him or her. You probably have seen these in movies.
  6. Sex in weird places. Ever though of having a romantic or sensual relationship that ends in copulation in places such as the cow shed, pool, beach, parking lot etc? This is sometimes called taboo sex.
  7. Sex with a celebrity. You probably have had this over and over again. Have you ever entered a guy’s hostel room and seen those sexy ladies’ portraits. What do you think these guys are thinking when they look at the curvy bodies? Of course some ladies have left some food burn in the microwave when Michael Scofield is on TV!

I guess we are all human.

Dating tips for men

Dating tips for men

Dating tips for men

Men love to fantasize, so do women. Men love to think about stuff they will do at any one time and move on. Women love to think about things that would take care of their emotions, for as long as it is possible.
What’s a fantasy? In her book, Men in Love,

Nancy Friday describes a fantasy as a map of desire, mastery, escape, and obscuration; the navigational path we invent to steer ourselves between the reefs and shoals of anxiety, guilt, and inhibition. She adds on that it is a work of consciousness, but in reaction to unconscious pressures. Men have these fantasies every other time. Most of the fantasies are about sex. It’s a form of worship. Ever visited a guy’s room at high school of college? You will on most occasions see a colorful poster of Jlo, Monroe and many more sexy figures. Before he sleeps, after he wakes, up every time he is in the room, the image attracts his attention.

Why do men do this? The reasons are different, but the point here is that men are programmed to do this at any one time. In Genesis, God instructs man to go out, multiply and replenish the earth. Man is to take care for not only the garden, but the earth as well. This is a command not a suggestion. It only becomes a suggestion when this is reduced I to a form of sports. Some men become tourists, looking out with predatory eye waiting to devour on the innocent. Poor self control and pervertism hangs around due to influence from the media, peers, and many more.  Perves are here with us.

Read moreDating tips for men

Treating male infertility

Treating male infertility

Treating male infertility

Dealing with the psychological factors

Most infertile couples or males would go through several emotional states on learning that they are unable to achieve a pregnancy by the man being infertile or the woman being infertile. They go through feelings such as having:

  • States of shock
  • Anxiety and fears
  • Sadness
  • Anger and resentment
  • Shame
  • Feeling of loneliness
  • Self blame

Read moreTreating male infertility

Testing for Fertility in Men

Testing for Fertility in Men

Testing for Fertility in Men

It is now obvious that no matter what your female fertility testing indicates, most men must also be evaluated for their own fertility. Male fertility testing is typically much simpler and straightforward than the woman’s. The reason being that

  • The male reproductive organs are located outside of the body.
  • The male hormones are usually steadier and not subject to the monthly cyclic changes as seen in women

In the first visit to the doctor, he/she will take a detailed medical, drug, social and fertility history.
After the history ad physical examination, the doctor will perform some tests to help in diagnosis of infertility and try to find the exact cause. The following are descriptions of a variety of tests and procedures that you may encounter during your fertility evaluation.

Blood tests

The tests done in blood are helpful in finding out the normal factors such as:

  • Hormone testosterone tests. Testosterone is a primary male hormone, directly linked to sex drive and function. It is also associated with sperm growth and maturation
  • Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which both play a key role in sperm production
  • Prolactin hormone test may indicate presence of a pituitary brain tumor or could be a sign of an abnormal thyroid function
  • Human immunodeficiency virus (HIV) test
  • Hepatitis test
  • Syphilis (VDRL) test.

Semen analysis tests

The semen will be checked for the presence of white blood cells. If a large number of white blood cells are present, this may indicate an infection. Other tests done on semen include tests for specific bacteria and viruses. The following are the key infections typically checked during a basic fertility evaluation of semen:

  • Chlamydia
  • Gonorrhea

Urine tests

A urinalysis is performed to help diagnose

  • The presence of bacteria and the white blood cells. White blood cells may indicate an infection either within the urinary tract or the prostate gland.
  • The urine is also checked for the presence of sperm. A high concentration of sperm in the urine may indicate retrograde ejaculation where sperm go backward into the bladder instead of moving forward into the penis.

The semen analysis test

During ejaculation, semen is produced from a concentrated suspension of spermatozoa, stored in the paired epididymides, mixed with, and diluted by, fluid secretions from the accessory sex organs. The semen is emitted in several boluses. About 90% of semen volume is made up of secretions from the accessory organs mainly the prostate and seminal vesicles, with minor contributions from the bulbourethral (Cowper’s) glands and epididymides.

Semen analysis test is a major part of the male fertility assessment. This test checks for both the quality and quantity of sperm. The semen sample is obtained by the male partner through

  • Performing masturbation either at home or in other situations, the semen sample must be obtained at the clinic or laboratory.
  • Using the non-spermicidal condoms used during intercourse at home

How to prepare for semen collection

Preparation

  • The healthcare provider will provide a private room near the laboratory, where you will collect the semen and hand over to the lab staff. The specimen container should be kept at ambient temperature, between 20 °C and 37 °C, to avoid large changes in temperature that may affect the spermatozoa after they are ejaculated into it. This helps to minimize the exposure of the semen to fluctuations in temperature and to control the time between collection and analysis
  • The man is advised to abstain from sexual intercourse for minimum of two days and a maximum of seven days. The doctor must give you clear written and spoken instructions concerning the collection of the semen sample. You are advise to report any loss of any fraction of the sample as this is also measured

Semen collection

Collecting semen at the laboratory;

The man should:

  • Pass urine all urine
  • Wash the hands and penis with soap, to reduce the risk of contamination of the specimen with bacteria or viruses from the skin.
  • Rinse the soap away from the hands and the penis with water.
  • Dry hands and penis with a fresh disposable soft towel.
  • Perform the masturbation and ejaculate into a sterile container.

Collecting semen at home

This is only done in exceptional circumstances, such as a demonstrated inability to produce a sample by masturbation at the laboratory or the lack of adequate facilities near the laboratory. The same instructions are followed.

  • The lab technologist will provide a pre-weighed container, labelled with the patient’s name and identification number.
  • The same cleaning procedure is advised and semen collection time and delivery time recorded.
  • During transport to the laboratory, the sample should be kept between 20 °C and 37 °C if possible

Collecting semen by condom

The same reason applies for this means as in the collection using a container at home

  • The man is provided with special non-toxic condoms designed for semen collection. Such are available commercially.
  • Information on how to use a condom is usually provided
  • The time of collection and delivery to the lab must be recorded. The same should be stored at a temperature between 20 °C and 37 °C.
  • It should e noted that coitus interruptus is not a reliable means of semen collection, because the first portion of the ejaculate, which contains the highest number of spermatozoa, may be lost.

Testing the semen specimen

Once the semen sample is obtained, it is analyzed in the laboratory. The semen sample is typically evaluated under a microscope and/or by computerized evaluation.

The key features studied are:

  • Semen volume per ejaculation
  • The thickness (viscosity) of the semen
  • The quantity (concentration) in terms of the number of sperm present in the semen
  • The shape (morphology) of the sperm in percentage of normally shaped sperm against the abnormal ones
  • The sperm movement (motility). This can be forward, circular or irregular movements.

Continue reading Testing for Fertility in Men part two.

Check list for male infertility

Check list for male infertility

Check list for male infertility

Traditionally, most couples with fertility problems would want to visit a doctor for the lady to have a thorough medical check up. How ever, due to changing lifestyles, increasing consumption of toxins n foods and many other factors, this is becoming a problem of both males and females. Some infertile couples with an unremarkable female evaluation and normal semen parameters are termed unexplained infertility. It is therefore important for the doctor to evaluate the males with a thorough medical history in these categories:

Read moreCheck list for male infertility

Safety at home; does your house meet the standards?

Safety at home; does your house meet the standards?

Safety at home; does your house meet the standards?

The house one lives in entails his environment .It has an important influence on health. A standard house should have the following:

  • Be structurally stable.
  • Free from dampness.
  • Have a sink with satisfactory supply of hot and cold water.
  • Have a toilet available for exclusive use of occupants in the house.
  • Satisfactory provision of heating, lighting and ventilation.

Damp houses

Damp housing has effects on health though other factors influencing health may such as smoke, overcrowding and low income. Occupants are encouraged to heat their houses properly. Housing conditions are positively associated with   physical ill health in children. Symptoms such as pain, diarrhea, anxiety, and coughs are more frequent in children from damp houses

Damp /cold houses are also hazardous to the elderly and chronically sick   need to heat their houses longer yet many live in houses without a central heating. Sometimes people find themselves homeless    or lacking housing because of reasons beyond their control. These include people living in refugee camps after civil wars, hostel inhabitants who include the mentally ill, alcoholics on rehabilitation or drug abusers.

Read moreSafety at home; does your house meet the standards?

Are fish oils the cure for mental health?

Are fish oils the cure for mental health?

Are fish oils the cure for mental health?

This month in our Health promotion calendar we are focusing on mental health.

WHO definition of Health

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

With this in mind then it is clear that mental health is a priority for healthcare providers and should be a concern of all adults just as much, if not more than the concern and care that goes into preserving their physical health.

The rationale here is: if one is willing to wake up at 6 am and jog for 1 hour or sweat it out in the gym, choose carefully what they eat and dedicate time to living a healthy lifestyle then some effort should be spared towards promoting mental health. Here is some information on how to achieve the same with your mental health.

OMEGA 3 FATTY ACIDS:

What are they?

The Omega 3’s are a group of essential fatty acid nutrients derived from marine or plant sources. The two principle types of Omega-3 are EPA and DHA – both found in fish oil. Omega 3 fatty acids have been shown to have mood stabilizing effects, and fish oil has become a very popular choice among those with bipolar disorder and depressive illnesses seeking natural treatment for their symptoms.

Fish, particularly fatty ocean fish, is an excellent source of omega-3 fatty acids. At least three clinical trials have observed a marked improvement in depressed patients given relatively high doses of fish oils. This has spurred other scientists to look closer at the potential benefits of fish oil supplementation. At the moment there are at least 10 clinical trials underway evaluating fish oils in the treatment of depression, attention deficit disorder, and schizophrenia

Fish oils: A cure for depression?

According to a BBC report, on a worldwide basis more working days are lost to depression than to any other illness. The incidence of depression is growing with people born within the last 50 years being twice as likely to suffer from it as were their parents.

Dr. Joseph Hibbeln of the National Institutes of Health believes that the reason for the increase in depression can be directly attributed to a major shift in dietary patterns, specifically fat intake. He points out that the vast increase in the use of soy, corn, palm and cotton seed oils in the last 100 years has totally changed the traditional ratio of omega-6 to omega-3 fatty acids in the diet. Soy oil consumption in the US, for example, has increased thousand-fold in the last 100 years helping to skew the omega-6 to omega-3 ratio from about 1:1 to today’s 16:1.

The brain consists pretty well entirely of fat so clearly one’s fat intake could affect one’s brain composition, particularly the ion channels which channel signals in and out of the brain. There is also evidence that low levels of omega-3 fatty acids are associated with low levels of the mood hormone serotonin.

Dr. Hibbeln’s hypothesis is supported by the fact that the incidence of depression is considerably lower in countries with high fish consumption.

HEALTH EFFECTS OF FATS:

BENEFITS:

Omega 3 fatty acids have been linked to various clinical and behavioral conditions involving mental function. These include depression, bipolar disorder, schizophrenia, violence, aggression, and attention deficit hyperactivity disorder.

These fatty acids are also associated with certain neurodegenerative diseases such as Alzheimer’s and Parkinson’s diseases. A common feature of these disorders is low levels of the marine or fish oil omega-3s, EPA and DHA and arachidonic acid.

Low levels of omega-3s have not been shown to cause any of these disorders, but they appear to significantly increase the chance of developing them. Other factors are often involved, such as family history and environmental influences. All the same, there is a plausible basis and growing evidence for the involvement of marine omega-3s in brain function in these conditions.

Depression: This is the most common form of mental affliction. The National Institute of Mental Health in the U.S. estimates that about 4% of adolescents also get seriously depressed. More than just feeling «down,» depression affects a person’s ability to work, sleep, eat, and experience pleasure; it can be disabling. It is more common in women than men, particularly after childbirth.

Depression is least common in countries where people eat the most fish, such as Japan, Iceland, and Korea, while countries with low fish consumption have the highest rates. They include the U.S., Canada, and West Germany.

People with depression often have low levels of EPA and DHA in their tissues compared with healthy people, but it is not clear what this means.

Several studies have reported positive outcomes in depressed patients who took EPA along with their usual medication.

Schizophrenia: Less common than depression, schizophrenia is a crippling mental illness that affects about 1% of the US population. There are several neurological and biochemical alterations in this condition, including reduced cell membrane levels of arachidonic acid and DHA. Occurrence of schizophrenia in different countries does not appear to be linked to seafood consumption. Nearly all patients are treated with medications, so studies of supplementation with omega-3s include drug treatment too. Some medications may reduce cell fatty acids, so it is difficult to distinguish the effects of more than one treatment.

Studies have confirmed that people in this country and in many other countries around the world are not eating enough of the right kinds of fish and are therefore not getting enough of the right type of fatty acids. This not only leads to depression but can have horrible effects on physical health as well. The only documented side effects of the Omega 3 fatty acids seem to be nausea, diarrhea, and a fishy aftertaste.

Editor’s comment: Daily supplementation with 1-3 grams of high quality fish oil is entirely safe and may not only improve your mood, but help protect you from heart disease, stroke and arthritis as well!
I don’t know about you but I’m off to purchase some omega 3 as soon as possible.

On that note, here are some locally available preparations:

  • Seven seas: caps and suspension
  • Omega 3 caps.

Sources:
Small, Meredith F.  The happy fat. New Scientist, August 24, 2002, pp. 34-37.
www.fatsoflife.com
BBC.

Adult ADHD

Adult ADHD

Adult ADHD

Have you ever had trouble concentrating, found it hard to sit still, interrupted others
during a conversation or acted impulsively without thinking things through? Can you
recall times when you daydreamed or had difficulty focusing on the task at hand?

Most of us can picture acting this way from time to time. But for some people, these and
other exasperating behaviors are uncontrollable, persistently plaguing their day-to-day
existence and interfering with their ability to form lasting friendships or succeed in
school, at home and with a career.

Experts used to believe children would grow out of ADHD by the time they were adults.
In recent years, it’s been recognized that ADHD can continue on into adulthood. This
relatively recent acceptance of adult ADHD means that many adults remain
undiagnosed and aren’t aware their symptoms and behaviours are actually part of an
identifiable condition.

Unlike other mental disorders such as depression, ADHD does not start in adulthood.
Adult ADHD is a continuation of ADHD from childhood. The main difference is in the type
of difficulties and symptoms experienced. Adults are less likely to have intense
hyperactivity.

Rather than problems at school, its work lives and relationships that prove troublesome.
Instead of hyperactivity, one is likely to feel restless, fidget a lot, have difficulty relaxing
and feel on edge a lot of the time.

A typical ADHD adult may have gone through life being constantly misunderstood:
One’s behavior and actions may have caused difficulties with teachers, friends and work
colleagues. One may have been called clumsy, hyper, rude, abrupt, lazy, insensitive and
irresponsible. Smoking, drinking alcohol and, in some cases, drug taking are also more
common among ADHD adults.

What are the symptoms of adult ADHD?

Like childhood ADHD, adults share the symptoms of inattention, impulsiveness and
hyperactivity. For some adults, the hyperactivity part of things calms down and is more
controllable as they get older.

Adults can experience ADHD in different ways, but some of the common symptoms
include:

  • Concentration problems
  • Forgetfulness and poor short-term memory
  • Lack of organization
  • Problems with creating and maintaining routines
  • Lack of self-discipline
  • Impulsive behaviour
  • Depression
  • Low self-esteem
  • Restless mind
  • Restlessness
  • Poor time management
  • Impatience and frustration
  • Poor social skills and making inappropriate remarks
  • Feelings of underachievement.

Diagnosis difficulties with adult ADHD

As an adult, getting a diagnosis of ADHD is not straightforward. ADHD adults will have
experienced their symptoms for most of their life and, despite frustration, are likely to
have reluctantly accepted them as part of their unique make-up. Some will have learnt to
develop their own coping strategies and may remain unaware they have a recognisable
condition. In most instances it’s friends, family or work colleagues who instigate a visit to
a doctor.

What treatment is available?

Although there’s no complete cure for ADHD, a number of treatments can significantly
help with the management and control of symptoms. The most appropriate treatment
regime varies according to individual needs and set of symptoms. The best treatment
should accommodate all areas of need.

Treatment focuses on helping behaviour, emotional problems and social difficulties
caused by ADHD. The main treatments for adult ADHD are:

Behavioural therapy

It helps one learn about the disorder and ways to manage it effectively. For example,
manage and maintain daily schedules better through making lists, cope with large
projects at work by breaking them down into smaller chunks.

Psychotherapy

Psychotherapy helps treat the emotional disturbances of people with ADHD. Sessions
can take place:

  • on a one-to-one basis with a professional
  • in a group
  • in conjunction with a partner if relationship difficulties are the main problem.

Psychotherapy can help remove or modify troublesome emotional symptoms and help
you cope with the daily challenges of living with ADHD.

Medication

Is usually used alongside other therapies; The most common medication for adults is
stimulants, but some people benefit from taking antidepressants – particularly if they
have co-existing symptoms such as anxiety and mood swings.

It is important to note that a treatment plan is developed according to the
individual needs of each person.

Treating breast cancer

Treating breast cancer

Treating breast cancer

There are several modes of treatment for breast cancer including:

  • Surgical management of breast cancer
  • Reconstructive surgery
  • Chemotherapy or endocrine therapy
  • Diet management. Dietary phytoestrogens such as those found in soybeans have a chemical structure that is similar to that of 17b-estradiol and can bind to the estrogen receptor to compete with estrogen. Their consumption may have a weak protective effect against breast cancer and are good for preventive treatment.

Treating the invasive breast cancer

Surgery in treatment of breast cancer

  • Treatment with surgery involves removal of the lump in the breast. For patients with tumors smaller than 5 cm are best managed with lump removal (lumpectomy) followed by irradiation treatment to the affected breast.
  • In larger tumors a process called mastectomy (removal of the breasts) is preferred. In this procedure, there an additional use of drugs for treating cancer. In estrogen-receptor positive tumors, endocrine treatment is added to the mastectomy to shrink the tumors before surgery
  • A process of axillary node (lymph nodes in the armpits) evaluation should be performed on most women who are suitable candidates for preventive (adjuvant) treatment. In this process, the sentinel node (the first lymph node where metastatic spread of cancer goes to) is taken for biopsy. Some oncologists will inject a dye, isosulfan blue dye, a radioactive isotope compound around the primary tumor or areolar area of the breasts to help identify the first node (or nodes) draining the primary lesion. Majority of patients have the sentinel node in the same side of the arm pit as the breast. In a study, about 60% of patients with positive tests for the sentinel node, there have been results of only the sentinel node having the tumor.

Breast reconstruction surgery

This type of procedure is performed at the same time with breast mastectomy. With this, women have a chance to overcome the psychological effects of loosing their breasts. A woman will feel complete and better with both breasts intact and the psychological effect of restoring to the original shape the lost breast is paramount.

The choice of breast implants to be used is also important to the patients. Several types are in the market including saline or silicone implants and are less costly and generally easy to implant.

Other types of reconstruction include the use flaps or grafts from other parts of the body. It is recommended to go for the implants in cases of loosing large amounts of tissue during surgery of the breasts.

Psychosocial Support

Loosing a breast to a woman is a tragedy. She will not feel complete and this affects her body image and to some extent her sexual sense too. There is a greater need to have psychological support and counseling before and after the procedure. The good thing is that most implants and types of reconstructive surgeries in the market help in restoring theta lost confidence.

There is need to offer psychosocial support shortly after diagnosis is made, especially to the most vulnerable or the most distressed, to cope better.

Preventive treatment

Preventive (adjuvant) therapy is defined as the use of chemotherapy, hormonal drugs, radiation or a combination of these before, during, or after definitive treatment of the primary breast cancer.

  • The objective of adjuvant therapy is to destroy small, hidden (occult) distant tumor spreads( micrometastases)
  • In addition, adjuvant therapy helps to delay cancer recurrence for a median of 2 to 3 years in the majority of treated women.
  • Those who require this type of treatment are those in menopause, have large tumor size, poor tumor grade, tumor spread to lymph nodes, positive HER2 status and positive estrogen and progesterone status.

Adjuvant Endocrine Treatment

  1. Tamoxifen is used to treat patients who are in postmenopausal stage and are estrogen or progesterone receptor positive. Its estrogen-agonist effects on bone and liver help to maintain bone density and to lower cholesterol levels in postmenopausal women. The risk is that it may cause bone loss in premenopausal women, risk of endometrial cancer, increase the risk in developing deep venous thrombosis and exacerbate hot flashes in 10 to 30% of postmenopausal women.
  2. The use of aromatase inhibitors such as anastrozole, exemestane and letrozole are used in endocrine management of breast cancer too. Unlike tamoxifen, aromatase inhibitors are not associated with an increased risk of vein thrombosis or endometrial cancer. There common risks are joint pins, muscle aches and bone loss with fractures.

Chemotherapy

  • There are various drugs in the market for treating breast cancer. Most treatments involve the use of combination therapy to achieve the best results. These are also superior in the management of breast cancer
  • The commonest drugs used in management include: Anthracyclines such as epirubicin or doxorubicin, taxanes, humanized monoclonal antibodies such as trastuzumab against a protein encoded by the HER-2 gene.

Radiation treatment of breast cancer

  • Studies have proven that breast irradiation following removal of the affected breast lumps ( lumpectomy)reduces the risk of breast tumor recurrence
  • This kind of treatment involves the streaming of radiation beams to the chest wall following mastectomy. There is a significant decrease I rates of recurrence besides killing of the tumor in early stage cancer
  • The treatment is offered to women who have lumps ranging is sizes of > 5cm in diameter and those with extensive lymph node involvement.
  • There is a risk of developing Lymphedema in the upper limbs and on the side of the mastectomy in radiation treated patients.

Cervical cancer

Cervical cancer

Cervical cancer

Introduction

Cervical cancer is uncontrolled growth of abnormal cells and tissue within the cervix (the neck of the uterus). The uterus is the womb where babies are grown. There is then an abnormal growth of cells presenting with hypertrophy (increase of cell size), hyperplasia (the increase of the numbers of cervical cells), anaplasia (formation of atypical shapes of cervical cell shape), and poor cervical cell function.The increasing cell size and numbers lead to an increase in the size of the surrounding tissues with the invasion of more abnormal cells from the cervix.

The cells are so aggressive and invade the surrounding tissues by competing for blood supply to the tissues. These cells are easily detected by a Pap smear test as they are shed from the.

Cervical cancer causes

There are several know causes of cervical cancer. The main cause of cervical cancer is an infection with Human papilloma virus (HPV) serotypes 16, 18, 31, 33, 45, and 56 which account for more than 80% of all invasive cervical cancers.

However most of the causes are associated with specific risk factors that women face. A regular Pap smear tests is important as a screening tool and a preventive measure for cervical cancer among women.

What are the risk factors for cervical cancer?

  • Associated risk factors include
  • Having multiple sexual partners
  • Women living in lower socioeconomic status
  • Cigarette smoking
  • A history of sexually transmitted diseases such as chlamydia, HPV infection
  • Immunosuppression
  • Oral contraceptive use.
  • Certain types of sexual behavior such as
    1. Women who have sex at an early age
    2. Women who have multiple sexual partners
    3. Women who have partners who have many other sex partners
    4. Women who have sex with uncircumcised men
  • Smoking or nicotine
  • Infections with Human immunodeficiency virus (HIV)
  • Diet with increased levels of homocysteine has been associated with increased risk of having cervical cancer. Vitamin deficiency has also been implicated in development of cervical cancer. Lack of
  • Prolonged use of oral contraceptives (birth control pills)
  • Women who have multiple pregnancies
  • Women living in low socioeconomic status
  • Injection with diethylstilbestrol (DES) drugs
  • Women who have relatives who had cervical cancer
  • Exposure to radiation of any type especially these on treatment for other cancers
  • Exposure to compounds that may affect nuclear genetic material such as benzene
  • Prolonged stressful conditions

Screening for cervical cancer

From the evidence obtained from large control studies, it is recommended that:

Screening for cervical cancer with a Pap smear test can achieve an 80% reduction in death rates from the cancer in the target population of women aged between 25 to 60 years.

It is also recommended that women have a screening interval of one year with conventional Pap smear tests or every 2 years using liquid-based cytology.

After the age of 30, women who have had three consecutive, technically satisfactory screening results may be screened every 2-3 years.

The American Cancer society recommend that cervical cancer screening should begin 3 years after the onset of vaginal intercourse and no later than age 21 years of age

Women who are age 70 years or older with an intact cervix and who have had 3 or more documented satisfactory cervical screening test results within the 10-yr period before age 70 may cease to have the routine cervical cancer screening tests

Those who have had uterus removal (with removal of the cervix need not undergo screening tests.

Cervical cancer epidemiology

Although cervical cancer is the third most common gynecologic cancer in the United States, it is the most common malignancy worldwide.

Cervical cancer is the second most common cancer in women in the world, with an estimated 500,000 cases in 2003.

Screening for cervical cancer with follow up and treatment has helped reduce the incidences of cancer. How ever this may not be true in some countries or regions such as the Latin America, the Caribbean, and Africa, where cervical cancer is the most common cause of cancer-related death in women

The incidences are high among the whites in the United States with an estimated 8.1 new cases per 100,000 each year as compared with 11 per 100,000 in African-American women and 14.4 per 100,000 in Hispanic populations.
Symptoms of cervical cancer

  • There are no symptoms in those in precancerous stage
  • There is an unusual vaginal bleeding, particularly after sex
  • A vaginal discharge with odor
  • Early invasive cancers may also present with no symptoms although some women will notice postcoital (after sex), between menses, or postmenopausal spotting.
  • Some women will present with malodorous vaginal discharge
  • Painful coitus (dyspareunia)
  • Cramping pelvic pain from uterine contractions
  • Chronic blood loss may result in symptoms of anemia in some patients
  • There may be pelvic pain
  • In advanced stages, there may b lower limb swelling (from occlusion of pelvic lymph vessels or thrombosis of the external iliac vein)
  • Advanced stages of disease may lead to anorexia, dysgeusia and unintentional weight loss

Diagnosing cervical cancer

  • The following tests may be performed to help in diagnosis of cervical cancer.
  • The healthcare provider will perform a detailed history and physical examination
  • Pelvic examination which includes examination of the vagina, cervical and related organs
  • Pap smear test.
  • Test for human papilloma virus (HPV) DNA. There is a high sensitivity for the detection of cervical intraepithelial neoplasia with these tests. This test helps to reduce the incidence of grade 2 or 3 cervical intraepithelial neoplasia (CIN) or cancer detected by subsequent screening examinations.
  • Colposcopy The method of examining the vagina and by means of a binocular instrument known as the colposcope, to screen for cancer of the cervix. The clinician may also use this test to do biopsy and endocervical curettage.
  • Complete blood count
  • A squamous cell carcinoma (SCC) antigen test
  • Carcinoembryonic antigen (CEA)
  • Chest x-ray examination

Continue reading about Treatment of Cervical cancer.

Valentines Day: A complete woman’s guide

Valentines Day: A complete woman’s guide

Valentines Day: A complete woman’s guide

Imagine yourself in a movie. You wake up the following day, shower or just before that, stare at the figure in front of you on the mirror and …..oops! You see the best booby, the best behind and the cutest faces you ever saw.

Put that cucumber down- we’ll have plenty of time to play later. You’ll soon stop thinking like a man and learn to think like woman.

In the living room, you press on the messages and a number of them are waiting for you. «Hey gal, its mike from Club Dimples, we met yesterday? I thought…eerrrr…we could meet, if that’s ok with you. If you are ready, this is my number. Please call back. Then comes the next one: Hi cute little thing, its Jack. What’s up sugar? You were so moody last night. I couldn’t see you. Will you call me back?

Let’s fast forward to the mall, where you spend a fortune on facials, cosmetics and clothing. You had your nails done, pedicure, and massage…its party time. You start choosing what to wear….»But wait, don’t I look fat….» crying. «No, sweetie, your hips are good, your friend responds. You get weird thoughts about yourself. It’s an emergency here. Just few days to go to Val’s day, you need a complete facial and body makeover. Everybody is in it and you can’t be left behind.

Welcome back to earth. I hope I made you think of this day deeply. No more movies. In this planet, we have men. These are a certain species of beings with minds, and eyes, eyes that are predatory. And they make a kill out of them. Men are visual human beings. They look at facts and digest them instantly. Well they look at women and that’s it. A man has few things that are still carries on from childhood to adulthood.

From the time when mother’s breasts were all the beauty the world could offer, both sexes have had feelings of enlarged, enhanced life from seeing a gloriously naked woman. The male body holds no such primitive magic. It is one of the dissymmetries of our biological life.

In matters of love, you must understand that men are emotionally much more sensitive than women. Thus, it is much more humane to be firm and break a man’s heart early than to let him get his hopes up only to waste away in anguish or vindictiveness.

Women control intimacy. His is a powerful tool, and the extraordinary emotional power they have over men needs some form of responsibility to steer men in the right direction.

The game of love is a lot more complicated than sex. Do men only want one thing- – sex? No. If it were true that men only wanted one thing, then all men would be visiting brothels for this. Do all women want one thing– sex? If that were true then all women would be visiting gigolos. Men and women are two completely different creatures that must come together in a relationship.

Valentine’s Day is here and this is your chance to spice up the relationship

Love and romance

Think about the following things; «What about the two of you? What about your future? Where are you going?» It may not be for Valentines Day alone but from now on, a few tips could help you send him messages of your intentions. These include;

  • Your visit to his crib. While visiting him, leave your personal effects in his home. This is a clear territory demarcation. Other females will get the message too. By the way, even animals do this. Without territorial markings, you have no chance. Other will do it. Even if it means leaving your scarf in his car, send the message.
  • Your mother is your attorney. Quite interesting, the experienced lover has some lectures to give.
  • Have you met his family? You won’t get noticed. Probably Mike has another one at upcountry. Just check.
  • Gifts, gifts, gifts. Even lingerie for him.
  • Give him an ultimatum. You are not cheap to be used up. Let him prove your worthiness. On this day, you could play cat and mouse till the proves you worth.
  • Give him a complete home make over. Rearrange his kitchen, bedroom. After all one day it will be yours, you may do this just be for the main event.
  • Arrive unannounced at his home, with groceries, etc. But be careful this may sound that you are sneaking in on him. Some guys just don’t like it, and it may mean you raise your antenna.
  • When introducing yourself to others, your boss, your friends, church mates, mention these words; wife, mistress, or fiancée, it’s the weapon at your disposal.
  • Drive his car, but don’t crash it. It could crash your romance too. Men and toys are one thing.
  • Surprise him with midweek luncheon dates and come with two or three of your secretarial friends and/or your mother.
  • Clean up his house. You have the freedom to remove all unwanted magazines, his other women’s stuff,… and tell him

Continue reading Valentines Day time: A complete woman’s guide.