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 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 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.




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


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


  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.


3246 kJ
Fat saturated
34.00 g
Fat Total
53.00 g
Carbohydrate sugars
41.00 g
Carbohydrate Total
50.00 g
Dietary Fibre
5.00 g
134.00 mg
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

What are some of the tests done in lung cancer?

What are some of the tests done in lung cancer?

What are some of the tests done in lung cancer?

Read lung cancer and How do those with lung cancer present first.

  • The most important examination at the early stage is plain chest x-ray.
  • Other tests include the endoscopic studies
  • CT scan of the chest
  • MRI of the chest
  • Tissue biopsy ( done during the endoscopy)
  • Flexible fiberoptic bronchoscopy
  • A transbronchial needle aspiration: done via a special needle passed through the bronchoscope. This technique can be used to sample out mediastinal masses or paratracheal lymph nodes
  • Transthoracic fine-needle aspiration biopsy with fluoroscopic or CT scan guidance
  • Mediastinoscopy
  • Pleural biopsy in patients with pleural effusion
  • Thoracentesis of pleural effusion and cytologic evaluation of the obtained fluid

Read moreWhat are some of the tests done in lung cancer?

Treatment of Cervical cancer

Treatment of Cervical cancer

Treatment of Cervical cancer

Read Cervical Cancer First.

Treatment of cervical cancers depends on the staging and the depth of invasion. For example for invasion of less than 3 mm (stage IA-1) treatment includes a hysterectomy or the option of cervical conization in women who wish to preserve fertility. The staging of cervical cancer involves the following:

The International Federation of Obstetrics and Gynecology (FIGO). It permits assessment through biopsy, physical examination, cystoscopy, proctoscopy, excretory urography (intravenous pyelography or IVP), and plain film x-ray of the chest and skeletal system. The American Joint Cancer Committee staging is also involved.

Staging in cervical cancer

Read moreTreatment of Cervical cancer

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

How do those with lung cancer present

How do those with lung cancer present

How do those with lung cancer present

Read lung cancer first.

The early symptoms of lung cancer and their prevalence include:

  • Cough or altered cough in 60% of patients.
  • Coughing blood( Haemoptysis) in  27% of cases
  • Chest pain in 34%.
  • Difficulty in breathing (Dyspnea) in 46% of cases.
  • Loss of appetite
  • Weight loss 56%.

On examination of the patients

Read moreHow do those with lung cancer present




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.


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 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

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

Fish Oils

Fish Oils

Fish Oils

Fish Oils Contain these Substances references


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

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

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

  • 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 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.


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.

Cervical cancer

Cervical cancer

Cervical cancer


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.

Lung cancer

Lung cancer

Lung cancer


This is primary lung malignancy that arises from the lung tissue. There are several types of primary cancer of the lung including squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and large cell carcinoma. Here are some of the listed types

Adenocarcinomas: These types of cancers are common in North America and Japan. They tend to occur among smokers, although nonsmokers are more likely to develop adenocarcinoma than other lung cancer types. On radiological examination, they are found more peripherally, but can occur almost anywhere, and can be multifocal. They have been known to fill the entire lobe of the lung tissue. Other x-ray findings show that they are associated with solid opacities, ground-glass opacities, or mixed patterns. Epidemiologically, Adenocarcinomas represent 35%-40% of lung carcinomas. The variants of adenocarcinomas include types such as signet ring, clear cell, mucinous, and fetal adenocarcinomas

Squamous cell (Epidermoid): This type of cancer tends to occur centrally and is highly associated a history of smoking. It’s a malignancy that shows squamous differentiation 20% to 30% of lung cancers. It spreads by locally invading the surrounding tissues and forms cavities in the lungs. The differential diagnosis includes reactive processes that may result in squamous metaplasia with reactive atypia as seen during infections or radiation-induced injury

Read moreLung cancer

Common causes of hair loss in children

Common causes of hair loss in children

Common causes of hair loss in children

Hair loss in children is a common observation. There are several causes and most of them are easily treatable. Among the commonest know causes include:

Fungal infection (TINEA CAPITIS)

Fungal skin and scalp infections account for the majority causes of hair loss. The prevalence is about 90% of causes presenting to the doctor. The fungus has no known natural reservoir and persists for long periods on fomites, such as hairbrushes, combs, furniture, stuffed toys, and clothing. The highest incidence of this kind of infection is during school opening season when there is over crowding and contact with the infected persons. Most patients are between 1 and 10 years of age, but infection may occur at any age.

The infection survives in environments such as tight braiding, or the use of pomades.

How fungal infection presents:

The classic presentation is of one or more round to oval patches of partial to complete hair loss and with varying degrees of redness at the infection site. There may be repeated episodes of itchiness and scratching. The scratching may lead to secondary bacterial infection since there is introduction of bacteria to the injured area.

How is Tinea Diagnosed?

The bets diagnosis is clinical. The doctor examines and notices a clear pattern of presentation to the scalp. Some of the lesions may be noted on other sites such as the skin on the armpit, neck, fingers and interdigital spaces. A lab test with KOH staining also helps diagnose the fungi. The fungi are collected with a toothbrush on a culture plate or on a moistened culturette swab.

Treating fungal scalp infections

Treatment may be difficult in some patients due to various factors such as, repeated infections, poor drug compliance, incorrect diagnosis or resistance to treatment. Successful treatment requires a combination therapy with oral griseofulvin tablets and antifungal creams. Some antifungal shampoos are also available for use such as ketoconazole (candid –TV) shampoo. Griseofulvin is the agent of choice that is best taken with fatty food to promote absorption. The treatment may last 4 to 6 weeks or even up to 12 weeks depending on the response to treatment and severity.

Other types of shampoos in use include selenium sulfide 2.5%. This is done twice weekly

Partial hair loss (ALOPECIA AREATA)

Alopecia areata is a condition that is characterized by the sudden onset of asymptomatic round, bald patches located on any hair-bearing part of the body. The presentation is common on the head. There are no hair follicles and the patients have a scaly reddish crusting on the scalp. There may be pus formation too. Most patients recover well and have hair growing back in 1 to 2 years.

How alopecia areata is treated?

The main aim of treatment is to reduce the inflammation and infections. Treatments available include the use of topical steroids, topical minoxidil, tar preparations, and anthralin. Some healthcare providers may also use ultraviolet light to treat. The medications with minoxidil are used to promote hair growth and give good results.


This is a form of hair loss that is characterized by diffuse alopecia that is usually not clinically obvious to anyone but the patient and parent. The causes may be due to physiologic and pathologic stresses such as recent infections, high fever, severe influenza, surgery, and drugs. The hair follicles normally regress to the resting, or telogen, state of hair cycle. Telogen effluvium usually occurs 3 to 5 months after the stressor and is self-limited. The patients need not worry about it but may use minoxidil in cases of severe hair loss.


Trichotillomania is a type of hair loss that is caused by the compulsion to pull out one’s own hair. This applies traction to the hair leading to hair loss. The patients may present with areas of incomplete hair loss. Some of the hairs appear short and broken. Amazingly other areas involved include the eyebrows and eyelashes. This condition may be due to a psychiatric illness and treating it may help resolve the compulsion.


Traction alopecia is hair loss that comes after forms of hairstyles that apply tension for long periods of time. Some patients also do like to pull on their hairs and this can cause hair loss (see Trichotillomania). The patients normally have noninflammatory linear areas of hair loss at the margins of the hairline, part line, or scattered regions, depending on hair styling or mode of traction used. The best treatment is avoidance of the causes of traction or styling products or styles that result in traction.

Diabetes: Are you scared of it?

Diabetes: Are you scared of it?

Diabetes: Are you scared of it?

What exactly is diabetes? What types do we know and what can we do about it –this is what this article is all about


Diabetes is essentially all about blood sugar control.
Normally our blood sugar levels are all within a certain range between 3.5 mmol/L and 8 mmol/L depending on whether we are fasting or have just eaten. We have a delicate balance of blood sugar, controlled by a number of different hormones, the most important of which is Insulin.

We speak about Diabetes when the blood sugar goes above the normal reference ranges on a continuous basis.
What happens when the blood sugar is higher then normal?
It tends to stick to certain proteins in the body and leads to the symptoms & signs of diabetes, and eventually to complications if not managed adequately.

Read moreDiabetes: Are you scared of it?