Category Archives: Health

CARING FOR YOUR PROSTATE

A professor of Anatomy once said :
“Man has three balls, two dangling outside, while the third remains up inside. ”

The prostate is a male accessory organ of reproduction. The prostate is a walnut-sized gland located between the bladder and the penis, just in front of the rectum. The urethra runs through the center of the prostate from the bladder to the penis, letting urine flow out of the body. This is the reason why any condition affecting the normal size of the prostate, internally or externally also affects the amount of urine retained in the bladder and its rate of flow out of the bladder. 

The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it is expelled with sperm as semen.This function of the prostate requires it to have loads of zinc. 

Do you know that all men over 50 years old have prostate enlargement? Do you know that 90 percent of men over 70 years old suffer from one prostate problem or the other?  And that for all men that died of natural causes, on autopsy, their prostate already was having one problem or the other, and it was only a matter of time, the prostate would have been the very cause of death? 

And do you also know that changes in lifestyle and diet before reaching fifty years of age and after can be all the difference that will exclude you from those having prostate problems? Wouldn’t you rather be among those whose prostate problems would probably be detected only on routine autopsy after living a healthy and active life well into old age? I am sure that you will prefer to outlive your prostate. 

Basically, there are three main types of Prostate Problems :

1.Prostatitis: Inflammation of the prostate, sometimes caused by infection. In some cases, it is treated with antibiotics.

2.Enlarged prostate: Called benign prostatic hypertrophy or BPH. This affects virtually all men over fifty years old, and it is associated with symptoms of difficult urination. 

3.Prostate cancer: It is the most common form of cancer in men (besides skin cancer), but only one in 40  men die from prostate cancer. 
Here are some dietary factors to consider in preventing or managing prostate enlargement: cooked tomatoes have lycopene in a concentrated form, much higher than ordinarily available in raw tomatoes. Lycopene is very essential for prostate health, preventing enlargement and cancer.
Sesame seeds are rich in zinc – an important prostate mineral (research shows that men with prostate cancer have up to 75 percent depletion in their zinc). Pumpkin seeds, almonds and oysters also have high levels of zinc. It is important to note that zinc is more easily absorbed when it is in a food as opposed to in a supplement. African Walnuts are also very good for the prostate. The use of turmeric with ginger in foods is probably the best investment a man can make on his prostate health. 

Peppers : Cayenne pepper, Alligator pepper, Black Pepper, Bell Pepper are all powerful anti oxidants and anti inflammatory agents. They prevent prostate enlargement.

Water Melon : this is a must for every man on regular basis. All parts of this fruit is consumable and loaded with nutrients, especially the seeds and the external cover. Grapefruits are also rich in lycopene, but unlike in tomatoes, grapefruit needs no cooking to make their lycopene available. Simply cut up the whole grapefruit into pieces, put in blender, add some lemon and blend! Aside of these dietary tips there are also a few lifestyle changes necessary for a healthy prostate that needs mentioning. 

Avoid dairy milk and beverages containing sugar or other sweeteners. Avoid soft drinks. Avoid any food packed in tin. Avoid wearing of tight nylon under- wears. And lastly but not the least in importance is the need to sit less and walk more. Move those legs to keep those dangling two balls rolling, so as to keep the third ball upstairs healthy. Your prostate will be happy for it!

EBOLA DISEASE AND THE RECENT OUTBREAK IN THE DRC

By Jereaghogho Efeturi Ukusare

Ebola Virus Disease (EVD) is a severe hemorrhagic fever that affects humans and other mammals. It is a highly fatal disease. The virus family Filoviridae includes three genera: Cuevavirus, Marburgvirus, and Ebolavirus. Within the genus Ebolavirus, five species have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. The first three, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. The virus which caused the 2014–2016 West African outbreak belongs to the Zaire ebolavirus species according to the World Health Organisation. Fruit bats of the Pteropodidae family are natural Ebola virus hosts. 

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelopes and porcupines found ill or dead or in the rainforest. Ebola spreads through human-to-human transmission by direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids. Burial ceremonies requiring direct contact with the body of the deceased also contribute in the transmission of Ebola. People remain infectious for as long as their blood contains the virus.

Difficulties exists in clinically distinguishing EVD from other infectious diseases such as malaria, typhoid fever and meningitis. The confirmation that symptoms are caused by Ebola virus infection are made using the following diagnostic methods:
antibody-capture enzyme-linked immunosorbent assay (ELISA)
antigen-capture detection tests

serum neutralization test

reverse transcriptase polymerase chain reaction (RT-PCR) assay

electron microscopy

virus isolation by cell culture.

The World Health Organisation recommends the following tests for EVD:

1. Automated or semi-automated nucleic acid tests (NAT) for routine diagnostic management.
2. Rapid antigen detection tests for use in remote settings where NATs are not readily available. These tests are recommended for screening purposes as part of surveillance activities, however reactive tests should be confirmed with NATs.

According to the World Health Organisation (WHO), the preferred specimens for diagnosis include:

Whole blood collected in ethylenediaminetetraacetic acid (EDTA) from live patients exhibiting symptoms.

Oral fluid specimen stored in universal transport medium collected from deceased patients or when blood collection is not possible.

Samples collected from patients are an extreme biohazard risk; laboratory testing on non-inactivated samples should be conducted under maximum biological containment conditions. All biological specimens should be packaged using the triple packaging system when transported nationally and internationally.

In treating EVD, supportive care-rehydration with oral or intravenous fluids and treatment of specific symptoms increases survival chances. There is as yet no proven treatment available for EVD. However, a range of potential treatments including blood products, immune therapies and drug therapies are currently being evaluated. According to the World Health Organisation (WHO), an experimental Ebola vaccine proved highly protective against the deadly virus in a major trial in Guinea. The vaccine, called rVSV-ZEBOV was studied in a trial involving 11,841 in 2015. Among the 5,837 people who received the vaccine, no Ebola cases were recorded 10 days or more after vaccination. In comparison, there were 23 cases 10 days or more after vaccination among those who did not receive the vaccine.

The trial was led by WHO, together with Guinea’s Ministry of Health, Médecins sans Frontieres and the Norwegian Institute of Public Health, in collaboration with other international partners. A ring vaccination protocol was chosen for the trial, where some of the rings are vaccinated shortly after a case is detected and other rings are vaccinated after a delay of 3 weeks. 

The recommendation for good outbreak control relies on applying a package of interventions, these include case management, surveillance and contact tracing, a good laboratory service, safe burials and social mobilisation. Community engagement is key to successfully controlling EVD outbreaks. Raising awareness of risk factors for Ebola infection and protective measures (including vaccination) that individuals can take is an effective way to reduce human transmission. Risk reduction messaging should focus on several factors.

According to the WHO, reducing the risk of wildlife-to-human transmission from contact with infected fruit bats or monkeys/apes and the consumption of their raw meat, animals should be handled with gloves and other appropriate protective clothing. Animal products (blood and meat) should be thoroughly cooked before consumption. Reducing the risk of human-to-human transmission from direct or close contact with people with Ebola symptoms, particularly with their bodily fluids, gloves and appropriate personal protective equipment should be worn when taking care of ill patients at home. Regular hand washing is required after visiting patients in hospital, as well as after taking care of patients at home.

Reducing the risk of possible sexual transmission, based on further analysis of ongoing research and consideration by the WHO Advisory Group on the Ebola Virus Disease Response, WHO recommends that male survivors of Ebola virus disease practice safe sex and hygiene for 12 months from onset of symptoms or until their semen tests negative twice for Ebola virus. Contact with body fluids should be avoided and washing with soap and water is recommended. WHO does not recommend isolation of male or female convalescent patients whose blood has been tested negative for Ebola virus.

Outbreak containment measures, include prompt and safe burial of the dead, identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days. The importance of separating the healthy from the sick to prevent further spread and the importance of good hygiene and maintaining a clean environment cannot be overemphasised.

The recent outbreak in the Democratic Republic of Congo (DRC), has seen the influx of international organisations and agencies as International Red Cross and Crescent Societies, Medicines San Frontieres (MSF), World Health Organisation (WHO) and the Institute of Tropical Medicine (ITM). While the MSF has been very actively involved in carrying out awareness campaigns to stop the spread, the WHO has been working very closely with the government of the country ensuring proper measures are put in place to facilitate containment and control as well as putting out situation reports, the ITM is on ground for epidemic surveillance and confirmation of ebola diagnoses, the Red Cross and Crescent Societies have been handling the burial of victims. 

The earliest cases are believed to have occurred in early April 2018. The suspected index case was a police officer who died in a health center in the village of Ikoko-Impenge near the market town of Bikoro in Équateur province, according to the International Federation of the Red Cross and Red Crescent Societies. After his funeral, eleven family members took ill and of whom seven died. All of the seven deceased had attended the man’s funeral and or cared for him while he was sick. The identification of this individual as the index case has not yet been confirmed. 

Équateur province’s Provincial Health Division reported 21 cases with symptoms consistent with Ebola virus disease of whom 17 had died. Out of this number, eight cases have been shown not to have been Ebola-related. The outbreak was declared on 8 May 2018 after samples from two of five patients in Bikoro tested positive for the Zaire strain of the Ebola virus. On 10 May, 2018, the World Health Organization (WHO) stated that the Democratic Republic of the Congo had a total of 32 cases of EVD and a further two suspected cases were announced the following day, bringing the total cases to 34.

The health care facilities in the area are described by the WHO to have “Limited Functionality”. The remoteness of the areas where bulk of the people have been infected suffer inadequate infrastructure as there is no road to this area (Ikoko-Impenge area of Bikoro) and this is hindering treatment of EVD patients as well as surveillance and vaccination efforts. 

This goes to show the much neglect suffered by the people of Democratic Republic of Congo under its current leadership. It is clear that the government of the country has placed no priority on health care provision, neither has it placed priority on the provision of infrastructure as roads and standard hospital buildings that are multifunctional. It is also clear that the government has not invested in education as to reduce the level of illiteracy. No wonder three people infected with the EVD escaped from their solitary confinements, two of these later died. It is also obvious that the government of the DRC is reactive rather than being proactive in its approach to the handling of health care in the country. 

Currently, the DRC’s Ministry of Public Health are using recombinant vesicular stomatitis virus –Zaire Ebola virus (rVSV-ZEBOV) vaccine – a recently developed experimental Ebola vaccine, produced by Merck and donated to the government – to try to suppress the outbreak. This live-attenuated vaccine expresses the surface glycoprotein of the Kikwit 1995 strain of Zaire ebolavirus in a recombinant vesicular stomatitis virus vector. This rVSV-ZEBOV was trialed in Guinea and Sierra Leone during the West African epidemic of 2014–2016.

HANDLING HORMONAL IMBALANCE

By Jereaghogho Efeturi Ukusare

Hormones are chemical substances produced by your body that influences its growth, development and condition. They are also referred to as your body’s chemical messengers. They are produced in the endocrine glands and tell your tissues and organs what to do.

Hormonal imbalance is having too much or too little of a certain hormone. Even tiny changes can have serious effects throughout your whole body.

How do you sense hormonal imbalance? In women, the most common hormonal imbalance is polycystic ovary syndrome (PCOS) . Your normal hormonal cycle also changes naturally during:

puberty

pregnancy

breastfeeding

menopause

Symptoms of a hormonal imbalance specific to women include:

heavy or irregular periods , including

missed periods, stopped period or

frequent period

hirsutism, or excessive hair on the face, chin, or other parts of the body

acne on the face, chest or upper back

thinning hair or hair loss

weight gain or trouble losing weight

darkening of skin, especially along neck creases in the groin and underneath the breasts

skin tags

vaginal dryness

vaginal atrophy

pain during sex

night sweats

For men, testosterone plays an important role in development. If you are not producing enough testosterone, it can cause a variety of symptoms.

In the adult male, symptoms include:

development of breast tissue

breast tenderness

erectile dysfunction

loss of muscle mass

decreased sex drive

infertility

decrease in beard and body hair growth

osteoporosis which is the loss of bone mass

difficulty concentrating and 

hot flashes

In children, puberty is the time when boys and girls start producing sex hormones. Many children with delayed puberty will go on to experience normal puberty, but some have a condition called hypogonadism. Symptoms of hypogonadism in boys include: 

muscle mass doesn’t develop

voice doesn’t deepen

body hair grows sparsely

penis and testicular growth is impaired

excessive growth of the arms and legs in relation to the trunk of the body

gynecomastia which is the development of breast tissue

In girls:

period does not begin

breast tissue does not develop

growth rate does not increase

There is no single test available for doctors to diagnose a hormonal imbalance. Begin by making an appointment with your doctor for a physical exam. Be prepared to describe your symptoms and the timeline along which they’ve occurred. Carry along a list of all medications, vitamins, and supplements you are currently taking.

Treatment for a hormonal imbalance will depend on the cause. Common treatment options include:

Estrogen therapy

Vaginal estrogen

Hormonal birth control

Anti-androgen medications

Metformin

Testosterone therapy

Thyroid hormone therapy

Flibanserin (Addyi)

Eflornithine (Vaniqa)

$1Bn FRAUD IN NIGERIA’S HEALTH CARE, HMOs GO FREE

By Jereaghogho Efeturi Ukusare

Health Management (or Maintenance) Organisations (HMOs) are companies that provide or arrange managed care for health insurance, self-funded health care benefit plans, individuals and other entities, acting as a liaison with health care providers – hospitals, doctors et cetera – on a prepaid basis. 

In Nigeria, HMOs are expected to deliver quality health care to a designated population in a cost effective manner through health care providers that are paid either a fixed budget or discounted fees. The value-driven system is one of managed care, to provide affordable health services. The financial burden or the risks of over-using health services are borne by the HMO, it’s service providers or both. There exists various explicit and implicit rules which governs the risk-sharing. The member must receive health care from an HMO approved provider.

HMOs have exclusive provider networks. On certain occasions, they also use primary care providers (PCP) as gatekeepers. Gatekeepers are responsible for arranging a patient’s referral to a specialist or admission to a hospital.

In 2017, Nigeria’s House of Representatives’ Committee on Health Care Services organised a two-day investigative hearing where Nigeria’s Minister of Health Prof. Isaac Folorunsho Adewole revealed that the sum of N351 billion ($1Billion) had been expended on health management organisations (HMOs) so far without commensurate result. The Government of Nigeria pays 5% of consolidated salary as a premium to NHIS which in turn pays HMOs. By law, 70% of this fund is required to be paid immediately to health care services providers to provide care for those paid for. Failure to make immediate transfer is a punishable offence by law. It is pertinent to note that there is immense private sector participation in this scheme as there are 59 HMOs in this country. 

It is mind boggling that this revelation was made last year and up till now no action has been taken to punish offenders in the system. No HMO has been sanctioned. No service (care) provider sanctioned. This deliberate silence quickly brings to mind the pathetic nature of the corruption in Nigeria. More than 70 new born babies and over a 100 women die daily from avoidable mortality despite the fact that they are on the National Health Insurance Scheme.

It is still not clear what exactly is going on at this time. However, one thing is clear and it is the fact that it is only in a corrupt society that a huge amount of money as this will be  embezzled or mismanaged and the culprits will walk away free. The misery of the Nigerian masses will only be continually magnified by the mysteries of the disappearance of this money as justice is not served on the masterminds. 

RIVER BLINDNESS IS BLIND. DON’T BE!  

By Jereaghogho Efeturi Ukusare

Carrying out its God’s given assignment around a fast flowing river is the blackfly from the genus Simulium. This type of blackfly is usually found near rivers and streams. The bite of the infected female blackfly injects into the human body or animal the larvae of the worm known as Onchocerca volvulus. It is from this worm that the  disease gets its scientific name “Onchocerciasis”. This worm is a parasite. And because the fly that infects with this worm is found around rivers and streams, the disease is popularly called “River Blindness.”

Affecting approximately half a million people across sub saharan Aftica annually, in its early stages, an infected individual notices no symptoms. It could take up to a year for symptoms of this disease to appear and the infection to become apparent. Once the infection becomes severe, symptoms may include: 

skin rashes

extreme itching

bumps under the skin

loss of skin elasticity, which can make skin appear thin and brittle

itching of the eyes

changes to skin pigmentation

enlarged groin

cataracts

light sensitivity

loss of vision

In rare cases, you may also have swollen lymph glands. Obviously, this disease is “very blind.”

Adult worms can live for up to 10 to 15 years and produce millions of microfilariae within this period of time. Microfilariae are baby or larval worms. Symptoms appear when microfilariae die, so symptoms can continue to worsen the longer you are infected. The longer these organisms stay in you, the closer you are to blindness.

Several tests are currently in use in diagnosing onchocerciasis. The first thing the clinician does is to feel the skin to try to identify nodules. Your doctor will do a skin biopsy, known as a skin snip. During this procedure, they will remove a 2 to 5 milligram sample of the skin. The biopsy is then placed in a saline solution. This will make the larvae to emerge. Multiple snips, usually six are taken from different parts of the body. Other methods of diagnosis also exist. 

The most common treatment for onchocerciasis is ivermectin (Stromectol). It is considered to be safe for most people and it is administered once or twice a year to be effective. It also does not require refrigeration.

Amazingly, there is currently no vaccine to prevent onchocerciasis. For most people, the risk of contracting onchocerciasis is low. Those at the highest risk are residents of certain regions of Africa and Latin America. The best way to keep away from being blind, that is, preventing the disease from getting to you is to avoid being bitten by blackflies when you find yourself in its territory. Wear long sleeves and pants during the day, use insect repellant and wear permethrin-treated clothing. Make sure to visit a doctor if you suspect an infection so you can begin treatment before symptoms become severe. Do not go blind. It is hard. 

PRIMARY HEALTH CARE IN NIGERIA

By Jereaghogho Efeturi Ukusare

The 1% Consolidated Revenue Fund for Primary Healthcare included in the budget of Nigeria as part of the country’s 2018 Appropriation Bill that was recently passed into law is an example of responsive leadership in Africa.  The implication of this is that poor families in Nigeria will be able to get free health care. With the prevalence of malaria especially and other diseases in Nigeria that are usually quite expensive for poor Nigerian families, this is a boost not only to the health sector but also to the Nigerian economy. Nigeria looses millions of dollars in cost in the purchase of malaria drugs annually. A trend that this will not stop but take away the burden from poor families. 

The 1% of the national budget allocated to Primary Healthcare will also reduce the high rate of both maternal and infant mortality related deaths in the country. Statistics show that 10% of infant and maternal mortality in the world occurs in Nigeria.

While this seems to be one cheering news out of Africa, it is quite pertinent to place emphasis on the management of the fund. There must be prudence in  the administration of the fund for it to have any meaningful impact in the society. There was high level of corruption in the NHIS scheme, this fund is also susceptible to such. It is recommended that the Nigerian government sets in motion a mechanism that would prevent corrupt practices, mismanagement and diversion of the fund from its original purpose into the hands of individuals or for political purposes.

It is expected that there would be fiscal accountability in the management of this fund to the benefit of poor Nigerians.  

7  THINGS YOU MUST NOT DO AFTER A MEAL

1. Do not smoke after a meal!
Experiments from experts prove that smoking a cigarette after a meal is comparable to smoking TEN cigarettes (Chances of Cancer are higher).

2. Do not eat fruits immediately after meals. It will bloat your stomach. Therefore have your fruits one or two hours before or after your meal.

3. Do not drink tea after a meal as tea leaves contain a high content of acid. This substance will cause the protein content in the food you consume to be hardened, making it difficult to digest.

4. Do not loosen your belt after eating. Loosening the belt after a meal can cause intestinal problems.
5. Do not bathe after eating. Bathing will cause the increase of blood flow to the hands, legs and body thereby causing the amount of blood around the stomach to decrease. This will weaken the digestive system in your stomach.

6. Do not walk after a meal even though you have heard people say that after a meal, walking a hundred steps will make you live till 99. Walking immediately after a meal will make it difficult for the digestive system to absorb the nutrition from the food we eat. Wait at least an hour after your meal and then walk if you want to.

7. Do not sleep immediately after a meal. The food will not be able to digest properly thereby leading to gastro-intestinal problems.