The mental health angle of epilepsy

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Do you know some people believe that when a person has seizures, the saliva coming out of such patients can actually infect anyone that comes into contact with it.

Myths and misconceptions about epilepsy are the reason why Nigerians delay seeking appropriate medical attention, which invariably contributes to psychiatric complications.

Caregivers often keep such patients at home without seeking medical help. They patronise alternative care that could invariably worsen the clinical condition especially when the seizure is not effectively controlled, resulting in brain damage.

An epileptic seizure is a clinical manifestation presumed to result from an abnormal and excessive discharge of a set of neurons in the brain; usually after two or more discrete and unprovoked seizures.

The broad division of epilepsy family lies between the focal epilepsies arising from a known or suspected cause and the generalised epilepsies. Epilepsy can be classified taking into consideration the known cause, age of onset, the region of the brain affected and the seizure subtype.

The two broad divisions following seizure subtypes are: the partial seizures usually with a focal onset which may become generalised; and the generalised seizures that involve both hemispheres of the brain simultaneously with attendant motor manifestations and impaired consciousness.

The inference is that epilepsy occurs when the constituent elements of the brain – the neurons – discharge abnormally with attendant manifestation traceable to the region of the brain where those neurons are located.

Heralding an attack, there is the prodromal phase usually characterised by mood changes, impaired memory and concentration and some anxiety which may last for days.

For intelligent caregivers, this may be a proactive signal to ascertain compliance with medical care. There is also the aura which rarely lasts more than a few seconds characterised by sensations arising from the stomach, abnormal perception in the sense of taste and smell; tasting and seeing things other folks may not perceive in clear consciousness.

The next critical phase is the actual ‘seizure attack’ which could be automatism characterised by involuntary behaviour when the individual assumes  the control of posture and muscle  tone and performs simple or complex movements without being aware of what is happening.

But when it is generalised, a brief stiffness in the muscles, associated salivation, loss of bladder control, a fall which may cause injury form the basis for restricting epileptics from operating machineries or driving until seizure free.

There is also the absence seizures characterised by abrupt cessation of ongoing activity, a vacant stare, and a period of unresponsiveness lasting from a few seconds to half a minute.

In childhood and adolescence, inherited disorders of metabolism, birth complications, infection, consequences of febrile convulsion may be implicated while in middle life; trauma and tumour are most common. In the advanced years, stroke and degenerative disorders are predominant.

Only one quarter of cases of epilepsy are known while the remaining belongs to the recognisable epilepsy syndromes. A seizure site may be identified in some cases but the actual cause may be unknown although genetic factors may be very important.

In some instances, the cause may be the abuse of some drugs especially alcohol, overhasty withdrawal of some medications and head injury from okada commercial motorcycle accidents. Psychiatric complications arise majorly due to brain damage secondary to poor seizure control, the stigma of the illness itself following restriction in job opportunities and some other discriminatory in social contracts including marriage and inappropriate use of drugs to control the seizures.

When patients do not come early for treatment, there is brain damage with behavioural manifestations referable to the particular region. The notion of an ‘epileptic personality’ is obsolete but some affectation of personality development may arise following brain damage, rather than the epilepsy.

The attendant learning difficulties will lead to limited educational opportunity, adult unemployment and socio-economic disadvantages. There is increased evidence of psychotic illness among epileptic patients especially when the focus of the seizures starts in the temporal lobe, especially in the left side.

There may be behavioural disturbances often confusional in nature, or mood-related, which may remit spontaneously after a seizure attack.

A diminution in sexual interest and impaired sexual performance are quite common. There is an association between epilepsy and criminal activity especially among males possibly operating through low intelligence, impaired social development and poverty.

The adverse social, educational, and economic disadvantages that confront people with epilepsy may give rise to anxiety and depression.

Suicide is increased almost five-fold among epilepsy patients which emphasises the crucial role of effective control to prevent brain damage.

Wrong use of medication by the non-specialist doctors to control seizures may also be responsible for some mental health problems which reinforce the fact that appropriate specialist doctors should attend to the patients for effective seizure control.

Lassa fever is back! kills 2, infects doctor in LUTH-Lagos, Nigeria

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Two persons were yesterday confirmed dead from Lassa fever at the Lagos University Teaching Hospital, LUTH, even as a resident doctor has been infected with the disease.

Confirming the development, the Chief Medical Director, LUTH, Prof Chris Bode, said not less than 100 hospital workers exposed to the index case are currently   being   monitored.

According to Bode, the patients who were presented very late died after spending a few days on admission.

“Each of these two patients were presented very late and died in spite of efforts to salvage them.  The first was a 39-year old pregnant lady with bleeding disorder who died after a stillbirth.”

He said a post-mortem examination had been conducted before her Lassa fever status was eventually suspected and confirmed.

Bode also confirmed that a resident  doctor  from  the Department of Anatomic and Molecular Pathology, who took part in the autopsy was  later  confirmed   with   the   disease and is  currently   on admission and   responding well to   treatment   at   the   Isolation   Ward of the hospital.

The Chief Medical Director further disclosed that two other suspected cases from Lagos State are   presently admitted and   quarantined while undergoing confirmatory laboratory tests.

He   enjoined   all   LUTH   workers   to maintain a heightened level of alert in the wake of this new outbreak and observe universal precautions in handling all suspected cases of this viral hemorrhagic fever.

Bode said already, LUTH was working with officials of the Lagos State Ministry of Health and the Federal Ministry of Health to contain the present Lassa fever outbreak by mobilising human and material resources to trace the sources   and   extent   of   the   disease,   follow   up   on   potential   contacts, identify early and test suspected cases.

In a related development, Vanguard gathered that the Lagos state epidemiology unit has put out a notice to all heads of health departments in Ikorodu local government area over one of the corpses of the victims allegedly released from LUTH.

The unit has directed health officials to list all contacts with the body. Unconfirmed report said the family had collected the corpse for burial, but the unit directed the officials to prevent the body from being buried in Imota, Ikorodu in order to prevent the spread of the disease.

A notice issued by the Lagos state government to all health workers reads in part: “All HODs in lkorodu LGA and the five LCDAs are hereby alerted to swing into immediate action to list all contacts with the body from the hospital to their destination.

“They should also prevent the body from being buried at home. The address would be posted as soon as it is confirmed. Meanwhile, all officers in lmota are by this notice directed to mount surveillance in lmota town to know where a woman died in LUTH today.

“In addition, we should all note that on no account should a patient suspected to have any of the viral haemorrhagic fevers be moved or transferred from where he/she has been diagnosed. The officer there should contact his superiors locally plus the state epidemiology unit at Alausa and receive clear instructions on what to do next.

“Moving or transferring the suspect will only ignorantly expose more people and create unnecessary, irrational panic. Detain the patient there and make the call. We have two Lassa fever suspects admitted at Mainland Hospital, Yaba,” the notice directed.

World Hepatitis Day 2017: Top 5 Tips To Follow To Never Get Hepatitis

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Viral hepatitis is inflammation of the liver caused due to a virus, and it is one of the leading causes of death globally, accounting for 1.34 million deaths per year.

Viral hepatitis is inflammation of the liver caused due to a virus, and it is one of the leading causes of death globally, accounting for 1.34 million deaths per year. If that weren’t enough, there are five different types of hepatitis virus that you are prone to.The five main types of Hepatitis virus referred to as Types A, B, C, D, and E. But B and C are on the rise globally and are getting to a burden status requiring quick intervention.

The virus spreads quite easily, but there are many ways you can protect yourself from it. So for this World Hepatitis Day, here are our top five tips to save yourself from the hepatitis virus:

1. Stay clean
Practicing good hygiene and sanitation will help reduce your risk of contracting hepatitis A and E. Always wash your hands, clean fruits and vegetables before eating, stay away from under cooked meat or animal products and make sure to have clean water as well. If you are somewhere and unsure of how pure the water is, bring it to a boil for a minute and then have it. Do not share razors, scissors, and needles. If you are around or living with someone who has hepatitis B, make sure to stay away from their blood and bodily fluids.

2. Get vaccinated
Prevention is always better than cure. There are vaccinations available for both hepatitis A and B, and ideally children above a year or older should get it.

3. Be informed
It is important to be educated about the different kinds of hepatitis virus and how they all spread. Hepatitis A and E are usually spread through contaminated food or water, as it is usually excreted through the feces of an infected person. Hepatitis B, C and D are primarily spread through contact with infected blood. Sexual transmission is common in hepatitis B.

4. Take precautions while travelling
It is important to get vaccinated if you are travelling to places where hepatitis virus is common, or there is a high chance of you contracting it. Some areas include Asia, Eastern Europe, Central and South America, Mexico and Africa. Again, make sure to stay clean and sanitary, especially when it comes to food and water.

5. Practice safe sex
Unprotected sexual contact puts you at risk of contracting the hepatitis virus, especially hepatitis B. Using a condom and practicing safer sex can help minimize the risk. It is important to note that you may be at high risk if you have sex with an infected person, have multiple sexual partners, or are a man who has sex with men.

Why is my period late? 8 Possible Reasons You Might Have a Late Period—Other Than Pregnancy

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Having a late period can be very distressing, especially if you are used to having regular periods or concerned about an unexpected pregnancy.

Worried about a late period, but know you’re not pregnant! Missed or late periods happen for many reasons other than pregnancy. Common causes can range from hormonal imbalances to serious medical conditions.

There are also two times in a woman’s life when it’s totally normal for her period to be irregular: when it first begins, and when menopause starts. As your body goes through the transition, your normal cycle can become irregular.

Most women who haven’t reached menopause usually have a period every 28 days. However, a healthy menstrual cycle can range from every 21 to 35 days. If your period doesn’t fall within these ranges, it could be because of one of the following reasons.

 

1. Stress

Stress can throw off your hormones, change your daily routine, and even affect the part of your brain responsible for regulating your period — your hypothalamus. Over time, stress can lead to illness or sudden weight gain or loss, all of which can impact your cycle.

If you think stress might be throwing off your period, try practicing relaxation techniques and making lifestyle changes. Adding more exercise to your regimen may help get you back on track.

2. Low body weight

Women with eating disorders, such as anorexia nervosa or bulimia, may experience missed periods. Weighing 10 percent below what’s considered a normal range for your height can change the way your body functions and stop ovulation. Getting treatment for your eating disorder and putting on weight in a healthy way can return your cycle to normal. Women who participate in extreme exercise such as long distance running/marathons may stop their periods as well.

3. Obesity

Just as low body weight can cause hormonal changes, so can being overweight. Your doctor can recommend a diet and exercise plan that works for you if they determine that obesity is a factor in your late or missed periods.

4. Polycystic ovary syndrome (PCOS)

PCOS is a hormone imbalance that comes down to a lack of ovulationis one of the most common hormonal disorders among women of childbearing age.Though the symptoms vary between individual women, those who have PCOS tend to have abnormal hormone levels, which can cause small cysts to develop on the ovaries, acne, excess facial and body hair, male-pattern baldness, and obesity.

Irregular or even absent periods are also a common feature of this condition.

Women who suspect that they have PCOS should visit their doctor for an evaluation. If not properly treated, the absence of periods during childbearing years may cause endometrial cancer.

5. Birth control

Some types of birth control, particularly hormonal methods, can cause a woman to miss a period.Typically, hormonal birth control provides a form of estrogen combined with progesterone for a set amount of time, followed by several hormone-free days. The withdrawal of these hormones triggers a period.

Sometimes, these hormones keep the lining of the uterus so thin that there is not enough of the lining to cause a period. This applies to all forms of hormonal birth control, including pills, patches, shots, implants, and rings.

In most cases, this is not harmful, but women should speak to a doctor with any concerns about their birth control method.

6. Chronic diseases

Chronic diseases such as diabetes and celiac disease also can affect your menstrual cycle. Changes in blood sugar are linked to hormonal changes, so even though it’s rare, poorly controlled diabetes could cause your period to be irregular.

Celiac disease causes inflammation that can lead to damage in your small intestine, which may prevent your body from absorbing key nutrients. This can cause late or missed periods.

7. Early peri-menopause

Most women begin menopause between ages 45 to 55. Women who develop symptoms around age 40 or earlier are considered to have early peri-menopause. This means your egg supply is winding down, and the result will be missed periods and eventually the end of menstruation.

Irregular estrogen levels can alter a woman’s menstrual cycle, making it common for women in perimenopause to experience irregular or missed periods. Once a woman has gone a full year without a period, she is said to have gone through menopause.

8. Thyroid issues

An overactive or underactive thyroid gland could also be the cause of late or missed periods. The thyroid gland, located in your neck, regulates your metabolism. It also interacts with many other systems in your body to keep things running smoothly The thyroid regulates your body’s metabolism, so hormone levels can be affected as well.

Thyroid issues can usually be treated with medication. After treatment, your period will likely return to normal.

When to see your doctor

If you are concerned about missed periods, it can be helpful to keep a written record of your periods, including the start and end dates, and a list of any other associated symptoms.

If your doctor has a written record to refer to, they can make a diagnosis more quickly. Using a simple calendar can work, but there are also apps available for smartphones.

diary to record missed periods

Having regular check-ups with a gynecologist or women’s health specialist can help address many questions about menstrual cycles. Sometimes, a late period is an isolated occurrence and is not a cause for concern.

However, certain symptoms may require medical attention. They include:

  • missing several periods in a row
  • a positive pregnancy test
  • having symptoms of PCOS, as described above
  • having gained or lost a lot of weight
  • feeling overly stressed

If you have the following symptoms, contact a doctor right away:

  • unusually heavy bleeding
  • fever
  • severe pain
  • nausea and vomiting
  • bleeding that lasts longer than seven days
  • bleeding after you’ve already entered menopause and had no periods for a year

For more info please send a mail to doctorsmagazineng@gmail.com

‘Save my son’s life’, mother cries!

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After visits to several spiritual homes failed to yield the expected results, mother of David Effiong, 14-year-old boy who has been down with Ameloblastoma of Madible for the past four years, Mrs. Maria Effiong, is seeking financial assistance to save her son’s life.

David’s education journey seems to have come to a halt since the crisis started but his mother doesn’t want his life to stop. She said the problem began four years ago when David’s jaw appeared to look like a baby affected by heat, which the family did not bother about,

“We did not bother because we thought it wasn’t serious but after a month, it developed to something like a big boil, and after he complained, I sought the help of pharmacists who gave me drugs to use. Instead of healing, the swelling began to grow bigger.

 “I took him to the hospital, where he was treated for a while before I was told the ailment cannot be cured in the hospital, that I should take him to church. I was later told to take him to specialist hospital after the many church programmes could not make the swelling disappear. Presently, we cannot afford the hospital bills.”

The mother who went to The Guardian Newspapers from Nsit Atai local council, Uyo, in Akwa Ibom State with her son and brother in-law residing in Lagos, said: “I don’t know where else to run to than to come to The Guardian Newspapers so that the public can help me, and also the Akwa Ibom State government can learn about my ordeal.”

An Indian hospital, Yoshooda, stated that the surgery would cost around $5,465 to $6560 with seven days stay in the hospital for the surgery. The family is appealing to the public to raise N5 million, an estimated cost of surgery and travel.

David’s mother can be reached on 08058047600 and donations can made to Union Bank, David Effiong, 0056840909.

Finally! Nigerian Senate passes bill for compulsory treatment and care of victims of gunshots

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The Senate on Tuesday passed the Compulsory Treatment and Care of Victims of Gunshots Bill aimed at ensuring that victims of gunshot wounds receive treatment from medical workers and assistance from security agencies.

Speaking on the passage of the Bill, the Senate President, Abubakar Saraki, said not every victim of gunshot wound is a criminal, hence, it is important that a legal framework be put into place to avoid unnecessary loss of lives.

By the passage of this Bill, the Senate has moved to ensure that every hospital in Nigeria, both public and private, must accept to treat victims of gunshot wounds without any clearance from the police,” the Senate President said.

“What we have done is to ensure that everyone is entitled to medical treatment, irrespective of the cause of the shooting. We should reserve judgment for the criminal justice system, and leave healthcare for the medical professionals.”

The Compulsory Treatment and Care of Victims of Gunshots Bill also ensures that every person including security agents shall render every possible assistance to any person with gunshot wounds and ensure that the victim is taken to the nearest hospital for treatment.

Additionally, the Bill mandates that no person with gunshot wounds shall be refused immediate and adequate treatment by any hospital in Nigeria whether or not initial monetary deposit is paid.

Premium Times

Bill to make premarital Genotype test compulsory scales second reading

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A bill seeking to make haemoglobin-genotye testing compulsory for intending couples in Nigeria passed the second reading on Tuesday.

The bill, which was sponsored by Senator Ahmed Ogembe (PDP, Kogi Central), will make the screening of couples compulsory before a marriage is conducted under the Marriage Act and before registration of new births under the Birth, Death Compulsory Registration Act.

Leading debate on the bill at the plenary on Tuesday, Ogembe said the objective of the bill was to establish a clear legislative framework for effective management of sickle cell disease, which is caused by mismatch of couples’ genotype.

According to Ogembe, the bill has become necessary, following the untold pains suffered by people living with sickle cell disease.

Sickle-cell Disease

He said, “We simply want to avoid human anxiety, pains and death as related to sickle cell disease.

“We want to improve the lives of often forgotten citizens who live with it.

“Unknown to many, it is one of the biggest public health problems in Nigeria. Nigeria, from reports, is known to have the greatest number of sickle cell disease in the world.

“The picture is brought into sharper focus when we consider the findings by the American Centre for Disease Control and Prevention that, slightly above 300,000 babies globally are born with severe sickle cell diseases; out of which 225,000 are born in Sub-Sahara Africa, representing 75 per cent of the global figure.

“This bill, when passed, will reduce the incidence of the disease to the barest minimum in our nation and allow families to live in joy.

“Research has shown that only five per cent of children born with sickle cell disease live past the age of 10 years in Nigeria.”

The lawmaker noted that while the life expectancy of persons living with sickle cell disease in advanced countries was between 40 and 60 years, it was lower in Nigeria.

He stated that there was an urgent need for a solution to the problem, adding that, “A situation where, in every two babies born in the world with sickle cell, one is a Nigerian, is not encouraging.”

Senators who spoke on the bill hailed the sponsor, while saying that the proposed law would help to protect unborn children from the excruciating pains associated with the disease.

They described the disease as ‘avoidable,’ with proper awareness on the need for intending couples to undergo the test.

In his remarks, the President of the Senate, Bukola Saraki, referred the bill to the Committee on Health, to be returned to the Senate in four weeks.

He urged the committee to merge the bill with one currently before it, which has similar objectives, and for it to come up with a single bill that would address the problem.

Mystery Bumps Near Your Vagina? Here’s What They Could Be.

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You may need to constantly check out for cyst.

Have you noticed small bumps on your vaginal area? Health’s medical weighs in on what they could be—and whether you should have a doctor check them out.

If you spot small bumps near your vagina, don’t panic. Do some checks…do they look like little pimples? Small red bumps/sometimes itchy or slightly tender can occur when hair follicles get clogged or infected (a.k.a. folliculitis). You can get bumps and irritation below the belt from shaving, waxing, or wearing tight, sweaty workout leggings or dirty underwear, which allows bacteria to breed and clog the pores in the area. Red bumps, and possibly itchy, rash-like, or swollen skin around them, might also be contact dermatitis caused by an allergy or skin sensitivity to, say, a new detergent or body wash.

If you are seeing a small lump near the vaginal opening, it could also be a cyst cyst is a sac-like pocket of tissue that contains fluid, air, or other substances. There are two small glands (called Bartholin’s glands) on either side of the opening that secrete mucus to lubricate the vagina, and a cyst can form if fluid builds up in a gland and causes a blockage. The cysts typically go away on their own, but if your lump is painful or very large, see your doctor, who can drain it if need be.

Certain sexually transmitted infections, like herpes and genital warts, and a skin infection called molluscum contagiosum do cause sores or bumps on the genitals. So if there is a possibility that you contracted an STI, be sure to get examined by your gyno ASAP, and avoid sexual activity until you get test results and treatment if needed.

Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine.

World Sickle Cell Day 2017: Celebrating The Warriors!

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World Sickle Cell Day (World Sickle Cell Awareness Day) is an annual global public health campaign held on June 19. It focuses on raising awareness of sickle-cell disease, also known as sickle-cell anemia, which is the most frequent genetic disorder worldwide.

Sickle-cell disease (SCD) is a hereditary blood disorder, characterized by an abnormality in the oxygen-carrying hemoglobin molecule in red blood cells. Affected cells assume an abnormal sickle-like shape, hence the name of the disease.

SCD may lead to a number of complications, some of which may cause death. The most common health problems associated with SCD are sickle-cell crisis (an acute condition characterized with severe pain attacks), severe infections and stroke. These complications can be prevented, but only if a person with SCD has access to adequate health care facilities.

Almost 300,000 children are born with SCD and over 100,000 people die due to it each year. The highest frequency of the disorder is found in tropical regions, particularly sub-Saharan Africa, the Middle East, and the West Indies.

On the occasion of World Sickle Cell Day, health organizations throughout he world organize events and activities aimed at raising awareness of sickle-cell anemia and the importance of its research.

1. Sickle Cell affects all races but is predominant among people in SubSaharan Africa.
2. West Africa hosts the largest pool of people with Sickle Cell anaemia and sickle cell trait         worldwide.
3. Between 3 and 5 million Nigerians have Sickle Cell anaemia and 50 million harbour the           trait.
4. Every fourth Nigerian has sickle cell trait, the majority unaware.

Please go round and give a give to a Sickle Cell warrior around you!