SICKLE CELL DISEASE

This is one of the sickle cell disorders. It is the commonest in this part of the World. It is estimated that approximately 25% of the population have the sickle cell trait (AS). In Nigeria, it is estimated that about 100,000 babies are delivered yearly with sickle cell anaemia. Sickle cell anaemia occurs when two individuals with haemoglobin type AS get married. The outcome of this is that anytime the woman is pregnant, there is a 25% chance that the baby is going to have Haemoglobin type SS. Image

Sickle cell anaemia is a problem of the blood where an individual is born with Haemoglobin type SS. Haemoglobin is the substance in blood responsible for the transfer of oxygen from one part of the body to the other. Individuals with sickle cell anaemia cannot transport oxygen properly in blood. The haemoglobin forms crystals whenever oxygen concentration drops in the blood. This then leads to sickling of the red blood cells, hence the name sickle cell anaemia. The sickled cells then block blood vessels leading poor blood flow to vital parts of the body. The organs become ischaemic and may become infarcted. Image

The earliest sign of sickle cell anaemia is swelling of the hands and feet in the first year of life. This usually occurs from the age of 6 months. The children are also prone to recurrent bone pains as well as body pains. They will be weak and get fatigued easily as a result of the anaemia. The anaemia results from the excessive destruction of the sickled cells by the spleen. The children will also have jaundice which is a yellowish discolouration of the eyes. More severe complications include stroke, priapism, kidney problems and leg ulcers among others.

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It is important that a child should get to start seeing a specialist once the diagnosis of sickle cell is made. This will prevent some of this problems. Prevention is for individuals who are Haemoglobin type AS to refrain from getting married. Image

LABORATORY DIAGNOSIS OF SICKLE CELL DISEASE

There are several techniques which include: – Full Blood Count (FBC)/ Film Reading – Haemoglobin Electrophoresis – Use of amniotic fluid for prenatal diagnosis (Amniocentesis) – Sickling test – Solubility test  The routinely carried out techniques at St Nicholas Hospital laboratory are Electrophoresis, FBC and blood film appearances. In electrophoresis there is migration of different haemoglobin variants in an electrically charged field. This separates the haemoglobin variants and they are identified accordingly. FBC reveals anaemia,i.e. the low level of patient’s packed cell volume (PCV), increased WBC count etc.The blood film will show the red cell morphology which is sickled in shape (i.e. crescent), nucleated RBC and target cells with distortion in sizes and shapes of the RBCs. It is advocated that sickle cell carriers should seek to marry non-sickle cell carriers  to avoid increased population of individuals with the sickle cell disease. 

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Is Second Hand Smoke as unsafe as Smoking?

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Most people, even smokers, have become aware that smoking is bad for the health.
In reality, most of the smoke from a burning cigarette doesn’t get sucked down into a smoker’s lungs – it escapes into the air, where it can be inhaled by anyone unfortunate enough to be nearby.

Second Hand Smoke (SHS) or Passive smoking is the inhalation of smoke or environmental tobacco smoke (ETS), by persons other than the intended “active” smoker.

Most exposure to second hand smoke occurs in homes and workplaces. Second hand smoke exposure also continues to occur in public places such as restaurants, bars, and casinos, as well as in vehicles.

Nathan’s Story

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Nathan, 54, Idaho; diagnosed with severe lung damage from second hand smoke exposure

Nathan, a Native American, never smoked cigarettes.
For eleven (11) years, he worked at a casino that allowed smoking. The exposure to second hand smoke caused him to develop allergies and serious infections that triggered asthma attacks, eventually causing permanent lung damage called bronchiectasis. “The casino was filled with smoke from so many people smoking,” he said. Breathing in other people’s smoke on a daily basis made his health so bad that he had to leave that job.
Nathan used to be active and athletic. He served in the Marines. He loved to participate in tribal dances. After getting sick, dancing just a few steps wore him out. Nathan hoped that sharing his story would help others understand how dangerous exposure to second hand smoke really is. Nathan’s lung damage led to his death on October 17, 2013. He was 54.

 

References: http://www.cdc.gov/tobacco/quit_smoking/

PEEK

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A new smart phone based system, known as PEEK (Portable Eye Examination Kit) has been developed by a team of experts in the fields of eye care, research, and mobile technology.

PEEK is designed to be a comprehensive eye examination tool that leverages mobile phone technology to extend the availability of ophthalmic diagnostic tests beyond expensive treatment centres to anywhere in the world, no matter how remote.

According to The World Health Organization (WHO), 285 million people are estimated to be visually impaired worldwide. Out of which, 39 million are blind and 246 million have low vision. Moreover, 90% of the world’s visually impaired live in developing countries; a staggering statistic, considering that 80% of all visual impairment can be avoided or cured (WHO).

Currently, PEEK has the following applications:

  • Patient record with Geo-tagging
  • Visual Acuity
  • Visual field testing
  • Colour Vision Testing
  • Contrast Sensitivity Testing
  • Lens imaging for cataract
  • Retinal Imaging
  • Image grading

The ultimate vision of PEEK developers is to create an affordable and portable device that empowers general health workers and eye care practitioners to diagnose eye diseases and provide a means for managing and monitoring the treatment of patients, anywhere in the world.

MATERNAL, NEW BORN, AND CHILD HEALTH IN NIGERIA

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Every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world – UNICEF

Such an alarming rate of deaths occurring in the country every single day is unacceptable. Consequently, there is an immediate need to identify practices that have been successful in other countries, distilling the pertinent information and hopefully adapting it in such a way that the country’s mortality and morbidity rates for mother and infant alike are significantly reduced

CONTRIBUTING FACTORS

There are several factors that cause high rates maternal and infant mortality in Nigeria. For the sake of brevity they will be listed as follows:

  1. Lack antenatal care
  2. Absence of skilled midwives/birth attendants
  3. Delay in treatment of pregnancy complications
  4. Malnutrition, particularly in the case of post-neonatal mortality
  5. Indirect factors such as:
    1. Socio-economic status (i.e. poverty)
    2. Maternal education level
    3. Cultural practices

THE WAY FORWARD

The first step that must be taken in order to improve Nigeria’s abysmal Maternal, New born and Child Health (MNCH) status is to extrapolate good practices seen in other parts of the world, particularly other parts of Africa and adapting them to facilitate the desired change.

A comprehensive MNCH report presented by the African Union Commission (AUC) offers evidenced based practices form different parts of Africa that have been helpful in improving reproductive and maternal, new born, and child health outcomes. For example the initiatives discussed for maternal health are:

  1. Midwifery education and professional development
  2. Creation of midwifery database
  3. Maternity waiting homes
  4. Community based approach to increase utilization of maternal health services
  5. Civil society engagement in prevention of obstetric fistula
  6. Reforming laws and expanding access to safe abortion services

Each of the aforementioned initiatives is not intended to be implemented by one individual or organisation, but in tandem with several implementation partners and collaborators.

St. Nicholas House Fire Incident

PRESS RELEASE

For Immediate release: February 3, 2014

 

Feb. 3, 2014, 9:00 a.m. WST – At approximately 5:55 p.m. on Sunday, Feb. 2, 2014, there was a fire on the 9th floor of St. Nicholas House.   The appropriate agencies were alerted and a combined effort ensured the fire was promptly extinguished and the site was secured. 

No other floors or buildings were affected.  Contrary to reports, there were neither injuries sustained nor loss of life.

St. Nicholas House, where the incident occurred, is a 14-story office building adjacent to St. Nicholas Hospital Lagos and is a considerable distance from the patient wards. As a result an evacuation was unnecessary and there were no patient or staff casualties of any kind. Furthermore, there was no damage to the hospital itself.

Although investigations are on going, the cause of the fire is likely to be electrical.

We kindly request that all statements indicating any form of patient casualties and/or structural damage to St. Nicholas Hospital be regarded as false and should be ignored.

This incident has not affected the daily operations of St. Nicholas Hospital in any way and we are currently open and continue to operate at normal capacity.

For further information please contact:

ENGR BELLO

Resident Engineer

St. Nicholas House

Catholic Mission Street

Lagos

Telephone: (+234) 802 310 7306

 

Thank you.

For St Nicholas Hospital

Polio in Nigeria

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According to the Global Polio Eradication Initiative, Nigeria is one of the most entrenched reservoirs of wild poliovirus (WPV) in the world. Nigeria is the only country with the on going transmission of all three serotypes of the poliovirus namely, wild poliovirus type 1 (WPV1), wild poliovirus type 3, and circulating vaccine-derived poliovirus type 2 (cVDPV2). In its weekly report, the Global Polio Eradication Initiative highlighted the north of the country as the main source of polio infection. The disease also remains endemic in Afghanistan and Pakistan.

In 2013, The Bill and Melinda Gates Foundation made wiping out Polio in the next six years its utmost priority. However, on January 21, 2014 Bill Gates warned that violence in Nigeria and Pakistan could be a major setback in achieving his goal of eradicating Polio. The Islamic insurgency, chiefly in the form of Boko Haram, is the major cause for concern as regards progress in Nigeria.

Polio This Week in Nigeria

  1. No new WPV cases were reported this week. The total number of WPV cases for Nigeria 2013 remains 53 (all WPV1). The most recent WPV1 case in the country had onset of paralysis on 15 December 2013 (from Damboa, Borno).
  2. No new cVDPV2 case was reported in the past week. The total number of cVDPV2 cases for 2013 remains 3. The most recent cVDPV case had onset of paralysis on 6 November 2013 (from Konduga, Borno).
  3. Sub-National Immunization Days (SNIDs) were conducted in south-eastern states of Nigeria on 7-9 and 14-17 December 2013. Further National immunization days (NIDs) are planned for late January, followed by National immunization days in March.

Tips For a Better Memory

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Normal age-related changes in the brain tend to slow some of our cognitive processes, making it harder to learn new things and easier to get distracted. It can also represent a loss of self as our memories make-up an internal biography of things we have done, people we love, and much more.

As a result, much research has been done on ways people, both young and old, can sharpen their minds.

From Harvard Health Publications here are a few research proven tips for a better memory:

1. Economize your brain use

Take advantage of calendars and planners, maps, shopping lists, file folders, and address books to keep routine information accessible. Designate a place at home for your glasses, keys, and other items you use frequently

2. Organize your thoughts

New information that’s broken into smaller chunks, such as the hyphenated sections of a phone or social security number, is easier to remember than a single long list, such as financial account numbers or the name of everyone in a classroom.

3. Use all your senses

The more senses you use when you learn something, the more of your brain will be involved in retaining the memory. For example, odours are famous for conjuring memories from the distant past, especially those with strong emotional content, such as visits to a cookie-baking grandparent.

4. Repeat after me

When you want to remember something you have just heard or thought about, repeat it out loud. For example, if you’ve just been told someone’s name, use it when you speak with him or her: “So John, where did you meet Paul?”

5. Space it out

Instead of repeating something many times in a short period, as if you were cramming for an exam, re-study the essentials after increasingly longer periods of time — once an hour, then every few hours, then every day. Spacing out periods of study is particularly valuable when you are trying to master complicated information

6. Make a mnemonic

Mnemonic devices are creative ways to remember lists. They can take the form of acronyms — such as the classic “Every good boy does fine,” to remember the musical notes E, G, B, D, and F on the lines of the treble clef. For older learners, a particularly helpful system is a story mnemonic — that is, a brief narrative in which each item cues you to remember the next one

7. Challenge Yourself

Engaging in activities that require you to concentrate and tax your memory will help you maintain skills as you age. Discuss books, do crossword puzzles, try new recipes, travel, and undertake projects or hobbies that require skills you aren’t familiar or comfortable with.

Adapted from Harvard Health Publications by Ladipo Eso