DO YOU KNOW YOUR HEPATITIS B STATUS?

Hepatitis B virus (HBV) is an infection that can cause severe liver damage, sometimes resulting in death. Hepatitis B is very common around the world, particularly in Africa, the Indian sub-continent and throughout the rest of Asia.
An estimated 240 million people are chronically infected with hepatitis B (defined as hepatitis B surface antigen positive for at least 6 months). More than 686 000 people die every year due to complications of hepatitis B, including cirrhosis and liver cancer.Hepatitis B is an important occupational hazard for health workers.However, it can be prevented by currently available safe and effective vaccine.
Transmission and prevention
Hepatitis B virus (HBV) and HIV can be transmitted in similar ways, but hepatitis B is more infectious. Both are spread by contact with infected body fluids such as blood, semen and vaginal fluid, or from a mother to her baby during pregnancy or delivery.
Diagnosis and monitoring
All people living with HIV should be screened for hepatitis B. There are a number of tests to determine if you are currently infected with hepatitis B, if you have been infected and if you have managed to clear the infection – which makes you immune to future infection – or if you are immune due to vaccination. Following detection of HbsAg in the blood, further investigation would be conducted like Full hepatitis B profile, Liver Function Test, Viral Load, and abdominal scan with subsequent monitoring based on the discretion of your physician.
Symptoms and disease progression
The majority of adults who are infected with hepatitis B have no symptoms, and infection is often only diagnosed by routine blood tests and monitoring the health of the liver.
Some people, however, develop symptoms soon after being infected with hepatitis B (known as the acute phase). These can include the following:
 Fatigue (unusual tiredness).
 Fever (high temperature).
 Nausea and vomiting.
 Loss of appetite.
 Pain in the upper abdomen or belly.
 Muscle or joint aches.
 Feeling generally unwell (malaise).
 Yellowing of the skin and the eyes (jaundice)

Hepatitis B and HIV
Between 5 and 10% of people with HIV are also infected with hepatitis B virus (often called co-infection). People with HIV are less likely to naturally clear the hepatitis B without treatment. People with HIV and hepatitis co-infection can have faster liver disease progression and may not respond as well to hepatitis B treatment. But having hepatitis B does not seem to make HIV disease worse.
Treatment Options
If you know your hepatitis B status and you are positive, or you know someone who is kindly leave a comment below or contact us at whitecoatweb@gmail.com to book a clinic visit with our Consultant Gastroenterologist or seek advice from a General Practitioner.

REFERENCES
1. www.who.int/mediacentre
2. http://www.aidsmap.com

HEALTH IMPACTS OF FLOODS.

A flood is an overflow of water that submerges land which is usually dry.

The primary effects of flooding include loss of life, damage to buildings and other structures, including bridges, sewerage systems, roadways, and canals.

The Nigeria Meteorological Agency (NIMET) Has issued a red alert regarding flooding in 11 states in Nigeria in the month of August.

The states listed are Akwa Ibom, Bauchi, Benue, Borno, Cross River, Delta, Kaduna, Kwara, Nasarawa, Yobe and Zamfara states.

This was contained in a statement issued on Tuesday, August 9, and released to journalists in Abuja, Sahara Reporter.

A study conducted by Du W, FitzGerald GJ, Clark M, Hou XY on the above topic showed that the health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the medium-term, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy.

Flood Control Tips.

Sea/Coastal defence walls
Sea walls and tide gates have been built in some places to prevent tidal waves from pushing the waters up ashore. In some areas too, sand bags are made and placed in strategic areas to retain flood waters.

Retaining walls in some places, retaining walls levees, lakes, dams, reservoirs or retention ponds have been constructed to hold extra water during times of flooding.

Town planning
It is important that builders acquire permission before buildings are erected. This will ensure that the waterways are not blocked. Also, drainage systems must be covered and kept free from objects that chock them. This way, water can quickly run through if it rains and minimize any chance of town flooding. Drainage systems should also be covered to prevent litter from getting into them.

Vegetation
Trees, shrubs and grass help protect the land from erosion by moving water. People in low-lying areas must be encouraged to use a lot of vegetation to help break the power of moving flood water and also help reduce erosion.

Education
In many developing countries, drainage systems are chocked with litter and people have little knowledge of the effects that can have during a rain. When it rains, waterways and culverts are blocked by massive chunks of litter and debris, and water finds its way into the streets and into people's homes. Education is therefore very important, to inform and caution people about the dangers of floods, what causes floods, and what can be done to minimise its impact.

Detention basin
These are small reservoirs built and connected to the waterways. They provide a temporary storage for flood waters. This means in an event of flooding, water is drained into the basin first, giving people more time to evacuate. It can also reduce the magnitude of downstream flooding.

References

1. http://eschooltoday.com/natural-disasters
2. https://www.ncbi.nlm.nih.gov/pudmed
3. https://en.wikipedia.org

POLIO ERADICATION (POLIOMYELITIS)

In the early 80s infants mortality due to polio infection was very high, secondary to lack of health education, poor hygiene and unavailability of polio vaccine, but with public health awareness and vaccination, mortality due to infectious diseases have reduced drastically.  A study conducted by WHO showed  that Polio cases have decreased by over 99% since 1988, from an estimated 350 000 cases in more than 125 endemic countries then, to 74 reported cases in 2015.

Despite this huge achievement, the world is practically not safe until polio is totally eradicated. There are pockets of polio cases in developing countries like ours despite the huge funds already spent to eradicate polio, and the most recent outbreak in Nigeria is linked to the Insurgency in the North eastern part of Nigeria, which has denied several people in that area access to quality health care.

Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. The virus is transmitted by person-to-person spread mainly through the fecal-oral route or, less frequently, by a common vehicle (e.g. Contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis. Polio mainly affects children under 5 years of age. There is no cure for polio, it can only be prevented. Polio vaccine, given multiple times, can protect a child for life.

Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio, it can only be prevented by immunization.

There are two types of vaccine that protect against polio: inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV). IPV is given as an injection in the leg or arm, depending on the patient's age. Polio vaccine may be given at the same time as other vaccines. Most people should get polio vaccine when they are children. Children get 4 doses of IPV at these ages: 2 months, 4 months, 6-18 months, and a booster dose at 4-6 years.

Considering the extent of damage caused by the polio virus evidenced by the attached pictures, Its important to ensure that our children get vaccinated to avoid the associated physical disability and eventually reduce the global financial burden as it was estimated that once global polio eradication is achieved a net gain of  40-50 billion dollar would be saved.

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Maternal and Child Health Receives Boost in Northern Nigeria

Minister of State for Health Dr. Muhammad Ali Pate has said that   maternal and child health in Northern Nigeria will received a boost as the Nigerian Union of Road Transport Workers (NURTW) and Partnership for Reviving Routine Immunization in Northern Nigeria and Maternal and Newborn and Child Health (PRRINN-MNCH) collaborated to provide emergency services to pregnant women in the rural areas in the Northern Nigeria.

The Minister made this known over the weekend, in Abuja in a keynote address at the signing of Memorandum of Understanding (MOU) between the PRRINN-MNCH and NURTW on how to accelerate provision of Transport Service to pregnant women on emergency.

The Minister said that the partnership between the two organizations will complement Federal Government effort in providing maternal and child healthcare service in the rural area.

He said that there are socio-economic disparities between rural and urban duelers in Nigeria adding that women in the rural areas have the highest risk of dying during child birth than those living in the urban centres.

However, the Minister said that the Federal Government has deployed Midwives and community health workers to the rural areas across the country to assist pregnant women.

Earlier, the President, National Union of Road Transport Workers Union (NURTW) Alh. Najeem Usman said that studies have shown that one of the barrier that delay women from getting to health facility in the rural area is lack of transport.

To bridge the gap, he said the NURTW and PRRINN-MNCH in collaboration with the Jigawa, Katsina, Yobe and Zamfara  state governments decided to set up an Emergency Transport Scheme (ETS) to ease the suffering of women and minimize maternal complication caused through delay in reaching health facility.

Alhaji Usman also noted that MOU was to expand the Emergency Transport Services (ETS) initiative to the entire rural communities in the country.

To achieve the overall goal of reducing the high maternal mortality ratio in Nigeria, the ETS need to be scaled up beyond the four states”, he said.

Brain Injury Doesn't Raise Dementia Risk for Most: Study But likelihood of re-injury does increase

 Having a traumatic brain injury at some time in your life doesn't raise the risk of dementia in old age, but it does increase the odds of re-injury, a new study finds.

"There is a lot of fear among people who have sustained a brain injury that they are going to have these horrible outcomes when they get older," said senior author Kristen Dams-O'Connor, assistant professor of rehabilitation medicine at the Icahn School of Medicine at Mount Sinai Medical Center in New York City.

"It's not true," she said. "But we did find a risk for re-injury."

The 16-year study of more than 4,000 older adults also found that a recent traumatic brain injury with unconsciousness raised the odds of death from any cause in subsequent years.

Those at greatest risk for re-injury were people who had their brain injury after age 55, Dams-O'Connor said. "This suggests that there are some age-related biological vulnerabilities that come into play in terms of re-injury risk," she said.

Dams-O'Connor said doctors need to look out for health issues among older patients who have had a traumatic brain injury. These patients should try to avoid another head injury by watching their balance and taking care of their overall health, she said.

To investigate the consequences of a traumatic brain injury in older adults, the researchers collected data on participants in the Adult Changes in Thought study, conducted in the Seattle area between 1994 and 2010. The participants' average age was 75.

At the start of the study, which was published recently in the Journal of Neurology, Neurosurgery & Psychiatry, none of the participants suffered from dementia. Over 16 years of follow-up, the researchers found that those who had suffered a traumatic brain injury with loss of consciousness at any time in their lives did not increase their risk for developing Alzheimer's or other forms of dementia.

The risk of another traumatic brain injury, however, more than doubled if the first injury occurred before age 25 and almost quadrupled if the injury happened after age 55. Similarly, a recent traumatic brain injury more than doubled the odds of death from any cause, the study found.

Dams-O'Connor's group plans to look at risk factors to try to understand why some people have poor long-term prognosis after a brain injury.

One expert said genetics may play a role. "My guess is that the risk for post-traumatic-brain-injury Alzheimer's disease has a genetic component with some genes increasing risk and others offering protection," said Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer's Disease Research Center in New York City.

These findings should not be confused with those regarding athletes who suffer brain injuries, Gandy said.

"The dramatic examples of former [National Football League] players, hockey players and wrestlers who have an unusual illness, marked by depression, agitation and psychosis are quite different from Alzheimer's disease patients who tend to be apathetic," he said.

"Much remains to be discovered about the role of lifelong traumatic brain injury history, including severity and nature of torque and other physical factors, and late-life mental decline," Gandy said.

Another expert, Dr. Danny Liang, a neurosurgeon at North Shore-LIJ Cushing Neuroscience Institute in Manhasset, N.Y., thinks these findings are too narrow to say much about the risk of dementia as a result of traumatic brain injury.

"The study is restricted to a limited population so it's hard to extrapolate these findings to other populations," he said. "It is also possible that there were people who had traumatic brain injury who did develop dementia before age 65, so they were not included in the study," Liang said.

There also was no data on injury severity or duration of unconsciousness, he said. Brain injuries differ, and knowing the severity is important to determine the ultimate outcome, he said.