HEPATITIS B MANAGEMENT

A man once volunteered to donate blood to his family member who needed blood transfusion. After doing all the necessary checks, the man was told that he was not qualified to do so and was asked to see the doctor for further examination.

On getting to the doctor, he was told he had hepatitis B. He was given medications and managed for six months. After that period, a repeat test was done twice and both came out negative.

The doctor first congratulated the patient, saying his own immune system got rid of the virus, and that his condition was called acute hepatitis.

 A hepatitis B infection can result in either an acute infection or a chronic infection. When a person is first infected with the hepatitis B virus, it is called an “acute infection” (or a new infection).

Most healthy adults infected do not have any symptoms and are able to get rid of the virus without any problems. Some are, however, unable to get rid of the virus after six months and they are diagnosed as having a “chronic infection.” A simple blood test can diagnose an acute or chronic hepatitis B infection.

Hepatitis B is a global public health threat and the world’s most common liver infection. It is up to 100 times more infectious than the HIV/AIDS virus. It is deadly because the hepatitis B virus attacks and injures the liver. Two billion people, basically one in three people, have been infected worldwide.

Diagnosis

Seeking medical attention if one doesn’t feel well or if one is uncertain about whether or not if one has been infected with hepatitis B. A simple hepatitis B blood test can easily diagnose whether or one has an infection. Testing is the only way to know for sure if one is infected.

Symptoms

Hepatitis B is called a “silent infection” because most people do not have any symptoms when they are first infected. Thus, they can unknowingly pass the virus to others and continue the silent spread of hepatitis B.

The common symptoms are fever, fatigue, unexplained weakness, muscle pain, joint pain, loss of appetite, mild nausea and vomiting, stomach pain, pale or light-coloured stools and dark-coloured urine. Serious symptoms that require immediate medical attention are severe nausea and vomiting, yellow eyes and skin (called “jaundice”), bloated or swollen stomach.

Transmission

The hepatitis B virus is transmitted through blood and bodily fluids. This can most commonly occur in the following ways: Direct contact with infected blood, unprotected sex, use of illicit drugs, needles that are contaminated or not sterile, from an infected woman to her newborn during pregnancy, childbirth and breastfeeding. Also, body piercing, tattooing, acupuncture and even nail salons are other potential routes of infection unless sterile needles and equipment are used. In addition, sharing sharp instruments such as razors, toothbrushes, nail clippers, earrings and body jewellery can be a source of infection. Hepatitis B is NOT transmitted casually. It cannot be spread through toilet seats, doorknobs, and sneezing, coughing, hugging or eating meals with someone who is infected.

Prevention

Everyone should be tested; if they have not been infected and have not received the hepatitis B vaccine then they should also start the vaccination immediately. In addition to vaccination, there are other simple ways to help to stop the spread of  the virus. These are:

Washing of hands with soap and water after any potential exposure to blood; use of condoms with multiple sexual partners, non-direct contact with blood and bodily fluids.

 Also, clean up blood spills with a fresh diluted bleach solution (mix one part bleach with nine parts water), cover all wounds carefully, avoid sharing sharp items such as razors, nail clippers, toothbrushes, and earrings or body rings. Discard sanitary napkins and tampons into plastic bags, using new sterile needles for tattoos and acupuncture.

Management of hepatitis B

Have you recently been diagnosed with hepatitis B? Has any of your family members or loved ones tested positive for hepatitis B?  You are not alone. In fact, nearly one in three people worldwide are infected with the hepatitis B virus in their lifetimes. Receiving a diagnosis of hepatitis B can be confusing or overwhelming, and may lead to many questions or concerns.

Do you have an acute or chronic infection? When someone is first infected with hepatitis B, it is considered an acute infection. If you continue to test positive for hepatitis B after six months, it is considered a chronic infection.

Pregnancy and hepatitis B:

Babies born to a mother with hepatitis B have a greater than 90 per cent chance of developing chronic hepatitis B if they are not properly treated at birth. It is imperative for pregnant women to know their hepatitis B status in order to prevent passing the virus on to their newborn baby during delivery.

Their new-born must be given two shots immediately in the delivery room: first dose of the hepatitis B vaccine, one dose of the Hepatitis B Immune Globulin.

Breastfeeding and Hepatitis B:

The WHO recommends that all women with hepatitis B should be encouraged to breastfeed their newborns. The benefits of breastfeeding outweigh any potential risk of infection. Since it is recommended that all infants be vaccinated against hepatitis B at birth, any potential risk is further reduced.

Adults living with hepatitis B: All patients with chronic hepatitis B infections, including children and adults, should be monitored regularly since they are at an increased risk for developing complications (cirrhosis, liver failure, or liver cancer).

Are you infected with hepatitis B?

Are you protected from hepatitis B because you were vaccinated or have recovered from a past infection? Are you at the risk of being infected with hepatitis B? It is very important to understand your hepatitis B blood test results so that you can receive the right kind of care and follow-up.

Not everyone who tests positive for hepatitis B will require medication. Other tests like liver function test ,abdominal scan and viral load are important. Depending on your test results, you and your doctor might decide to wait and monitor your condition.

If your test results indicate that you would be a good candidate for treatment, then your doctor will discuss the current treatment options with you.

While living with hepatitis B can be difficult and scary at first, the more information and support that you have, the easier it gets. The most important thing to remember is that hepatitis B is a chronic medical condition (such as diabetes and high blood pressure) that can be successfully managed if you take good care of your health and your liver.

You should expect to live a long, full life. Once you are diagnosed with chronic hepatitis B, the virus will most likely stay in your blood and liver throughout your life. It is also important to know that you can pass the virus to others, even if you don’t feel sick. This is why it’s so important that you make sure that all close household contacts and sex partners are tested and vaccinated against hepatitis B.

Vaccination

It takes only three shots to protect yourself and your loved ones against hepatitis B. The hepatitis B vaccine is a safe and effective vaccine that is recommended for all infants at birth and for children up to 18 years.

The hepatitis B vaccine is also recommended for adults living with diabetes and those that can be infected in the course of their jobs, lifestyle, living situations, or country of birth.

Since everyone is at some risk, all adults should seriously consider getting the hepatitis B vaccine for a lifetime protection against a preventable chronic liver disease .To be certain that you are protected against hepatitis B, ask for a simple blood test to check your “antibody titres” that will confirm  whether the vaccination was successful.

The Better Life Medical Mission, an NGO, will on Saturday July 29 organise a seminar in Lagos to mark the World Hepatitis Day 2017. There will be health talks, counselling, hepatitis testing and screening, hepatitis B immunisation and opportunity to join hepatitis support group.

http://www.premiumtimesng.com/entertainment/artsbooks/237819-art-exhibition-raise-awareness-hepatisis-b-holds-abuja.html
Call to participate and register on 09094638795, 08186549147. Remember that every single person can be affected by viral hepatitis and we all have a part to play to achieve elimination. 

WORLD HEPATITIS DAY 2017 SEMINAR

Join us on Saturday 29th July 2017 by 9:00AM. Federal College of Education (Technical) Akoka, Yaba Lagos. KEEP A DATE WITH US. 09094638795, 08186549147. e mail.....roayad@yahoo.com.

https://www.facebook.com/groups/732188010298018/

Bed bugs can cause skin problems

Four students who were boarders from the same hostel complained of skin rashes and severe itching on their backs.They were treated for two weeks with the advice that they should be observant as to know what could be causing the skin reactions. 

They were also told to change their beddings and report back to the hospital two times in a week. One of the students told the doctor that he saw two bed bugs under his bed cover .This ultimately solved the puzzle of what caused the skin reactions. It was a clear case of bed bug dermatitis.

Bed bugs are tiny insects that feed on human blood. They hide in dark places close to where humans sleep and usually crawl out to feed while people are fast asleep. They can be a problem in the cleanest of homes.

These insects need only human blood to survive and it is easy to bring them into your home. They can crawl into luggage, clothing, even furniture, unnoticed. Once inside the home, they will find a hiding place in mattresses, couch and tiny cracks or crevices in the wall.

Having bed bugs in the home can cause a great deal of anxiety and restless nights.

They feed on the host when he or she is fast asleep, generally just before dawn. The parasites are attracted to warmth, which is why they bite when sleeping. They will usually not be seen during the daylight hours unless the infestation is severe. This bug will secure itself to the host’s skin by piercing the skin, injecting saliva that contains anaesthetics and anti-coagulants into the host, which often makes their bites painless initially. After feeding on the host’s blood for several minutes, bedbugs will crawl back to their hiding place. This saliva is what causes the itching sensation on the human’s skin.

Signs

Having bite marks on the body is the most common sign of bed bugs. Most people are bitten while they sleep and do not know that they have been bitten until the next day. This is because bed bug bite is painless compared to mosquito bite which is painful.

Some people develop itchy swellings within a few days of the first bite, but it can take as long as 14 days before the bites itch. Most people tend to become increasingly sensitive to bed bug bites. If one has a bed bug infestation and the bugs bite repeatedly, it may develop itchy swelling within seconds. Bed bugs are not visible on the body like lice and the mites that cause scabies, bed bugs come out of hiding to feed on human blood.

It is possible to develop a serious or even life-threatening reaction to bed bug bites. These reactions include breathing difficulty, irregular or forceful heartbeat, swollen tongue, blisters, especially large blisters; fever, nausea and skin infection from scratching.

Serious reactions require immediate medical care. Some individuals may develop insomnia and anxiety from serious or repeated bed bug infestations.

Treatment

Medical treatment is usually aimed at relieving the symptoms and discomfort caused by the bites.

1. Wash affected area with soap and water
2. Consider a steroidal anti-inflammatory cream or calamine lotion.
3. Take an oral antihistamine or pain relief medication if needed.
4. See your doctor if the bites become infected or do not clear up within one week or two weeks.

Affected individuals may feel and see the consequences of the bed bug bite afterward, although many individuals may not develop any physical signs. Bed bugs do not transmit or spread malaria or any severe human disease.

Prevention

Place the legs of bed frames into containers containing paraffin oil or water to prevent bedbugs from gaining access to the bed, and tuck in sheets and blankets so they do not contact the floor. Wear pyjamas that cover as much skin as possible to limit bedbug bites. Vacuum, heat and steam exposure to intense sunlight of furniture and beddings may be effective against infestations.

Place infested bedding or garments in clothes dryer for 10-20 minutes, using medium to high heat and items can be laundered using hot water measuring at least 120 F. Encase the mattress and box spring in a special impermeable mattress cover. Sometimes it may be necessary to discard infested mattresses and furniture.

PS:  July 28th of every year has been designated the World Hepatitis day. Studies done in the country shows that one to two people out of 10 are infected with Hepatitis B virus. In order to educate and curb the scourge of the disease, a new interactive Facebook page tagged, ‘HEPATITIS B ALERT GROUP’ was born. The page is open to all who may be interested in contributing to the reduction of the scourge of hepatitis B infection to join.

HEPATITIS B ALERT GROUP ON FACEBOOK

 JOIN AN INTERACTIVE FACEBOOK PAGE ON HEPATITIS B: Hepatitis B ALERT GROUP: 

Visit: https://www.facebook.com/groups/732188010298018

How to prevent respiratory tract infection (cold)

I once granted an interview to a correspondent of Radio Nigeria, Ibadan, on the effects of the rainy season. I emphasised on cold as one of the effects of harmattan or rainy season but after the interview, the world common cold keep ringing in my ears.

Common cold is common and it occurs throughout the years even though there are increased cases during harmattan and rainy season due to the harsh weather. It is the most frequently occurring illness all over the world, and it is a leading cause of visits to doctors and missed days from school and work. 

It is a self-limited contagious illness that can be caused by a number of different types of viruses.

Children in preschool and elementary school can have cold monthly while adolescents and adults typically have two to four colds per year.

Flu has been used  interchangeably with the common cold but they are not the same thing. The ‘flu’, which is also known as influenza, is caused by a different virus (influenza A or B). Influenza is much more serious than a cold and can be life-threatening.

 A cold is a milder respiratory illness than the flu. While cold symptoms can make one feel bad for a few days, flu symptoms can make one quite ill for a few days to weeks.

The flu can also result in serious health problems such as pneumonia and hospitalisations. Flu can also be prevented by Influenza (Flu) vaccine.

Transmission

The common cold virus is typically transmitted via air- borne droplets, direct contact with infected nasal secretions, hand-to-hand , hand-to-surface or contaminated objects.

Transmission is common in daycare and at school due to the proximity of many children with little immunity and frequently poor hygiene. These infections are then brought home to other members of the family. Some of the viruses that cause the common colds are seasonal, occurring more frequently during cold or wet weather. 

Poor immune function, stress, insufficient sleep and malnutrition  are also a risk factor for disease.

Breast feeding decreases the risk of lower respiratory tract infections among other diseases and it is recommended that breast feeding be continued when an infant has a cold.

Symptoms

Cold symptoms usually last five to seven days. During the first three days, it is very contagious. This means you can pass the cold to others. So stay at home and get some much-needed rest.

Cold symptoms usually begin with a sore throat, which usually goes away after a day or two. Nasal symptoms such as runny nose, sneezing, congestion, cough and headache often occur by the fourth and fifth days.

Fever is uncommon in adults, but a slight fever is possible. Children are more likely to have a fever with a cold. A dry cough can last up to two weeks even after you feel better.

Coloured discharge from the nose is a normal part of your immune response and doesn’t mean that you need antibiotics.

Treatment

• No cure for the common cold exists, but the symptoms can be treated.
• Paracetamol is effective for fever and mild pain, and is a common ingredient in many ‘cold and flu’ medicines.
• Nasal decongestants can help to ease a blocked nose. They work in the nose by reducing blood flow and swelling, making it easier to breathe.
• Sore throats can be relieved with gargling salt water; licking throat lozenges, other home remedies are sipping a warm drink with lemon and honey and eating garlic.
• Antibiotics do not help treat colds and overuse may lead to resistance, making them less effective when they are needed.
• They can also cause many unwanted side effects such as allergic reactions, diarrhoea and thrush. However, if cold symptoms do not seem to be improving after a week, you may have a bacterial infection, which means you may need the antibiotics.

Prevention

• The most important prevention measure for preventing colds and flu is frequent hand washing. Hand washing by rubbing the hands with warm soapy water for at least 20 seconds or alcohol-based hand sanitiser and hand wipes helps to slough germs off the skin.
• Teach everyone in the household to cough or sneeze into a tissue. If you can’t reach a tissue on time, cough or sneeze into the crook of your arm.
• Avoid sharing utensils, drinking glasses, washcloths, towels and other items that might harbour germs with anyone who has a cold or fever.
• Avoid close, prolonged contact with anyone who has a cold or other communicable infection.

In conclusion, let’s take the preventive measures to reduce the spread of cold especially during this rainy season.

Know the diseases linked to frequent urination in men

Many men who read my last piece in this column, titled, ‘Why women urinate frequently ’’, have asked for a similar piece.

They want to know and I put together this article to address the issue in men. I hope to put up a piece on why children urinate frequently too.

If you need to go to the toilet more than usual, it’s known as frequent urination. It usually involves going to the loo more than eight times a day. You may also wake up frequently at night needing to wee (nocturia). Symptoms often include bladder discomfort and a strong, urgent need to wee due to an overactive bladder.

Causes

There are many potential causes of urinary frequency. They range from minor and very easily treated conditions to more serious diseases. Not all causes of urinary frequency are caused by bladder dysfunction. Occasionally this is related to the amount or type of fluid consumed.

Caffeine and alcohol can cause frequent urination in some patients. One of the more common causes of urinary frequency is a urinary tract infection. Sometimes urinary frequency can be caused by stones in the urinary tract. Bladder obstruction due to an enlarged prostate can lead to urinary frequency, just as the frequency can be caused by tumours in the bladder.

Urinary frequency is occasionally related to neurologic conditions. Stroke, spinal cord injuries and multiple sclerosis are often associated with frequent urination. Often, urinary frequency is caused by abnormal pelvic nerve function and coordination.

Urinary frequency can be associated with some serious diseases. Diabetes mellitus and siabetes insipidus can cause frequent urination. Diabetes mellitus can lead to high-volume frequent urination.

Diagnosis

A thorough history and physical examination can often give insight to the cause of frequency. A urine test/analysis is necessary to check for the presence of glucose, protein, ketones, or signs of infection.

Occasionally checking how much urine is left behind after urination is performed with a bladder scanner. In some cases, looking in the bladder with a telescope (cystoscopy) is performed to ensure there is no evidence of tumors in the bladder wall. Blood tests are also used to assess kidney function and the presence of glucose. Neurological tests can establish the presence of nerve damage or a nerve disorder.

Treatment

There are many treatment options for urinary frequency. Not all patients need treatment. If the frequency is not bothersome, no treatment is necessary. In some cases simple dietary modification can improve frequent urination. This may involve limiting certain foods and drinks such as alcohol, caffeine, tomato-based products, chocolate, artificial sweeteners, spicy foods.

Excess weight can put unnecessary pressure on your bladder. A healthy, low-fat diet and regular exercise can help to reduce weight and decrease frequent urination or incontinence. Treatment of bladder infections with antibiotics may alleviate the frequency. If a patient has medical conditions such as diabetes and prostrate gland disorders, the urinary frequency can improve as the disease process is better controlled. In some cases, treatment may simply involve altering your daily habits, including limiting your fluid intake, especially before bedtime, being familiar with side effects of any medication you take.

Depending on the root cause of frequent urination, other non-surgical treatment may include pelvic floor exercises These exercises can strengthen the muscles that support the bladder and urethra. Exercising for just five minutes, three times a day, can help you to control your bladder more effectively.

Bladder retraining: This involves learning techniques that help to retrain your bladder, and gradually increase the time between visits to the toilet. It usually takes about six to 12 weeks to retrain yourself to hold urine longer and to pass urine less frequently. There are medications that can slow down an overactive bladder. If these steps are not effective then medication, or sometimes surgical treatment, may be recommended depending on the underlying cause of the problem.

Prevention: While not all urological problems or disorders can be avoided, there are lifestyle choices one can make every day to help to reduce the chances of developing a serious problem.

Some of these include avoiding excess alcohol or caffeine, avoiding certain medications, i.e. diuretics,. Do not smoke. Engage in moderate physical activity and maintain a healthy weight.

In conclusion, when a man experiences urinary symptoms such as frequent urination, he should talk with a doctor without delay. This or other symptoms may be a sign of a more serious problem that needs attention

Why women urinate frequently

A woman, a beer parlour owner, who was passing urine frequently, was accused by husband of taking too much of what she sells. The argument got so heated that he forced her to go for a test. Lo and behold, the result had no traces of alcohol, rather it was a case of frequent urination due to an overactive bladder! Urination is the body’s way of getting rid of excess water, as well as wastes. While this is an important function for survival, its frequency can interfere with a woman’s quality of life.

Symptoms

Frequent trips to the bathroom, not sleeping through the night or refraining from going out for fear that they will leak urine, are often familiar to women who experience frequent urination.

A change in the colour of urine (red, pink, or cola-coloured),  a sudden and strong urge to urinate, difficulty in emptying the bladder,  urinary incontinence and painful urination are all indications of bladder control problems in women.

Causes and risk factors

Diets: Caffeine intake through coffee, tea, alcohol intake and certain soft drinks

Lifestyle: Obesity (excess weight) can place extra pressure on the bladder. The result can be weaker pelvic floor muscles and a need to urinate more frequently.

Pregnancy: Frequent urination is common with pregnancy. The growing uterus can place extra pressure on the bladder during pregnancy. As a result, a woman may have to go to the bathroom more frequently.

Menopause: It can also affect bladder control. When women no longer have their periods, their bodies stop making estrogen.

Medical: Bladder stones, diabetes, cystitis (a chronic, inflammatory disorder of the bladder),  low  estrogen levels, urinary tract infection and a weak pelvic floor organ.

Childbirth: Childbirth can weaken the pelvic floor muscles and damage the nerves in the bladder. Sometimes a woman may not experience problems with bladder control immediately after giving birth, but she may experience symptoms years later.

Complications

Complications associated with urinary frequency often depend on the condition’s underlying cause, which would be urinary tract infection, pyelonephritis, renal failure  or damaged kidneys.

If urinary frequency occurs on its own with no immediate treatable illness, it can affect a woman’s quality of life. A woman may not be able to sleep well due to having to wake up to go to the bathroom very often. She may also refrain from social events for fear of having to go to the bathroom too frequently. These complications can all influence a woman’s sense of well-being.

Diagnosis

A doctor may take a urine sample for evaluation. A laboratory can identify the presence of white or red blood cells, as well as other compounds that should not be present in the urine that could indicate an underlying infection.

Tests for blood sugar are mandatory, the urine can also be tested for the presence of glucose.

Abdominal scans may be done, while taking blood samples for electrolytes to rule out complications is also necessary.

Other tests may include cystometry or the measure of pressure in the bladder, or cystoscopy, which involves using special instruments to look inside the urethra and bladder. Other diagnostic methods may depend upon a woman’s specific symptoms.

Treatments and preventive techniques

There are lifestyle and medical means to treat frequent urination so that a woman does not have to suffer with the symptoms.

Lifestyle modifications: Avoiding foods and drinks known to irritate the bladder can help a woman experience fewer episodes of urination. Examples include avoiding caffeine, alcohol, carbonated beverages, chocolate, artificial sweeteners, spicy foods and alcoholic drinks.

Adjusting patterns of fluid intake: Avoiding drinking too much water before bedtime can reduce the likelihood of waking up at night to go to the bathroom.

Bladder retraining: Bladder retraining is another method to reduce the amount of times a woman goes to the bathroom per day. To accomplish this, she will work on a regular schedule instead of always waiting until she feels the need to urinate.

Antibiotics: If a urinary tract infection is causing a woman’s frequent urination, taking antibiotics to cure the infection may help. Other treatments and preventive techniques for frequent urination that is not due to infection include:

In addition to these methods, medications can be prescribed that reduce bladder spasms and encourage relaxation of the bladder. Sometimes a doctor will recommend injections which can reduce the incidence of bladder spasms.

In conclusion, painful urination or pelvic pains along with frequent urination, are also causes for concern. A woman should also see her doctor any time that she experiences symptoms make her uncomfortable or interfere with her quality of life.

THE MONTH OF MAY IS HEPATITIS B AWARENESS MONTH

PATERNITY TESTING

A story that touches the heart was featured by the punch newspaper on the valentine day, It was the story of a middle aged Nigerian man who discovered that a young man he raised from birth and who is now 32 years old is not his biological son.

The Nigerian man who resides in the United Kingdom, Mr. Oscar, was forced to arrange for a DNA test to determine the paternity of his erstwhile son, Valentine, when his wife allegedly told their presumed son that Oscar was not likely to be Valentine’s biological father.

Valentine had dragged his supposed dad, Oscar, to a DNA test centre in Britain after his mother informed him a month earlier that the man who had brought him up for the last 32 years may not actually be his dad. It was reported that Mr Oscar took Valentine to England from Nigeria and put him through school till graduation in the University of Britian. The result of the DNA test was read to Oscar who wailed in agony as the results said there was “zero per cent chance” he and Valentine were biologically related.

DEOXYRIBONUCLEIC ACID (DNA)

The DNA is like an instruction manual for how to build a person. Most DNA is basically the same in everyone - two eyes, two ears, one nose, etc - but there is enough variation in certain parts of the DNA that everyone turns out slightly different from everyone else. Because of this, DNA can be used to identify individuals. Human DNA can be extracted from many types of body fluid or tissue (saliva, semen, blood, hair, nails etc.) Also DNA can be extracted from an item that is contaminated with body fluids (such as chewing gum, cigarette butts, sanitary towels etc.)

DNA paternity testing is the use of DNA profiling (known as genetic fingerprinting) to determine whether two individuals are biologically parent and child. A paternity test establishes genetic proof whether a man is the biological father of an individual, and a maternity test establishes whether a woman is the biological mother of an individual. Tests can also determine the likelihood of someone being a biological grandparent to a grandchild.

In the case of a paternity test, for example, if we test a child and its mother, we can compare where the two match. This tells us which parts of the DNA have come from the mother. The remaining parts must therefore have come from the father. If we look at a man's DNA and it matches those remaining points, the man is the father. If the parts don't match, the man could not have supplied the child's DNA and is therefore not the father.

DNA can also establish relationships between siblings and more distant relatives as they all will have common DNA inherited from an ancestor.

The testing is performed by collecting buccal cells found on the inside of a person's cheek using a buccal swab or cheek swab. The buccal cells are then sent to a laboratory for testing. For paternity testing, samples from the alleged father and child would be needed. For maternity testing, samples from the alleged mother and child would be needed.

Consent is required for DNA testing

If the child is under the age of 18 years, both parents must consent to parentage testing for the result to have legal standing. All persons being tested must complete a form proving consent on the day of testing.

Accuracy of DNA Tests

DNA paternity testing has the highest likelihood of excluding a falsely assumed father. A man who does not match the child's paternal DNA type can be excluded with 100% certainty. If the man is not excluded, then with DNA testing, the probability of him being the father can be determined up to 99.999%.

Results

In the interest of the parties being tested, when the results are ready, the written reports are forwarded to a medical or legal professional as nominated by the applicant. Counselling before and after the test is also mandatory. This ensures confidentiality of the test results as well as professional supervision of the circumstances of the DNA test.

Peace of Mind DNA testing  

Questions about paternity and simple relationships can be answered by taking a Peace of Mind DNA tests. The sample collection processes for Peace of Mind testing are not admissible for legal purposes. Testing can determine paternity, maternity, common paternal lineage (along the male line), siblingship between 2 sisters (mother's sample is required) and twin testing. Prenatal paternity testing is performed by using samples of the unborn child either by chorionic villi, obtained by the CVS procedure (from 10 weeks gestation) or amniotic fluid, obtained by amniocentesis (from 14-16 weeks gestation).

Prevention of Typhoid Fever

Recently, there has been a lot of public outcry over repeated cases of misdiagnosis of typhoid fever. Nigerians deserve to know what this disease is all about; how it can be detected, treated and prevented.

Typhoid fever is an acute illness associated with fever caused by the Salmonella typhi bacteria. It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness. The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area.

Transmission

Typhoid fever is contracted by drinking or eating the bacteria in contaminated food or water. People with acute illness can contaminate the surrounding water supply through stool, which contains a high concentration of the bacteria. Contamination of the water supply can, in turn, taint the food supply. The bacteria can survive for weeks in water or dried sewage.

Diagnosis

After the ingestion of contaminated food or water, the Salmonella bacteria invade the small intestine and enter the bloodstream temporarily. The bacteria are carried by white blood cells in the liver, spleen, and bone marrow, where they multiply and re-enter the bloodstream. If a test result isn’t clear, blood samples will be taken to make a diagnosis.

The Widal test may suggest infection with Salmonella typhi. But they are not diagnostic because of the number of false-positive and false-negative. Isolation of Salmonella  bacteria that causes typhoid) from cultures of stool, blood, urine, or bone marrow are necessary to confirm the diagnosis of typhoid fever.

Symptoms

The incubation period is usually one to two weeks, and the duration of the illness is about three to four weeks. Symptoms include: Poor appetite, headaches , generalised aches and pains, fever, lethargy, diarrhea and chest congestion may develop some, and abdominal pain and discomfort are common. The fever becomes constant. Improvement occurs in the third and fourth week in those without complications. About 10 per cent of people have recurrent symptoms after feeling better for one to two weeks. Relapses are actually more common in individuals treated with inappropriate dosing of antibiotics.

Treatment

Typhoid fever is treated with antibiotics which kill the Salmonella bacteria. Prior to the use of antibiotics, the fatality rate was 20 per cent. Death occurred from overwhelming infection, pneumonia, intestinal bleeding, or intestinal perforation. With antibiotics and supportive care, mortality has been reduced. With appropriate antibiotic therapy, there is usually improvement within one to two days and recovery within seven to 10 days.

Several antibiotics are effective for the treatment of typhoid fever. Chloramphenicol was the original drug of choice for many years. Because of side effects, chloramphenicol has been replaced by other effective antibiotics. Those who become chronically ill (about three to five per cent of those infected), can be treated with prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, will provide a cure.

Prevention

Prevention is the best way to protect the child against typhoid fever. Some simple steps to reduce chances of catching this infection are listed below:

Drink pure or bottle water

Contaminated drinking water is a common source of the infection. Boil your water and allow it to cool before drinking or stick to purified water .

Hand washing

Teach children to wash hands frequently. Wash with warm, soapy water before eating food. Also wash after using the toilet. Public education campaigns encouraging people to wash their hands after defecating and before handling food are an important component in controlling spread of the disease. Alcohol-based hand sanitiser can kill germs when water is not available.

Wash fruits and vegetables thoroughly

Raw fruit or vegetables may have been washed in contaminated water. There is the need to rewash the fruits and vegetables thoroughly.

Typhoid immunisation / vaccination

Typhoid vaccine is readily available and can be used in children from two years of age. Adults can also be given the typhoid vaccination to prevent them from typhoid fever. For those travelling to high-risk areas, vaccines are now available.

Managing meningitis in children

The Nigeria Centre for Disease Control, NCDC, has confirmed the outbreak of Cerebro Spinal Meningitis, CSM, in the northern part of the country with at least 324 deaths related to the disease.

Over 2,900 suspected cases have been recorded while 109 have been confirmed and are being treated.

Cerebrospinal Meningitis is the medical term for inflammation of the tissues (meninges) that surround the brain and spinal cord. The inflammation is most commonly caused by a virus or a bacterium, which travels from an infection in another part of the body through the bloodstream to the meninges (brain).

There are two main types of meningitis — the viral and bacterial meningitis

Bacterial meningitis: There are many types of bacteria that can cause bacterial meningitis. The most likely type depends upon the child’s age, history of vaccinations, current or past medical problems. The common causes of bacterial meningitis in older infants and children are Streptococcus pneumonia, Haemophilus influenzae type b (Hib) and Neisseria meningitides. Bacterial meningitis is a medical emergency that must be treated quickly to minimise the risk of serious illness or even death.

Certain factors can increase a child’s risk of developing bacterial meningitis, including recent exposure to someone with bacterial meningitis, recent infection of the ear or sinus infection, travel to areas where bacterial meningitis is common such as sub-Saharan Africa, serious head injury, problems with the immune system, cochlear implants, and certain anatomic abnormalities.

Viral meningitis: The most common cause of viral meningitis is a family of viruses called enterovirus. Other viruses that cause meningitis can be transmitted airborne, by direct contact with an infected animal.

Signs and symptoms

Although bacterial meningitis is usually more severe, the signs and symptoms of bacterial and viral meningitis can be similar.

Newborn: They may develop a fever accompanied by non-specific symptoms (e.g, poor feeding, vomiting, diarrhoea, rash). The infant may have a stiff neck or bulging fontanel (soft spot on the skull) and may be irritable, restless, or lethargic.

Older children: They may develop a sudden fever, headache, nausea, vomiting, confusion, stiff neck, and complain that light bothers their eyes (photophobia). Meningitis can cause seizures, and decreased level of awareness. Certain types of bacterial meningitis may be associated with petechiae and purpura rash.

Diagnosis

Bacterial meningitis is a medical emergency that must be treated promptly. The following tests are generally recommended, and are usually performed in a hospital emergency department:

A blood culture – A sample of blood is cultured in the laboratory to determine if there are bacteria present (normally, no bacteria should be present in the blood). The results of the blood culture can also help determine which antibiotic is best.

Lumbar puncture – During a lumbar puncture, also known as a spinal tap, a clinician uses a needle to remove a sample of spinal fluid from the area around the spinal cord in the low back. Several tests are done on the cerebrospinal fluid to determine if a bacterial infection is present, and if so, which antibiotic treatment is best. The CSF may also be sent for viral cultures and/or molecular tests (called “PCR”) for enteroviruses.

CT scan may be recommended when and where the facility is available.

Treatment

The treatment for meningitis depends upon whether the meningitis is caused by a virus or a bacterium. However, this distinction may not be clear until the culture results are available (usually 48 to 72 hours after they are obtained).

In many cases, children are treated as if they have bacterial meningitis until bacterial meningitis is definitively excluded. The reason for this is that there is a significant risk of serious illness or even death if the child has bacterial meningitis and treatment is delayed for a prolonged period of time.

Bacterial meningitis is a life-threatening illness that requires hospitalisation and treatment with intravenous antibiotics. Depending upon the severity of the illness, the child may also need supportive treatments to aid breathing, oxygen support, maintain blood pressure, prevent excessive bleeding, and keep the child hydrated.

However, even with proper treatment, meningitis can damage the brain and cause long-term complications, including deafness, developmental delay or learning disabilities, spastic or paralysed muscles, coma and seizures. Complications are more common in children who live in developing and endemic regions.

Prevention 

Vaccines: Several routine childhood vaccines reduce the risk of developing bacterial meningitis, including the pneumococcal, meningococcal, and Haemophilus influenzae type b (Hib) vaccines. Vaccines are also available to prevent certain types of viral infections that may cause meningitis or other central nervous system infections, including polio, influenza, varicella, measles and mumps.) Preventive antibiotics are recommended for close contacts of anyone infected with meningococcal infection, even if the contact was previously vaccinated.

Families of children with meningitis should take care of them and avoid becoming infected. This includes washing hands after touching the child or changing diapers and before eating or preparing food. Utensils and cups should not be shared, the child’s mouth should be covered during a cough, and the child should not be kissed on the mouth.

Any parent who suspects that their child could have meningitis should seek medical attention immediately with their child physician. Meningitis affects all ages (the young and elderly).