BOY ATTACKED BY DOGS RETURNS FROM INDIA

Omonigho; now and then

Omonigho Abraham, the four year old boy who was attacked by dogs in the Igando area of Lagos State, has returned into the country from an India medical trip.

Omonigho returned into Nigeria on Thursday in company with his father, Odia, and mother, Helen, who went with him on the trip.

The victim was attacked by two dogs in their house on Adegboyega Street, Akesan Estate.

as playing with his two brothers, Osemudiamen and Bobby, when the dogs, owned by their landlord, pursued them.While the others escaped because they were older, the dogs reportedly bite off the scalp of the victim and dragged him around.

It was said policemen and residents who came around could not rescue him until his mother arrived at the scene and fought off the dogs.

In December, Odia announced that the Delta State Government and a non-governmental organisation, Global Initiative for Peace, Love and Care had concluded plans to fly him to India.

An alternative plan by the Lagos State Government was turned down by the victim’s family, who said the India travel plan had been concluded.

The four-year-old departed for India on November 28, 2014 despite concerns by the Lagos State Commissioner of Health, Mr. Jide Idris, that his condition was delicate and needed special attention.

“The doctors in India have completed their job. My boy is back to normal. I thank God that everything is okay.” said the father.He appreciated the efforts of the Delta State Government, the NGO and the media for the attention given to his son.

He also acknowledged the support of the Lagos State Government during his admission in LASUTH.

MANAGEMENT OF FATTY LIVER DISEASE

With the exception of the brain, the liver is the most complex organ in the body. Fatty liver disease is a term for conditions where fat builds up in the cells of the liver. It can be caused by drinking too much alcohol or it may be unrelated to alcohol.

Fatty liver disease is becoming one of the most common types of liver disease and can sometimes lead to serious health problems.

If the liver is healthy, there should be little or no fat in it. However, sometimes, fat molecules begin to collect in the liver cells. Small amounts of fat in the liver usually cause no problems. However, when too much fat builds up, this is called fatty liver disease.

Fatty liver disease can sometimes lead to serious liver problems, such as liver cancer and cirrhosis.

Fatty liver disease can lead to an inflamed liver and scarring. This is called alcoholic hepatitis if it’s caused by drinking too much alcohol and non-alcoholic steatohepatitis  if it’s not related to alcohol.

Risk factors

• Obesity. Most people with Fatty liver are obese or overweight.
• Diabetes… People with type 2 diabetes have an increased risk of developing non alcoholic fatty liver.
• Age….Fatty liver is more common in people aged over 50 years. It is also more common in men.
• High blood pressure (hypertension)… People with hypertension are at a greater risk of developing Non alcoholic fatty liver.
• High level of blood fats (hyperlipidaemia)…. High level of cholesterol and/or triglycerides in the blood increases the risk of developing Non alcoholic fatty liver.
• Chemotherapy: For example, methotrexate and tamoxifen can, rarely cause Non alcoholic fatty liver.
• Alcohol excess predisposes to Alcoholic liver disease.
• Others includes: Polycystic ovarian syndrome, Starvation or rapid weight loss.

Symptoms of Fatty liver disease: Non alcoholic fatty liver disease usually causes no signs and symptoms. When it does, they may include: Fatigue, pain in the upper right abdomen, weight loss.
 Complications: A swollen abdomen, itchy skin, vomiting and bringing up or passing blood, bruising easily, confusion or poor memory, weakness and muscle wasting, yellow whites of your eyes and skin (jaundice)

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Diagnosis of Fatty liver disease : Fatty liver disease can sometimes be difficult to diagnose because one may not have any symptoms. There is no single test that can be used to diagnose fatty liver disease, but one may carry out some of the tests listed below.

• Blood test… Blood tests to detect various viruses (Hepatitis B and C) and other liver-related chemicals. Liver function test LFTs are tests that are done for various reasons.
• Ultrasound or scan. An ultrasound, CT scan or MRI scan can all be used to create images of your liver. These images will show any fat in the liver.
• Liver biopsy. This helps to confirm how much damage there is to the liver.

Prevention

You may be able to prevent non-alcoholic fatty liver disease by:

• Maintaining a healthy weight for your height.
• Being active – try to do at least 150 minutes of moderate exercise each week.
• Eating healthy foods that are low in saturated fat
• Those who are obese or overweight, a gradual weight loss and regular exercise is advised. This not only helps with fatty liver but will help reduce your risk of developing cardiovascular problems.
• It is advised not to drink too much alcohol; even modest amounts of alcohol may make Fatty liver worse.

Conclusion

Alcoholic Fatty liver disease is reversible. The liver should return to normal if one stops drinking alcohol for two weeks, Even if one has been a heavy drinker for many years, reducing or stopping alcohol intake will have important short- and long-term benefits for the liver and overall health.

''A MEDICAL MISSION OF HOPE''

                     THE BETTER LIFE MEDICAL MISSION.....a non governmental organization (NGO).
                        visit our websites : www.betterlifemission2007@yahoo.com
                                                   

HOW TO PREVENT TYPHOID FEVER IN CHILDREN

A parent of my sons’ school mate called on phone at the weekend to seek for my expert opinion and requesting for a consultation with her child. We had a very short conversation over the child’s condition. She has been convinced by the previous caregiver that the child has Malaria and typhoid fever.

I tried to convince her that her child may not have typhoid fever based on the history of the illness. The following conversation ensues:

Mrs O: Good evening doctor, I am Mrs O, A parent of your sons’ school mate

Dr: Ok, good evening ma

Mrs O: My Child developed fever a week ago which persisted till now, I have taken her to hospital, we have done test and was told its Malaria and typhoid fever.

Dr Adesanya: How old is your child

Mrs O: less than 2 years

Dr Adesanya: What tests were ordered by your doctor?

Mrs O: MP and Widal test. The result of the test was explained to me that its malaria and typhoid.

Dr Adesanya: Was any test done to screen for infections. Was the ear and throat examined?

Mrs O: Not at all. Could it be teething?

Dr Adesanya: It’s possible, it could be teething or any other conditions that causes fever like viral, bacteria and other infections.

There is need for public enlightenment on diagnosis and management of Typhoid fever, this condition has been severally overdiagnosed, misdiagnosed, wrongly treated. Laboratory tests for typhoid fever is also over requested, inadequate and misinterpreted.

Typhoid fever is a bacterial infection. Children can become very sick or even die without treatment. Typhoid fever is common in areas with poor sanitation.

Signs and symptoms

Signs and symptoms appear about 7 to 14 days after catching the disease and may include a persistent fever that rises gradually to 39ºC to 40ºC, a headache a sore throat, tiredness, low energy, stomach pain, constipation, diarrhoea rash with pink spots on the stomach or chest

 Causes

Typhoid fever is caused by bacteria. The bacteria is most often found in food or water contaminated by an infected person. Infection can also occur when food or drink is served by an infected person who has not washed after using the bathroom.

Risk factors

Having close contact with an infected person increases chances of infection. Children with weak immune systems are also at a greater risk of getting sick. A Child is at higher risk of infection if he or she travels to a country where the fever is common.

Complications

If typhoid fever is not treated quickly, the child may become very ill and develop other complications which may include: severe weight loss, severe diarrhoea, persistent high fever, becoming unresponsive, delirium or hallucinations

Laboratory test

Widal test may suggest infection with salmonella typhi however, they are 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.

Monitor the fever and complete the antibiotics

The fever and any pain usually go away 48 hours after starting antibiotic therapy. It is important to complete the antibiotics according to prescriptions inorder to prevent recurrence, antibiotic resistance, and complications. 

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 to cool before drinking or Stick to pure satchets /bottle 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 sanitizer 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 need to rewash the fruits and vegetables.

Vaccinations

Typhoid vaccine is readily available and can be used in children from 2 years of age. Adults can also be given the Typhoid vaccination to prevent them from Typhoid fever.

TAKING CARE OF A CRYING BABY

A colleague’s wife called recently due to frustration from the baby endless cry at night. She was frustrated due to sleepless nights resulting from this. The mother advised her to get some over the counter medications, while some other people suggested an herbal mixture. I advise her to keep doing exclusive breastfeeding, making sure the child is comfortable at all time by  making sure room is well ventilated, wearing light clothing for the baby when the room is stuffy, feeding baby on demand and changing diaper as at when due.

 I discourage her from buying the over the counter drugs as most may bring about a temporary and not a permanent relief but causing unfavourable side effects to the babies especially constipation.

She called back to say the excessive crying is now under control without any medication.

Sometimes, a child who is less than 90 days old may have the sudden onset of unexplained crying. The parents may notice that crying is the only symptom they can relate to the doctor, because the younger the child, the harder it is to identify the cause of the crying.

The common causes of new-onset crying include hunger, desire to sleep, pain, when the child feels too cold or too hot, or when the clothing is too tight. Sometimes, the main cause of recurrent crying may be the normal fussy crying.

When a child cries for over three hours in a given day, it may be due to colic. Again, babies cry because of a bloated stomach as a result of overfeeding. Unlike gas, excessive milk can cause temporary discomfort.

Generally, gas does not cause crying, as all crying babies pass lots of gas and their intestines make lots of gassy noises. The gas comes from swallowed air and it is normal and does not become trapped or cause any pains.

Abdominal colic

This can cause excessive crying by the baby once or twice per day. When it happens, the baby is usually consolable when held and comforted. He acts normal (happy, contented) between bouts of crying, especially when he gets enough to eat and is not hungry. In this case, the baby is not sick.

The colic usually starts before a child is two weeks old and usually resolves by the time he is three months old and sometimes when he is four months old. In most cases, it does not require any medications.

Tackling normal crying or colic

•Reassurance: All babies cry when they are hungry. In addition, the average baby has one to two hours of unexplained crying scattered throughout the day. As long as they are happy and content when they are not crying, this is normal.

•Colic: Some babies cry excessively (over three hours a day) or are very difficult to comfort. If they are growing normally and have a normal medical exam, the crying is called colic. Remind and reassure yourself that colic is due to brain immaturity and has nothing to do with your parenting or any medical issue.

•Feeding: Feed your baby if more than two hours have elapsed since the last feeding (one and a half hours if the baby takes only breast milk).

•Hold and comfort: Hold and try to calm your baby whenever he cries without a reason. The horizontal position is usually best for helping a baby relax and go to sleep. Rock your child in a rocking chair, in a cradle or while standing. (Many babies calm best with rapid tiny movements like vibrations).

•Place the child in a windup swing or vibrating chair. Take him for a stroller ride, outdoors or indoors. Do anything else you think may be comforting (such as a gentle massage, or warm bath).

•Caution: Avoid baby slings before a child is four months old because they have caused suffocation in some babies!

When a child cries to sleep

If you can’t stop the crying and your baby is not hungry, let your baby cry himself to sleep. For some overtired babies, this is the only answer. You may strap him to the back your baby firmly, because if more than three hours have elapsed since he had the last nap, you can be sure your baby needs to sleep.

To take care of this problem,

•Encourage night time sleep (rather than daytime sleep): Try to keep your child from sleeping excessively during the day. If your baby has napped two hours or longer, gently wake him. Play with him or feed him, depending on his needs. This will help to reduce the amount of time your baby is awake at night.

•Warning: Never shake a baby. It can cause bleeding on the brain and severe brain damage. Also, never leave your baby with anyone who is immature or has a bad temper. If you are frustrated, put your baby down in a safe place and get help!

•Expected course: Once you find the right technique, the crying should decrease to one hour per day. Colic improves after two months of age and is usually gone by the time the baby is three months old. No medication is required!

In conclusion, call your paediatrician (baby doctor) if your baby starts to look or act abnormal, if he cries constantly over two hours even when you are using this advice; or if he cannot be comforted or the child becomes worse.

HOW TO RESCUE A PERSON WHO SLUMPS BEFORE MEDICAL HELPS ARRIVE

In my last piece, i narrated the true life story of a woman who slumped at a meeting few weeks ago. Everyone near her rushed instantaneously to give a helping hand and lift her up. She was put on a chair and they started fanning and pouring water on her. She was then rushed to the General Hospital. But within minutes of her arrival, she was pronounced dead by the doctor after examination. The doctor told them this is B.I.D voice, a medical abbreviation meaning brought in dead.

I also mentioned last week that cases of Sudden death syndrome from sudden cardiac arrest are on the increase in the country thereby creating worries and anxieties.

As a reminder, a cardiac arrest is when the heart suddenly stops beating. A person who has a cardiac arrest slumps/collapses (falls down) doesn’t react to call or touch, and doesn’t breathe normally. The person will most likely die if he/she is not treated immediately.

In adults, it affects men twice as it does women. Men are more susceptible because of activities, stress, hustling. Cardiac arrest is often caused by a heart attack from complicated medical conditions like hypertension, but it can also be caused by other things, such as drowning and electric shock.

Cardiac arrest in a child or baby can be caused by many different things, including drowning, choking, sudden infant death syndrome, asthma, infections or congenital abnormalities

Treatment 

When a person slumps, is unresponsive, and is not breathing normally, Whether or not the victim survives depends largely upon the immediate intervention of bystanders. There is a brief timeframe for saving the victim’s life.

The victims can survive if they receive immediate helps from those around .To be effective, this treatment must be delivered quickly—ideally, within five minutes after collapse.

Even the best emergency medical services may not be able to reach a victim within five minutes. This is why prompt action by bystanders is so critical and why it is so important for laypersons to learn and get trained in what we called Basic life support (BLS).

Basic life support (BLS) is the level of medical care which is used for victims of life-threatening illnesses or injuries until they can be given full medical care at a hospital. It can be provided by trained medical personnel, including paramedics, and by laypersons who have received BLS training.

The victim should be laid down on a flat surface probably on the floor, lying on the back; rescuer should not attempt to sit the victim down as no active resuscitation is done that way.

The usual practice of pouring water on the head or body of a victim should be discouraged; this may cause hypothermia (low temperature) which is not good for survival. It is not time to start forcing milk or malt drink in the person’s mouth, this is dangerous as it may block the air way. When the victims get to the hospital, it’s always challenging trying to clear the airway of the particles in the mouth

BLS is generally used in the pre-hospital setting, and can be provided without medical equipment. The BLS procedure is explained below with an acronym: DRS ABCD

D ….. Check for Danger signs, in cases of electrocuting, rescuers should avoid moving too close to ensure safety.

R… Check for Response by calling the person and shaking the shoulders.

S…..If no response. Shout for help. Get a 2^nd person to call the emergency numbers or the hospitals.

A…. Check that the Airway is open and clear any secretions from mouth and nostrils.

B.. Check for Breathing. If not breathing or not breathing normally

C …… Start Cardiopulmonary resuscitation (CPR). Give 30 chest compressions: 2 breaths. Continue CPR until responsiveness or normal breathing return.

Do not stop to check the victim or discontinue CPR unless the victim starts to how signs of regaining consciousness, such as coughing, opening his eyes, speaking, and starts to breathe normally. Once the medical personnel or ambulance arrives, the rescuer may assist in moving the victim to the ambulance for onward transport to hospital

D…. Attach a Defibrillator; A defibrillator is a machine that gives the person’s heart a controlled electric shock that may make it start beating again.

The steps listed above are guides and not training, it is mandatory for persons interested in doing CPR to attend the BLS training.

Conclusion

In conclusion, regular medical check-up is key to preventing sudden cardiac arrest and should be promoted. Those who are over 40 years are advised to do a six-monthly or yearly comprehensive medical screening under the supervision of their physicians.

Those with unexplained or persistent symptoms like weakness, weight loss, headache, body pain, tiredness etc will also need guided medical checks. Blood pressure and blood sugar should be monitored regularly.

In conjunction with the management of the strategic health insight (The hospital) Magodo GRA, Lagos I will be organising a monthly healthy lifestyle seminars from January 2015.

It is a community service hence no fee is charged for the sessions, experts in various fields of medicine, dentistry, physiotherapy and nursing will be leading the sessions. It is going to be a very interactive session. Pharmaceutical and other health care companies can also partner with us in this wellness programme.

The seminars are fixed for 5pm -7pm every (Every 2nd Saturdays). The maiden edition takes place on January 10th 2015.Participants are to indicate their participation by calling or sending text messages to 08188343865 or 08186549147.

PART B

A cardiac arrest happens when your heart stops pumping blood around your body.
If someone has suddenly collapsed, is not breathing normally and is unresponsive, they are in cardiac arrest.
There is no time to lose. Even if you are untrained your actions can help.

A cardiac arrest is an emergency.  If you witness a cardiac arrest, you can increase the person’s chances of survival by phoning 767 or 112 (Lagos emergency nos) immediately and giving CPR.

CPR means:

• chest compression (pumping the heart by external cardiac massage), to keep the circulation going until the ambulance arrives and
• rescue breathing (inflating the lungs by using mouth-to-mouth resuscitation).

Remember - even if you haven't been trained in CPR with rescue breathing, you can still use hands only CPR



Signs of Cardiac arrest
Cardiac arrest strikes immediately and without warning.

• Sudden loss of responsiveness (no response to tapping on shoulders).
  • No response to tapping on shoulders.
  • Does nothing when you ask if he's OK.

If these signs are present think of cardiac arrest.

CPR VIDEO AVAILABLE VIA U TUBE ................https://www.youtube.com/watch?v=ZjszBXF0l8A
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For detailed  CPR training for groups,individuals and organizations,contact 08186549147.

A DEFRIBILLATOR