Friday 8 September 2017

SEXUALLY TRANSMITTED DISEASES STDs volume one

Sexually transmitted diseases: these are diseases contracted during sexual intercourse.
They are so numerous that they make a broad topic;  hence we shall discuss them in segments.

Today,  we shall be discussing about two examples of STDs Gonorrhea and  Chlamydia infections .
I decided to take these two today,  to enable us understand their almost insignificant etiological/pathological differences and not confuse them again.

The similarity of these diseasesI has lead mostly to their wrong diagnosis in most hospitals and  pharmacies and in turn plunge a lot of persons into the sequels of their poor management.

Gonorrhoea

This is a common human sexually transmitted infection caused by the bacterium Neisseria gonorrhoea.
It has an incubation period (time between infection and disease manifestation) of 2 to 14 days.
It is characterized by some specific symptoms as found below:

In Man
It causes burning sensation during urination (urethritis) and discharges of a whitish and viscous fluid from the penis.

In woman
It is mostly asymptomatic but sometimes presents vaginal dischrage and pelvic pain.

During oral sex
Persons are exposed to "gonorrhea of the throat" when performing oral sex on an infected partner,  usually male. This throat gonorrhea may be asymptomatic but at times,  presents sore throat.

Untreated/poorly treated gonorrhea may precipitate the following complications:

1. Skin lesions

2. Joint infection (pain and swelling of the joint)

3. Endocarditis of the heart (when it settles on heart valves)

4. Meningitis (when it settles in the spinal column)

5. In women, it may cause Pelvic inflammatory disease (infection of the womb,  fallopian tube and ovaries)  and making pregnancy impossible.

6. In man, it may cause epididymitis(noticed by pain in the scrotum) and this may result to infertility

7. Can be transmitted from infected mother,  to child during childbirth,  and in such it causes conjunctivitis.

Gonorrhea can be 'easily' treated if diagnosed on time, and such diagnosis requires some laboratory investigations ( NAATs, culture), which must be carried out on noticing any of the above listed symptoms.

Treatment of detected gonorrhea includes the use of
Ceftriaxone and other third generation cephalosporin.

Chlamydia infection:

This is another std commonly found in human,  caused by the bacterium Chlamydia trachomatis (this specie of chlamydia is found only in human and as an intracellular bacterium).

Modes of transmission includes:

1.  Sexual intercourse (Vaginal, Anal and Oral sex)

2. From infected mother to child,  during childbirth

The symptoms of this disease includes:

In man

• It causes urethritis (painful urination but not always as found with gonorrhea)

• White non-viscous discharge from the penis (watery, as against in gonorrhea where the discharge is sticky like pus) which is also lighter in colour than in gonorrhea.

• Swollen or tender testes

• fever

In Woman

This infection is mostly asymptotic in women,  but sometimes present the following symptoms:

• vaginal bleeding between periods

• Pain in the abdomen (stomach region)

• Painful sexual intercourse

• vaginal discharg

• Fever

• Painful urination

• Urge to urinate more frequently than usual.

Poorly treated/untreated chlamydia infection may lead to the following complications:

In Women

• Pelvic Inflammatory disease (PID) which affects her fertility

• ectopic pregnancy secondary to PID

• Spontaneous abortion in pregnancy

• Premature birth

When transmitted to the newborn,  it causes:

• Pneumonia

• gonococcal ophthalmia (cause of blindnes)

In man

Chronic Epididymitis which may result to abscess formation and testicular infarction (death of the testicles)  and in turn, Infertility and hypogonadism.

This specie of CHLAMYDIA also causes:

1. Trachoma (eye disease) a significant cause of blindness. 
NB Trachoma can be spread from eye to eye by fingers, shared towels or cloths,  coughing,  sneezing,  and eye-seeking flies.

2. Reactive arthritis (Reiter's syndrome)  which is more in men.

Chlamydia infection can be confirmed by some laboratory investigations which are mostly of NAAT type (Nucleic Acid Amplification Tests).

When diagnosed, uncomplicated chlamydia infection can easily be treated using antibiotics which includes:
Azithromycin,  doxycycline,  erythromycin,  or ofloxacin.

ADVICE

1. Adults are advised to always undergo screening tests for chlamydia and gonorrhea whenever they notice changes

2. In the course of ensuring total eradication of these diseases in any patient, any of it is detected, Patient-Delivered Partner Therapy is recommended,  whereby prescription/medication is provided for the patient's sex partner without the partner going for examination.

3. Adults are most advised to stick to one sex partner (whose health status they must know), 

4. Where (3) is not very possible,  disease-protection mechanisms must be employed,  which includes the use of condoms

5. During treatment of gonorrhea,  it is pertinent to include azithromycin or doxicycline,  as chlamydia may occur alongside gonorrhea.

6. Patients diagnosed,  are advised to cease sexual intercourse until they finish their antibiotics regimen.

7. Going for check up after three months of treatment is important,  to ensure there is no chances of relapse (recrudescence or recurrence)

Thanks.

Pharm. Chuka Amukamara (Bpharm, PharmD)
Faculty of Pharmacy
University of Benin.

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Monday 14 August 2017

GIVE ME ONE CAPSULE OF AMPICLOX™ please!

This question or demand has always dazed me. Random people enter random pharmacies and ask for just this single capsule. 

The use of this “one capsule” is numerous.
•Some claim it “washes” their system clean

• Some claim it has a good sexually transmitted infection prevention ability

• A man said that he pours about 3 capsules of ampiclox™ into his cough syrup and drinks it because it is the best regime for his cough

• Some women claim it prevents them from getting pregnant after sexual intercourse without contraceptives, hmmm!

• Some even demand for just one capsule of ampiclox™ when they have a boil on their skin and that is all the drug they take.

This act has caused more harm to the health-world of antibiotics through the principles of ANTIBIOTIC RESISTANCE.

Using ampiclox™ as an example, a capsule of ampiclox contains 250mg each of ampicillin and cloxacillin (both are penicillin-classed antibiotics). For these drugs to be used for complete care or eradication of a susceptible microorganism, a total of at least 20 capsules must be taken (5grams), that is 4 capsules per day for at least 5 days. Now, imagine taking just one of these capsules (250mg),  it achieves nothing but the likelihood of future problems.

The use of antibiotics has saved millions of lives but its pervasive use to treat any infection, whether serious, minor, or even viral has led to the increased antibiotics-resistance.
It has been repeatedly said that one of the causes of antibiotics resistance is ANTIBIOTIC MISUSE where patients fail to complete their medication as prescribed and dispensed.  Antibiotic dosages are designed to eradicate the entire population of the pathogens, when antibiotics are not taken completely as rightly recommended for the infection they are prescribed,  pathogenic bacteria  adopt measures to thrieve in the presence of low dose antibiotics, and eventually form a population that is completely resistant to the antibiotic regardless of the dosage used.
This simply implies that the misuse of ampiclox in treating skin infections (when not yet recommended) may lead to resistance of the pathogen,  making ampiclox inactive to the pathogens that caused the skin infection.
The spat of antibiotics resistance is not limited to the negligence of patients alone but the negligence to this by all other members of the healthcare society.
Other causes of antibiotic resistance are INAPPROPRIATE PRESCRIBING. Incorrectly prescribed antibiotics also contribute to the promotion of resistant bacteria. Studies have shown:
°that treatment indications
°choice of agents and
°duration of antibiotic therapy are incorrect in 30% to 50% of cases where these agents are prescribed.

Incorrectly prescribed antibiotics have questionable therapeutic benefits and exposes patients to potential complications of antibiotic therapy. Subinhibitory and subtherapeutic antibiotic concentrations can promote the development of antibiotic resistance.

In conclusion, it is the collective responsibility of everyone to tackle this problem of resistance. Antibiotic resistance leads to the inappropriateness of previously useful agents and this creates more burden for pharmaceutical companies to meet up with the pace of demand for new antibiotic that further widens the problems of effective therapeutics.

As a patient, always contact your doctor or pharmacist before the use of any antibiotic on medical conditions, whether major or minor to ensure that it is correctly used and you get the best outcome from the treatment process.
For health practitioners, prescribing physicians and pharmacists alike, the correct use of these agents is important and all antibiotics prescription must be thoroughly scrutinized before release for dispensing.

Editors note:
Resistance to antibiotics by microorganisms presents:
1. Treatment failure
2. Increased cost of treatment
3. Poor quality of life
4. Death

Now that you know,  why not cease self-diagnosis and self-medication and prevent the vices of the practices.
Self-diagnosis lead to self-medication which in turn presents drugs overdose,  antibiotics resistance,  poor health and death.
Let us refrain,  and live healthy.

Author:  Dr. Justice Enoma (The everyday pharmacist)
Justice.enoma@gmail.com

Editor:   Dr. Chuka Amukamara (Pharmacist @ health medium International)

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Sunday 16 July 2017

INDIAN HEMP DRIVES FEAR



When soaked in hard-drugs, fear and anxiety become history,  but then,  this anxiolysis has no limit  when lost,  that one can donate his head for another's beating.

Dangerous risk taking
• Let me die for her!
• Trailer does not kill,  let me try!
• That food is poisoned,  lie,  let me eat it first!
• HIV is real,  says who,  let me try!
• If you fight,  you will be jailed,  story,  let me try!
• Flee from hard-drugs they can kill even as they give you pseudo-ecstacy and euphoria!

Refrain: Codeine,  Cocaine,  alcohol,  rohypnol, hashish, Indian hemp, tobacco, tramadol, animal wastes, heroin, gums,  and others.

• Bring down your alcohol consumption to moderation.
• Reject cigarette smoking!
Take only calculated risks and not drug-directed risks,  they are not the same.
Live safe
Allow safety!

Chuka Amukamara
Faculty of pharmacy
University of Benin

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Wednesday 12 July 2017

OPIOID

Friends and Enemies of OPIOIDS

Considering the rate of abuse and misuse of opioids, I wish to ask if the discovery of opioids was a blessing to the world or a curse?

OPIOIDS are chemical agents derived from opium puppy;  They act on the opioid receptors and produce  morphine-like effects. They are classified as either semi-synthetic or synthetic in nature. They include morphine, tramadol, codeine, methadone, pentazocine, loperamide and the less popular such as hydrocodone, oxycodone, fentanyl,  pethidine etc.
Opioids are mostly available as oral and parenteral preparations.

Opioids are very effective for a host of medical conditions for which the most important is their use for PAIN

Treatment :  they are used for the treatment of acute pain such as post surgical pain or for the treatment of chronic non cancer and cancer pain.
They provide immediate relief for mild to severe pain, and are usually reserved as second line therapy.
Opioids are diverse in nature as certain types of Opioids are used in the treatment of Cough (e.g hydrocodone and codeine as well as opioid analogue such as dextromethorphan) as well as  treatment of diarrhoea (loperamide, diphenoxylate) and shortness of breath.

Even as they present benefits, we are pushed to tag their occurrence as CURSE and not blessing?
ADDICTION; DEPENDENCE; TOLERANCE; WITHDRAWAL SYMPTOMS; RELAPSE

Opioids are amongst psychoactive agents with high addictive tendencies; with heroin an opioid having the highest addiction rating of 3.0 (although other Opioids are less addictive compared to heroin).
The continuous use of these drugs leads to cases of physical and psychological dependence:  where the individual finds it difficult to cope without the drug.

Due to tolerance resulting from their persistent use,  the individual tends to increase the dose consumed in order to experience the prior euphoric feeling ,thus having to do everything possible to get such quantities (armed robbery, pilfering).

Chronic use of these agents gives way to system-drug synchronization such that an attempt to stop-use would present the following withdrawal symptoms: severe dysphoria, craving, irritability, sweating, nausea, rhinorrhea, tremor, vomiting and myalgia. Such untoward effects which are mostly unbearable discourage quitting and hence,  relapse ensues.

A number of arthritic patients become addicted to oral tramadol as well as codeine or other opioid preparations,
girls addicted to opioids after use for painful menstruation,
sickle cell patients become addicted to parenteral opioids after they were used to treat some of their painful episodes,
young boys addicted to cough preparations containing Opioids such as codeine or dihydrocodeine.

Editor's note: 
The use of opioids as well as  "drugs" can only be a blessing to humanity if they are used as prescribed and advised by our health professionals and not as self-prescribed.
Drugs are primarily defined as poisons,  but become medicines only when they are presented by the right persons.
To avert misfortunes that follow the use of opioids, always consult your doctor or pharmacist for the best advice on the use of drugs.

Author: Justice Enoma
Editor:   Chuka Amukamara
Faculty of Pharmacy
University of Benin

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Wednesday 24 May 2017

WATER THERAPY

WATER THERAPY

Drinking of water and the benefits that ensue, has induced a number of writers to put up different notes,  directing us on the do's and don'ts of drinking water, the when to and when not to,.
The benefits of drinking water varies in the organs/tissues affected in the body as the intervals of it's consumption varies.
The earth is filled to about 70% with water,  same is the whole body weight;  made up of about 70% by water.
The total water input must be equal to total water output to ensure homeostasis in the body's fluidity!
Water therapy therefore implies the medical benefits derived from drinking water;  benefits ranging from prophylactic, palliative to curative basis.
You may have read lots of notes in the past about when and how to drink water and all it promises, nevertheless;
please find below some of the benefits of water and when to take water in order to enjoy such nature's gift to man.
  


1.  Early morning

Taking about 4 glasses of water first thing in the early morning :
At the beginning, you may not be able to take such a volume,  but start with the quantity you can tolerate and increase subsequently.
A number of benefits have been credited to this practice.
Let us state and explain some of them:

a. Prevents colon cancer: this quantity of water aids in washing properly the walls of the empty intestine as it pushes all the debris down to the rectum to initiate defecation reflex, thus preventing clogging up of debris and other harmful particles on the pores of the intestine .

b.  Prevention of arthritis and it's crisis (gouty arthritis) : gout is a medical condition that is mostly caused by poor excretion of urates and a build up of uric acid in the blood,  which accumulates in the joints to cause inflammation. When such volume of water is taken, it dilutes these crystals and exerts sufficient pressure on the kidney to expel all of the urates preventing their accumulation.

c.  Prevention of Kidney stone and kidney diseases: similarly as in (b) above, water dilutes the chemical build ups on the kidney and prevent the formation of crystals, casts, and their resultant renal disturbances.


2. Before going to bed

Drinking a glass of water while going to bed:
Helps keep heart problems far from you. [The water ensures that your plasma volume is maintained while sleeping and not requiring the heart to do extra work in ensuring appropriate blood pressure]
Although you may be woken up by micturation reflex to urinate,  but still,  the benefit outweighs the disturbance.

3. Drinking while eating:

Several writers have written against this act without being able to draw lines and explain the reasons behind it.
Taking small quantity of temperate water while eating starchy and hard foods like garri helps one prevent:
Constipation or Strenuous defecation
Hemorrhoids or pile

But drinking plenty water while eating foods rich in protein is wrong as such quantity of water may dilute to some extent your gastric acid content leading to the indigestion of some food particles, this in turn may cause
Flatulence
Belching
Tinnitus

Again, Drinking cold water while eating is wrong! Cold water reduces the optimal temperature of the stomach required for the instant enzymatic activities on the ingested food leading to some portions of the food not being properly digested. The undigested food undergoes fermentation causing :
Flatulence
Belching
Steartorrhea
GIT disturbances
Colon cancer
Tinnitus (sounds of wave in the ear)

4. Interval Drinking of water:

The act of drinking water during the day is another good one.
Mostly,  you see some persons carry bottled water along, yes,  they do so because they understand the benefits of drinking water.
Since water intake must be equal to water loss:
We loss water through urination, sweating, perspiration, breathing, talking etc, this requires that we replenish the lost water from drinking and from food.
Drinking enough water keeps you far from kidney diseases and to some extent cardiovascular diseases, fights internal stress and restores vitality.

5. Taking medicine with water:

Check leaflets of every pharmaceutical you are taking,  it always says "take with a glass full of water" this water aids in the dissolution and proper absorption of the medicament inturn enhancing bioavalability. Water here is indispensable hence should not be replaced with any soft drinks or the likes (remember the issue of coca-cola and Vitamin C ).

Thanks.

Chuka Amukamara
Faculty of Pharmacy
University of Benin


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Thursday 6 April 2017

MARKING WORLD HEALTH DAY; WITH DEPRESSION AS THE TOPIC


JOIN THE FIGHT AGAINST DEPRESSION. 

Depression! Depression!! Depression!!!

: a state of feeling sad

: a serious medical condition in which a person feels very sad, hopeless, and unimportant and often is unable to live in a normal way

: a period of time in which there is little economic activity and many people do not have jobs.

By virtue of bad government, a very significant risk factor of depression,  an average Nigerian is predisposed to depression.

Yesterday,  a man stopped his vehicle,  came down and jumped into the sea,

The other day,  someone was cooking and something stoke her mind, she immediately killed herself with the knife she was cutting onions with,

A young boy suddenly stopped talking, couldn't reason out answers to questions,

One man just resigned not considering the outcome of his resignation.

His wife just put to birth ,and he rememered his condition prior to wife's parturition, became suddenly thoughtless and was tagged a psychiatric patient afterwards.

A student who always hoped for the best result couldn't read to see the result manifest.

Husband sees wife as a problem and burden,

Depression the deadly scourge  that drains people's optimism must be dealt with.

When finally the person is taken to hospital,  cos hardly can they differentiate between depression,  schizophrenia manifesting negative symptoms and manic-depressive-psychosis,  hence the person is subjected to all kinds of therapy which mostly are pharmacotherapy with dreadful side effects.

Dear fellow Nigerians,

As our government has refused to lift this risk factor placed permanently on our side,  can we adopt the following  recommendations to help ourselves and one another:

1.  Always give someone around you hope,

2. Do not add to someone's stress. ,help them

3. Always check on your neighbor. ,ask him/her "how are you?

4. Join social groups where we have a lot reasons to laugh freely

5. Discover those musics that help your moment,  as good musics have been identified as prophylactic antidepressants.

6. Always pray,  and leave your problems with God.

7. Reduce your rate of expectations from human,

8. Always assume  that there is no government

9. Discover positive people and make them friends

10. Read your Bible always.


Chuka Amukamara
Faculty of Pharmacy
University of Benin


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Tuesday 4 April 2017

MENINGITIS THE MONSTER

                    Join the fight against Meningitis 






Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.

The inflammation may be caused by infection with:

viruses : enterovirus, herpes simplex virus, Varicella zoster virus, mumps virus, HIV and LCMV

bacteria: Nisseria meningitidis, Streptococcus pneumoniae, Listeria monocytogenes etc

other microorganisms: fungi, protozoa etc

drugs: NSAIDS, some Antibiotics, IV immunoglobulin


Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency.

Symptoms

• headache

• neck stiffness associated with fever

• confusion or altered consciousness, vomiting,

• Inability to tolerate light (photophobia) or loud noises (phonophobia).

• Children often exhibit only nonspecific symptoms, such as irritability and drowsiness.

• Rashes

Preventive/control measures
As we await government and the vaccines for meningitis, let us employ the following measures to at least control it's spread.

• Avoid contact with respiratory droplets

• Be conscious of whom you kiss

• Coughing or sneezing on someone should be avoided

• Contaminations from feces or fecal matters should be avoided

• Avoid self-diagnosis

• Avoid self-medication

• Visit or take to the nearest hospital for proper attention, anyone who exhibits any of the above symptoms; especially where these triad is found

1. Severe Headache
2. stiffness of neck with high fever
3. Sudden alteration of mental status




Chuka Amukamara
Department of Pharmacy
University of Benin

Nigeria. 





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