ضوء الطاقة الشمسية

16/12/2021

Hypertension and Prevention
Leave a Comment / Health / By Amohn

Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure, the harder the heart has to pump.

Hypertension is a serious medical condition and can increase the risk of heart, brain, kidney and other diseases. It is a major cause of premature death worldwide, with upwards of 1 in 4 men and 1 in 5 women – over a billion people ­– having the condition. The burden of hypertension is felt disproportionately in low- and middle-income countries, where two-thirds of cases are found, largely due to increased risk factors in those populations in recent decades.

Key facts
Hypertension ̶ or elevated blood pressure ̶ is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases.
An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries
An estimated 46% of adults with hypertension are unaware that they have the condition.
Less than half of adults (42%) with hypertension are diagnosed and treated.
Approximately 1 in 5 adults (21%) with hypertension have it under control.
Hypertension is a major cause of premature death worldwide.
One of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.
What is hypertension?
Blood pressure is the force exerted by circulating blood against the walls of the body’s arteries, the major blood vessels in the body. Hypertension is when blood pressure is too high.

Blood pressure is written as two numbers. The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats. The second (diastolic) number represents the pressure in the vessels when the heart rests between beats.

Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days is ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg.

Read Also: All You Need to Know About HIV/AIDS

What are the risk factors for hypertension?
Modifiable risk factors include unhealthy diets (excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables), physical inactivity, consumption of to***co and alcohol, and being overweight or obese.

Non-modifiable risk factors include a family history of hypertension, age over 65 years and co-existing diseases such as diabetes or kidney disease.

What are common symptoms of hypertension?
Hypertension is called a “silent killer”. Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms. For this reason, it is essential that blood pressure is measured regularly.

When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors.

The only way to detect hypertension is to have a health professional measure blood pressure. Having blood pressure measured is quick and painless. Although individuals can measure their own blood pressure using automated devices, an evaluation by a health professional is important for assessment of risk and associated conditions.

What are the complications of uncontrolled hypertension?
Among other complications, hypertension can cause serious damage to the heart. Excessive pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can cause:

Chest pain, also called angina.
Heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs.
Irregular heart beat which can lead to a sudden death.
Hypertension can also burst or block arteries that supply blood and oxygen to the brain, causing a stroke.

In addition, hypertension can cause kidney damage, leading to kidney failure.

Why is hypertension an important issue in low- and middle-income countries?
The prevalence of hypertension varies across regions and country income groups. The WHO African Region has the highest prevalence of hypertension (27%) while the WHO Region of the Americas has the lowest prevalence of hypertension (18%).

The number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015, with the increase seen largely in low- and middle-income countries. This increase is due mainly to a rise in hypertension risk factors in those populations.

Our top post: Mental Health Disorders: CAUSES AND REMEDY

How can the burden of hypertension be reduced?
Reducing hypertension prevents heart attack, stroke, and kidney damage, as well as other health problems.

Prevention

Reducing salt intake (to less than 5g daily).
Eating more fruit and vegetables.
Being physically active on a regular basis.
Avoiding use of to***co.
Reducing alcohol consumption.
Limiting the intake of foods high in saturated fats.
Eliminating/reducing trans fats in diet.
Management

Reducing and managing stress.
Regularly checking blood pressure.
Treating high blood pressure.
Managing other medical conditions.
CC: World Health Organization

16/12/2021

Hypertension and Prevention
Leave a Comment / Health / By Amohn

Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure, the harder the heart has to pump.

Hypertension is a serious medical condition and can increase the risk of heart, brain, kidney and other diseases. It is a major cause of premature death worldwide, with upwards of 1 in 4 men and 1 in 5 women – over a billion people ­– having the condition. The burden of hypertension is felt disproportionately in low- and middle-income countries, where two-thirds of cases are found, largely due to increased risk factors in those populations in recent decades.

Key facts
Hypertension ̶ or elevated blood pressure ̶ is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases.
An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries
An estimated 46% of adults with hypertension are unaware that they have the condition.
Less than half of adults (42%) with hypertension are diagnosed and treated.
Approximately 1 in 5 adults (21%) with hypertension have it under control.
Hypertension is a major cause of premature death worldwide.
One of the global targets for noncommunicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.
What is hypertension?
Blood pressure is the force exerted by circulating blood against the walls of the body’s arteries, the major blood vessels in the body. Hypertension is when blood pressure is too high.

Blood pressure is written as two numbers. The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats. The second (diastolic) number represents the pressure in the vessels when the heart rests between beats.

Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days is ≥140 mmHg and/or the diastolic blood pressure readings on both days is ≥90 mmHg.

Read Also: All You Need to Know About HIV/AIDS

What are the risk factors for hypertension?
Modifiable risk factors include unhealthy diets (excessive salt consumption, a diet high in saturated fat and trans fats, low intake of fruits and vegetables), physical inactivity, consumption of to***co and alcohol, and being overweight or obese.

Non-modifiable risk factors include a family history of hypertension, age over 65 years and co-existing diseases such as diabetes or kidney disease.

What are common symptoms of hypertension?
Hypertension is called a “silent killer”. Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms. For this reason, it is essential that blood pressure is measured regularly.

When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors.

The only way to detect hypertension is to have a health professional measure blood pressure. Having blood pressure measured is quick and painless. Although individuals can measure their own blood pressure using automated devices, an evaluation by a health professional is important for assessment of risk and associated conditions.

What are the complications of uncontrolled hypertension?
Among other complications, hypertension can cause serious damage to the heart. Excessive pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can cause:

Chest pain, also called angina.
Heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs.
Irregular heart beat which can lead to a sudden death.
Hypertension can also burst or block arteries that supply blood and oxygen to the brain, causing a stroke.

In addition, hypertension can cause kidney damage, leading to kidney failure.

Why is hypertension an important issue in low- and middle-income countries?
The prevalence of hypertension varies across regions and country income groups. The WHO African Region has the highest prevalence of hypertension (27%) while the WHO Region of the Americas has the lowest prevalence of hypertension (18%).

The number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015, with the increase seen largely in low- and middle-income countries. This increase is due mainly to a rise in hypertension risk factors in those populations.

Our top post: Mental Health Disorders: CAUSES AND REMEDY

How can the burden of hypertension be reduced?
Reducing hypertension prevents heart attack, stroke, and kidney damage, as well as other health problems.

Prevention

Reducing salt intake (to less than 5g daily).
Eating more fruit and vegetables.
Being physically active on a regular basis.
Avoiding use of to***co.
Reducing alcohol consumption.
Limiting the intake of foods high in saturated fats.
Eliminating/reducing trans fats in diet.
Management

Reducing and managing stress.
Regularly checking blood pressure.
Treating high blood pressure.
Managing other medical conditions.
CC: World Health Organization

2care health services is a low cost health care delivery organization for primary and secondary health care focus on easy accessibility and affordability.

19/11/2017

*MANAGEMENT OF SNAKE BITE*
Snake bite is an injury cause by the bite of a snake. Snake bite can be life threatening especially if is from a venomous snake. Venomous snakes include black mamba, king cobra, and rattlesnake. Some snakes are not venomous but it is important to treat every snake bite as a medical emergency.

_*People at highest risk for snake bite*_
1) Hunters
2) Farmers
3) Children – due to curiosity
4) Persons that walk barefooted
5) Sneak charmers

*Snake Venoms and the Effects*
1) Neurotoxic – paralysis of the respiratory center and facial nerve, ptosis, external ophthalmoplegia etc.
2) Cytotoxic – necrosis and deaths of different cells, massive swelling, blistering
3) Hematoxicity which can lead to:
· Bleeding
· Anemia
4) Myotoxicity – stiffness of muscles, trismus, pain (muscle) and myoglobinuria

*_MANAGEMENT_*
1) Prehospital
2) Hospital
*Prehospital* *Management* (first aid)
1) Take patient away from the scene to avoid multiple bite
2) Reassure the patient.
3) Immobilize the limb.
4) Washing the site thoroughly with soap and water
5) Do not incise the wound or apply tourniquet
6) Don’t press the wound with your hand.
7) Do not run immediately after snake bite to avoid fast spreading of the toxins due to increase in blood supply.
8) Take the patient to the hospital immediately
*Hospital Management*
· *History*
· Time of bite?
· Site of the (the close the site to the heart the worse)?
· Type of bite – provoked or unprovoked? Provoked snake produces more venom
· Where did the bite occur; farm, within the house or bush?
· Was the snake killed?
· What type of snake (helps in knowing whether is venomous or not)?
History suggestive of Local Envenomation
· Local smelling
· Pain around the side of bite
History Suggestive of Systemic Envenomation
· Vomiting
· Progressive increased swelling
· Hemotoxicity – bleeding from the mucous membrane, epistaxis, blood in urine, weakness due to anemia
· Neurotoxicity – difficulty in breathing and swallowing, confusion, signs, of CN palsy
· Myotoxicity – muscle weakness, pain stiffness of the muscles
· History of care/intervention/
· Was the wound wash?
· Did patient apply anything?
· History of drug and allergy?
· Immunization history (TT)
*Examination*
General – examine the site of bite
· Check for bleeding around the site
· Check for fang marks
· Check for swellings and mark it to monitor it’s change in size
· Check for tenderness at the site

CNS exam – confusion, ptosis, muscle fasciculation, cranial nerve pulses
CVS – signs of shock, hypotension
· Respiratory – dyspnea, tachypnea
· Monitor the vital signs
*Investigation*
*Specific*
1) Elisa
2) Immunoenzymatic test: it is used to identify the specific venom
Supportive
1) FBC (anemia low platelet count)
2) Clothing profile – may be abnormal
3) Blood group and cross matching – in case of any need for transfusion
4) Urinalysis – proteinuria, myoglobinuria
5) E/U/Cr – because myoglobin can cause renal failure
*Treatment*
· If patient has no sign of envenomation, reassure him/her and observe for 12-24 hours.
· Patient with sign of envenomation
Specific treatment
Antivenom – a polyvalent antivenom. Give a test does of 0.02mls subcutaneously with a control of 0,02mls of aqua water. If patient reacts, dilute it more. If there is no reaction then:
· 5ml/min of antivenom in N/S over 30-60min via I.V infusion.
· Monitor for 6 hours, if signs does not disappear, repeat the dose.

*_Note_* :
1) Antivenom is most effect if given within 4 hours
2) The dose is not age dependent but depends on the degree of envenomation.

*_Supportive treatment*
· Severe bleed – transfuse fresh whole blood
· Analgesia
· Diazepam to relieve anxiety
· Wound care (debridement and open dressing)
· Antitetanus
· Prophylactic antibiotics
· Acute renal failure – manage properly
· Respiratory failure – early CPR

*Factors Affecting Severity*
1) Extreme age
2) Site of bite (the closer it is to the heart the worse it is)
3) Coexisting illness (morbidity)
4) Exercise and exertion worsens it (e.g. running immediately after bite)
5) Sensitivity to venom
6) Super-infection
7) Protective clothing
8) Number of bites
9) Depth of bite
10) Duration between bite and hospital management

*Don’ts in Prehospital Management of Snake Bite*
1) Don’t run immediately after bite
2) Don’t apply pressure on the wound
3) Don’t apply tourniquet as it will prevent blood supply
4) Don’t try to kill the snake to avoid multiple bite
5) Don’t by to suck out the venom with your mouth.
6) Don’t apply extreme temperature on it.
7) Don’t incise the wound
8) Don’t delay in taking the patient to a good hospital

*Complication of Snake Bite*
1) Shock
2) Acute renal failure
3) DIC
4) Respiratory failure
5) Compartment syndrome
6) Anaphylaxis to the antivenom

24/10/2017

Human s*xuality is a complex rainbow. If, like me, you were raised in Nigeria as an excessively religious person, but unlike me, remains a religious fundamentalist jerk and homophobe in your adulthood, you may never learn about or experience the full range of human s*xual behaviour and human experience of s*xuality.

Nigerians generally are raised to view s*x as a taboo subject, evil even, and patently diabolical, if it veers off the track of missionary style between a "man" and a "woman", both of these gender entities being mutually exclusive in biology and behaviour.

However, in both my professional and social experience and interactions, humans are neither rigid nor simple in their s*xual preferences and expression, at least not as viewed in the Nigerian moral and social framework.

There are men who like women a lot and don't like men at all. There are men who like women a lot and like men a little; and there are men who like men a lot and don't like women at all. And there are tens of shades in between: men who like men and women equally; women who like men and women equally; women who like women only, women who like men and do the occasional woman.... In short, there are as many variations as one can possibly imagine, and I have come across many.

But what we all see and imagine, in it's simplest form, are straight men and women, and LGBTQ (Le***an, Gay, Bis*xual, Transs*xual and Q***r) persons. Unfortunately, it is often not that straight forward at all. Fortuitous events have made people who had never experienced a certain part of their s*xuality, understand more about themselves, the same selves that they had lived with for decade.

And this is where learning and experience begin. We have all always thought that human emotion and love drama only occur between males and females. Wrong. In 2012, I learnt about a gay guy who beat up another gay man because the said guy disrespected his special gay partner. It was as intense as the fight involving a guy trying to "defend the honour of his lady", whatever the hell that means. Also, you would think only immature young men kiss and tell. Wrong again. I have heard stories of women who brag to other women about the women they have " chopped", and some would even bet with fellow women that they would "chop" a certain young woman in the neighborhood. I have heard about a le***an lady who would call her friend at odd hours, crying of heartbreak from another le***an, who recently discovered that she was actually bis*xual and preferred the p***s of a particular new guy to the vaginas of her numerous previous female lovers. There was also this lady who was complaining bitterly the other day that her female lover who was bis*xual and married with a child was not paying her any attention and only wanted to f**k and move on to enjoy her own husband, leaving her, an obligate le***an, crazily h***y and lonely. And there was the woman who left her husband and three children to pursue her love of other women, when she no longer found joy or fulfilment in s*x with her husband. Who knows, maybe she never really did find joy and fulfilment in heteros*xual s*x, and only had to get married to fulfil social obligations and family expectations.

In all of this, there are usually intense human emotion and suffering involved, and it would indeed be callous to dismiss them with a wave of the hand. Men cry over women because of love. Women experience heartbreak from men and from fellow women. Men have been known to lose it when they discover that their wives of many years find time to go down on the occasional woman. The drama in human love and s*xual behaviour is definitely not restricted to heteros*xual relationships alone. It exists on every point of the rainbow.

There was the fellow who had always known that he was 100% gay. When his friends were fancying girls in primary school, he never did and he thought his relatively uncorrupted mind was due to his outstanding Christian upbringing. Puberty came, accompanied with a brigade of raging hormones, and s*xual urges arrived strong and potent, but not in the expected direction. Girls did not interest him one bit. But he was a Christian and he believed there was nothing prayer could not do. He prayed and got married to his Christian heartthrob. Six years after, he still hadn't consummated the marriage. He just couldn't get it up with his wife. The usual early morning tumescence would become flaccid instantly at the touch of his wife. Several trials with commercial s*x workers did not help either. But he would go for hours nonstop with a gay partner. Interestingly, he liked the idea of being married and coming home to his wife. When the wife could no longer cope, she called a meeting of the man's family, came clean, and packed her things and left in search of "a real man with a real p***s". Her husband became depressed and suicidal and was desperately in search of whoever was capable of exorcising him of the "spirit of gayness".

There was also the guy who always knew he was gay and had gay lovers till he was 26. Then he responded to an altar call in church one day to dedicate his life to Christ. He "repented" and stopped seeing his gay partners. A few months after, he found that he could neither form a stable relationship with women nor even be turned on enough to have s*x with them, no matter how extraordinary their anatomy were. So he returned to his gay partners. And became guilty after a few months. He kept swinging from guilt to "re-dedication" and back, until his psyche could no longer cope and had a psychotic illness, necessitating a psychiatric consult.

And there was the case of two gay guys who married two bis*xual women unbeknownst to any of the parties involved. One of them later began to suspect and piece the information together when the men would go on long golfing trips and the women spent too much time behind closed doors, ostensibly comparing notes on current fashion trends.

It is not likely that we would learn to appreciate the s*xual diversity in nature nor appreciate the range of human s*xual emotion on offer if we are unwilling to free ourselves of deeply rooted bias, malignant religious indoctrination and inability to learn to be empathic and less judgemental.

Humans are humans. Humans are s*xual in a complex manner. And humans can and do misbehave socially irrespective of s*xual orientation and s*xual behaviour. Learning to understand these things is the first step in understanding human behaviours, preventing undue human suffering and learning to become better human beings ourselves.
© Olatunde o consultant psychiatrist

06/02/2016