Essential Medical Facts

24/05/2024

03/10/2022

There are ADVANTAGES and DISADVANTAGES to having more than 1 anesthetist in the operating room

1. ADVANTAGES
Increased Efficiency
Less Fatigue
Division of Labour
Sharing of Challenges - especially if the case is difficult such as an ASA 4 patient undergoing major vascular surgery

2. DISADVANTAGES
Distraction
Complacency
Drug Errors
Differing opinions

What is your take on this ?
🙂

10/06/2022

*xAndFertility

Theme: Does frequent S*x Affect A Man's S***m Count & Fertilty ?



Good evening Doc! Does having s*x every other day reduce s***m quality?



Here is the deal. S*x is good! There is nothing like too much or too little s*x, s*x is what you make it. If you prefer, you can get it every day, or every two years, your choice. For some people, s*x is so much fun that you just feel like doing it over and over again.

And truly, from a health perspective, the desire to have s*x, doing it again and again is never-ending. FACT!

But, the big question are;

· How much s*x is good for you?

· How often can you have s*x without the fear that it may affect your fertility?

Generally, for a woman, fertility means the ability to get pregnant, within a short period of trying, about one year and for men; fertility is about the ability to impregnate a woman, within one year of trying,

So, the BIG QUESTION REMAINS, 'Does frequent s*x affect a man's s***m count?'

Let’s dig in!

Out, there, you must have heard the common word that, frequent s*x may lead to infertility in men due to lowered s***m count. But how true is the commonly believed statement?

THIS IS FACTUALLY FALSE AND THERE IS NO PROVEN EVIDENCE TO SUPPORT THIS CLAIM!

There is also this urban legend about s*x, that “having s*x once a week is good for you and does not harm fertility, and that too much s*x may eventually lower a man's s***m count which eventually leads to infertility. Well, THIS IS ANOTHER LIES FROM PIT OF HELL. This is just a myth!

This is the FACT! The body of a healthy man needs anything between 24-36 hours for creating more s***ms. So based off this alone, by default, apparently, frequent s*x can lower s***m count temporarily. But here's the deal! Fresher s***m have higher speed and motility!

Fresh s***ms are more live and have higher motility, thus improving fertility. Hence, if s***ms are stored inside the body of a man for too long, it can lead to lowered fertility temporally, as they become more sensitive to harm from heat and exposure.

Fertility experts explain that infrequent ej*******on can put a man's fertility at risk and a man can stay without ej*******on for as many as 7 days. They advise on frequent ej*******on.

So if you are in the GOING TO CONCEIVE CATEGORY AND, you are trying to conceive, having s*x every 2-3 days, apart from the bleeding days is good for you.

This is because, frequent ej*******on, leads to new and fresh s***m, and fresh s***ms are available for the o**m (egg/s) and it can lead to higher chances of conception.

Also, in GTC couples, having s*x daily before ovulation is an added advantage as it improves fertility to a great extent.

So ladies and gentlemen, ROLL UP your sleeves and go to work! It is time to get over the fear that too much s*x will harm your fertility and bring your s***m count to a low level. THIS IS NOT TRUE. So, quit counting numbers and engage in passionate love-making with your partner to bond and get rid of too much stress as well.

GOOD LUCK.

Makumbi Mathew

05/06/2022

THE PREGNANCY PACKAGE

Pregnancy package differs from one woman to another. Some will suffer so much from nausea and vomiting, some will battle with constipation throughout, another will struggle through with gassy tummy and so on.

PROGESTERONE; a very important hormone needed to keep pregnancy going, to support and nurture pregnancy is the culprit of most of these symptoms.

Progesterone will relax the muscles of the body especially the smooth muscles of the body and will cause them to be “slow” in their action. So your food don’t digest/ move fast in your gut which will make it easy for heartburn to occur (as food not quickly evacuated from the stomach gets to move back up into your esophagus (food pipe).
Also remember that this same progesterone has relaxed the Lower esophageal sphincter which is suppose to be shut tight to prevent regurgitation.

Also as food lingers in the intestines, it leaves enough and much more time for the bacteria in your intestines to act on your food and in the process produce so much gas which will make you Gassy and fart a lot (with offensive, room scattering odor)

This same progesterone alongside its sister hormone “RELAXIN” will relax joints/ligament to allow the pelvis be loose to accommodate the the growing womb/uterus and so also cause the waist/thigh/back pain.
And so many things discomfort pregnant women experience in pregnancy.

What can you do to help?

First, realize that you are not alone on this journey and what you are experiencing is not abnormal/strange.
It’s all part of the process your body is taking to accommodate your precious growing baby(ies)

Now you will need to make some adjustment to your lifestyle as listed below:

✔️Avoid or reduce carbohydrate drinks (when broken down they generate more gas)
✔️Avoid fatty fried foods (they exacerbate heart burn)
✔️Drink from a glass without using a straw (you don’t want to gulp in more air through the straw)
✔️ Eat smaller meals throughout the day
✔️Exercise, yes do. This will help stimulate digestion and increase your metabolism
✔️Limit or avoid artificial sweeteners
✔️Drink plenty of water, plenty plenty which will help prevent constipation and help move the bowel too
✔️Eat slowly and chew thoroughly. Chewing your food thoroughly is one of the best ways to reduce gas. Most gas is caused by bacteria in the large intestine working to break down food that was not digested thoroughly by enzymes in the stomach.
✔️Invest in a good maternity belt to help with the waist pain.

If all these don’t help, be sure to visit your doctor for help. Some medications may help in relieving some of the pain.

Dr Makmat
Essential Medical Facts

20/07/2021

My Autism isn't your Autism
--------------------------------------------

The idea that any autistic person would understand a stranger’s autistic child better than their parents just because they share a diagnosis is idiotic.

I’m autistic, but that doesn’t mean I understand how your child experiences their autism. Someone like a parent or guardian has that everyday detailed view.

Of course, the best expert on an autistic person is, simply, that autistic person. The issue is that this cannot apply to the many people on the spectrum who can't communicate their needs and struggles, or perhaps much of anything at all.
In those cases, who better to advocate for a child, to interpret their behavior, than someone who observes and cares for them often 24/7?

Who can advocate for a child better than the people who are often able to interpret the meaning behind the various incomprehensible sounds that they do make?

Who can advocate for a child better than the people who love them?

Certainly not a stranger on the internet who happens to share a diagnosis of something with such a broad, varied, and unique array of characteristics. The spectrum is too broad for any autistic to be able to speak for every other. No two autistics have the same exact strengths and weaknesses nor array of autistic characteristics.

An autistic person who can self-advocate on social media doesn’t experience autism the same as someone with severe autism.

Many autistics make it to adulthood without ever learning how to communicate. Inspirational stories are great, but we can’t forget about those who will need care for the rest of their lives.

Autistic people are experts only in their autism. And parental figures who educate themselves, can help be their child’s voice until they find a way to communicate independently, if they ever do.

16/07/2021

A rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens with the use of the arm away from the body.

Rotator cuff injuries are common and increase with age. These may occur earlier in people who have jobs that require repeatedly performing overhead motions. Examples include painters and carpenters.

13/05/2021

SPINE CONDITIONS

14/02/2021

Today,s photo (Case 38) Lymphadenopathy
Examine pre and post -aurical ,submental ,tonsillar and occipital lymph nodes along with detection of enlarged supraclavicular lymph nodes in the head and neck area .
In the upper limb, always look for enlargement of epitrochlear lymph nodes .Now examine both axillae and groins for any lymphadenopathy .
Do not forget to examine the abdomen for any enlargement of paraaortic or iliac lymph nodes and hepatic or splenomegaly ,
Always look for consistency ,tenderness and matting of the lymph nodes which help in deciding about the possible cause of lymphadenopathy .
(Q) What are the causes of generalized lymphadenopathy ?
(A) (1) Acute and chronic leukemias .
(2) Lymphoma .
(3) Infections e.g. infectious mononucleosis ,secondary syphilis and miliary tuberculosis (4) Collagen diseases e.g. systemic lupus erythematosis , Still,s disease and rheumatoid arthritis .
(5) Other conditions e.g. sarcoidosis .

11/12/2020

A state-of-art gynecologist's view of male factor infertility...

1. Never rely on a single abnormal semen analysis. Time-to-time and lab-to-lab variations are obviously frequent in semen analysis...

2. Always request semen analysis in one of the well-known infertility centers. Semen analysis highly depends on the analyst's view. Embryologists who check tens of analyses per day have by far much more experience than technicians or even physicans in general labs...

3. Computer-assisted semen analysis offers no added diagnostic yield when compared to conventional semen analysis...

4. Only 4 parameters that actually count in a semen analysis: volume (>= 1.5 ml), concentration (>= 15 million per ml), progressive motility (>= 32%) and morphology (>= 4% normal forms)... Other parameters (e.g. viscosity) are of no predictive value..

5. The more parameters which show abnormality, the more serious is testicular disease, and the more consistent is the etiologic link to infertility...

6. The single most important parameter is s***m concentration. Values below 10 million per ml should be actively managed. Values below 5 million per ml should be labelled as severe oligozoos***mia...

7. Karyotyping should be asked for in any man who has severe oligozoos***mia, to exclude Y chromosome abnormalities...

8. Low semen volume in a diabetic or neuropathic man usually implies retrograde ej*******on. There is no effective medical treatment for retrograde ej*******on.. ICSI (with testicular FNA) is the only known effective treatment for infertile men with retrograde ej*******on..

9. Unless there is a detectable endocrine abnormality (e.g. hyperprolactinemia, hypogonadotropic hypogonadism), there is no value of any hormonal treatment for semen analysis abnormalities... Indeed, in severely low s***m comcentrations, hormonal treatment might actually worsen the condition and cause transient or permanent testicular failure and complete azoos***mia in some cases...

10. Varicocelectomy might have some benefit in men with borderline concentration and/or motility, and ONLY when varicoceles are clinically detectable. This procedure should always be performed by skilled hands as it may end in serious untreatable complications up to tesicular atrophy and necrosis. This procedure should CAUTIOUSLY be performed in men with severe oligozoos***mia... This procedure should NEVER BE repeately performed...

11. There is NO medical treatment for abnormal s***m morphology. Antioxidants and adjuvant treatment are actually useless in such cases... The key factor that counts in such cases if they are subjected to ICSI is meticulous s***m selection by the most senior embryologist. Such men also do benefit from freezing more than semen specimen and getting two fresh ej******es on the same day of o**m pickup...

12. IUI is a good choice for men with mild semen abnormalities and men with erectile dysfunction..

13. ICSI should not be delayed as a fertility treatment choice in obvious and repeated poor semen analysis..

14. The standard practice is to have s***ms in hand (through either frozen semen specimen or frozen tesicular biopsy from elective TESE) before ICSI cycle is started...

15. Fresh TESE/ICSI can be considered only when obstuctive (rather than nonobstructive) azoos***mia is DEFINITELY diagnosed and when the husband is diagnosed as Kleinfelter's syndrome. In this latter diagnosis, the few s***ms retrieved from an elective TESE usually do not withstand vitrification...

16. Within the ICSI cycle, intentionally induce women whose husbands have semen abnormalities with higher gonadotropin doses, so that more oocytes are retrieved.. Fertilization rates in such couples are generally suboptimal... The more oocytes retrieved, the better chance to have good number of good quality embryos to transfer...

والله تعالى أعلى وأعلم....

11/11/2020

Delayed Onset Muscle Soreness (DOMS)

It is a muscle pain that begins post-workout. The pain is usually caused by high-intensity exercise that results in microtrauma in the muscle fibers. The body naturally heals this damage by increasing the inflammation which may lead to DOMS.

The pain is usually not felt during the exercise as the body is warm at that time. However, the pain starts a day or two after work out, peaks for two to three days, and then ease up after that.

Symptoms:
Tenderness
Reduced range of motion of the joints
Swelling
Muscle fatigue

Treatment:
* Cold bath for 10 to 15 minutes
* Protein intake - It helps in healing the micro trauma that has occurred in the muscles.
* Massage
* Stretching

18/10/2020

Sciatica
Sciatica is one of the most common, yet misunderstood, types of pain. As many as 40% of people will get it during their life, and it becomes more frequent as you age. Sciatica tends to get lumped in with regular back pain, but it is different. The pain originates with the sciatic nerves and often goes away by itself within a few hours or days. However, some attacks can come and go for several weeks or even months. Fortunately, there's a lot you can do to prevent sciatica, as well as relieve the pain.
The sensation of pain can vary widely. Sciatica may feel like a mild ache; a sharp, burning sensation; or extreme discomfort. Sciatica can also cause feelings of numbness, weakness, and tingling.
Pain may be made worse by prolonged sitting, standing up, coughing, sneezing, twisting, lifting, or straining. Treatment for sciatic pain ranges from hot and cold packs and medications to exercises and complementary and alternative remedies.
Common Causes of Sciatica
• Lumbar herniated disc. Research suggests that up to 90% of sciatica is caused by a lumbar herniated disc.3 The herniated disc typically compresses one or more spinal nerve roots (L4-S3) that form the sciatic nerve. A lumbar herniated disc can cause sciatica in two ways:
- Direct compression.
- Chemical inflammation.
A herniated disc may compress the sciatic nerve on one side, causing symptoms in one leg, or the disc may bulge or herniate from both sides, causing symptoms in both legs (bilateral sciatica). Bilateral sciatica may also be caused by two adjacent segments discs herniating on either side, although this possibility is rare.
• Degeneration. Degeneration of tissues in the lumbar spine can compress or irritate the sciatic nerve.
• Lumbar spinal stenosis. Spinal stenosis is the narrowing of the spinal canal and is relatively common in adults older than age 60.
• Spondylolisthesis. Spondylolisthesis occurs when a small stress fracture causes one vertebral body to slip forward on another.
Exercise is a key way to prevent or help relieve sciatica. Consider these types:
• Aerobic exercise: walking, jogging, swimming, cycling, dancing, and other activities that increase your heart rate without causing more pain if you already have sciatica.
• Strength training: exercises using free weights or weight machines, or isometric exercises, which involve contracting muscles without obvious movement.
• Flexibility training: yoga, tai chi, Pilates, and similar activities that increase both flexibility and strength.
Really, any exercise that you can enjoy and do regularly is going to help. So try something new, go back to an old favorite, or both.
Strengthen your core
It might not seem obvious that a stronger core could improve your spinal health. But your core is not just your abdominal muscles, even though they are key contributors to the stability of your spine. Muscles in the back, sides, pelvis, and buttocks also are part of your core. Strengthening all of these muscles helps to support your spine.
Many types of exercise, including yoga and Pilates, can strengthen the core muscles. For example, planks and bridges are movements that target the core.
Avoid sitting for long periods
Prolonged periods of sitting put pressure on the discs and ligaments in the low back. If you have a job that requires a lot of sitting, take frequent breaks, or try a standing desk. Less sitting is better.
Manage your weight
Being overweight or obese can increase your risk for sciatica. And people who have sciatica and are overweight tend to heal more slowly. Why? The increased weight puts pressure on your spine and can lead to herniated discs. Even minor weight loss will reduce inflammation and pressure on the spine.
Practice good posture
Mom was right—slouching isn't good for you. But you don't have to walk around the room with a book on your head to practice good posture. Follow these tips:
• Pay attention to your body's position when you're standing or sitting.
• To prevent slouching, pull your shoulders down and back. Imagine your shoulder blades touching.
• If you work at a computer, take frequent breaks. Position your monitor so you can see it without bending your head down or tilting it back.
Consult doctor for prescription of pain medication and advice.

21/09/2020

A cystic hygroma also known as (Macrocystic lymphatic malformation, Cystic lymphangioma) is a fluid-filled sac that results from a blockage in the lymphatic system. It is most commonly located in the neck or head area, but can be located anywhere in the body. It may be discovered in a fetus during a pregnancy ultrasound, or it may be apparent at birth as a soft bulge under the skin.
▪︎A cystic hygroma may be caused by genetic or environmental factors that cause abnormal development of the lymphatic vascular system during embryonic growth. It may occur on its own or as part of a genetic syndrome with other features, such as Turner syndrome, Down syndrome or Noonan syndrome.
▪︎Treatment involves removing the cystic hygroma, although removing all of it may not be possible. Other treatments that have been tried with limited success include chemotherapy, injection of sclerosing medicines, radiation therapy, and steroids.