FEMALE FACTOR INFERTILITY

FEMALE FACTOR INFERTILITY

She looked at me in desperation, as if to say ‘’Give me a child now or I die here, because I cannot go home without one. I cannot afford to fail the second time’’.
Her case is like the plight of so many infertile African women.
She had been married to her first husband for over 10 years without giving him a child. When the man got tired of waiting , he decided to test his manhood by playing an away game with his secretary, and scored, she became pregnant for him.
As if that was not enough problem for the poor lady, her mother in-law and sisters in-law came over , beat her thoroughly then threw her out of her matrimonial home to make way for the new pregnant secretary/wife to take over.
Luckily she was such a pretty and desirable lady, so not long she had remarried to another man.
She is now married to her new husband for 4 years without giving him any child.
Now she is desperate.

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INFERTILITY: is usually defined as no pregnancy after one year of unprotected intercourse. This is a relative measurement. Over time, many couples may achieve pregnancy. In five years, nearly one half of "infertile" couples will conceive.

SUBFERTILITY: is used to describe gradations between normal fertility and sterility, often used interchangeably with infertility.

FECUNDABILITY: is the pregnancy rate from one menstrual cycle. The normal rate in humans is 20%. Seventy-five percent of normally fertile couples are expected to have conceived in six months and almost 100% by one year.

STERILITY: is the absolute inability to procreate: an absent uterus in women, absent testes in men. In years past, a woman with blocked fallopian tubes or man with an obstructed vas deferens would be sterile. But with assisted reproductive technology (ART), this is no longer the case.Normal fertility can be considered from several different points of view: the couple, the female and the male. In this article, we are going to look at female fertility: the biological steps and mechanisms, the defects, the causes of the defects and what to do.

THREE BASIC QUESTIONSThere are really three basic questions that have to be answered when doctors try to determine why a woman is having problems getting pregnant.
[1]Is she ovulating?
[2]Is there a clear passage from the ovary to the uterus?
[3]How old is she?
A similar set of questions has to be answered in men. Is there sperm? Can it be delivered to the female? Is the sperm normal? In the male these questions are answered in a preliminary and rather thorough way by semen analysis. With women the process is more complicated.

FEMALE INFERTILITYFemale factor infertility is the inability to conceive or carry a pregnancy to term due to one or more problems specific to females. For example, if a couple is struggling to achieve pregnancy and the male has adequate sperm count, motility, and shape, but the woman has polycystic ovarian syndrome, then their inability to conceive is likely due to female factor infertility.

FEMALE FERTILITY PROBLEMS
There are several conditions that contribute to female factor infertility, including uterine and pelvic abnormalities, secondary infertility, polycystic ovarian syndrome, and hostile cervical mucus. It is important to understand, however, that infertility, whether male infertility or female infertility, is not the same thing as sterility - conception and successful pregnancy are possible in many cases. Likewise, secondary infertility (the inability of a couple to conceive after having already achieved a successful pregnancy or pregnancies) can often be treated.
[1] Abnormal Uterine/Pelvic Area
[2] Blocked Fallopian Tubes
[3] Endometriosis
[4] Hostile cervical mucus. This is a condition in which the cervical mucus creates a thick barrier that sperm cannot penetrate.
[5] Irregular Ovulation
[6] Medications/Contraceptives and Infertility
[7] Polycystic Ovarian Syndrome
[8] Premature Ovarian Failure
[9] Uterine Fibroids
[10] High levels of the hormone prolactin
[11] Galactorhoea (milk leaking from the breasts).
[12] Amennorhoea [absence of periods]
[13] The production of sperm antibodies (when a woman develops antibodies to her partner’s sperm).

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INFERTILITY AFTER MISCARRIAGEThe termination of a pregnancy is devastating to couples who wish to have a baby; worse yet is the prospect of female infertility after miscarriage. Unfortunately, such a fate is possible. This form of female factor infertility can be caused by hormonal, environmental, immunological, and even physiological problems. There is hope, however, with treatment from a female fertility specialist.

SECONDARY INFERTILITY
Sometimes female infertility occurs after a woman has already given birth to one or more children. If a couple has already successfully conceived and delivered before, but is having difficulty becoming pregnant again, they may be experiencing secondary infertility.Secondary infertility can be caused by a wide range of issues, including age, irregular ovulation, endometriosis, hostile cervical mucus, and an abnormal uterus or pelvis. Scar tissue from the previous pregnancy may be causing blockage to the fallopian tubes or cervix, resulting in female factor infertility.

INFERTILITY CAUSED BY ABORTION
There is a risk of becoming infertile after an abortion, arising from various complications. If you have had a first trimester abortion (in the first 13 weeks) this is done by vacuum suction which can cause perforation of the womb. This is when the womb ruptures and causes internal bleeding. It is life threatening and the surgeon would be required to do additional surgery to repair the damage. Sometimes after this has occurred, the damage to the womb prevents another embryo from attaching. Rupture happens in about 1% of cases, so if 100 women had an abortion, one of them would have this problem.The main abortion complications that could cause infertility:90% of abortions are done in the first trimester. However, a late abortion frequently requires a material called laminaria to dilate the cervix. This makes the passage large enough to allow a suction tube to be inserted. The laminaria could weaken the cervix and conceivably cause infertility.If the physician scrapes too hard, the lower lining of the uterus can be removed. This is extremely rare.An untreated infection can scar the uterus and cause later fertility problems. The infection rate for first trimester abortions is less than 1%. Most women monitor their body temperature after an abortion to detect if an infection has occurred. Early detection should prevent any problems.
A woman who already have gonorrhea or chlamydia are very likely to suffer pelvic inflammatory disease which causes infertility. They are particularly susceptible to damage from PID after an abortion. This can be avoided by obtaining a STD test before the abortion.The suction tube can perforate both the uterus and a large blood vessel or intestine. If the latter happens, then surgery may be required. The surgery can cause infertility. Perforation of the uterus is also quite rare.
It would seem that if the physician is competent, and the woman monitors her body temperature after the procedure, that the chances of an abortion causing later infertility is quite remote.

CAUSES AND MECHANISMS OF FEMALE INFERTILITYThe main causes of female factor infertility are ovulation disorders, tubal disease and endometriosis. In a population of infertile couples, if you consider unexplained and male factor infertility at about 25% each, ovulatory disorders and tubal factors would be about 20% each and endometriosis 5-10%, with small percentages for uterine/cervical problems.3

The history and physical exam offer us many hints about the cause of infertility :


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FEMALE INFERTILITY WORK-UP: HISTORY AND PHYSICAL EXAMINATION.

HISTORY[1]Systemic illnesses: weight gain, weight loss
[2]Cancer, chemotherapy, radiation treatment, surgery
[3]Urogenital system: surgery: D & C, laparoscopy
[4]Pregnancy: outcome
[5]Menstruation: regular, irregular, absent
[6]Pelvic pain, dysmenorrhea, dyspareunia
[7]Sexual history: function, sexually transmitted disease, pelvic inflammatory disease
[8]Endocrine history: diabetes, thyroid disease

FAMILY HISTORYInfertility, cystic fibrosis, endometriosis

MEDICATIONS AND DRUGS
Prescription: endocrine, psychoactive, anti-hypertensive

PHYSICAL EXAMINATION
[1]Height & weight, neck, arms (carrying angle)
[2]Skin: hirsuitism
[3]Breasts: galactorrhea
[4]Abdomen: girth, adiposity
[5]Mass Pelvic exam: uterus, ovaries, pelvic mass, tenderness Genital ulcers, warts

QUESTIONS AND ANSWERS
[1]IS SHE OVULATING?Defects in ovulation comprise about 25% of female fertility problems. The biggest clue that ovulation is occurring is the presence of regular menstrual periods. Regular periods are almost always associated with ovulation. Irregular or scanty menstruation (oligomenorrhea) or absent periods (amenorrhea) have to be investigated by your doctor.It is impossible to describe all the conditions that affect ovulation, but let me hit the highlights and give you some examples of the mechanisms involved. Causes for ovulatory defects can be genetic, as in Turner's syndrome, or hormonal, as in prolactinoma or the polycystic ovary syndrome (PCOS). Deficient or excessive body fat can also lead to hormonal changes that stop ovulation.


[2]IS THERE A CLEAR PASSAGE FROM THE OVARY TO THE UTERUS?The two main conditions that can affect the fallopian tubes are endometriosis and tubal infection.

[A] ENDOMETRIOSISIn this condition, implants of endometrial tissue are found outside the uterine cavity, primarily in the pelvis, on the ovaries, tubes, body linings and adjacent organs of the GI and GU tracts. This extra endometrial tissue responds to cyclical estrogen and progesterone in the same way the uterine endometrium does -- proliferating, swelling and bleeding. The implants can invade the surrounding tissues, affect nerve endings, and cause scarring and adhesions on adjacent peritoneal surfaces. The most common symptoms of endometriosis are pelvic pain, painful periods (dysmenorrhea) and painful sexual intercourse (dyspareunia). These symptoms generally coincide with menstruation but can become chronic. That said, there are women who have had no complaints at all and are found to have endometriosis at laparoscopy or surgery.

[B] PELVIC INFLAMMATORY DISEASE [PID] / SALPINGITIS
PID is the most common cause of tubal factor infertility. The infection involves the upper genital tract (the uterus, the fallopian tubes and the ovaries) and structures around these organs. The infection of the fallopian tube (salpingitis) is the most crucial element causing infertility. The fallopian tube is lined with special, ciliated cells that direct the egg toward the sperm and the fertilized egg into the uterine cavity. Infection can destroy these cells and distort and/or block the tube.
The main bacterial culprits are Neisseria gonococcus (NG) and Chlamydia trachomatis (CT). NG is directly kills the special cells; CT probably destroys cells through immunological mechanisms. With the infection, the tubes can become thickened, distorted and blocked. Abscesses can form between the tube and the ovary or in the adjacent pelvis, and can be life threatening. This condition requires prompt, broad-spectrum antibiotic treatment. Interestingly, in about half of cases of tubal infertility secondary to PID, there is no history of acute infection. Chlamydia in particular can linger in the genital tract, causing ongoing subclinical damage. Chronic pelvic pain, infertility and ectopic pregnancy (where the pregnancy develops in the tube instead of the uterus) are the serious consequences of PID.


[3]HOW OLD IS SHE?
Fertility decreases with age. Nationally, in assisted reproductive technology facilities, live birth rates are 37% for women <35>42. As mentioned earlier, there are only so many primordial follicles present in the ovary at birth and they decrease steadily until the time of menarche, from 2-4 million to 400,000. With every cycle, primordial follicles are lost. As women age, more chromosomal abnormalities occur during cell division of the ova. The decreasing numbers of follicles, cycles without ovulation (anovulatory) and poor quality of the ova all combine to diminish the chances of older women, especially after age forty, becoming pregnant.While age is the strongest predictor of a women's ovarian function, there are some tests that are also helpful. They are the follicle count, which is determined by ultrasound, and blood tests for follicle stimulating hormone (FSH) and estradiol. All these tests are performed on or about the third day of the menstrual cycle. Follicle count is used because the number of small follicles seen on Day 3 gives a good idea about ovarian reserve.The hormone levels give indirect evidence about ovarian reserve because inhibin, secreted by cells of the follicles, effects the hormone FSH. As the follicle number diminishes, there are fewer cells producing inhibin and FSH increases. As the specialized cells, called granulosa cells, continue to diminish, ovarian estrogen decreases despite elevated FSH. A high FSH and a low estrogen indicate severe loss of follicles.
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INFERTILITY DIAGNOSTIC TESTS
The Female Work-up (Diagnostic Tests)

[1] ULTRASOUND : Ultrasound scan is a simple and easy outpatient procedure to examine the internal reproductive organs. It can clearly show the position and size of uterus, endometrial lining and the ovaries. Certain abnormal conditions such as fibroid, double uterus and ovarian cyst can be diagnosed through ultrasound scan alone. In addition, ultrasound scan can be used for the diagnosis of ovulation.
Ultrasound scan appears as a routine practice in the management of infertility, from the initial stages of diagnosis of the cause of infertility, to the eventual confirmation of pregnancy, including routine monitoring of early pregnancy. Ultrasound scan is probably the most important test in investigation of infertility. A well-preformed and detailed ultrasound scan of the female pelvis will give more information than any other single test.
Ultrasound is the only definitive way to tell you have ovulated. Especially TRANSVAGINAL ULTRASOUND SCAN. This can tell if you have LUFS (Lutenized Unruptured Follicle Syndrome), which looks exactly like you are ovulating in every way except the egg is not released.

[2] HORMONAL BLOOD TESTS: perform some basic hormone blood tests. Here is a list of the common blood tests performed. FSH (Follicle Stimulating Hormone)LH (Lutenizing Hormone)EstrogenProgesterone
including estradiol, inhibin B, Pooled progesterone, prolactin,thyroid stimulating hormone, testosterone.

[3] POSTCOITAL TEST: This test will tell if you and your partner's cervical mucus and sperm are compatible. During the fertile time of your cycle, the doctor will take a sample of the female's cervical fluid withintwo hours of intercourse. If the sperm survive and move forward in the cervical fluid, you will know the sperm andcervical mucus are compatible.

[4] HSG (Hysterosalpingogram) : This is a Special X-Ray examination. This will tell if your fallopian tubes are open by injecting dyethrough the cervix. Blocked tubes and lesions or polyps on the uterine cavity can be foundwith this method.

TRANSVAGINAL ULTRASOUND SCAN
Definition
Transvaginal ultrasound is a imaging technique used to create a picture of the genital tract in women. The hand-held device that produces the ultrasound waves is inserted directly into the vagina, close to the pelvic structures, thus often producing a clearer and less distorted image than obtained through transabdominal ultrasound technology, where the probe is located externally on the skin of the abdomen.
Purpose
Transvaginal ultrasound can used to evaluate problems or abnormalities of the female genital tract. It may provide more accurate information than transabdominal ultrasound for women who are obese, for women who are being evaluated or treated for infertility , or for women who have difficulty keeping a full bladder. However, it does provide a view of a smaller area than the transabdominal ultrasound.

Types of conditions or abnormalities that can be examined include:
[a]the endometrium of women with infertility problems or who are experiencing abnormal bleeding
[b]sources of unexplained pain
[c]congenital malformations of the ovaries and uterus
[d]ovarian cysts and tumors
[e]pelvic infections, such as pelvic inflammatory disease
[f]bladder abnormalities
[g]a misplaced IUCD (intrauterine contraceptive device)·
[h]other causes of infertility
Transvaginal ultrasound can also be used during pregnancy. Its capability of producing more complete images means that it is especially useful for identifying ectopic pregnancy, fetal heartbeat, and abnormalities of the uterus, placenta, and associated pelvic structures.


FOLLICULOMETRY [ULTRASOUND]
Ultrasound Folliculometry is a serial Transvaginal ultrasound scan test carried out to monitor follicular growth . Ovulation/Follicular growth can be best monitored by ultrasound folliculometry, providing 40–60% effectiveness.
Folliculometry is one of the most accurate method for determining ovulation. Ovulation scans allow the doctor to determine accurately when the egg matures; and when you ovulate. This is often the basic procedure for most infertility treatment since the treatment revolves around the wife's ovulation. Daily scans are done to visualize the growing follicle, which looks like a black bubble on the screen. Most women can see the follicle clearly for themselves - and know by the scans when the egg has ruptured.
Other useful information which can be determined by these scans is the thickness of the uterine lining - the endometrium. The ripening follicle produces increasing quantities of estrogen, which cause the endometrium to thicken.
The doctor can get a good idea of how much estrogen you are producing (and thus the quality of the egg) based on the thickness and brightness of the endometrium on the ultrasound scan. Ultrasound Folliculometry is started from day 6 – 8 counting from the first day of menstruation. Folliculometry is performed every 2 or 3 days in the initial stages and can be done daily from the day 12, till after the follicle ruptures [post ovulation]. So in a routine ultrasound folliculometry the lady could be scanned transvaginally for between 3 to 6 sessions.
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JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI]. For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria. For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact JOAS MEDICAL DIAGNOSTIX JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES. We are located at JOAS HOUSE, 2, Okesuna Street, Opposite The Synagogue Church Busstop, Bolorunpelu, Ikotun, Lagos Postcode: 100265 Nigeria. TEL: 08032509975, 08184590752, 08058166504, 08064981455 EMAIL: joasmedicaldiagnostix@yahoo.com joasmedicaldiagnostix@gmail.com DISCLAIMER The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us. The informations provided in this site is subject to change without notice. This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

TYPHOID FEVER KILLS AGAIN

TYPHOID FEVER KILLS AGAIN

As a resident of Nigeria, a third world country in Africa, whenever I think of typhoid fever I feel dreadful, especially after the numerous times I myself have falling prey to this highly resistant and recurring illment.
Since typhoid fever seem to be a very popular illment in Nigeria, it never really got to me that it is also a ‘’KILLER DISEASE’’ until it hit very close to me.
Brother A is a very close friend and a fellow church member. I remembered asking about him in Church one Sunday, because he was not in church service that day, and I know him to be a very serious church goer, never missing church service.
Latter that day, I and some church members went to visit him at home, and found him very ill and weak. We quickly rushed him to the nearest General Hospital, where the doctors confirmed that he has typhoid fever, he was admitted and treatment commenced.
The next day I received a call from one of the church members, who informed me that my friend, Brother A has died early that morning, he died from complications of typhoid perforation. That really got to me and up till this day remains with me.

Typhoid fever, also known as enteric fever, is a potentially fatal multisystemic illness caused primarily by Salmonella typhi. The protean manifestations of typhoid fever make this disease a true diagnostic challenge. The classic presentation includes fever, malaise, diffuse abdominal pain, and constipation .Untreated, typhoid fever is a grueling illness that may progress to delirium , obtundation, intestinal hemorrhage, bowel perforation, and death within one month of onset. Survivors may be left with long-term or permanent neuropsychiatric complications.
Typhoid fever is a bacterial disease, caused by Salmonella typhi. It is transmitted through the ingestion of food or drink contaminated by the faeces or urine of infected people.

SYMPTOMS

Typhoid fever is characterized by a sustained fever as high as 40 °C (104 °F), profuse sweating,gastroenteritis, and nonbloody diarrhea. Less commonly a rash of flat, rose-colored spots may appear.
Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. In the first week, there is a slowly rising temperature with relative bradycardia, malaise, headache and cough. A bloody nose (epistaxis) is seen in a quarter of cases and abdominal pain is also possible. There is leukopenia, a decrease in the number of circulating white blood cells, with eosinopenia and relative lymphocytosis, a positive diazo reaction and blood cultures are positive for Salmonella typhi or paratyphi. The classic Widal test is negative in the first week.
In the second week of the infection, the patient lies prostrated with high fever in plateau around 40 °C (104 °F) and bradycardia (Sphygmo-thermic dissociation), classically with a dicrotic pulse wave. Delirium is frequent, frequently calm, but sometimes agitated. This delirium gives to typhoid the nickname of "nervous fever". Rose spots appear on the lower chest and abdomen in around 1/3 patients. There are rhonchi in lung bases. The abdomen is distended and painful in the right lower quadrant where borborygmi can be heard. Diarrhea can occur in this stage: six to eight stools in a day, green with a characteristic smell, comparable to pea-soup. However, constipation is also frequent. The spleen and liver are enlarged ( hepatosplenomegally) and tender and there is elevation of liver transaminases. The Widal reaction is strongly positive with antiO and antiH antibodies. Blood cultures are sometimes still positive at this stage. (The major symptom of this fever is the fever usually rises in the afternoon up to the first and second week.)
In the third week of typhoid fever a number of complications can occur:

[1]Intestinal hemorrhage due to bleeding in congested Peyer’s patches ; this can be very serious but is usually non-fatal.
[2]Intestinal perforation in distal ileum: this is a very serious complication and is frequently fatal. It may occur without alarming symptoms until septicaemia or diffuse peritonitis sets in.
[3]Encephalitis
[4]Metastatic abscesses, cholecystitis, endocarditis and osteitis
The fever is still very high and oscillates very little over 24 hours. Dehydration ensues and the patient is delirious (typhoid state). By the end of third week the fever has started reducing ( defervescence). This carries on into the fourth and final week.

TRANSMISSION
S typhi has no nonhuman vectors. The following are modes of transmission:
[1]Oral transmission via food or beverages handled by an individual who chronically sheds the bacteria through stool or, less commonly, urine
[2]Hand-to-mouth transmission after using a contaminated toilet and neglecting hand hygiene
[3]Oral transmission via sewage-contaminated water or shellfish (especially in the developing world)


DIAGNOSIS/TESTS
In order to make a typhoid fever diagnosis, a doctor will ask a number of questions about the patient's recent medical and travel history, perform a physical exam, and recommend certain tests. As part of diagnosing a typhoid fever bacterial infection, the doctor will also rule out other causes of possible typhoid fever symptoms, such as viral hepatitis, mononucleosis, and malaria (to name a few).
Diagnosis is made by any blood, bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and H-flagellar). In epidemics and less wealthy countries, after excluding malaria, dysentry or pneumonia, a therapeutic trial time with chloramphenicol is generally undertaken while awaiting the results of Widal test and blood cultures.
The term "enteric fever" is a collective term that refers to typhoid and paratyphoid.

ULTRASOUND SCAN IN THE DIAGNOSIS OF TYPHOID FEVER
In endemic areas like Nigeria, ultrasound findings of hepatomegaly, splenomegaly, ileal and cecal thickening, mesenteric lymphadenopathy and thick-walled gallbladder are diagnostic features of typhoid. Ultrasound can be a non-invasive, economical and a reasonably sensitive tool for diagnosing typhoid when serology is equivocal and cultures are negative. So abdominal ultrasound scan is a vital initial diagnostic tool in assessing typhoid fever. It has also being found to be very useful in areas of typhoid intestinal perforation, because it can locate the site of perforation and also identified fluid collections [peritonitis].


TREATMENT/PREVENTION
Typhoid fever can be treated with antibiotics. However, resistance to common antimicrobials is widespread. Healthy carriers should be excluded from handling food.
In many developing nations, the public health goals that can help prevent and control typhoid — safe drinking water, improved sanitation and adequate medical care — may be difficult to achieve. For that reason, some experts believe that vaccinating high-risk populations is the best way to control typhoid fever.
Two vaccines are currently in use — one is injected in a single dose, and the other is given orally over a period of days. Neither is 100 percent effective, and both require repeat vaccinations.
If you're traveling to an area where typhoid fever is endemic, consider being vaccinated. But because the vaccine won't provide complete protection, be sure to follow these guidelines as well:

[1]Wash your hands. Frequent hand washing is the best way to control infection. Wash your hands thoroughly with hot, soapy water, especially before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when water isn't available.
[2]Avoid drinking untreated water. Contaminated drinking water is a particular problem in areas where typhoid is endemic. For that reason, drink only bottled water or canned or bottled carbonated beverages, wine and beer. Carbonated bottled water is safer than uncarbonated bottled water is. Wipe the outside of all bottles and cans before you open them. Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.
[3]Avoid raw fruits and vegetables. Because raw produce may have been washed in unsafe water, avoid fruits and vegetables that you can't peel, especially lettuce. To be absolutely safe, you may want to avoid raw foods entirely.
[4]Choose hot foods. Avoid food that's stored or served at room temperature. Steaming hot foods are best. And although there's no guarantee that meals served at the finest restaurants are safe, it's best to avoid food from street vendors — it's more likely to be contaminated.

To prevent infecting othersIf you're recovering from typhoid, these measures can help keep others safe:

[1]Wash your hands often. This is the single most important thing you can do to keep from spreading the infection to others. Use plenty of hot, soapy water and scrub thoroughly for at least 30 seconds, especially before eating and after using the toilet.
[2]Clean household items daily. Clean toilets, door handles, telephone receivers and water taps at least once a day with a household cleaner and paper towels or disposable cloths.
[3]Avoid handling food. Avoid preparing food for others until your doctor says you're no longer contagious. If you work in the food service industry or a health care facility, you won't be allowed to return to work until tests show that you're no longer shedding typhoid bacteria.
[4]Keep personal items separate. Set aside towels, bed linen and utensils for your own use and wash them frequently in hot, soapy water. Heavily soiled items can be soaked first in disinfectant.

JOAS MEDICAL DIAGNOSTIX Ikotun Lagos Nigeria ,have a well equipped computerised laboratory and also a 4D Colour Doppler Ultrasound Scan. We also have qualified, very experienced and licensed medical laboratory scientists and Clinical Specialist Sonographers. We offer accurate Typhoid Fever Testing like blood and stool cultures, including Widal Tests and General Abdominal Ultrasound Scan. We also offer other laboratory tests. If you suspect you have Typhoid fever or other feverish conditions, contact JOAS MEDICAL DIAGNOSTIX Ikotun Lagos Nigeria.

Regards
Dr. Victor Efughi
Consultant Clinical Specialist Sonographer

For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact
JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.
We are located at

JOAS HOUSE, 2, Okesuna Street, Opposite Synagogue Church Busstop, Bolorunpelu, Ikotun, Lagos, Nigeria, WestAfrica.

TEL:
+23418112054
+2348023069403
+2348033535729

EMAIL:
joasmedicaldiagnostix@yahoo.com
joasmedicaldiagnostix@gmail.com

http://www.joasdiagnostix.8m.net
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DISCLAIMER
The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.
The informations provided in this site is subject to change without notice.
This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

LOW SPERM COUNT AND STAPHYLOCCOCUS IN NIGERIA

LOW SPERM COUNT AND STAPHYLOCCOCUS IN NIGERIA


A wonderful looking couple came to our clinic sometime ago. The man and his wife indeed were really looking lovely, he was a very tall and athletic built handsome man , his wife could easily pass for Miss World.
They had been married for more than 10 years with no child [ a case of primary infertility].
After consulting with the two of them, the wife then left to our other departments to conduct some tests. The man now had some free time with me, and decided to open up.
He confessed that before marriage he had successfully impregnated more than 6 ladies [ which all of course underwent abortions]. He also contracted at different times sexually transmitted diseases and others [ of course they were all treated successfully].
When he got married to his wife, they tried having a child for 5 years without success. The wife had undergone many tests in many places that proved she was ok.
He privately did some tests five years ago, and discovered he had very low sperm count and staphylococcus infestation. He had treated it all these years and up till this moment [ however without the knowledge of his wife] was still having low sperm count. He told me he had visited many doctors, native doctors, traditional drug street hawkers, pastors, imam, babalawos and many others privately seeking solution to his problems.
So indeed he knew he was a cause of childlessness in the marriage .

Staphyloccocus infection has being a serious issue in Nigeria as regards infertility and still is . Many unorthodox practitioners have continued to make millions of naira, branding staphylococcus as the only cause of infertility and have continued to give myriads of different concoctions to cure it. Up till today the situation remains the same.
There are many causes of low sperm count, which includes different types of infections [staphylococcus being one].
In this article we are going to look at low sperm count, their causes, diagnosis/tests done to investigate it and some preventions/treatments.


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INFERTILITY
Infertility is the inability of a woman to get pregnant after a period of one year despite regular or normal sexual intercourse with her male partner during ovulation or without family planning.It can also be defined as the inability of a woman to carry pregnancy due to miscarriage. Infertility is also a common case among men. In their own case, it is their inability to impregnate a woman after a year of regular sexual intercourse during a woman’s ovulation.
As incidence of infertility is gradually getting to epidemic level, healthcare providers have fingered sexually transmitted infections as the major cause.Prominent among these infections are gonorrhea, syphilis and staphylococcus.
According to a recent research, infertility is known to be majorly caused by infection which ranges from Sexually Transmitted Diseases (STDs) such as gonorrhea and syphilis. It blocks the passage of the sperm.

Chronic Prostatitis which could also be as a result of Staphylococcus infection causes infertility in men thereby leading to complication like low sperm count (Oligospermia) watery sperm (Necrospermia) zero sperm count (Azoospermia).
Staphylococcus aureus was consistently isolated from the semen cultures of men with Low Sperm Count.

Low sperm count (Oligozoospermia) is one of the main causes of male infertility. It is considered that a man has low sperm count when he has less than 20 million spermatozoa per one ml of ejaculate.
A great number of medical conditions as well as many biologic and environmental factors can cause low sperm count temporarily or permanently. Unfortunately, the reliable treatments for increasing sperm count are not as many.

CAUSES OF LOW SPERM COUNTHere are some of the possible causes of low sperm count:
[1]Absence of sperm or low sperm count may be due to an infection associated with high fever that occurs after puberty. Mumps has long been associated with infertility in a man. Infections like gonorrhea, syphilis and staphylococcus and tuberculosis can destroy the male reproductive tracts and inhibit sperm production or kill sperm cells.
[2]Problems with sperm production - such problems can be genetic (for example Klinefelter's syndrome) or based on a hormonal disorder
[3]Testicular injury and disease - injuries that affect the testicles may affect sperm production and cause low sperm count
[4]Malnutrition and nutrient deficiencies - deficiency of some nutrients (for example Zinc, Selenium, vitamin C, etc.) may also lead to low sperm count
[5]Overheating - excessive heat from saunas, hot tubs, etc. may decrease sperm production and lower sperm count
[6]Smoking - smoking cigarettes may impair male fertility since it is known to reduce sperm count and sperm lifespan
[7]Drugs - the use of cocaine and heavy marijuana is known to reduce sperm count by 50%
[8]Excessive alcohol consumption - alcohol is toxic to sperm and may reduce sperm count and quality
[9]Prescribed medications - many prescription medications are known to reduce sperm count and decrease fertility
[10]Environmental toxins, radiation and heavy metals - a number of environmental factors, such as exposure to toxins or chemicals, can reduce sperm count either by affecting testicular function directly or by affecting the hormone system
[11]Obesity - many studies find association between low sperm count and obesity in men
[12]Stress and excessive physical or mental exertion - these can cause some hormonal changes in the body that can affect sperm count and fertility
[13]Varicocele - A varicocele is a varicose vein in the cord that connects to the testicle. (A varicose vein is one that is abnormally enlarged and twisted.) Varicoceles are found in 15% to 20% of all men and in 25% to 40% of infertile men. A varicocele is a small flaw in the anatomy of a vein. If such a vein exists, surplus blood, and therefore too much heat, gets to the testicles, causing the sperm to die. Every man who has a varicocele is not infertile. However, about 30 percent of men who are infertile have a varicocele. The size of the varicocele seems to have no bearing on sperm count.
Varicoceles can be corrected with a simple surgical procedure or a new nonsurgical technique in which a tiny silicone balloon or coil is inserted into the area to close off the swollen vein, rerouting the blood to other blood vessels.

[14]Bicycling/Motorcycling - blood vessels and nerves may be damaged due to the pressure from the bike seat.
[15]Some jobs can lead to low sperm count- Men who work as painters, decorators and printers are much more likely to have a low sperm count compared with other male professionals, due to their repeated exposure to organic solvents, such as paint thinner and turpentine, new research suggests.


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DIAGNOSIS AND TESTING
[1] SEMEN ANALYSIS - This is a very simple and important test and should be done early in the evaluation process. Sometimes the test should be done 2, or even 3 times to get an accurate reflection of the numbers and their variation over time. Semen analysis is a test to measure the amount and quality of a man's semen and sperm. Semen is the thick, white, sperm-containing fluid released during ejaculation.
The test is sometimes called a sperm count.
You will need to provide a semen sample. Your health care provider will explain how to collect a sample.
Sample collection may involve masturbation and collecting the sperm into a sterile container. It may also be collected during intercourse by using a special condom supplied by your health care provider.
A laboratory specialist must look at the sample within 2 hours of the collection. The earlier the sample is analyzed, the more reliable the results.

[2] BLOOD TESTS - For most infertile men, the semen analysis is the only test which needs to be done - after all, the only job of a man is to provide sperm to fertilise the egg ! For men with a low sperm count, there is need to do any other tests, such as blood tests for measuring the levels of key reproductive hormones, such as prolactin, FSH, LH and testosterone. For men with azoospermia ( zero sperm count), additional blood tests may be useful . The serum FSH (follicle-stimulating hormone) level test is a useful one for assessing testicular function. If the reason for the azoospermia is testicular failure, then this is reflected in a raised FSH level. This is because, in these patients, the testis also fails to produce a hormone called inhibin (which normally suppresses FSH levels to their normal range). A high FSH level is usually diagnostic of primary testicular failure, a condition in which the seminiferous tubules in the testes do not produce sperm normally, because they are damaged.

[3] ULTRASOUND SCAN FOR LOW SPERM COUNT - The use of ultrasonography has become an important component in the evaluation and treatment of male reproductive tract disorders.
Ultrasound scan of the Urinary bladder, prostate, seminal vesicles, ejaculatory ducts, testes, epididymis and for varicocoele, spermatocoele and hydrocoele including scrotal hernia are very important .
From the use of color flow Doppler ultrasonography for the assessment of varicoceles to transrectal ultrasonography combined with seminal vesiculography for the evaluation of ejaculatory duct obstruction, ultrasonography has practical clinical applications. The recent advances in diagnostic transrectal ultrasonography for ejaculatory duct obstruction.


TREATMENT FOR LOW SPERM COUNT

The treatment for low sperm count that will be assigned to you will depend on its cause.
However, sometimes the real cause of low sperm count is never found. Additionally, many disorders affecting sperm production cannot be cured at all or do not respond well to treatment.
Yet, this does not mean that you should be reconciled to the problem. There are a lot of things you can do to reduce the risk of low sperm count.
[1]Switch to a healthier, balanced diet, rich in vegetables and whole grains.
[2]Exercise regularly.
[3]Try to reduce stress.
[4]Keep weight off; if you are overweight, lose the excess weight.
[5]Don't smoke
[6]Reduce or eliminate alcohol consumption.
[7]Don't use recreational drugs.
[8]Ejaculate less often; maintain a gap of three days between ejaculations.
[9]Avoid tight underwear, saunas, hot tubs and anything else that may increase the temperature of the testicles.
[10]Maintaining a healthy weight, sticking to a healthy diet, avoiding alcohol, cigarettes, and illegal drugs can all help you get your sperm count back to norm. Add to this healthy lifestyle the proper blend of herbs, vitamins and minerals and you will be able not only to increase your sperm count but also improve sperm quality and motility.


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JOAS MEDICAL DIAGNOSTIX Ikotun Lagos Nigeria , offers comprehensive Low Sperm Count and Staphyloccocus Check for Male Factor Infertility Investigations .such as Semen/sperm analysis. Blood tests for Hormone checks [FSH, LH, Prolactin and Testosterone]. Colour Doppler Ultrasound Scan for male infertility checks [Testes, Varicoceles, and Ejaculatory duct obstruction] , contact JOAS MEDICAL DIAGNOSTIX Ikotun lagos Nigeria.

For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.

For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact

JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.

We are located at

JOAS HOUSE, 2, Okesuna Street,

Opposite The Synagogue Church Busstop,

Bolorunpelu, Ikotun, Lagos

Postcode: 100265

Nigeria.  

TEL:

08064981455

08032509975

08184590752

08037668535

EMAIL:

joasmedicaldiagnostix@yahoo.com

joasmedicaldiagnostix@gmail.com

DISCLAIMER

The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.

The informations provided in this site is subject to change without notice.

This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX
WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER WE ARE EXPERTS IN

ULTRASOUND SCAN SERVICES
[a]Pelvic Scans [Obstetrics and Gynaecology]
TRANSVAGINAL ULTRASOUND SCAN,
FOLLICULOMETRY ULTRASOUND SCAN
[b] General Abdominal Scan --- Liver, Kidneys, Pancreas, Aorta, Bladder, etc...
[c] Small Parts Scans ---- Thyroid, Scrotum & Testes, Eye [Orbits], Breasts, Prostate, etc
[d] Musculoskeletal Scan -- Shoulder, Elbow, Wrist, Hip, Knee, Ankle, etc...
[e] Colour Doppler Vascular Scans ------- Blood Vessel Scans--Carotids, DVT, Vascular Studies etc...
[f] 3D/4D Baby Scans
[g] SonoHysterography [SonoHSG]
[h] Chest Ultrasound Scan
[i] Emergency [FAST] Ultrasound Scan
[J]SonoMammography [Breast Ultrasound]
X-RAY/RADIOLOGY SERVICES
MAMMOGRAPHY [BREAST XRAY]
ECG SERVICES
FERTILITY SERVICES
LABORATORY SERVICES
[a] DNA Paternity Testing
[b] Clinical Chemistry
[c] Hormonal Profile and Special tests
[d] Hystocytopathology
[e] Blood Group Serology
[f] Microbiology
[g] Parasitology and other Tests
BLOOD BANKING SERVICES
HEALTH CONSULTANCY/COUNSELLING SERVICES ETC……

For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests ContactJOAS MEDICAL DIAGNOSTIX
We are located at

JOAS HOUSE, 2, Okesuna Street, Opposite Synagogue Church Busstop, Bolorunpelu, Ikotun, Lagos, Nigeria, WestAfrica.

TEL:
+23418112054
+2348023069403
+2348033535729

EMAIL:
joasmedicaldiagnostix@yahoo.com
joasmedicaldiagnostix@gmail.com

http://www.joasdiagnostix.8m.net
http://www.joasmedicaldiagnostix.8m.com
http://www.youtube.com/watch?v=0DqKdifKE7I

MALARIA KILLS MOTHER AND CHILD IN NIGERIA

MALARIA KILLS MOTHER AND CHILD IN NIGERIA

Malaria causes miscarriages and stillbirths, and can be fatal to anyone whose defences are impaired because of poor health. But the huge death toll is not the only devastation wreaked by malaria. Recurrent bouts of fever drain a child's ability to learn, cause anaemia and poor growth, make people too ill to work, and earn a good living.

Malaria is an infection of the blood that is carried from person to person by mosquitoes. The disease has been recognized for thousands of years and once was found almost everywhere except in the most northern areas of the world.
Malaria is a vector-borne infectious disease caused by protozoan parasites. It is widespread in tropical and subtropical regions, including parts of the Americas, Asia, and Africa. Each year, there are approximately 350–500 million cases of malaria, killing between one and three million people, the majority of whom are young children in Sub-Saharan Africa.
Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells.

SIGNS AND SYMPTOMS
Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.
Symptoms of malaria include
[1]Moderate to severe shaking chills
[2]High fever
[3]Profuse sweating as body temperature falls
[4]General feeling of unease and discomfort (malaise]
[5]Headache
[6]Nausea
[7]Vomiting
[8]Diarrhoea
[9] shivering
[10] arthralgia (joint pain)
[11] anemia (caused by hemolysis)
[12]hemoglobinuria [blood in urine]
[13] retinal damage [eye problems]
[14]convulsions.

The classic symptom of malaria is cyclical occurrence of sudden coldness followed by rigor and then fever and sweating lasting four to six hours, occurring every two days in P. vivax and P. ovale infections, while every three for P. malariae. P. falciparum can have recurrent fever every 36–48 hours or a less pronounced and almost continuous fever. For reasons that are poorly understood, but that may be related to high intracranial pressure, children with malaria frequently exhibit abnormal posturing, a sign indicating severe brain damage.Malaria has been found to cause cognitive impairments, especially in children. It causes widespread anemia during a period of rapid brain development and also direct brain damage. This neurologic damage results from cerebral malaria to which children are more vulnerable.Cerebral malaria is associated with retinal whitening,which may be a useful clinical sign in distinguishing it from other causes of fever.
Severe malaria is almost exclusively caused by P. falciparum infection and usually arises 6–14 days after infection.Consequences of severe malaria include coma and death if untreated—young children and pregnant women are especially vulnerable. Splenomegaly (enlarged spleen), severe headache, cerebral ischemia, hepatomegaly (enlarged liver), hypoglycemia, and hemoglobinuria with renal failure may occur. Renal failure may cause blackwater fever, where hemoglobin from lysed red blood cells leaks into the urine. Severe malaria can progress extremely rapidly and cause death within hours or days. In the most severe cases of the disease fatality rates can exceed 20%, even with intensive care and treatment.

DIAGNOSIS/TESTING
Diagnosis of malaria involves identification of malaria parasite or its antigens/products in the blood of the patient. Although this seems simple, the efficacy of the diagnosis is subject to many factors. The different forms of the four malaria species; the different stages of erythrocytic schizogony; the endemicity of different species; the population movements; the inter-relation between the levels of transmission, immunity, parasitemia, and the symptoms; the problems of recurrent malaria, drug resistance, persisting viable or non-viable parasitemia, and sequestration of the parasites in the deeper tissues; and the use of chemoprophylaxis or even presumptive treatment on the basis of clinical diagnosis can all have a bearing on the identification and interpretation of malaria parasitemia on a diagnostic test.

The diagnosis of malaria is confirmed by blood tests

REMEMBER THIS:
[1] Ask for Malaria Parasite test in all cases of fever and related symptoms and also whenever there is high level of suspicion.
[2] Malaria Parasite test can be done at any time. Do not wait for typical symptoms and signs or for chills.
[3] A negative test DOES NOT rule out malaria. Repeated tests may have to be done in all doubtful cases. Duration of the illness, level of parasitemia, expertise of the technician and the method of examination may all have a bearing on the result of the Malaria Parasite test.

JOAS MEDICAL DIAGNOSTIX Ikotun Lagos Nigeria ,have a well equipped computerised laboratory. We also have qualified, very experienced and licensed medical laboratory scientists. We offer accurate Malaria Parasite Testing. We also offer other laboratory tests. If you suspect you have Malaria or other feverish conditions, contact JOAS MEDICAL DIAGNOSTIX Ikotun lagos Nigeria.

Regards
Dr. Victor Efughi
Consultant Clinical Specialist Sonographer

For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact
JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.
We are located at

JOAS HOUSE, 2, Okesuna Street, Opposite Synagogue Church Busstop, Bolorunpelu, Ikotun, Lagos, Nigeria, WestAfrica.

TEL:
+23418112054
+2348023069403
+2348033535729

EMAIL:
joasmedicaldiagnostix@yahoo.com
joasmedicaldiagnostix@gmail.com

http://www.joasdiagnostix.8m.net
http://www.joasmedicaldiagnostix.8m.com
http://www.youtube.com/watch?v=0DqKdifKE7I

DISCLAIMER
The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.
The informations provided in this site is subject to change without notice.
This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

FREE SHOULDER PAINS ULTRASOUND SCAN IN LAGOS NIGERIA

FREE SHOULDER PAINS ULTRASOUND SCAN IN LAGOS NIGERIA

Shoulder pain is an extremely common complaint, and there are many common causes of this problem. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have shoulder pain, some common causes include:

Bursitis Rotator Cuff Tendonitis:The most common diagnosis in patients with shoulder pain is bursitis or tendonitis of the rotator cuff.

Rotator Cuff Tear:
Rotator cuff tears occur when the tendons of the rotator cuff separate from the bone. Surgery is sometimes necessary for this condition.
Frozen Shoulder:Also called 'adhesive capsuliitis,' this is a common condition that leads to stiffness of the joint. Physical therapy and stretching are extremely important aspects of treatment.
Calcific Tendonitis:Calcific tendonitis is a condition of calcium deposits within a tendon -- most commonly within the rotator cuff tendons. Treatment of calcific tendonitis depends on the extent of symptoms.
Shoulder Instability:Instability is a problem that causes a loose joint. Instability can be caused by a traumatic injury (dislocation), or may be a developed condition.
Shoulder Dislocation:A dislocation is an injury that occurs when the top of the arm bone becomes disconnected from the scapula.
Shoulder Separation:Also called an AC separation, these injuries are the result of a disruption of the acromioclavicular joint. This is a very different injury from a dislocation!
Labral Tear:There are several patterns of a torn labrum and the type of treatment depends on the specific injury.
Arthritis:Shoulder arthritis is less common than knee and hip arthritis, but when severe may require a joint replacement surgery.
Biceps Tendon Rupture:A proximal biceps tendon rupture occurs when the tendon of the biceps muscle ruptures near the joint.

SIGNS AND SYMPTOMS

Inability to carry objects or use the arm
Injury that causes deformity of the joint
Shoulder pain that occurs at night or while resting
Shoulder pain that persists beyond a few days
Inability to raise the arm
Swelling or significant bruising around the joint or arm
Signs of an infection, including fever, redness, warmth

SHOULDER ULTRASOUND SCAN
In patients older than 40 years, the main causes of shoulder pain and/or functional deficit are adhesive capsulitis (frozen shoulder) and impingement and/or rotator cuff disease. Ultrasonography has a proven role in assessing tendons of the rotator cuff.1 This examination is used to identify and classify pathology, and it can help clinicians in making decisions about ongoing management of the condition.
Ultrasonography is well tolerated and cost-effective. Its disadvantages include a long learning curve and reduced sensitivity in patients who are obese or who have severely restricted shoulder movement.

INDICATIONS FOR ULTRASOUND SCANNING OF THE SHOULDER:
1. Suspicion of rotator cuff pathology
a. Full thickness cuff tears
b. Partial thickness tears
c. Tendonitis/tendonosis
d. Calcific Tendonitis
e. Subacromial impingement / bursitis
2. Long Head of Biceps pathology such as tendonitis or tears, subluxation or dislocations.
3. Acromioclavicular Joint pathology such as arthritis, osteolysis and subluxations.
4. Glenohumeral pathologies such as:
a. Glenohumeral arthritis (osteophytes).
b. Glenohumeral effusions.
5. Rarely, labral pathology.
6. Bony lesions such as Hill-Sachs Lesions

TREATMENTS FOR SHOULDER PAIN
The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment.
Not all treatments listed here are appropriate for every condition, but may be helpful in your situation.
Rest: The first treatment for many common conditions that cause shoulder pain is to rest the joint, and allow the acute inflammation to subside. It is important, however, to use caution when resting the joint, because prolonged immobilization can cause a frozen shoulder.
Ice and Heat Application: Ice packs and heat pads are among the most commonly used treatments for shoulder pain.
Stretching: Stretching the muscles and tendons that surround the joint can help with some causes of shoulder pain. A good routine should be established
Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.
Some specific exercises may help you strengthen the muscles around the joint and relieve some of the pain associated with many conditions.
Anti-Inflammatory Medication: Nonsteroidal anti-inflammatory pain medications, commonly referred to as NSAIDs, are some of the most commonly prescribed medications, especially for patients with shoulder pain caused by problems such as arthritis, bursitis, and tendonitis.
Cortisone injections: Cortisone is a powerful medication that treats inflammation, and inflammation is a common problem in patients with shoulder pain. Discuss with your doctor the possible benefits of a cortisone injection for your shoulder pain condition.

LIMITED FREE SHOULDER ULTRASOUND SCAN SERVICE

FREE SHOULDER ULTRASOUND SCAN SERVICES are now available for the first 50 patients at JOAS MEDICAL DIAGNOSTIX Ikotun Lagos Nigeria .It is strictly on a first come first serve basis.

DATE: From 15TH SEPTEMBER to 30TH NOVEMBER 2009
TIME: 2pm to 4pm [Mondays to Fridays – Except on Public Holidays]
NUMBERS OF PATIENTS PER DAY: Maximum of 2 patients per day

You can contact JOAS MEDICAL DIAGNOSTIX Ikotun Lagos Nigeria, for Enquiries, booking, appointment, and allocation of day, date and time for your FREE examination.


For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact
JOAS MEDICAL DIAGNOSTIX

JOAS MEDICAL DIAGNOSTIX-------WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.
We are located at

JOAS HOUSE, 2, Okesuna Street, Opposite Synagogue Church Busstop, Bolorunpelu, Ikotun, Lagos, Nigeria, WestAfrica.

TEL:
+23418112054
+2348023069403
+2348033535729

EMAIL:
joasmedicaldiagnostix@yahoo.com
joasmedicaldiagnostix@gmail.com

http://www.joasdiagnostix.8m.net
http://www.joasmedicaldiagnostix.8m.com
http://www.youtube.com/watch?v=0DqKdifKE7I

DISCLAIMER
The contents, blogs and postings provided in this site are offered strictly for informational purposes only and should not be construed as legal, medical nor financial advice on any matter. We have made every effort to ensure the accuracy of the information presented, and if you have any questions regarding the contents please contact us.
The informations provided in this site is subject to change without notice.
This site may contain links to other internet sites, we are not responsible for the privacy, practices nor the content of such sites, nor their relationships

LUNG CANCER, CHIEF GANI, AND YOU

LUNG CANCER, CHIEF GANI, AND YOU

September, 5, 2009, Vanguard Nigerian Newspaper reads: Fire-eating lawyer and Nigeria’s foremost human rights activist, Chief Ganiyu Oyesola Fawehinmi is dead. The news of the death of the Human Rights crusader hit the Nigerian nation early this morning.
According to some Nigerian medical experts , In the case of Chief Gani Fawehinmi, he was initially undergoing asthma treatment because he was coughing before his condition was eventually diagnosed to be lung cancer. “Since they were treating him for asthma, this did not allow him to go early for definite assessment of his ailment”. Because of the early need for diagnosing lung cancer, people that cough require to be screened to be sure that the cough is not a symptom of lung cancer or even tuberculosis.

LUNG CANCER
Lung cancer remains the greatest killer of all cancer worldwide and its course may be brutally short. According to the WHO, in 2004, 7.4 million people died of cancer worldwide, the greater majority attributed to lung cancer.
The rate of occurrence of lung cancer has been reported to have a striking parallel to the incidence of cigarette smoking in any nation. And a heavy smoker consuming more than 20 cigarettes per day has a 30 to 40 times higher risk of developing the illness.
The risk is increased by early age of commencement of smoking and the duration of smoking. Other identified risk factors include second-hand smoking, air pollution and exposure to chemicals like arsenic, randon gas (radiation) and the notorious asbestos.
THE LUNGS: The lungs are a pair of cone-shaped organs that are situated inside the chest. The lungs bring oxygen into the body and take out carbon dioxide, which is a waste product of the cells of the body. Tubes called bronchi make up the inside of the lungs. Your lungs have an extensive network of blood and lymph vessels. Cancer cells may grow into these vessels and be carried by the blood or lymph and be deposited elsewhere in the body. Cancer can spread from the lungs to almost any site in the body. Most commonly it spreads to the brain, bone, bone marrow and liver. Lung cancer takes many years to develop. It is the second most common cancer in women.

SIGNS AND SYMPTOMS
Symptoms that suggest lung cancer include:
[1]dyspnea (shortness of breath)
[2]hemoptysis (coughing up blood)
[3]chronic coughing or change in regular coughing pattern
[4]wheezing
[5]chest pain or pain in the abdomen
[6]cachexia (weight loss), fatigue, and loss of appetite
[7]dysphonia (hoarse voice)
[8]clubbing of the fingernails (uncommon)
[9]dysphagia (difficulty swallowing).
[10]If the cancer grows in the airway, it may obstruct airflow, causing breathing difficulties. This can lead to accumulation of secretions behind the blockage, predisposing the patient to pneumonia. Many lung cancers have a rich blood supply. The surface of the cancer may be fragile, leading to bleeding from the cancer into the airway. This blood may subsequently be coughed up.
[11]Depending on the type of tumor, so-called paraneoplastic phenomena may initially attract attention to the disease. In lung cancer, these phenomena may include Lambert-Eaton myasthenic syndrome (muscle weakness due to auto-antibodies), hypercalcemia, or syndrome of inappropriate antidiuretic hormone (SIADH). Tumors in the top (apex) of the lung, known as Pancoast tumors,may invade the local part of the sympathetic nervous system, leading to changed sweating patterns and eye muscle problems (a combination known as Horner's syndrome) as well as muscle weakness in the hands due to invasion of the brachial plexus.
[12]Many of the symptoms of lung cancer (bone pain, fever, and weight loss) are nonspecific; in the elderly, these may be attributed to comorbid illness. In many patients, the cancer has already spread beyond the original site by the time they have symptoms and seek medical attention. Common sites of metastasis include the brain, bone, adrenal glands, contralateral (opposite) lung, liver, pericardium, and kidneys. About 10% of people with lung cancer do not have symptoms at diagnosis; these cancers are incidentally found on routine Chest X-Ray.

DIAGNOSIS/TESTS
Performing a Chest X-Ray is the first step if a patient reports symptoms that may be suggestive of lung cancer. This may reveal an obvious mass, widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (collapse), consolidation (pneumonia), or pleural effusion. If there are no radiographic findings but the suspicion is high (such as a heavy smoker with blood-stained sputum), bronchoscopy and/or a CT scan may provide the necessary information. Bronchoscopy or CT-guided biopsy is often used to identify the tumor type.

CHEST X-RAY
A chest x-ray is usually the first test performed to evaluate any concerns based on a careful history and physical. This may show a mass in the lungs or enlarged lymph nodes. Sometimes the chest x-ray is normal, and further tests are needed look for a suspected lung cancer. Even if a mass is found, these are not always cancerous and further studies are needed.

BLOOD TEST
A full blood count is generally taken at the start of any investigation into possible disease, including lung cancer. Changes in the number of red and/or white blood cells help doctors understand if the body is reacting/responding to a disease. Various different naturally occurring substances, such as proteins, antibodies, and the bodies own chemicals may differ from the normal range when cancer is present.
Complete blood count (CBC). This test determines the number of red blood cells, white blood cells, and platelets within the blood.

PREVENTION
There's no sure way to prevent lung cancer, but you can reduce your risk if you:
· [1]Don't smoke. If you've never smoked, don't start. Talk to your children about not smoking, so they can understand how to avoid this major risk factor for lung cancer. Many current smokers began smoking in their teens. Begin conversations about the dangers of smoking with your children early, so they know how to react to peer pressure.
· [2]Stop smoking. Stop smoking now. Quitting reduces your risk of lung cancer, even if you've smoked for years. Talk to your doctor about strategies and stop-smoking aids that can help you quit. Options include nicotine replacement products, medications and support groups.
· [3]Avoid secondhand smoke. If you live or work with a smoker, urge him or her to quit. At the very least, ask him or her to smoke outside. Avoid areas where people smoke, such as bars and restaurants, and seek out smoke-free options.
· [4]Test your home for radon. Have the radon levels in your home checked, especially if you live in an area where radon is known to be a problem. High radon levels can be remedied to make your home safer. For information on radon testing, contact your local department of public health or a local chapter of the American Lung Association.
· [5]Avoid carcinogens at work. Take precautions to protect yourself from exposure to toxic chemicals at work. In the United States, your employer must tell you if you're exposed to dangerous chemicals in your workplace. Follow your employer's precautions. For instance, if you're given a face mask for protection, always wear it. Ask your doctor what more you can do to protect yourself at work. Your risk of lung damage from these carcinogens increases if you smoke.
· [6]Eat a diet full of fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as there may be unknown harms. For instance, researchers hoping to reduce the risk of lung cancer in heavy smokers gave them beta carotene supplements. Results showed the supplements actually increased the risk of cancer in smokers.
· [7]Drink alcohol in moderation, if at all. Limit yourself to one drink a day if you're a woman or two drinks a day if you're a man. Anyone age 65 and older should drink no more than one drink a day.
· [8]Exercise. Aim to achieve at least 30 minutes of exercise on most days of the week. Check with your doctor first if you aren't already exercising regularly. Start out slowly and continue adding more activity. Biking, swimming and walking are good choices. Add exercise throughout your day — park farther away from work and walk the rest of the way or take the stairs rather than the elevator.

TREATMENT
Treatment for lung cancer depends on the cancer's specific cell type, how far it has spread, and the patient's performance status. Common treatments include surgery, chemotherapy, and radiation therapy.




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Regards
Dr. Victor Efughi
Consultant Clinical Specialist Sonographer

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