Migraines are more than just headaches; they are a complex neurological condition that can be debilitating for those who suffer from them. Characterized by intense pain, often associated with nausea, sensitivity to light and sound, migraines can affect a person’s quality of life negatively.

Understanding the different types of migraines and debunking common myths is crucial for effective management and treatment.

1. Migraine without Aura (Common Migraine)

This is the most common type of migraine, accounting for about 70-80% of cases. It is characterized by headaches described as pulsating and throbbing in nature, typically felt on either side of the head. The pain can last from a few hours to several days and is often accompanied by nausea, vomiting, and sensitivity to light (photophobia) or sound (phonophobia).

2. Migraine with Aura (Classic Migraine)

Migraine with aura occurs in about 25-30% of people who have migraines. An aura is a group of sensory, motor, or speech symptoms that usually precede the headache phase. These symptoms can include visual disturbances such as flashing lights, zigzag patterns, or blind spots. Auras typically develop gradually over a few minutes and last for up to an hour.

3. Chronic Migraine

Chronic migraine is diagnosed when a person experiences headaches on 15 or more days per month, with at least eight days meeting the criteria for migraine, for more than three months. Chronic migraines can be particularly challenging to manage due to their frequency and the impact they have on daily life.

4. Hemiplegic Migraine

Hemiplegic migraines are a rare and unusual type of migraine that typically presents as mild weakness or temporary paralysis on one half of the body mimicking a stroke. This type of migraine can also be accompanied by other aura symptoms, such as visual disturbances, speech difficulties, or confusion.

5.Retinal Migraine

Retinal migraine is characterized by temporary vision loss or visual disturbances in one eye. This type of migraine is rare and should be promptly evaluated by a healthcare provider, as it can sometimes indicate other serious conditions.

6. Migraine with Brainstem Aura (Basilar-Type Migraine)

This type of migraine involves aura symptoms originating from the brainstem, such as dizziness, double vision, difficulty speaking, or loss of coordination. The headache phase is often accompanied by nausea and vomiting, and in some cases, loss of consciousness.

Debunking Common Migraine Myths

Despite being a well-known condition, migraines are surrounded by several myths and misconceptions. Let’s debunk some of the most common ones:

Myth 1: “Migraines are just bad headaches.”

Fact: Migraines are not just severe headaches; they are a neurological disorder with a range of symptoms, including visual disturbances, nausea, and sensitivity to light and sound. The pain of a migraine is often more intense and disabling than that of a typical headache.

Myth 2: “Migraines are caused by stress.”

Fact: While stress can trigger migraines, it is not the root cause. Migraines are believed to be caused by a combination of genetic, environmental, and neurological factors. Triggers vary from person to person and can include hormonal changes, certain foods, lack of sleep, and sensory stimuli.

Myth 3: “Only women get migraines.”

Fact: Although migraines are more common in women, men can also suffer from them. In fact, about 6% of men experience migraines, compared to 18% of women. The higher prevalence in women is often linked to hormonal fluctuations, particularly related to menstruation, pregnancy, and menopause.

Myth 4: “You can just take a painkiller and it will go away.”

Fact: While over-the-counter painkillers can help relieve mild migraines, they are not always effective for more severe cases. Many people with migraines require prescription medications specifically designed to treat migraines. Additionally, taking painkillers too frequently can lead to medication-overuse headaches, making migraines worse.

Myth 5: “Migraines are a sign of a brain tumor.”

Fact: Migraines, though painful and severe, are not typically a sign of a brain tumor. However, if you experience a sudden change in your migraine pattern, new symptoms, or headaches that are significantly different from your usual migraines, it’s important to consult a healthcare provider to rule out other conditions.

Myth 6: “Migraines are always triggered by food.”

Fact: While certain foods and drinks, like chocolate, caffeine, and alcohol, can trigger migraines in some people, not everyone with migraines has food triggers. Each person’s triggers are unique, and it can be a combination of factors, including stress, hormonal changes, weather conditions, and sensory overload.

Conclusion

Migraines are a complex condition with various types, each requiring a unique approach to management and treatment. Understanding the specific type of migraine you or someone you know experiences is the first step in finding effective relief. Additionally, debunking common myths can lead to better awareness and treatment options, helping to reduce the stigma and misunderstanding surrounding this often debilitating condition.

If you suspect you have migraines or if your symptoms change, consult with a healthcare professional to develop an appropriate treatment plan. Managing migraines effectively often involves a combination of lifestyle changes, medications, and understanding your unique triggers.

Hypertension or high blood pressure is a silent but powerful force that affects millions of people globally. Often undetected until it causes significant harm, hypertension is a chronic condition that, if left untreated, can lead to severe health complications. 

Understanding these potential complications is essential for those living with the condition and for those aiming to prevent it.

1. Heart Disease:

Hypertension is a major risk factor for several types of heart disease. When your blood pressure is consistently high, it forces your heart to work harder than it should. Over time, this extra effort can cause the heart muscles to thicken and the heart chambers to enlarge, leading to a condition called left ventricular hypertrophy. This can eventually result in heart failure, where the heart becomes too weak to pump blood effectively. Moreover, hypertension can contribute to the development of coronary artery disease. High blood pressure damages the arteries, making them less elastic and more prone to the buildup of fatty deposits, known as plaque. This plaque narrows the arteries, restricting blood flow to the heart, and increasing the risk of a heart attack.

2. Stroke:

Strokes are another serious complication of hypertension. High blood pressure can cause the arteries in the brain to burst or become blocked, leading to a stroke. There are two main types of stroke related to hypertension:
Ischemic stroke occurs when a blood clot blocks a vessel in the brain, cutting off the blood supply.
Hemorrhagic stroke happens when a blood vessel in the brain bursts, causing bleeding within or around the brain.
Both types of stroke can lead to long-term disability or death, making blood pressure management crucial in preventing these life-threatening events.

3. Kidney Failure:

Your kidneys are essential in filtering waste and excess fluids from your blood. High blood pressure can damage the blood vessels in your kidneys, reducing their ability to function properly. Over time, this can lead to chronic kidney disease (CKD), and eventually, kidney failure. When the kidneys fail, waste products and fluids build up in the body, which can lead to dangerous levels of fluid, electrolytes, and toxins. People with kidney failure may require dialysis or a kidney transplant to survive.

4. Vision Loss

Hypertension can also affect your eyes, leading to a condition known as hypertensive retinopathy. High blood pressure can damage the delicate blood vessels in the retina, the light-sensitive part of your eye, causing them to bleed or become blocked. This damage can lead to blurred vision, bleeding in the eye, and even complete vision loss if not treated promptly. People with hypertension are also at increased risk for other eye conditions, such as glaucoma and macular degeneration.

5. Aneurysm

An aneurysm is a bulge in the wall of an artery caused by the pressure of blood pushing against a weakened area. Hypertension is a leading cause of aneurysms, particularly in the aorta, the main vessel carrying oxygenated blood from the heart to other body parts. If an aneurysm ruptures, it can cause life-threatening internal bleeding. Even if it doesn’t rupture, an aneurysm can grow and press on other organs, causing pain and other serious complications.

6. Metabolic Syndrome

Hypertension is often a component of metabolic syndrome, a cluster of conditions that occur together and increase the risk of heart disease, stroke, and type 2 diabetes. Besides high blood pressure, the composition of metabolic syndrome includes high blood sugar, excess abdominal fat measured as waist circumference, and abnormal triglycerides or cholesterol levels. People with metabolic syndrome have a significantly higher risk of cardiovascular diseases, and managing hypertension is crucial to reducing these risks.

Hypertension is more than just high blood pressure; it’s a chronic condition that can lead to a cascade of other serious health issues if not managed properly. Heart disease, stroke, kidney failure, vision loss, aneurysms, and metabolic syndrome are among the most common complications associated with uncontrolled hypertension.

The good news is that hypertension is often preventable and manageable. Regular check-ups, a healthy diet, regular exercise, stress management, and medication (if prescribed) are all key strategies in keeping your blood pressure under control and reducing your risk of these severe complications.

Staying informed and proactive about your health is essential in the battle against hypertension. By understanding the risks and taking appropriate steps to manage your blood pressure, you can protect yourself from the dangerous complications associated with this condition.

References:

1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. J Am Coll Cardiol. 2018;71(19)
2. O’Donnell MJ, Chin SL, Rangarajan S, et al. Global and Regional Effects of Potentially Modifiable Risk Factors Associated With Acute Stroke in 32 Countries (INTERSTROKE): A Case-Control Study. Lancet. 2016;388(10046):761-775.
3. Rothwell PM, Coull AJ, Silver LE, et al. Population-Based Study of Event-Rate, Incidence, Case Fatality, and Mortality for All Acute Vascular Events in All Arterial Territories (Oxford Vascular Study). Lancet. 2005;366(9499):1773-1783.
4. Jha V, Garcia-Garcia G, Iseki K, et al. Chronic Kidney Disease: Global Dimension and Perspectives. Lancet. 2013;382(9888):260-272.
5. Wong TY, Mitchell P. The Eye in Hypertension. Lancet. 2004;369(9559):425-435.
6. Sakalihasan N, Limet R, Defawe OD. Abdominal Aortic Aneurysm. Lancet. 2005;365(9470):1577-1589.
7. Alberti KGMM, Zimmet P, Shaw J. The Metabolic Syndrome—A New Worldwide Definition. Lancet. 2005;366(9491):1059-1062.

In the fight against malaria, various malaria control programs have been developed and implemented. However, lives are still being lost because of the inability of most developing countries in Africa to access insecticide treated bed nets or other malaria prevention measures.

The World Health Organization launched a pilot program that aimed to immunize around 360,000 children each year in three African countries which are Ghana, Kenya and Malawi with the first and only vaccine known to reduce malaria in children.

The vaccine, called RTS,S/AS01 (Mosquirix) developed by GlaxoSmithKline (GSK) was deployed in 2019 and projected to April 2021. Extensive testing in clinical trials in the sub-Saharan region of Africa have confirmed that the malaria vaccine reduces malaria significantly including life-threatening severe malaria in young children.

From a recent World malaria report, it was found that over the last four years progress in reducing malaria has hit a plateau. In 2019, there were an estimated 229 million malaria episodes and 400,000 deaths from the disease. Over 90% of malaria deaths which occur in Africa, the majority – more than 265,0000 – involve young children.

However, this vaccination program is not without controversy. The RTS,S vaccine only prevents in 4 in 10 malaria cases, and must be given as 4 injections over 18 months. Some malaria researchers question the wisdom of spending time and money on the pilot programme, given that a handful of more effective vaccines are in clinical trials and could be available by the time RTS,S is ready for regular use. They say that the decades-long effort to roll out RTS,S exemplifies the plodding progress on vaccines for disease that affect the world’s poor, and highlights the need for a more efficient path forwards.

Currently the malaria vaccine is being introduced in areas where children are at high risk of illness and death from malaria. In these areas as much as 60% of childhood outpatient health facility visits are due to malaria. The RTS,S vaccine can reduce cases of malaria and severe malaria, hospital admissions and blood transfusions – it is expected to decrease child deaths and relieve health systems.

The introduction of Mosquirix in the routine health systems of Ghana, Kenya and Malawi by the respective country health ministries and World Health Organization (WHO) is in line with further development of the vaccine. The question of mosquito control and reduction in transmission cannot be wished away on the use of a vaccine. In the Phase 3 clinical trials, the efficacy was upon the use of other malaria control interventions, so the vaccine is implemented as an additional tool in the fight against malaria.

Other malaria vaccine candidates are in development or trail phases, including transmission-blocking vaccines that target the sexual stage of parasite development in the mosquito. The world leading global health organizations have developed the Malaria Vaccine Technology Roadmap for accelerating development of a highly effective malaria vaccine.

The roadmap involves the following strategic goals for malaria vaccines by 2030:

• Develop and license malaria vaccines with protective efficacy of at least 75% against clinical malaria for areas with ongoing malaria transmission.
• Develop malaria vaccines that reduce transmission and human malaria infection, enabling elimination in multiple settings through mass vaccination campaigns.

REFERENCES

1. https://www.who.int/news/item/20-04-2021-rts-s-malaria-vaccine-reaches-more-than-650-000-children-in-ghana-kenya-and-malawi-through-groundbreaking-pilot-programme#:~:text=Over%2090%25%20of%20malaria%20deaths,the%20need%20for%20blood%20transfusions.
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6697768/
3. https://www.afro.who.int/news/malaria-vaccine-pilot-africa-one-year-new-vaccine-could-boost-kenyas-malaria-fight
4. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003377
5. https://www.cdc.gov/malaria/malaria_worldwide/reduction/vaccine.html
6. https://www.nature.com/articles/d41586-019-01342-z
7. https://www.healio.com/news/infectious-disease/20190423/who-launches-malaria-vaccine-program-in-3-african-countries

OVERVIEW  DEFINITION ETIOLOGY  EPIDEMIOLOGY PATHOPHYSIOLOGY  SIGNS AND SYMPTOMS  DIAGNOSIS TREATMENT  COMPLICATIONS

OVERVIEW

A normal erection occurs in relation to sexual stimulation. It often lasts till the end of sexual arousal or intercourse. However, when an erection lasts for more than four hours and is not related to sexual stimulation, it most often could be an underlying medical condition. This condition which often leads to persistent and sometimes painful erections is known as priapism.

What then is priapism?

DEFINITION

Priapism is a prolonged and often painful erection of the penis. It causes blood in the penis to become trapped and unable to drain through the penile arteries.

Although priapism is an uncommon condition overall, it occurs commonly in certain groups, such as people who have sickle cell anemia. It is often unrelated to or continues long beyond sexual activity. It can be a serious condition due to the risk of permanent tissue damage.

Most clinicians consider priapism a medical emergency because the condition can result in impotence, sexual dysfunction and penile infection.

ETIOLOGY

An erection normally occurs in response to physical or psychological stimulation. Priapism results from abnormalities of blood vessels, red blood cells or nerves that cause blood to become trapped in the erectile tissue of the penis. Sometimes the cause is unknown. Below are the causes of priapism:

Blood Disorders

Blood-related disease might contribute to priapism – usually ischemic priapism, when blood is not able to flow out of the penis. These disorders include:

• Sickle cell anemia
• Leukemia
• Thalassemia
• Multiple myeloma and other hematologic disorders.

The most common cause of priapism in children is due to sickle cell anemia.

Prescription Medications

Priapism, usually ischemic priapism, is a common side effect of a number of drugs including:

• Antidepressants such as fluoxetine, bupropion and sertraline
• Penile injections used to treat erectile dysfunction such as alprostadil, papaverine, phentolamine and others.
• Alpha blockers including prazosin, terazosin, doxazosin and tamsulosin
• Antipsychotic medications such as hydroxyzine, risperidone, olanzapine, lithium, clozapine, chlorpromazine and thioridazine
• Blood thinners such as warfarin and heparin
• Hormones such as testosterone or gonadotropin-releasing hormone
• Medications used to treat attention-deficit/hyperactivity disorder (ADHD) such as atomoxetine.

Alcohol and drug use

Ischemic priapism, can occur from the use of alcohol, marijuana, cocaine and any other illicit drug.

Injury

A common cause of non-ischemic priapism – a persistent erection caused by excessive blood flow into the penis – is trauma or injury to your penis, pelvis or perineum, the region between the base of the penis and the anus.

Other factors related to priapism included:

• A spider bite, scorpion sting or other toxic infections
• Metabolic disorders including gout or amyloidosis
• Neurogenic disorders such as spinal cord injury or syphilis
• Cancers involving the penis

EPIDEMIOLOGY

The frequency of priapism varies in different populations. In the western world, agents used to treat erectile dysfunction are the leading cause of adult priapism. The overall rate of priapism in persons using these agents ranges from 0.05-6%. This group tends to be better educated about the risk of priapism; therefore, they seek early treatment.

In other population groups, sickle cell disease (SCD) and sickle cell trait predominate as the leading cause of adult priapism. This is particularly seen in the African and African-American population. The rate of priapism in adults with SCD is as high as 89%. In a recent study, 38-42% of adult males with SCD reported at least one episode of priapism.

In the pediatric population, about two thirds of all pediatric patients with priapism also have SCD. The rate of priapism among children with SCD is as high as 27%. Internationally, priapism is almost exclusively a disease of males. However, rare cases of clitoral priapism have been reported.

PATHOPHYSIOLOGY

The penis is composed of three cylindrical spaces (sinuses) of tissue through which blood can flow (known as erectile tissue). The larger two sinuses, the corpora cavernosa, occur side by side. The third sinus (the corpus spongiosum) surrounds the urethra and ends as the cone-shaped end of the penis (glans penis). When these sinuses fill with blood, the penis becomes larger and rigid (erect). Muscles then tighten around the veins of the groin, preventing blood from flowing out of the penis and keeping the penis erect.

• Ischemic priapism: Most cases of persistent erection involve failure of blood to flow out of the penis. Blood backs up, preventing new oxygen-rich blood from entering the penis. As a result, the penis can become starved of oxygen. This condition is known as ischemic priapism or low flow priapism.

Severe pain occurs if an erection lasts longer than 4 hours. The penis may be erect while the glans penis may be soft. Prolonged priapism can cause erectile dysfunction or even death of the penile tissue.

• Stuttering priapism: A recurring form of ischemic priapism in which episodes of erection alternate with periods when the penis is not erect.

• Non-ischemic priapism: Less common as compared to ischemic priapism. This is due to uncontrolled flow of blood into the penis. Such abnormal blood flow usually results from an injury to an artery in the groin area. Non-ischemic priapism is also called high-flow priapism. It is less painful than ischemic priapism and does not lead to tissue death. The penis is erect but not fully rigid. Subsequent erectile dysfunction is much less common than in ischemic priapism.

SIGNS AND SYMPTOMS

The primary symptom of priapism is a prolonged erection. Other symptoms depend on the type of priapism that is occurring.

Symptoms of ischemic priapism include:

• Penile pain that gets worse with time
• An erection where the tip of the penis remains soft

Non-ischemic priapism is usually painless and causes an erection that is not fully rigid.

DIAGNOSIS

A diagnosis of priapism is made based on a detailed medical history and physical exam performed by the general practitioner. The doctor will look at the genitals and groin to determine the pattern of rigidity and whether any trauma has occurred.

Some diagnostic testing may be required to gain more information. The procedure for this is as follows:

• A small sample of blood is taken from the penis
• If the blood is black in color, it indicates ischemic priapism
• If the blood is bright red in color, it probably is non-ischemic priapism

Other tests that may be requested by the doctor include:

• Blood tests
• Ultrasound scan
• Urine toxicology

These above tests determine what may be causing the condition.

COMPLICATIONS

Ischemic priapism can cause significant complications. Due to the lack of oxygen, there can be significant damage if priapism lasts for more than four hours. The complications include erectile dysfunction as well as disfigurement of the penis.

REFERENCES

1. https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/symptoms-of-kidney-and-urinary-tract-disorders/erection,-persistent?redirectid=25&query=Priapism
2. https://www.merckmanuals.com/professional/genitourinary-disorders/symptoms-of-genitourinary-disorders/priapism?query=Priapism
3. https://emedicine.medscape.com/article/437237-overview#showall
4. https://www.webmd.com/erectile-dysfunction/erectile-dysfunction-priapism#1
5. https://www.mayoclinic.org/diseases-conditions/priapism/symptoms-causes/syc-20352005#:~:text=Priapism%20is%20a%20prolonged%20erection,who%20have%20sickle%20cell%20anemia.
6. https://www.healthline.com/health/priapism
7. https://www.medicalnewstoday.com/articles/318737
8. https://www.medicinenet.com/priapism_penis_disorder/article.htm

Sperm quality isn’t something most men think about often. However, if there is a desire to expand or start a family, the number and quality of sperm produced would be foremost on every man’s mind.

While it only takes one sperm to fertilize an egg, the journey getting there can be a tumultuous one. The more sperm present, the better the chances.

Low sperm count also known as oligozoospermia refers to the presence of fewer than 15 million sperm per milliliter of semen.

A complete absence of sperm in semen is known as azoospermia. Having a low sperm count decreases the odds that one of the sperm will fertilize the egg of a female, resulting in pregnancy. Nonetheless, many men who have a low sperm count are still able to father a child.

Sperm count is considered low if it falls below 15 million sperm per milliliter (mL) of semen, although the average is around 75 million sperm per ml.

Risk factors of oligozoospermia include obesity, previous history of trauma or surgery in or around the testicles and taking certain medications.

Beyond these, there are various causes of low sperm quality, which can be categorized into three main categories: medical, environmental and lifestyle.

• Medical Causes

A history of testicular injury or surgery as well as genetic conditions such as Klinefelter syndrome, may increase the chances of having a low sperm count.

Cancer treatments, such as chemotherapy, radiation or surgery may also affect hormone and sperm production. Radiation of the testicles directly damages the cells that produce sperm, while radiation or surgery of the brain can likewise cause low sperm count, as the hormones produced in the brain stimulate sperm production.

Other causes include:

-Swelling in the veins that drain the testicles, which is called varicocele.

-Previous infections or sexually transmitted infections (STIs), which can cause blockage, scarring or other damage to the reproductive system.

-Erectile dysfunction or Ejaculatory dysfunction (retrograde ejaculation).

-Immune system disorders

-Genetic conditions such as cystic fibrosis

-Medical procedures, treatments or medications such as antifungal, anticancer and antibiotic medications

• Environmental Causes

Overheating of the testicles can lower sperm production. The ideal sperm conditions are slightly less than body temperature, which explains why the testicles are positioned outside of the abdominal cavity.

Other possible environmental causes include occupational exposure to herbicides, pesticides, solvents and other industrial chemicals or heavy metals. Exposure to radiation from X-rays or other sources may harm sperm production as well.

• Lifestyle Causes

Use of anabolic steroids to increase muscle mass, will almost always shrink testicles and decrease sperm production. Recreational activities like heavy drug and alcohol use, as well as use of tobacco or vaping may likewise lower sperm count.

Marijuana and opioids also reduce sperm production.

Other possible causes include:

-Testosterone boosters, vitamins and pre-workout supplements containing anabolic steroids.

-Jobs that require long periods of sitting, such as truck driving.

-Emotional stress and depression especially if they are long term and severe

-Body weight, particularly being obese or overweight can affect sex hormone production

In a nutshell, low sperm count is a great challenge to men and symptoms and signs don’t present until attempts to start a family prove difficult. It is important to seek medical attention from a urologist if you have these symptoms present:

• Low sex drive (libido)
• Erectile dysfunction
• Swelling or pain in or around the testicles
• Less facial or body hair

REFERENCES

1. https://www.urologyhealth.org/urology-a-z/m/male-infertility
2. https://www.healthline.com/health/infertility/low-sperm-count
3. https://www.mayoclinic.org/diseases-conditions/low-sperm-count/symptoms-causes/syc-20374585
4. https://www.nhs.uk/conditions/low-sperm-count/#:~:text=A%20low%20sperm%20count%2C%20also,successful%20pregnancies%20can%20still%20occur.

Overview

Polluted water sources are habitats for some intestinal parasites known to cause endemics in most parts of the world. One parasite, in particular, that is the leading cause of waterborne illness in the United States is Giardia intestinalis, the causative agent of Giardiasis (Traveler’s Diarrhea).

Giardiasis is an infection of the small intestine that is caused by the parasite, Giardia duodenalis, also known as Giardia lamblia and Giardia intestinalis.

It is the most common cause of parasitic gastrointestinal disease, and there is a 20% to 40% prevalence in the world’s population.

Pathogenesis

Giardia lamblia exists in two forms, an active form called a trophozoite, and an inactive form called a cyst. The active trophozoite attaches to the lining of the small intestine with a ‘sucker’ and is responsible for causing the signs and symptoms of giardiasis.

The trophozoite cannot live long outside the body, therefore it cannot spread the infection to others. The inactive cyst, on other hand, can exist for prolonged periods outside the body.

Mode Of Transmission

Cysts of Giardia are present in the feces of infected people. Thus, the infection is spread from person to person by contamination of food with feces or by direct fecal-oral contamination. Cysts also survive in water, such as in freshwater lakes and streams.

Domestic mammals (such as dogs, cats and calves) and wild mammals (such as grasscutters, beavers and squirrels) can become infected with Giardia. However, it is not clear how often domestic or wild mammals transmit giardiasis to humans

Giardiasis can also occur as outbreaks from recreational water sources such as swimming pools, water parks and hot tubs, most likely because of an infected user rather than a contaminated water source.

Symptoms

Some people with giardia infection never develop signs or symptoms, but they still carry the parasite and can spread it to others through their stool. For those who do get ill, the signs and symptoms usually appear one to three weeks after exposure and may include:

• Watery, sometimes foul-smelling diarrhea that may alternate with soft, greasy stools
• Fatigue
• Stomach cramps and bloating
• Gas
• Nausea
• Weight loss

Signs and symptoms of giardia infection may last two to six weeks, but in some persons, they last longer or recur. 

Risk Factors

While anyone can catch giardiasis, some people are more likely to come in contact with the parasite:

• Children in child care centers
• Child care workers and parents
• People without access to safe drinking water (Hikers and campers)
• People who have anal sexual intercourse
• International travellers
• People who don’t practice good hygiene

Diagnosis

To find out if you have giardiasis, your doctor would require a stool sample. It would then be sent to the lab for testing. For best results, it would be tested for several days. If you do have giardiasis, the stool test would be repeated to see if the parasites have cleared.

Treatment

Most people get better without treatment. However, the health practitioner may want to treat with the following medications:

• Metronidazole
• Nitazoxanide
• Tinidazole

Complications

Giardiasis can cause problems even after the infection has been treated. These can be especially serious in infants and children.

• Dehydration – When the body doesn’t have enough water to work normally. It is often the result of severe diarrhea.
• Failure to thrive – Long-term diarrhea can affect a child’s mental and physical growth.
• Lactose intolerance – Many people who have a giardia infection find they cannot digest milk sugar (lactose) as they used to previously. This makes it difficult to eat milk or other dairy products.

Prevention

There is no vaccine to prevent it, however, there are steps to take to prevent it:

• • Wash your hands after you use the toilet, after you change diapers and before you eat or prepare food.
  • Filter or boil water if you are outdoors camping or hiking.
  • Try not to swallow water when you swim in a pool, lake or stream
  • Drink bottled water when you travel to places with unsafe water
  • Use a condom if you have anal sexual intercourse.

REFERENCES

1. https://www.merckmanuals.com/home/infections/parasitic-infections-intestinal-protozoa-and-microsporidia/giardiasis?query=giardiasis
2. https://www.merckmanuals.com/professional/infectious-diseases/intestinal-protozoa-and-microsporidia/giardiasis
3. https://my.clevelandclinic.org/health/diseases/15238-giardiasis
4. https://www.medicinenet.com/giardia_lamblia/article.htm
5. https://www.mayoclinic.org/diseases-conditions/giardia-infection/symptoms-causes/syc-20372786
6. https://www.webmd.com/digestive-disorders/giardiasis-overview

Just as humans and animals evolve and adapt over time, all viruses – including the SARS-CoV-2, the causative agent of the dreaded COVID-19 also evolve with time. These changes in a virus are known as mutations.

Viruses mutate as they replicate or make copies of themselves. A virus with one ore more new mutations is referred to as a ‘variant’ of the original virus.

The likelihood for a virus to mutate increases when the virus is widely spread in a population causing infections. The more opportunities for the virus to spread, the more it replicates, the more it mutates.

There are currently multiple variants of the SARS-CoV-2, however there are four notable variants of public health concern which are:

• 1.1.7 (Alpha)
• 1.351 (Beta)
• 1 (Gamma)
• 1.617.2 (Delta)

These variants seem to spread more easily and quickly than other variants, which may lead to more cases of COVID-19. An increase in the number of cases puts a strenuous strain on health care resources, leading to more hospitalizations and potentially more deaths.

So far, research suggest that the current authorized vaccines work on the circulating variants. Further studies are being conducted on these and other variants by scientists worldwide.

Impact Of New Variants

From the WHO, the COVID-19 vaccines that are currently in development or have been approved are expected to provide at least some level of protection against the new virus variants because these vaccines elicit a broad immune response involving a range of antibodies and cells.

Therefore, changes or mutations in the virus should not make vaccines completely ineffective. In the event that any of these vaccines prove to be less effective against one or more variants, it will be possible to change the composition of the vaccines to protect against these variants.

While studies are being conducted on these new variants, it is essential to stop the spread of the virus in order to prevent mutations that may reduce the efficacy of existing vaccines. In addition, manufacturers and programs using vaccines may have to adjust to the evolution of the COVID-19 virus.

Classification

According to the CDC, the new variants have been classified into three which are:

• Variant of Interest (VOI) – Being monitored and characterized.
• Variant of Concern (VOC) – Being closely monitored and characterized by federal agencies
• Variant of High Consequence (VOHC) – Currently there are no SARS-CoV-2 variants that rise to the level of high consequence

Currently below are the new strains under the above classification according to the CDC:

1. Variant of Interest (VOI)

• 1.427 (Epsilon)
• 1.429 (Epsilon)
• 1.525 (Eta)
• 1.526 (Lota)
• 1.617.1 (Kappa)

2. Variant of Concern (VOC)

• 1.1.7 (Alpha)
• 1.351 (Beta)
• 1 (Gamma)
• 1.617.2 (Delta)

The Delta Variant

The delta variant of the coronavirus is considered a ‘variant of concern’ by the CDC because it appears to be more easily transmitted from one person to another. As of July 2021, the delta variant is regarded as the most contagious form of the SARS-CoV-2 coronavirus so far.

Currently in the United States, the delta variant is rapidly becoming the dominant variant of the SARS-CoV-2 virus this year. Worldwide, many countries which have opened their borders to international travel are encountering the delta variant of the coronavirus.

Being fully vaccinated for COVID-19 can protect you from the delta variant, but breakthrough infections sometimes occur.

While the authorized COVID-19 vaccines are not perfect, they are highly effective against serious coronavirus disease and reduce the risk of hospitalization and death.

Although vaccines afford very high protection, infection with the delta and other variants remain possible. Fortunately, vaccination, even among those who acquire infections, appears, to prevent serious illness, hospitalization and death from COVID-19.

Unvaccinated adults and children should strictly follow mask, distancing and hygiene safety precautions and avoid international travel if possible.

REFERENCES

1. https://www.who.int/news-room/feature-stories/detail/the-effects-of-virus-variants-on-covid-19-vaccines?gclid=CjwKCAjw0qOIBhBhEiwAyvVcf0RSBflcM0V4h77-3IzbN17IsXVl16Q_X74Z7XL6zJdV319ktmaAHBoCL00QAvD_BwE
2. https://www.cdc.gov/coronavirus/2019-ncov/variants/variant.html
3. https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html
4. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/a-new-strain-of-coronavirus-what-you-should-know

That perfect feast you have always planned for and finally nailed puts a smile on your face but sets your body into work. The body irrespective of the route of anything introduced into it tries to make the best out of it but in the process, the excess of whatever produced, waste, and toxins needs to be excreted out of the body.

The kidneys are the main organs responsible for excretion although other organs play a minimal role. The kidneys are two bean-shaped organs located in our abdomen responsible for numerous functions like; excretion of waste, production of red blood cells, maintaining blood pressure, synthesis of vitamins, etc. These essential roles of the kidneys make it a vital organ because without it life is incompatible.

One might wonder, I know of someone who has only one kidney and still living a normal live. Yes, you are perfectly right. In the absence of one kidney whatsoever the cause is, the other remaining healthy kidney plays the function for both. This is why I can decide to donate one of my kidneys and still have a healthy and an exciting life.

Renal injury or failure are the most common terminologies you would usually come across and it simply means reduced or loss of kidney function. Renal failure can either be of an acute onset or from a chronic injury.

The etiology of renal failure is more than the scope in this article can cover but I would like to leave you with a few common causes; hemorrhage, drugs, hypoperfusion, heart failure, sepsis, diabetes, etc. This article is to enlighten us on the major signs and symptoms that can raise our suspicions of renal failure.

It must be noted that, a failing kidney can be saved when detected and managed accordingly in due time but a terminally failed kidney cannot be saved.

1. Decreased urine output: “it is no exaggeration to say that the composition of the blood is determined not so much by what the mouth takes in as by what the kidneys keep” Homer Smith made this beautiful quote about the kidneys and it is an exact Picasso of renal function. The kidneys filters blood to regulate effective circulating volume and also to excrete toxins or excess substances in plasma. Urine output is mostly a true reflection of renal function although there are a lot of factors that alter urine output. A decreased urine output within a certain period raises the alarm to clinically check the function of the kidneys whether its failing or it is of a different cause.

2. Fluid retention: As explained above on how the kidneys are responsible for regulating fluid volume in the body through urine production. A failing kidney losses the ability to filter the blood leading to the accumulation of excess fluid in the body. Accumulation of fluids leads to vascular engorgement and a resultant escape of the fluid into interstitial space. The clinical manifestation of fluid retention is generalized edema (facial puffiness, abdominal distention, leg swelling, etc.). Heads-up, fluid retention can also be seen in chronic liver disease, congestive heart failure, etc.

3. Shortness of breath: This not a direct sign of a failing kidney but it speaks loudly in support of the others mentioned above. Accumulation of fluid due to its retention leads to fluid sipping/leaking into the lungs causing pulmonary edema (accumulation of fluid in the lungs). This fluid accumulated in the lungs causes a deficit in the normal gaseous exchange in the lungs and also the fluid makes the lungs heavy hence, shortness of breath.

4. Palpitation: This is the feeling of one’s own heartbeat. This a symptom associated with a number pathological processes. Sometimes it can arise from just being anxious but in a failing kidney it is due electrolyte imbalance especially potassium leading to arrhythmias.

5. Pallor: Paleness is a classical sign of anemia (low levels of red blood cells). People with failing kidneys have low levels of erythropoietin. Erythropoietin is a hormone synthesized by the kidneys, it stimulates the bone marrow to produce red blood cells. The kidneys which are injured or diseased and are failing cannot synthesize enough erythropoietin resulting in anemia. The paleness can be seen from the conjunctiva, the palm of the individual, translucent mucosal surfaces, etc.

6. Nausea and vomiting: Build up urea due to a failing or failed kidneys lead to a syndrome called uremic gastritis. This is inflammation of gastric mucosa with symptoms of dyspepsia (abdominal pain, nausea, vomiting, etc.).

7. Hypertension: Markedly reduction in glomerular filtration rate causes the kidneys to release vasoactive substances (renin) which leads to fluid retention and vasoconstriction. Fluid retention and vasoconstriction leads to an increased blood tension against the arterial walls and this is basically hypertension. People who are not known hypertensive may develop hypertension when there is an impending kidney failure.

8. Seizures: Uremic encephalopathy is another syndrome of renal failure. Build up urea (a waste product) leads to cerebral edema. Edema of the brain, causes the brain to generate abnormal electrical signals with systemic manifestation called seizures. There might also be a change in personality, behavior, and other CNS manifestation.

It must be noted that most of these signs can happen in other conditions. So it is important to see a doctor when one start experience any of these signs.

                REFERENCES

1.https://www.mayoclinic.org/diseases-conditions/kidney-failure/symptoms-causes/syc-20369048

2.https://www.healthline.com/health/kidney-failure#symptoms

3.https://lifeoptions.org/learn-about-kidney-disease/kidney-disease-symptoms/

4.https://www.mayoclinic.org/diseases-conditions/kidney-failure/symptoms-causes/syc-20369048

5.https://www.dovemed.com/diseases-conditions/acute-kidney-failure/

Erectile dysfunction or impotence refers to the inability to achieve or sustain an erection satisfactory for sexual intercourse. In other words, it refers to inadequate size or hardness of erections or poor sustainable erections.

Initially erectile dysfunction was considered to be caused by psychological problems. Normally experienced during times of stress in men. Frequently erectile dysfunction can be considered a sign of health problems which needs treatment.

Erectile dysfunction could also be a sign of emotional or relationship difficulties that need to be addressed by a therapist.

Before we focus on the signs of erectile dysfunction, let us go through a few causes of erectile dysfunction. Here are some possible causes of erectile dysfunction:

• Cardiovascular disease
• Diabetes
• Hypertension
• Hyperlipidemia
• Damage from cancer or surgery
• Injury to the genitals
• Obesity or being overweight
• Increased age
• Stress
• Anxiety
• Relationship issues
• Drug use
• Alcohol use
• Smoking
• Liver cirrhosis

If you have erectile dysfunction you would be experiencing the following:

• Reduced interest in sex: This normally occurs in men with psychologic disorders. There would be signs of depression such as sadness, loss of appetite, hopelessness, and difficulty in sleeping. This could be as a result of hormonal disorders such as hypogonadism in men. They present also with sleep disturbances, decreased sex drive (libido), mood changes and eventually, decrease in the size of muscles and testes.

• Difficulty maintaining an erection during sexual intercourse: This occurs in men with systemic diseases such as hypertension. Antihypertensives given to these individuals such as beta blockers (atenolol, carvedilol, metoprolol and propranolol) and diuretics (such as furosemide and hydrochlorothiazide) has a side effect of reducing the duration of a sustained erection.

• Trouble getting an erection: This occurs in nerve disorders such as diabetic neuropathy, multiple sclerosis, spinal cord disorders and stroke. Patients present with numbness, burning sensation or pain in the feet and genitals. There is sometimes urinary incontinence.

There are other sexual disorders that are related to erectile dysfunction such as:

• Premature ejaculation
• Delayed ejaculation
• Anorgasmia (Inability to achieve orgasm after ample stimulation)

It is recommended to see your primary care physician, if erectile dysfunction creates anxiety or threatens your sexual relationship. In addition, seek medical care when there is evidence of painful erections or difficult erections because your penis is curved.

If erectile dysfunction persists, it is an early warning sign of a more serious condition. This could be due to a coronary artery disease or diabetes. Seeking medical attention during this period is key in treating the underlying medical condition involved.

REFERENCES

1. https://www.webmd.com/erectile-dysfunction/default.htm
2. https://www.merckmanuals.com/professional/genitourinary-disorders/male-sexual-dysfunction/erectile-dysfunction?query=erectile%20dysfunction
3. https://www.merckmanuals.com/home/men-s-health-issues/sexual-dysfunction-in-men/erectile-dysfunction-ed?query=erectile%20dysfunction
4. https://emedicine.medscape.com/article/444220-overview

“My baby enjoys it when I breastfeed him. I feel a unique bond between him and me,” said Rose, a middle-aged mother to her physician. This child was her second, and is currently 4 months old. This benefit is not only to the mother, but also to the child.

Breastfeeding, from the American Academy of Pediatrics, suggest that exclusive breastfeeding is essential for a minimum of 6 months and appropriate solid foods can be introduced between 6 months to 1 year. Breastfeeding is also encouraged as a complement to solid foods even after the first year of life.

1. Benefits to the Child:

• Nutrition: Breast milk serves as the ideal nutrition for infants. This is a perfect combination of vitamins, protein and fat – every nutrient essential for the growth of the baby. Breast milk especially the first milk secreted from the mother (colostrum) is more easily digestible than infant formulas. 

• Immunity: Not only is breast milk very nutritious and healthy for the infant, it is fortified with antibodies and immune cells. These elements help protect the infant from viral and bacterial infections. Risk of allergies and asthma is reduced due to breastfeeding. Recent studies suggest that infants breastfed exclusively for the first 6 months, without any formula are less prone to ear infections, respiratory diseases, and diarrhea. They also have lesser hospitalizations. 

• Mental and Emotional Development: Increased intelligence quotient (IQ) scores in childhood have been linked to breastfeeding. Moreover, even as the child develops better cognitively later in childhood, the physical closeness between the child and the mother, creates a sense of security and belonginess. This bond between mother and child, develops even better when there is prolong skin-to-skin contact and eye contact. 

• Other benefits to the child include: reduced risk of diabetes, obesity and cancers.

2. Benefits to the Mother:

• Weight loss: When breastfeeding, calories are lost and this eventually leads to a reduction in post-pregnancy weight. An average of 300-500 calories is lost when breastfeeding. This is normally dependent on how much the baby eats. Since breastmilk is rich in calories, most of the calories present in the mother are transferred to the child via the breastmilk. 

• Quick recovery after delivery: Breastfeeding helps mothers to recover from delivery by the release of particular hormones. Oxytocin, a hormone released for uterine contractions during labor is produced. This hormone assists the uterus return to its normal size and it reduces uterine bleeding after birth.

• Reduced cancer risk: Recent research has proven that breastfeeding reduces the risk of developing breast and ovarian cancers. This long-term health benefit is enhanced by a healthy varied diet rich in vitamins, minerals and energy-giving foods. In addition, it lowers the risk of osteoporosis, especially when the diet of the mother is rich in vitamin D and calcium. 

• Cost-effective: In other parts of the world, buying formulas, sterilizing nipples or warming bottles is a major problem. However, when a mother breastfeeds her child, it saves the mother time and money. These resources can be used for other necessities which would help in the normal upkeep and development of the infant.

• Bonding and relaxation: Breastfeeding helps reduce anxiety and depression present in mothers after delivery. It also creates quality time for the mother and child to relax and bond properly.

 KEY POINTS

• Breastfeeding provides long-term health benefits to the mother
• Breastfeeding boosts your child’s IQ scores.
• For quicker recovery after delivery, breastfeed your child.
• Breastfeeding helps mothers bond and feel close to their babies.
• Breastfeeding protects your baby against infections.

REFERENCES

• https://www.webmd.com/parenting/baby/nursing-basics#1
• https://emedicine.medscape.com/article/979458-overview#showall
• https://www.merckmanuals.com/home/children-s-health-issues/care-of-newborns-and-infants/breastfeeding?query=breastfeeding
• https://www.merckmanuals.com/professional/pediatrics/care-of-newborns-and-infants/breastfeeding?query=breastfeeding