Monday, 11 December 2017

Irrational use of medicines/drugs in Nigeria



 According to the World Health Organization (WHO), Rational use of medicines require that "patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community". Any usage of medicine that is not rational can be said to be irrational and therefore tantamount to abuse.

The Nigerian Healthcare system is bedevilled by so many problems amongst which is the irrational use of medicines. The ease of access to medicines in Nigeria makes it so easy to use medicines inappropriately. Almost everyone in Nigeria has at one point been involved in irrational medicine use. It is such an easy thing to do because almost every drug can be gotten without prescription.

Medicines play an important role in healthcare delivery. When used right, medicines can help cure diseases, but the wrong usage can harm the user.

Image result for irrational use of medicine
Source: slideplayer.com. 
You guilty of irrational use of medicine if you have done any of the following

  1. You have bought and/or taken any prescription-only medicine without a prescription from a licensed medical practitioner. Prescription-only medicines as the name suggest should only be taken when prescribed by a medical practitioner. Antibiotics are probably the most irrationally used medicines in Nigeria. Irrational use of antibiotics is said to be the leading cause of Antibiotic resistance and it's attendant risk of a post-antibiotic era.
  2.  You have taken antimalarials without running malaria test. Certain malaria drugs are allowed over-the-counter in malaria-endemic regions of the world like Nigeria. That does not mean we should self-medicate and randomly take malaria drugs when we so desire.  The presence of malarial parasites in a person's blood should be confirmed before taking malarial drugs. Failure to do so is tantamount to irrational use of antimalarials.  Most health facilities have Malaria Rapid Diagnostic Test (RDT) kits that can detect the presence of malaria parasites in blood within few minutes. It is necessary to confirm the identity of a disease before commencing treatment lest time and money be wasted on a wrong treatment course. 
  3.  You have taken more or less than the recommended dosage of a medicine. Paracetamol is one drug type commonly misused in this manner. People have been known to swallow more or less than the recommended dosage of paracetamol, citing the excuse that the recommended dose has no effect on them. If the recommended dose of a particular medicine produces no effect when you consume it, report to your practitioner who would be in a better position to review your dosage if necessary.
  4.  You have divided a drug meant for an adult and given a child. There are specific medicines meant for kids, formulated with them in mind. Do not divide an adult's tablet to give a child, doing so could expose the child to harm's way.  
  5. You have taken or caused someone else to take medicines prescribed for another person. A patient's medical history is put into perspective before drug prescriptions. What is medicine for one person could be poison for another. Medicines should not be transferable.
  6. You have stopped a medication too soon or taken the medication beyond the recommended length of time
Medicines are chemical compounds, and like all chemicals, they have the potential to cause harm. In fact, medicines should only be taken when absolutely necessary. Some diseases can run their course and therefore have no need for the intervention of drugs. Example cold. Most colds are caused by viruses so one may just be wasting one's time by taking antibiotics.

Every medicine carries the risk of side effects. Every medicine can be toxic.  Doctors take this, as well as a patient's medical history into account when making drug prescriptions. Different patients can be given different doses of same medicine because their different medical histories demand so.

While we pray and hope that the Nigerian Healthcare system improves, we need to make personal efforts to stay alive and healthy by completely avoiding the irrational use of drugs. Always bear in mind that the medicine in your hand could as well be poison so you need to be guided by medical professionals on how and when to take the medicine.   

Friday, 24 November 2017

Memoirs of a Nigerian mum:I am a good mother

Last week Thursday something interesting happened.
It was a work day at African Founders.
I rushed home to be there when the children are dropped off.
I got in earlier and reposted the graphics for the promo posts for the Content Creation Challenge on my Instagram and Facebook accounts.

Then it was time to put on the mommy hat.
The boys came back from school.
I gave them (snacks) yoghurt and peanuts.
We then spent the next hour or so doing homework.
Then it was playtime for them and dinner preps for me.
In my haste to quickly get food ready, I cut my finger. Ouch.
Every wash was added pain.
Seasoning the food added salt to my injury.
My legs were already tired.
Then while the food was on fire, I quickly bathed them.

I had the choice of giving them cereal for dinner but since it was a long time since they had eaten pepper soup, I decided to give them as well.
But it was still cooking.
Treasure was already hungry and clingy.
I had shooed him gently and he wasn't going.
He came back while I was slicing the scent leaves. I then raised my voice and told him to stay away from the kitchen.
He sulked away.
Finally!
I could get the food ready.
Minutes later, my glorious pepper soup was ready.
Come and eat, guys!
I entered the living room and what I saw stopped me dead in my tracks.
My boys were ASLEEP.
After all my efforts.
I then heard that ever-familiar voice of condemnation whisper, "you are a bad mother".
So this was how my children would go to sleep hungry.
Feeling the tears well up behind my eyelids, I retorted, "I'm not a bad mother. I'm doing the best I can".
I don't know how many times I said that to myself till I was in control again.

There are times when things would spiral out of control and you would be faced with the unexpected.
Drown the voice of condemnation faster than you can say your name.
Because if you wallow in self-pity and shame, you won't be able to produce anything positive.
When those voices come, just say to yourself, "I'm not a bad person. I'm not a failure. I'm doing the best I can".
But don't say this unless you are truly doing the best you can.
Keep your head up!
Yes You Can.

Love, RZ
PS: I later made the cereal and fed them half-asleep. They slept with food in their lil tummies. 😍 #goodmother


Culled from the Facebook group called BABES REDEFINED. 
Written by Ruth Zubairu

Thursday, 23 November 2017

Sleep position in late pregnancy linked to a mother's risk of having a stillbirth

Stillbirth; the death of a baby before birth,  almost always causes heartbreak to the hitherto expectant parents and often leaves them wondering what they may have done or avoided doing that led to the loss of their unborn baby. The babies lost before birth, just like those lost after birth are hardly ever forgotten. 

To contribute towards reducing incidences of stillbirths, risk factors are often studied to identify women at increased risk, with the aim of possibly reducing the risk factors.  Some researchers in the UK looked at the association between maternal sleep practices and stillbirths. 

Image result for maternal supine position
They found out that 'mothers who went to sleep on their back had at least twice the risk of stillbirth compared with mothers who went to sleep on their left-hand side'. The study suggested that 3.7% of stillbirths after 28 weeks of pregnancy in the UK was linked with going to sleep lying on the back. The report as presented in the International Journal of Obstetrics and Gynecology posited that the maternal supine position (a position where the pregnant woman lies horizontally with her face and torso facing up) is associated with compression of the inferior vena cava and reduced venous return, which in turn decreases the amount of blood pumped by the heart per minute and ultimately leads to reduced blood flow to the uterus. The study further reported the maternal supine position as a contributor to abnormalities in fetal heart rate traces in labor. 

Physiological studies had before now reported that unborn babies frequently adopt the quiet sleep position which is an oxygen sparing position whenever their mothers are in the supine position. 
Although women regularly change their sleep positions when sleeping, the report stated that the going-to-sleep position is very important as it is the one that is held longest and may have the greatest impact on the baby.The study suggests that incidences of late stillbirth will decrease if no pregnant mother goes to sleep on her back. 

Based on the reports of the study and other similar ones, pregnant women are recommended to as much as possible avoid the supine position, especially during the last trimester. 
While a pregnant mother may not be able to do anything about the position she wakes up in, she can do something about that which she goes to sleep in. Putting a pillow behind her back would help encourage side-sleeping.  It is best if she can afford a maternity pillow which can help her remain in the side-sleeping position. 



Image result for pillow behind back sleeping
Source; www.vkool.com. A maternity pillow


Sunday, 5 November 2017

MALNUTRITION IN CHILDREN



Malnutrition is a serious health condition that occurs when a person's diet does not contain the right amount of nutrients to meet the person's nutritional needs. It often occurs as a result of deficiency, excess or imbalance of food nutrients. Malnutrition includes both undernutrition and overnutrition; that is, both obese and starving persons are described as malnourished but this write-up is focused on undernutrition as that is the most prevalent type of malnutrition in Nigeria.
Image result for types of malnutrition
Source:www.slideshare.net
   
The problem of malnutrition should not be taken lightly as it can cripple a child's entire life. Almost half of all deaths in under five children in developing parts of the world  are attributed to malnutrition (undernutrition). Malnutrition is said to be the underlying cause of morbidity and mortality of a large proportion of children under five years old in Nigeria. 

 Malnourished children are prone to continuous bouts of  diseases which can affect their growth and development. They are exposed to common infections, the severity and frequency of which  contribute to delayed recovery or even death. Poor nutrition in the First 1000 days of a childs life can also lead to wasting and  stunted growth, which is irreversible and associated with impaired cognitive abilities and reduced school and work performance.
   
 Infants and pre-school children depend on adults around them for their nutritional needs and if the selection of foods for them is incorrect, they may suffer from malnutrition. The process of weaning a child off breast milk increases the risk of malnutrition in that child as complementary foods offered may be deficient in certain nutrients. In Nigeria, the most common food offered to infants for complementary feeding is pap (akamu in Igbo, Ogi in Yoruba).   Pap supplies carbohydrates with little or no proteins,  and lack of proteins in the diet may result to severe wasting of body tissues. This can be fatal, or may lead to impaired or delayed cognitive development. It is therefore necessary that an infant's pap be enriched with some protein-rich foods like milk, egg yoke, crayfish, soybeans, deboned and mashed fish etc, as well as with fruits and vegetables. From birth to 6 months, exclusive breastfeeding is recommended to take care of the infant's nutritional needs.  Beyond then,  an infant's meals should be carefully planned with a balanced diet in mind. 
Image result for malnutrition in children
Source:Www.unicef.ca
Measures used in dictating malnutrition
The three commonly used measures for detecting malnutrition in children are:
1. Stunting (extremely low height for age): Stunting  usually results from  chronic undernutrition;  it is  increasingly used  as  the key  measure of nutritional status  in under two  year olds. Stunting can lead  to irreversible cognitive damage. 

2. Underweight (extremely low weight for age).

3. Wasting (extremely low weight for height): Wasting usually results from an acute, significant shortage of food and/or disease.  It a strong predictor of mortality among children below five years old.
Image result for malnutrition in children
Source:www.interactivealjazeera.com
  

      CAUSES OF MALNUTRITION
The UNICEF conceptual framework on malnutrition takes into account three major causes of malnutrition which include 

1. Basic causes: such as human and environmental resources, economic systems, political and ideological factors. Basic causes of malnutrition often affects an entire community or nation.
2. Underlying causes: insufficient household food, inadequate maternal and Child care, and insufficient health services and unhealthy environments result to household malnutrition.
3. Immediate causes: inadequate dietary intake and diseases like diarrhea, infections etc are the immediate causes of malnutrition in children.  

     PREVENTION OF MALNUTRITION
Malnutrition  if not checkmated  can not only affect the affected persons but also influence the economic growth of the nation. The immediate causes of malnutrition can be prevented starting from the first 1000 days of a child's life, which is from the start of a pregnancy to a child's second birthday.The first 1000 days offer an opportunity for preventing undernutrition and it's consequences. 



Sunday, 29 October 2017

Nutrition for a healthy pregnancy

      
Image result for nutrition in pregnancy


Pregnancy is a very crucial period in a woman's life during which good nutrition is very important to ensure that mother and baby are healthy. The calorie needs of a pregnant woman is said to increase by about 150kcals per day during the first trimester. This figure is said to further increase to about  350 to 450 kcals per day during the second and third trimesters respectively. The increased need is necessitated by the increased metabolism during pregnancy which often leads to hunger pangs and food cravings.  Pregnancy increases the need for micro-nutrients  such as Iron, Folate, Calcium etc. by up to 50%  hence many medical practitioners recommend dietary supplements during pregnancy; where as the need for macro-nutrients  (protein, carbohydrates and fat) increases by about 20% during the second and third trimesters. All these needs can be met by choosing a diet full of healthy foods.The "eating for two" concept does not refer to doubling the food and calorie intakes, rather it refers to the increased need for several vitamins and minerals.

Rather than binge on sugary or fat filled snacks, increasing the serving size of foods should be sufficient to satisfy the increased calorie needs . The extra calories needed should come from  foods like whole grains, fruits, vegetables, lean meat, yogurt, snails, fish etc. Lucky enough, Nigeria is blessed with an abundance of nutrient-dense foods such as meat, beans, different sea foods, many varieties of vegetables and fruits most of which are easily accessible . Pregnant women should strive to maintain good nutrition during pregnancy and avoid both too little and too much food intake.Sadly, there are many Myths surrounding nutrition in our part of the world, most of which are baseless. 
  
 Gradual weight gain during pregnancy is necessary, with most of the weight gained in the last trimester. Pregnancy diet should allow  for approximately 0.9kg to 1.8kg(2 to 4 pounds) of weight gain during the first trimester and then subsequent weight gain of 0.3kg to 0.5kg (0.75lbs to 1lbs) weekly during the second and last trimesters.
  
 A healthy goal for total weight gain for women of normal weight ( based on Body Mass Index((BMI) 18.6 to 24.9) averages about 11.5kg to 16kg (25lbs to 35lbs). Women carrying more than one baby gain between 15kg to 23kg (35lb to 50lbs). For women who begin pregnancy with low BMI,  the goal increases to 12.5kg to 18kg (28lbs to 40lbs). It decreases to 7kg to 11.5kg for women who begin pregnancy with high BMI  .

   
To calculate your BMI,  measure your weight in kg and divide it by your height in meters square as shown in the image below.  
   Image result for bmi calculator kg
The chart below gives an idea of the range of a healthy BMI. 
Image result for bmi calculator kg cm chart


Suggested reads;

Friday, 27 October 2017

Nutritional needs of toddlers


A child is expected to triple its birth weight by his/her first birthday. At this stage, specific nutrients are needed for the child's optimal growth. Protein, fats, carbohydrate, vitamins and minerals should be provided from a variety of food sources. It is expected that a child's meal should contain at least 4 kinds of nutrients at suitable proportions before it can be said to be adequate. An adequate meal contains lots of different foods, offered in a variety of combinations to ensure a toddler gets all the necessary nutrients he needs to grow, explore and develop. Offering a variety of meals to a toddler helps him learn about new flavours and develop healthy eating habits.

Providing an adequate diet for a toddler at every meal can be challenging. As long as he eats most of what is offered, he would likely get the necessary nutrients his body requires. One does not
have to stick to a particular food to provide a certain nutrient. If a toddler refuses a particular food (as they are wont to) due to its texture, taste or flavour (especially vegetables), the food item can be blended or mashed, and added to his favorite food. A toddler should learn to get used to new textures, tastes and more regular meal times. Toddlers will be able to meet their nutritional needs if they are offered a variety of healthy family foods at regular times.
   A toddler should be offered a variety of healthy fruits and snacks (banana, pear, apple, smoothies, etc). Toddlers are known to be picky eaters so creativity in the preparation and presentation of their foods can go a long way towards improving their feeding habits.
Important nutrients for toddlers
Almost all healthy toddlers get enough protein, fat and carbohydrate in their diets. The nutrients most likely to be low in a toddler’s diet are calcium and iron, both of which are very important for the toddler’s growth and development.
Good sources of iron include: meat,  liver, kidney beans, and green leafy vegetables.  Some toddlers do not like eating meat as they find it hard to chew. Such toddlers should be offered well cooked,  soft or semi mashed meat , so they could be easily chewed.
Giving your toddler Vitamin C rich foods such as strawberries, citrus fruits, and vegetables increases the amount of iron that is absorbed from other plant-based foods like bread, Peas, spinach, and legumes. So aim to offer your toddler a Vitamin C rich food or drink at every meal  to improve his body’s absorption of dietary Iron.
Good sources of calcium include egg, seafoods such as crayfish and fish, legumes such as beans, groundnut and soybeans, milk, yogurt, and other dairy products.  It is important a toddler gets at least a portion of these each day.  



Suggested Reads;

Wednesday, 25 October 2017

Baby dies after contracting herpes. Please parents take note of how to avoid this.


Babies are born very fragile and their protection is always left to the adults around them, especially their parents. Their fragility and cuteness often make people want to kiss them on the cheek, lips, forehead, hands or whatever part of their body. Mothers are usually advised not to allow anyone kiss their newborn babies, in fact anyone who wants to touch a newborn should be required to wash their hands in clean soapy water. These may seem so much to ask for given the Nigerian culture of everyone coming to welcome newborn babies and longing to carry them in their arms; but reading this Iowa mum's story should make every mother rethink allowing whoever wishes to carry her baby or give the baby a kiss. 


Mariana Sifrit was born July 1 2017 and returned home few days later with her mother Nicole  and father Shane after being declared fit to go.
Little Mariana was born healthy and declared fit to go home
 By July 7th the newborn was taken to Blank Children's Hospital in Des Moines Iowa in USA; unable to eat and having difficulty waking up  where they learned that she had contracted HSV-1, a viral infection that which can be transmitted from one infected person to another even if they do not have an open sore. How Mariana contracted the virus was uncertain since both parents tested negative to the virus. 
Nicole's Facebook post while they fought for Mariana's life
Little Mariana fighting for her life in hospital

Little Mariana died on July 18 despite all efforts made to save her life as recounted by her mother Nicole on her Facebook page

Here are some things you may need to know about the Herpes Simplex Virus (HSV) as written by the World Health Organization (WHO);

  • The herpes simplex virus (known as herpes in short) is categorized into two types: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).
  • HSV-1 is mainly transmitted by oral contact and can cause cold sores, while HSV-2 is a sexually transmitted infection that causes genital herpes.
  • Symptoms of herpes include sores or blisters at the site of the infection but most cases of herpes are asymptomatic; that is they do not show any visible symptoms. Therefore you cannot by mere looking at a person determine he or she carries the virus.
  • Herpes is highly contagious and when contracted is lifelong; that is, there is no cure . Drugs exist to reduce the severity or frequency of symptoms but no drug exists for the cure of herpes.
  • 87% of the African population is said to carry the virus.
  • A person can carry the virus all his/her life without showing any symptoms but can transmit it to others especially those with weak immune systems.
  • Complications are rare and when they occur do so in newborn babies and immuno-compromised persons. Neonatal (newborn)herpes can lead to neurologic disability or death. 

There is therefore every need to protect your newborn baby. Be nice but firm when requesting that people wash their hands before touching your baby but do not allow anyone kiss your baby, it is safest if you don't also do so especially when the baby is still very young. You could read up some tips on newborn care here