Troop Pharmacy > Articles by: Winner Amawuru
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Hypertension

HYPERTENSION MANAGEMENT!!!

By definition hypertension is sustained elevation in blood pressure where the benefit of intervention outweighs the risk. Hypertension management has seen several trends and advancements in recent years, with a focus on a more holistic and individualized approach. Some current trends in hypertension management include:

1. Personalized Treatment Plans: Healthcare providers are increasingly recognizing the importance of tailoring hypertension treatment plans to individual patients. This approach takes into account the patient’s unique risk factors, medical history, and lifestyle, allowing for more precise and effective management.

2. Lifestyle Interventions: Lifestyle modifications are becoming a cornerstone of hypertension management. These include dietary changes (such as the DASH diet, which is rich in fruits, vegetables, and low-fat dairy products), increased physical activity, stress reduction, and weight management. Lifestyle interventions are often recommended in conjunction with medication.

3. Combination Therapy: Many patients with hypertension require multiple medications to achieve their blood pressure goals. Combining medications from different classes can improve efficacy while minimizing side effects. Fixed-dose combination drugs are increasingly prescribed for convenience.

Choose Single Pill Combinations(SPCs) at any step. Start with dual combination therapy in most patients. For instance, ACE(angiotensin converting enzyme) inhibitors or ARB(angiotensin 2 receptor blockers) + CCB(calcium channel blockers) or Diuretic(water pill).

Start with mono-therapy only in selected patients, i.e Low risk hypertension and BP <150/95 mmHg, or high normal BP and very high CV risk, or frail patients and/or advanced age. Also, it’s worth noting that beta blockers(atenolol, metoprolol) can be used as mono-therapy or at any step of combination.

4. Home Blood Pressure Control: There is a growing emphasis on patients taking an active role in their care. This includes home blood pressure monitoring, which provides valuable data for both patients and healthcare providers. This allows for more frequent and convenient follow-up care.

Diagnosis of hypertension:

At the first visit measure blood pressure in both arms. If the difference in readings between arms is more than 15mmHg, repeat the measurements. If the difference in readings between arms remains more than 15mmg on the second measurement, measure subsequent blood pressures in the arm with the higher reading and document.

Patient Preparation:

* Have an empty bladder and rest quietly for at least 5 minutes.
* No coffee or smoking in last 30 mins.
* Do not talk or text. Sit with back supported and both feet flat on the floor. Legs should not be crossed.
* BP cuff should be placed on bare arm above antecubital fossa
* The arm with the cuff should be supported on a flat surface e.g table or a pillow if patient is lying face upwards.
* The machine should be placed at the level of the heart

These trends reflect a more comprehensive and patient-centered approach to hypertension management, with a focus on prevention, lifestyle, and individualized care to reduce the risk of cardiovascular complications. Healthcare providers are increasingly focusing on educating patients about the risks of hypertension and the importance of adherence to treatment plans. Patient engagement and understanding play a crucial role in managing hypertension effectively. Drug therapy is a common approach to managing hypertension (high blood pressure), and it typically involves the use of medications to lower blood pressure and reduce the risk of cardiovascular complications. However, some individuals may develop a condition known as resistant hypertension.

What is Resistant Hypertension?

Resistant hypertension is a subset of high blood pressure that doesn't respond adequately to treatment with conventional antihypertensive medications. It is diagnosed when a person's blood pressure remains above 140/90mmHg despite taking three different types of blood pressure medications, including a diuretic (water pill) at their highest doses. Several factors can contribute to resistant hypertension:

1. Medication Non-Adherence: Sometimes, patients may not take their prescribed medications as directed, leading to inadequate blood pressure control.

2. Secondary Hypertension: Underlying medical conditions, such as kidney disease, hormonal disorders, or obstructive sleep apnea, can contribute to high blood pressure and may be more challenging to treat.

3. Lifestyle Factors: Unhealthy lifestyle habits like a high-sodium diet, excessive alcohol consumption, and physical inactivity can worsen hypertension.

4. Medication Interactions: Some individuals may experience medication interactions that reduce the effectiveness of antihypertensive drugs.

5. Genetic Factors: Genetic predisposition can make certain people more resistant to the effects of blood pressure medications.

Drug Therapy for Resistant Hypertension:

When dealing with resistant hypertension, healthcare providers may employ various strategies:

1. Medication Adjustments: This may involve optimizing the dosage or type of existing medications or adding new classes of drugs to the treatment regimen.

2. Identifying Underlying Causes: Determining and addressing any underlying conditions contributing to hypertension, such as kidney disease or hormonal imbalances.

3. Lifestyle Modifications: Encouraging patients to make lifestyle changes like reducing salt intake, losing weight, exercising, and limiting alcohol consumption.

4. Medication Compliance: Ensuring that patients are adhering to their medication regimen and addressing any barriers to compliance.

5. Referral to Specialists: In some cases, a patient may be referred to a hypertension specialist or nephrologist for further evaluation and management.

It's essential for individuals with resistant hypertension to work closely with their healthcare providers to find the most effective treatment plan. Managing resistant hypertension often requires a combination of medications and lifestyle changes, and it can be a complex and ongoing process to achieve optimal blood pressure control and reduce the risk of cardiovascular complications.

Here's the correlation between hypertension management and drug therapy, as well as the concept of resistant hypertension:

1. Hypertension Management with Drug Therapy:
– Hypertension management often begins with lifestyle changes such as a healthy diet, regular exercise, weight control, and reduced sodium intake.
– If lifestyle modifications alone do not effectively control blood pressure, healthcare professionals may prescribe antihypertensive medications.
– There are various classes of antihypertensive drugs, including diuretics, beta-blockers, ACE inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers, and others.
– The choice of medication depends on the individual's specific condition, as well as factors like age, underlying health conditions, and potential side effects.

2. Resistant Hypertension:
– Resistant hypertension is a condition where blood pressure remains elevated despite the use of three or more different antihypertensive medications at optimal doses, including a diuretic.
– Resistant hypertension can be classified into two main categories:
I. True Resistant Hypertension: This is when blood pressure remains high despite optimal therapy.
II. Pseudo-Resistant Hypertension: In some cases, high blood pressure may be related to factors such as poor medication adherence, white coat syndrome (elevated blood pressure in a medical setting), or secondary causes like kidney disease.

The correlation between hypertension management and drug therapy is that medications are often a crucial component of controlling blood pressure, especially when lifestyle changes are insufficient.
– For individuals with resistant hypertension, the correlation is more complex. Resistant hypertension may necessitate a more intensive drug therapy regimen, careful evaluation to identify underlying causes, and the addition of other medications or interventions.

In summary, hypertension management often involves drug therapy as part of a comprehensive treatment plan. For individuals with resistant hypertension, additional measures, investigations into potential underlying causes, and adjustments to drug therapy may be needed to achieve blood pressure control. It's crucial for individuals with resistant hypertension to work closely with their healthcare provider to find an effective treatment strategy.

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Prostate Cancer

When cancer starts in the prostate, it is called prostate cancer.

Prostate cancer is the uncontrolled growth of cells in the prostate, a gland in the male reproductive system just below the bladder.

Prostate is a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
As the tumor grows, it can damage nearby organs causing erectile dysfunction, blood in the urine or semen, and trouble urinating. Some tumors eventually spread to other areas of the body, particularly the bones and lymph nodes. There, tumors cause severe bone pain, leg weakness or paralysis, and eventually death.

Difference between benign and malignant tumor

A benign tumor is made up of cells that don’t threaten to invade other tissues. The tumor cells are contained within the tumor and aren’t abnormal or very different from surrounding cells.
WHILE
Malignant tumors are made of cancer cells that can grow uncontrollably and invade nearby tissues. The cancer cells in a malignant tumor tend to be abnormal and very different from the normal surrounding tissue.

SYMPTOMS

1. Frequent urination
2. Trouble urinating
3. Decreased force in the stream of urine
4. Blood in the semen and urine
5. Erectile dysfunction
6. Bone pain
7. Discomfort in the pelvic area
8. Discomfort or pain when sitting, caused by an enlarged prostate.

CAUSES

Prostate cancer is caused by the accumulation of genetic mutations to the DNA of cells in the prostate. These mutations affect genes involved in cell growth, DNA damage repair, and cell death. Changes to these genes can cause cells in the prostate to grow uncontrollably, resulting in a tumor. (american cancer society, may 2023).
Some abnormal cells can break off and spread (metastasize) to other parts of the body.

RISK FACTORS

1. Older age
2. Family history of prostate or breast cancer
3. Race
4. Obesity

COMPLICATIONS

1. Erectile dysfunction
The nerves that control a man’s erectile response are located very close to the prostate gland. A tumor on the prostate gland or certain treatments such as surgery and radiation can damage these delicate nerves. This can cause problems with achieving or maintaining an erection. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.

2. Incontinence
Prostatic tumors and surgical treatments for prostate cancer can also lead to urinary incontinence. Someone with urinary incontinence loses control of their bladder and may leak urine or not be able to control when they urinate. The primary cause is damage to the nerves and the muscles that control urinary function. Treatment for incontinence depends on the type you have, how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.

3. Metastasis (cancer that spreads)
Metastasis occurs when tumor cells from one body region spread to other parts of the body. The cancer can spread through tissue and the lymph system as well as through the blood. Prostate cancer cells can move to other organs, like the bladder. They can travel even further and affect other parts of the body, such as the bones and spinal cord. Prostate cancer that metastasizes often spread to the bones. This can lead to complications such as fractured or broken bones, severe pain, stiffness in the hip, thighs, or back, weakness in the arms and legs and higher-than-normal levels of calcium in the blood (hypercalcemia), which can lead to nausea, vomiting, and confusion.

STAGES

Staging typically describes how much cancer is present in the body and how serious the cancer is. Knowing the stage of prostate cancer can help a person understand what to expect and will inform decisions about treatment.
Stages may include:
1. Stage I: Cancer is only present in the prostate gland.

2. Stage II: Cancer has not yet spread from the prostate, but a person will have a higher PSA level.

3. Stage III: Cancer may have spread to nearby tissues.

4. Stage IV: Cancer may have spread to distant parts of the body.

TESTS AND DIAGNOSIS

Screening for prostate cancer
Prostate cancer screening searches for tumors in those without symptoms. Screening aims to separate men with high-risk cancers who would benefit from treatment, from those whose tumors are slow-growing and unlikely to impact health. This is typically done through blood tests for levels of the protein prostate-specific antigen (PSA), which are elevated in those with enlarged prostates, whether due to prostate cancer or benign prostatic hyperplasia.

Diagnosis for prostate cancer
A diagnosis of prostate cancer requires a biopsy of the prostate. Prostate biopsies are typically taken by a needle passing through the rectum or perineum, guided by transrectal ultrasound imaging, magnetic resonance imaging (MRI), or a combination of the two. Ten to twelve samples are taken from several regions of the prostate to improve the chances of finding any tumors. Biopsies are examined under a microscope by a pathologist, who determines the type and extent of cancerous cells present. Cancers are first classified based on their appearance under a microscope. Over 95% of prostate cancers are classified as adenocarcinomas (resembling gland tissue), with the rest largely squamous-cell carcinoma (resembling squamous cells, a type of epithelial cell) and transitional cell carcinoma (resembling transitional cells).

PSA testing

The blood test, called a prostate-specific antigen (PSA) test, measures the level of PSA and may help detect early prostate cancer. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in males.
It’s normal to have a low level of PSA in your blood. A high PSA level may be caused by:
• Prostate cancer
• An enlarged prostate (BPH) (benign prostatic hyperplasia)
• Other common prostate problems
•Taking certain medicines.

TREATMENT OF PROSTATE CANCER

Your prostate cancer treatment options depend on several factors, such as how fast your cancer is growing, how much it has spread and your overall health, as well as the benefits and the potential side effects of the treatment.

1. Active surveillance
For men diagnosed with very early-stage prostate cancer, treatment may not be necessary right away. Some men may never need treatment. Instead, doctors sometimes recommend active surveillance.
In active surveillance, regular follow-up blood tests, rectal exams and possibly biopsies may be performed to monitor progression of your cancer. If tests show your cancer is progressing, you may opt for a prostate cancer treatment such as surgery or radiation.

2. Radiation therapy
Radiation therapy uses high-powered energy to kill cancer cells. Prostate cancer radiation therapy can be delivered in two ways:
● Radiation that comes from outside of your body (external beam radiation): During external beam radiation therapy, you lie on a table while a machine moves around your body, directing high-powered energy beams, such as X-rays or protons, to your prostate cancer. You typically undergo external beam radiation treatments five days a week for several weeks.
● Radiation placed inside your body (brachytherapy): brachytherapy involves placing radioactive seeds inside your prostate. This approach kills cancer cells while preserving surrounding healthy tissue.

3. Hormone therapy
The hormone testosterone boosts cancer cell growth. Hormone therapy uses medications to combat testosterone’s role in fueling cancer cell growth.  Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly.

4. Surgery to remove the prostate
Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. 

5. Chemotherapy
Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.
Chemotherapy may be a treatment option for men with prostate cancer that has spread to distant areas of their bodies. Chemotherapy may also be an option for cancers that don’t respond to hormone therapy.

LIFESTYLE AND HOME REMEDIES

You can reduce your risk of prostate cancer if you:

1. Choose a healthy diet full of fruits and vegetables.
2. Exercise most days of the week
3. Maintain a healthy weight. 
4. Talk to your doctor about increased risk of prostate cancer.

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Skin Infections

PREAMBLE:
The skin, the body’s largest organ, plays a crucial role in safeguarding us from external threats, regulating our temperature, and enabling sensory experiences. Composed of various layers, including the epidermis, dermis, and subcutaneous tissue, it acts as a protective barrier against harmful microorganisms and environmental factors. Furthermore, it houses sensory receptors that allow us to sense touch, pain, and temperature. Additionally, the skin contributes to vitamin D synthesis and serves as a canvas for expressing individuality through its unique characteristics, colors, textures, and markings. A comprehensive understanding of the skin’s complexity and functions is vital for maintaining overall health and well-being.

Skin infections, also referred to as dermatological conditions, encompass a broad spectrum of issues that impact the body’s largest organ, the skin. Skin serves as a protective barrier, maintaining body temperature and contributing significantly to sensory perception. Nonetheless, it is vulnerable to a variety of disorders and illnesses, which can manifest in diverse ways, ranging from minor irritations to serious health problems. These conditions may arise due to genetic factors, environmental influences, infections, autoimmune reactions, or lifestyle choices. Examples of common skin disorders include acne, dermatitis (eczema), psoriasis, ringworm, athlete’s foot, among others. Meanwhile, certain conditions like skin cancer can pose life-threatening risks if not identified and treated promptly.

The successful management and treatment of these conditions frequently necessitate a collaborative approach involving a range of medical experts, including dermatologists, allergists, immunologists, and other health practitioners. Additionally, ongoing advancements in medical research and technology are enhancing our comprehension of skin disorders, resulting in improved diagnostic techniques and innovative therapies. Appreciating the diversity of skin disorders is crucial for preserving skin health, averting complications, and enhancing individuals’ overall well-being. Furthermore, we will delve into various aspects of skin disorders, including their causes, symptoms, treatment options, and preventive measures, all aimed at promoting skin health.

TYPES OF SKIN INFECTIONS:

Skin infections can vary greatly in symptoms, severity, and result from various causes, including bacteria, viruses, fungi, and parasites. Here’s a brief overview of some common types:

1. Ringworm (Tinea Corporis):
– Cause: Fungi called dermatophytes.
– Appearance: Red, itchy, ring-shaped rashes on the skin.
– Transmission: Can spread through direct contact with an infected person or animal or by sharing contaminated items like towels or combs.
– Treatment: Antifungal creams or oral medications prescribed by a healthcare professional.

2. Athlete’s Foot (Tinea Pedis):
– Cause: Fungi thrive in warm, moist environments.
– Symptoms: Itchy, peeling skin on the feet, especially between the toes.
– Transmission: Often spreads in locker rooms and public showers.
– Treatment: Antifungal creams or powders, and good foot hygiene.

3. Jock Itch (Tinea Cruris):
– Cause: Fungi that prefer the groin area.
– Symptoms: Itchy, red rash in the groin and inner thigh area.
– Transmission: Common in athletes and those in humid climates.
– Treatment: Antifungal creams or powders, and keeping the area dry.

4. Yeast Infections (Candidiasis):
– Cause: Candida yeast.
– Symptoms: Redness, itching, and sometimes white discharge, often in warm, moist areas like the genitals or mouth.
– Treatment: These fungal infections are typically not serious but can be uncomfortable and itchy. Treatment usually involves antifungal medications/creams, good hygiene, and keeping the affected area clean and dry.

5. Acne:
– cause: Excess sebum production(skin oil), clogged hair follicles, bacteria, hormonal changes, diet, genetics, certain medications (e.g corticosteroids), stress and environmental factors.
– Symptoms: Pimples(small, red, or white bumps on the skin), Blackheads(open clogged pores with dark centers), Whiteheads(closed clogged pores with white centers), Cysts(large, painful lumps under the skin), Inflammation, Scarring.

Treatment:
Acne treatment involves various approaches to manage and reduce the occurrence of acne.

– Cleansing: It’s important to wash your face regularly using a gentle cleanser to eliminate excess oil, dirt, and dead skin cells. Avoid using abrasive scrubs or washing too frequently, as they can cause skin irritation.
– Topical Treatments: Non-prescription products are available and may contain substances like benzoyl peroxide, salicylic acid, or alpha hydroxy acids (AHAs). These ingredients can assist in clearing clogged pores, reducing inflammation, and eliminating the bacteria responsible for acne.
– Oral Medications: In certain situations, healthcare professionals may recommend antibiotics such as doxycycline or tetracycline to reduce inflammation and bacterial growth.
– Chemical Peels: Health practitioners may recommend a visit to certified estheticians for facials like chemical peels to remove the outermost layer of skin, which can improve the appearance of acne scars and promote smoother skin.
– Lifestyle Adjustments: Maintaining a healthy lifestyle through a balanced diet, regular physical activity, effective stress management, and sufficient sleep can have an impact on acne.
– Avoid Picking or Squeezing: It’s crucial to resist the temptation to pop pimples, as this can worsen inflammation and result in scarring.

Keep in mind that treating acne requires patience and consistency. What works for one person may not be effective for another, so it’s essential to consult with a healthcare provider for personalized care. Additionally, some treatments may have side effects, so discussing these with a healthcare professional is important.

6. Dermatitis:
Commonly known as eczema, is a chronic skin condition characterized by inflammation, itching, and sometimes the formation of red, scaly patches on the skin.

Types of dermatitis:
– Atopic Dermatitis: This is the most common form, often appearing in childhood and typically associated with a family history of allergies or asthma.

– Contact Dermatitis: Caused by skin contact with irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis), such as certain soaps, cosmetics, or plants like poison ivy.

Symptoms:
– Intense itching is a hallmark of eczema.
– Redness and inflammation of the skin.
– Dry, scaly, or crusty patches.
– Skin may become thickened or leathery with chronic eczema.
– In severe cases, eczema can lead to open sores or oozing lesions due to scratching.

Causes/Triggers:
– Genetics play a role, as eczema tends to run in families.
– Environmental factors, like exposure to allergens or irritants.
– Dry skin can aggravate eczema.
– Stress and hormonal changes can trigger or worsen flare-ups.

Treatment/Management:
– Moisturizing regularly is essential to keep the skin hydrated.
– Topical corticosteroids and other anti-inflammatory creams or ointments are often prescribed to reduce inflammation and itching.

Prevention:
– Keeping the skin well-moisturized.
– Identifying and avoiding triggers.
– Using mild, fragrance-free soaps and detergents.
– Managing stress, as stress can worsen symptoms.

It’s crucial to understand that eczema is a long-lasting condition without a known remedy, but its signs can be effectively controlled through appropriate skincare, medications, and lifestyle changes. If you or someone you’re familiar with is coping with eczema, seeking advice from a dermatologist or healthcare expert for a tailored treatment plan is recommended.

7. Psoriasis:
This is a long-lasting autoimmune skin condition that impacts millions of individuals across the globe. It arises when the immune system erroneously recognizes skin cells as foreign intruders, prompting an accelerated generation of skin cells. While skin cells typically renew every 3 to 4 weeks, in psoriasis, this renewal process can take as little as 3 to 7 days. This swift turnover of cells results in an accumulation of skin cells on the surface, giving rise to various symptoms like itching, burning, or discomfort in affected areas, as well as dry, cracked skin that may bleed, among other indications. The choice of treatment varies based on the severity and type of psoriasis.
They may include:

– Topical treatments: Creams, ointments, or shampoos containing corticosteroids, vitamin D analogs, or retinoids to reduce inflammation and scale.
– Oral or injected medications: For severe cases, drugs like methotrexate, cyclosporine, may be prescribed to suppress the immune system and reduce symptoms.
– Lifestyle changes: Managing stress, maintaining a healthy diet, and avoiding triggers like alcohol and smoking can help.
– Moisturizers: Using emollients can soothe dry skin and prevent flare-ups. Always consult a healthcare provider for a proper diagnosis and personalized treatment plan.

8. Chickenpox:
This is an infection that causes a skin rash. The disease is caused by a germ called varicella-zoster virus. (Chickenpox itself is also called varicella-zoster.) Most people will get the virus when they are young if they haven’t had a chickenpox vaccine.
A child with chickenpox can easily give the virus to other children. Chickenpox today is much less common because most children are vaccinated when they are young. Having chickenpox once usually provides lifelong immunity to the virus. However, the virus can reactivate later in life, causing a different condition called shingles.

Vaccination:
– The varicella vaccine is highly effective at preventing chickenpox. It’s usually given in two doses to children, and a two-dose regimen is recommended for adults who are not immune to the virus.
Treatment:
– It is mainly focused on relieving symptoms, such as itching and fever, with antihistamines and fever-reducing medications. It’s important to avoid scratching the rash to prevent infection.

SUMMARY:
Various types of skin infections caused by bacteria, fungi, viruses, and parasites exhibit a wide range of characteristics that impact the skin. These infections differ in their origins, symptoms, and therapeutic approaches, underscoring the importance of seeking professional medical advice for precise diagnosis and suitable care. For instance, Pharmacists assume a pivotal role in addressing skin ailments, contributing significantly in multiple aspects. Moreover, they offer vital counsel and proficiency in managing skin conditions by overseeing medication, providing education, and offering patient assistance. Additionally, in cases demanding specialized treatment, pharmacists may refer individuals to dermatologists or other healthcare providers.

Reference:
Google scholar article(complicated infections of skin and skin structures)
Drugs.com
WebMD

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World Hepatitis Day 2023

Hepatitis is an inflammatory condition of the liver. It is commonly the result of viral infection, but there are other possible causes of hepatitis which includes autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.

FIVE MAIN VIRAL CLASSIFICATIONS OF HEPATITIS.

– Hepatitis A; This type of hepatitis is an acute short term disease.

– Hepatitis B; This is often an ongoing, chronic condition.

– Hepatitis C; This is among the most common blood borne viral infections and it presents as a long term condition.

– Hepatitis D; This is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus causes liver inflammation.

-Hepatitis E; This is a waterborne disease. It is found in areas with poor sanitation and typically results from ingesting fecal matter that contaminates the water supply.

SYMPTOMS OF HEPATITIS

* Fatigue
* Flu-like symptoms
* Dark urine
* Pale stool
* Abdominal pain
* Loss of appetite
* Unexplained weight​

TREATMENT

Treatment to prevent hepatitis infection after exposure. If you know you’ve been exposed to the hepatitis virus and aren’t sure if you’ve been vaccinated, call your doctor immediately. An injection of immunoglobulin (an antibody) given within 12 hours of exposure to the virus may help protect you from getting sick with hepatitis. Because this treatment only provides short-term protection, you also should get the hepatitis vaccine at the same time, if you never received it.

Treatment for acute hepatitis infection If your doctor determines your hepatitis infection is acute — meaning it is short-lived and will go away on its own — you may not need treatment. Instead, your doctor might recommend rest, proper nutrition and plenty of fluids while your body fights the infection. In severe cases, antiviral drugs or a hospital stay is needed to prevent complications.

Treatment for chronic hepatitis infection Most people diagnosed with chronic hepatitis infection need treatment for the rest of their lives. Treatment helps reduce the risk of liver disease and prevents you from passing the infection to others. Treatment for chronic hepatitis may include:

*Antiviral medications. Several antiviral medications — including entecavir (Baraclude), tenofovir (Viread), lamivudine (Epivir), adefovir (Hepsera) and telbivudine (Tyzeka) — can help fight the virus and slow its ability to damage your liver. These drugs are taken by mouth.

*Interferon injections. Interferon alfa-2b (Intron A) is a man-made version of a substance produced by the body to fight infection. It’s used mainly for young people with hepatitis B who wish to avoid long-term treatment or women who might want to get pregnant within a few years, after completing a finite course of therapy. Interferon should not be used during pregnancy.

*Liver transplant, If your liver has been severely damaged, a liver transplant may be an option. During a liver transplant, the surgeon removes your damaged liver and replaces it with a healthy liver.

PREVENTION

There are many ways you can reduce your chances of getting hepatitis:

*Get the vaccines for hepatitis

*Use a condom during sex.

*Don’t share needles to take drugs.

*Practice good personal hygiene such as thorough hand-washing with soap and water.

*Don’t use an infected person’s personal items.

*Take precaution when traveling to areas of the world with poor sanitation. (Make sure to get your vaccines.)

*Drink bottled water when traveling.

*It is very important that you take preventive steps too if you work in places like nursing homes, dormitories, daycare centers, or restaurants where there you have extended contact with other people and a risk of coming into contact with the disease.

SUPPLEMENTS FOR HEPATITIS

Milk Thistle

Helps protect the liver cell and reduces inflammation that can damage the liver.

Curcumin

This is a chemical in turmeric, the spice that gives many curries their flavor and yellow hue. It can help the body fight inflammation.

Probiotics

These are beneficial bacteria that help maintain the health of the gut and aid in digestion.

Licorice Root

This root helps to slow the growth of liver cancer.

 

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Diphtheria

Diphtheria is a dangerous bacterial infection that damages the mucous membranes in the nose and throat. Diphtheria can by avoided by the use of vaccines even through it is contagious from person to person.

WHAT CAUSES DIPHTHERIA?

Diphtheria is caused by a kind of bacteria called CORYNEBACTERUM DIPHTHERIAE. The disease is often passed from person to person or through touch with objects that have the bacteria on them, like a cup or used tissue. If you are in close proximity to someone who has diphtheria and they cough, sneeze or blow their nose, you could also contract the disease.
An infected person can potentially spread the bacterial infection for up to six weeks after the initial infection, even if they dont exhibit any diphtheria symptoms or signs.
The bacteria typically infect your throat and nose. The bacteria release harmful compounds known as toxins after you are infected. The poisons circulate throughout your bloodstream and frequently result in the formation of a thick, grey coating in the following bodily parts:
1) Throat.
2) Tongue.
3) Nose.
4) Airway.
These toxins can occasionally harm other organs including the heart, brain and kidneys. Complications that could be fatal can result from this, including:
1) Myocarditis ( inflammation of the heart).
2) Renal failure (kidney failure).
3) Muscular paralysis.

WHAT ARE RISK FACTORS.
Diphtheria is fairly common in developing countries where immunization rates are low. In these countries, children under age 5 and people over age 60 are particularly at risk of getting diphtheria. People are also at an increased risk of contracting diphtheria if they:
– aren`t up to date on their vaccinations.
– visit a country that doesn`t provide immunizations.
-live in unclean or crowded environment.
-have an immune system disorder such as AIDS.

WHAT ARE THE SYMPTOMS OF DIPHTHERIA?
Diphtheria symptoms frequently show up two to five days after the infection. While some people have moderate symptoms similar to the common cold, others don`t feel any symptoms similar at all.
A thick grey coating on the tonsils and throat is the most obvious and typical sign of diphtheria other typical symptoms include:
1) Fever.
2) Chills.
3) Rapid breathing.
4) Cough.
5) Sore Throat.
6) General fatigue.
7) Slurred speech.
8) Changes in vision.
9) Signs of shock.
HOW CAN DIPHTHERIA BE DIAGNOSED?
A diagnosis will be made by your doctor based on your symptoms and the results of a lab test. They obtain a sample from your sore or the back of your throat using a swab. The swab is subsequently sent to analysis and diagnosis.

HOW IS DIPHTHERIA TREATED?
Treatment for diphtheria starts immediately often even before the results of the lab tests are confirmed. To prevent organ damage your health care provider will administer diphtheria antitoxin. To treat infections, they`ll recommend antibiotics, usually penicillin or erythromycin.
To stop the spread of the disease, diphtheria patients are segregated from the general population. After taking antibiotics for around 48 hours, an infected person is no longer contagious. Tests will be be repeated to confirm that the bacteria are eliminated when therapy is finished. You will receive a vaccine to stop further illnesses after the bacteria are eliminated when therapy is finished. You will receive a vaccine to stop further illnesses after the bacteria are eliminated.

HOW IS DIPHTHERIA PREVENTED?
Antibiotics and vaccines can be used to prevent diphtheria. The vaccine for diphtheria is called DTap. It`s often administered in a single dose alongside the pertussis and tetanus vaccines. It takes five doses to fully protect against the DTap virus. Children receive it at the following ages trusted source:
1) 2 months.
2) 4 months.
3) 6 months.
4) 15-18 months.
5) 6 months.

A child may in extremely rare circumstances, develop an allergy to the immunization. This may cause lives or seizures that will eventually go away.
Since vaccines only remain effective for 10 years, your child will remain another vaccination around the age 12. it is advised that adults receive a single dose of a booster vaccine that include diphtheria, tetanus and pertussis. You will thereafter receive the tetanus-diphtheria(TD) vaccine every 10 years. By following these instructions, you or your child may be shielded from future diphtheria.

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VisuUltra

Visiultra is a dietary supplement for supporting the eyes that improves vision while preserving clarity. This formula consists of a natural combination of 14 components that have been scientifically shown to reverse eyesight loss by addressing the underlying cause of eye conditions.
The all-natural remedy works by promoting the bodys natural healing process. The body produces adult repair cells with the assistance of active substances like spirulina and astaxanthin. The macular is the repaired by these cells, undoing any damage and regaining your vision.
Benefits of Visiultra.
1. Visiultra decline the root cause of slow age-related vision.
This all natural complex may aid your damaged macula and stop vision loss in its tracks by encouraging the creation of adult self-repair cells, which may slow down vision loss from the inside out.

2. Naturally support your vision.
The floaters, flecks and black spots will appear considerably less noticeable with your macula supported. Enjoy the freedom that comes with having clear eyesight. From operating a vehicle to making dinner on your own or even starting to read independently once more.

3.Defend against potential damage.
Numerous scientific studies have demonstrated the protective effects of substances including spirulina, astaxanthin and L-carnitine, which have also been proved to be potent inhibitors of disorders connected to vision against retinal damage.

4. Complete Freedom.
You`ll find yourself rediscovering joys you believed to have long since vanished once your vision is clear and your mind is at ease. You`ll be brimmimg into youthful vitality as you regain control of your life and begin to appreciate pother interest you had to put on hold, in addition to being able to read properly once more.

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Can Vitamin C Really Help Prevent Colds and Flu?

 It’s such an oft-repeated thing it has become common knowledge: Vitamin C is what we need when we are coming down with a cold or flu. Many swear it helps them prevent winter ills; others say it eases and erases symptoms and helps them bounce back if they do get struck down. But what is the truth here? Is vitamin C the cold cure and immunity boost we may believe it to be?

Where did this idea come from?

The link between vitamin C and immunity is well established, in the sense that this is an essential vitamin that we need for the proper functioning of our immune system. Vitamin C plays a role in various processes in the body, including the production of white blood cells and antibodies. Having enough vitamin C in our bodies is important for our overall immune function, and our overall health.

This link was discovered way back before anyone had identified or named vitamins as vitamins, when it was found that sailors in the 18th century could recover quickly from scurvy when they ate citrus fruits, which we now know are high in vitamin C (it took until 1933 for the link to be fully understood).

We now know that this vitamin is crucial for collagen synthesis – it helps our skin heal and helps maintain bone, tendons and blood vessels – and it helps us absorb iron from the foods we eat. It is also an antioxidant, protecting cells from damage caused by harmful free radicals, reducing oxidative stress and promoting overall cellular health.

The idea of supplementing with vitamin C probably came from the fact that it is not stored in the body; we need to get it regularly from what we eat and drink in order to keep our levels up. The ‘insurance policy’ thinking that applies to most vitamins comes into play here: if we’re not getting enough from our food, we reason, why not top up with a supplement?

Do vitamin C supplements help us with colds and flu?

We know vitamin C is good for immunity. It is less clear, however, that supplements help with prevention or symptoms of colds and flu. Despite nearly a century of research, the evidence remains pretty mixed.

Taking vitamin C regularly as a supplement does not seem to prevent colds or flu in most people. There is an exception: there have been some studies looking at people under extreme physical stress, such as marathon runners and soldiers in sub-arctic conditions, where it was found that if the participants started taking vitamin C two to three weeks before their strenuous activities, their risk of developing a cold was reduced by about half.

For those of us who are not sub-arctic soldiers or marathoners, the evidence in large reviews shows that taking vitamin C does not prevent a cold. However, taking it regularly before you get the cold could shorten the amount of time you will be sick by around 10 percent. So a cold that would have lasted 10 days will be over in nine.

It has also been found that people who always took vitamin C had slightly milder cold symptoms. This seems to be particularly the case for children.

That said, taking vitamin C after your cold symptoms appear probably will not do any good. The evidence shows this does not have any effect on how long you will be ill for.

What about liposomal vitamin C?

Liposomal or lipo-spheric vitamin C seems to be all the rage. It comes with big claims – and a price tag to match. It is a form of vitamin C encapsulated in liposomes (tiny fat-like particles).

pills and multivitamins on a black backgroundPhoto: 123RF
There have been some studies looking at the effectiveness of liposomal vitamin C that suggest it appears to be absorbed better by the body. Whether that translates into any cold and flu benefits is not clear.

Any downsides to taking it?

Taking any vitamin C supplements in very high doses (more than 2000 milligrams a day, which is considered the safe upper limit) can cause diarrhoea and other digestive issues. There is no such risk in the vitamin C you get from food.

The only other downside is really that it is not doing anything, and you are simply excreting any excess in the form of, as nutritionists like to put it, expensive urine.

If not vitamin C… what can I take?

There is no magical thing that will protect us from viral illness (which hopefully we all know by now). But health experts stress that looking after ourselves as well as possible will help our immune system to stay in top shape, so that when we do get hit with a virus, we can handle it OK.

Nutritionist Nikki Hart is of this view, and cautions against singling out one vitamin as the solution.

“Vitamins, minerals, phytonutrients – they all work to repel oxidative damage”, she explains.

“So you can’t just label vitamin C as protective.
She stresses that the best way to get our vitamins – including vitamin C – is through food. Citrus fruit and other colourful fruits and vegetables are all useful here, and getting lots of those on our plates means we will easily hit the recommended daily intakes. Hart said food is best not only because it offers a highly bioavailable form of vitamin C, but we also get other goodies, too, like fibre and other vitamins.

No captionPhoto: Douglas Johns
She also said we need to remember all the things that boost immunity (and many other things too): physical activity, enough sleep, minimising alcohol and not smoking.

“The immune system is bigger than just vitamins and minerals.”

Lastly, there is one old bit of wisdom that might be true: one study found chicken soup is not only comforting, but it might have anti-inflammatory properties that lessen cold symptoms.

In other words, spending the supplement money on fresh produce might be a better, and more enjoyable, way of avoiding or treating a cold.

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Diabetes

Diabetes also known as diabetes mellitus, is a group of common endocrine disease characterized by sustained high blood sugar level.
Diabetes is due to the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.
Diabetes affect people of all ages. Most forms of diabetes are chronic(long-life),and all forms are manageable with medications and/or life changes.
Glucose(sugar) mainly comes from carbohydrates in food and drugs. Its the body`s go-to source of energy. Your body carries glucose to all your body`s cell to use for energy. When glucose is in your blood stream, it needs assistance(a key) to get to where it needs to go. Insulin is the key, a hormone.
Hyperglycemia or high blood sugar, results from the blood stream`s accumulation of glucose which can happen if your pancreas doesn`t use it properly. Constantly high blood sugar levels over time can lead to health risks like heart disease, nerve damage and vision problems.
Types of Diabetes.
There four different types of diabetes, they include;

1)Type 1 Diabetes: Although it can occur at any age, this variety is typically identified in children, teenagers and young adults. In type 1 diabetes, the pancreas stops producing insulin. This implies that you must take insulin daily.

2) Type 2 Diabetes: This type can appear at any age, however it seems to occur more frequently in people over 40. when your body isn`t using the insulin properly your pancreas isn`t producing enough, type 2 diabetes develops.

3)Gestational Diabetes(diabetes in pregnancy): Some women experience this type of development when pregnant. After pregnancy, gestational diabetes typically disappears. The chance of acquiring type 2 diabetes in life is increased if you have gestational diabetes.

4)Prediabetes: This is the precursor type 2 diabetes. Although your blood glucose levels are above average they are not yet high enough to be given a type 2diabetes diagnosis.

Symptoms of Diabetes.
They include:
1)Dry mouth and increased thirst(polydipsia).
2)Urination on a regular basis
3)Fatigue.
4)Eye sight that is fuzzy.
5)Unexpected weight loss.
6)Numbness of the hand or feet.
7)Recurring yeast infections of the skin or vagina.
8)Wounds or sores that take a long time to heal.
9)Extremely dry skin.
Other symptoms that can occur with type 1 diabetes
-Nausea.
-Abdominal pain.
-Vomiting.
-Urinary tract infections or yeast infections.
Causes of Diabetes.
Diabetes, irrespective of the kind is caused by an excess of glucose in the blood. However, depending on the type of diabetes you have, there are several causes for elevated blood glucose levels.
Causes of diabetes include;
1) Insulin resistance: The main cause of type 2 diabetes is insulin resistance. Cells in your muscles, fat and liver become insulin resistant when they don`t react to insulin as it should. Insulin resistance is caused by a variety of illness and circumstances including obesity, inactivity, hormonal imbalance, heredity, and some drugs.

2) Autoimmune disease: When your immune system destroys the insulin producing cells in your pancreas, you can develop type 1 diabetes and latent autoimmune diabetes of adults(LADA).

3) Hormonal imbalance: The placenta releases substances that lead to insulin resistance through out pregnancy. If your pancreas can`t create enough insulin to overcome the insulin resistance, you can develop gestational diabetes. Acromegaly and cushings syndrome (two other hormone related disease) can also lead to type 2 diabetes.

4)Pancreatic damage: Your pancreas capacity to produce insulin may be impacted by a condition, surgery or injury, leading to type 3c diabetes.

5)Genetic mutations: Onset diabetes of the young (MODY) and neonatal diabetes may be caused specific genetic mutations.

Long term usage of several drugs, such as corticosteroids and Hiv/Aids treatment can result in type 2 diabetes.
Complications of Diabetes.
Possible complications include;
1)Kidney damage.
2)Eye damage.
3)Heart disease and problem.
4)Nerve damage(Neuropathy).
5)Foot damage.
6)lots of hearing.
7)Depression.
8)Dementia.
9)Dental problems.
10)Erectile dysfunction.
Other possible complications for women who have gestational diabetes include:
-High blood pressure.
-A higher risk of developing gestational diabetes into future pregnancies.
-A higher risk of developing type 2 diabetes in the future.
Diagnosis of Diabetes.
1)Fasting blood glucose test: For this test you must fast for eight hours the previous evening before having blood drawn the following morning. Fasting blood glucose levels below 100mg/dl are considered normal. Prediabetes is indicated by a reading between 100 and 125mg/dl.
Diabetes is indicated if your level is 126mg/dl or greater. As food can greatly affect blood sugar, this test allows your provider to see your base line blood sugar.

2)Random blood glucose test: You can perform this blood test whenever you like without having to fast. Diabetic conditions are indicated by blood glucose levels of 200mg/dl or above.

3) A/C test: Although the A/C test requires blood, you don`t have to fast before having it done. Your medical practitioner will learn from the results. what your typical glucose level has been during the previous two to three months. According to the american diabetes association, your A/C is in the non- diabetes range if it is 5.6% or lower if between 5.7% and 6.4%, pre-diabetes is present. If your result is 6.5% or greater, you likely have diabetes.

How is diabetes managed?
The management of diabetes requires a number of strategies because it is a complex condition. Furthermore, because diabetes has a unique impact on each individual, management strategies must be highly tailored.
The following are the top five(5) components of managing diabetes:
1)Blood sugar monitoring: The effectiveness of your current treatment strategy can be assessed by regularly checking your blood sugar(glucose). It provides you advice on how to take care of your diabetes on a daily and occasionally even on daily basis. With a glucose monitor (CGM) , you can check your levels frequently to track your progress. The ideal blood sugar range for you will be chosen in consultation with your healthcare practitioner.

2)Oral diabetes drugs: Oral diabetes medications assist maintain blood sugar levels in persons with diabetes who still make some use of insulin, primarily those into type 2 diabetes and prediabetes. Oral medications may also be required for those with gestational diabetes.
There are numerous varieties, the most popular drug is metformin

3)Insulin: To maintain their health and control their diabetes, type 1 diabetes must inject synthetic insulin, Insulin may be needed by some type 2 diabetes. There are numerous varieties of synthetic insulin. They all begin to work differently and last in your body for various amounts of time. The four primary methods of ingesting insulin are rapid acting inhaled insulin, insulin pens, insulin pumps, and injectable insulin with a syringe(shot).

4) Diet: Considering how significantly food affects blood sugar levels, meal planning and selecting a balanced diet and important components of managing diabetes. An important aspect of managing diabetes if you take insulin is keeping track of the carbs in your diet. Your need for insulin during meals is influenced by the quantity of carbohydrates you consume. Additionally, healthy diet can lower your chance of developing heart disease and help you control your weight.

5)Exercise: Since exercise improves insulin sensitivity(and lowers insulin resistance),it is crucial for all diabetes to regularly engage in physical activity. As a result of the elevated risk for heart disease, its also critical to keep healthy;
1)Weight.
2)Cholesterol.
3)Blood pressure.
Importance of HbA1c in diabetes management.
Measuring your fasting and random blood sugar is not enough to check on your diabetes. Although, monitoring blood glucose levels when fasting and after meals is crucial, these tests can only measure your blood sugar at a specific period. Depending on what you ate the night before or at the proceeding meal, your findings may differ. The HbA1c test however examines the 3-month data.
HbA1c values for people with diabetes provide a good indication of how well their diabetes is controlled. According to scientific data, a lower Hba1c value indicates a lower risk of developing diabetic complications. Raised Hba1c values in individuals with or without diabetes have also been recognized as a stand alone risk factor for heart disease and stroke.
An Hba1c test requires no specific preparations, unlike fasting or past meal blood sugar. No need to observe a fast. Any time of day is acceptable for providing a test sample.
In general, HbA1c levels typically be checked every three months in persons with diabetes and pre-diabetes. An HbA1c test should be performed every six months, if you are healthy but have a family history of diabetes or believe your lifestyle makes you more likely to acquire diabetes. The frequency of your medical tests can be determined by controlling a health practitioner
.
Prevention of Diabetes.
Diabetes in its autoimmune and hereditary variants cannot be prevented. But there are several actions you can take to reduce your chance of getting gestational diabetes, type 2 diabetes and prediabetes such as:
1)Embrace a healthy diet.
2)Engage in atleast 3 months workout for 5 days in a week.
3)Work toward achieving a healthy weight.
4)Stress management.
5)Consume alcohol in moderation.
6)Get enough rest(usually 7-9 hours) and seek help if you have issues sleeping.
7)Stop using Tobacco.

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