Living with sickle cell disease

People with sickle cell disease need comprehensive healthcare; the disease comes with many complications that can be anticipated, prevented and managed effectively. Many patients are living full and healthy lives.

Children are born with the sickle cell disease; it is not contagious. It is passed down from parent to child when both parents have the sickle cell trait “AS”, or one parent has sickle cell disease “SS”, and the other parent has the trait “AS”.

Sickle cell disease (SCD) is an inherited disorder of the protein haemoglobin in the red blood cell that affects millions of adults and children around the world. It is caused by a genetic mutation in the body system that makes it produce a different kind of haemoglobin called haemoglobin S, and this causes a change in the shape of the red blood cell from its normal disc-shape to being sickled in shape giving it its name “sickle” cell disease. These misshaped cells break down easily causing anaemia, and they live for only 10-20 days instead of the normal 120 days.

To be infected with the sickle cell disease, you need to have two altered haemoglobin genes; one from each parent. If you have only one of these altered genes, you will be referred to as a carrier of the disease. Nigeria has the highest burden of the Sickle Cell Disease in the world where the trait occurs in 25% to 30% (40 million) of the population. About 150,000 babies are being born every year yearly with this disease with infant deaths of about 100,000, which represents 8% of child mortality in the country. Testing for sickle cell disease can be done in the newborn (HPLC, IEF) or through haemoglobin electrophoresis (genotyping).

The hallmark of the disease is anaemia (decrease in red blood cells). Complications of the disease include pain crises, infection, stroke, kidney and liver dysfunction, and can also affect the lung, spleen and heart.  Due to the high mortality rate and complications of the disease, many developed countries have adopted comprehensive healthcare for SCD and the mortality reduced from 16-30% to less than 1%. In 2003 the University of Benin teaching hospital also adopted this extended health care for the management of their SCD patients with similar results.

Infections, pain, crises, anaemia and damage to body Organs are the most common complications of sickle cell disease. You should contact your doctor when you or your child/ward has a fever, chest pain, Jaundice (Eye/Skin looking yellow) or headache/dizziness.

Nisa Premier Hospital recently launched the Sickle cell disease clinic during the Sickle Cell Disease Awareness Day on June 18th, 2016 to better care for our patients with SCD. The clinic which has adopted the comprehensive healthcare management officially opened on the 10th of August 2016. The aim of the clinic is early detection and prevention of the complications of the disease, though:

  • Parent and patient  counselling and education
  • Routine medical care for the SCD patient through regular medical follow-up
  • Immunizations (routine and additional vaccines for patients with SCD)
  • Routine laboratory testing
  • Prophylaxis for malaria and bacterial infections
  • Early identification of fever/infection and its management
  • Vitamins (Folic Acid and Vitamin C)

Some of the services we currently offer at Nisa include:

  • Pre-implantation genetic diagnosis (PGD) for single cell genetic defects
  • Testing for sickle cell disease through haemoglobin electrophoresis (genotyping)
  • Sickle Cell Disease Clinic: The clinic is run by the consultants at a discounted price on consultation and some laboratory tests. The clinic is by appointment every Wednesday from 9 am to 4 pm at the Congo building outpatient department (Adults) and Lieberman OPD (Paediatrics).

At Nisa Premier Hospital, our goal is to provide the best comprehensive care for our sickle cell patients that will afford them the full and healthy life that they deserve. We look forward to seeing and serving you at our clinic!

For all enquiries on sickle cell and Anaemia, please call: 08090457744, 08174210023.

What You Need to Know About Childhood Immunizations

What You Need to Know About Childhood Immunizations

1. Why your child should be vaccinated

Immunizations protect children from dangerous childhood diseases. Any of these diseases can cause serious complications

and can even kill.

We are also warned to immunize our children, ourselves as adults, and the elderly.

2. Diseases that childhood vaccines prevent

  • Diptheria
  • Haemophilus Influenzae type b (Hib disease – a major cause of bacterial meningitis)
  • HepititisA
  • HepititisB
  • Human papillomavirus(HPV – a major cause of cervical and other cancers)
  • Influenza
  • Measles
  • Meningococcal
  • Mumps
  • Pertussis (Whooping Cough)
  • Pneumococcal (causes bacterial meningitis and blood infections)
  • Polio
  • Rotavirus
  • Rubella (German Measles)
  • Tetanus (Lockjaw)
  • Varicella (Chickenpox)

3. Number of doses your child needs

The following vaccinations are recommended by age two and can be given over five visits to a doctor or clinic:

  • 4 doses of diphtheria, tetanus & pertussis vaccine (DTaP)
  • 3-4 doses of Hib vaccine (depending on the brand used)
  • 4 doses of pneumococcal vaccine
  • 3 doses of polio vaccine
  • 2 doses of hepatitis A vaccine
  • 3 doses of hepatitis B vaccine
  • 1 dose of measles, mumps & rubella vaccine (MMR)
  • 2-3 doses of rotavirus vaccine (depending on the brand used)
  • 1 dose of varicella vaccine
  • 1 or 2 annual doses of influenza vaccine (number of doses depends on influenza vaccine history)

4. Like any medicine,vaccines can cause minor side effects

Side effects can occur with any medicine, including vaccines. Depending on the vaccine, these can include: slight fever, rash, or soreness at the site of injection. Slight discomfort is normal and should not be a cause for alarm.

5. It’s extremely rare, but vaccines can cause serious reactions — weigh the risks!

Serious reactions to vaccines are extremely rare. The risk of serious complications from a disease that could have been prevented by vaccination is far greater than the risk of a serious reaction to a vaccine.

6. What to do if your child has a serious reaction.

If you think your child is experiencing a persistent or severe reaction, call your doctor or get the child to a doctor right away. Write down what happened and the date and time it happened.

7. Why you should not wait to vaccinate

Children under 5 are especially susceptible to disease because their immune systems have not built up the necessary defenses to fight infection. By immunizing on time (by age 2), you can protect your child from disease and also protect others at school or daycare.

8. Be sure to track your shots via a health record

A vaccination health record helps you and your health care provider keep your child’s vaccinations on schedule. If you move or change providers, having an accurate record might prevent your child from having to repeat vaccinations he or she has already had. A shot record should be started when your child receives his/her first vaccination and updated with each vaccination visit.

Keep immunizing until disease is eliminated.

Unless we can “stop the leak” (eliminate the disease), it is important to keep immunizing.

Nisa Workshop Series

NISA HOSPITAL COMMENCES HER 2017 WORKSHOP SERIES

Nisa Hospital, on the 20th of April 2017 organized a Continuing Medical Professional Education tagged ‘Childcare referral system Workshop’. The workshop is intended to provide a platform for the discussion of best practices in the implementation of child care referral systems within our immediate healthcare community. Participation in the workshop also attracts a 5 CME credit points accredited by the Nigeria Medical and Dental Council.

This high quality educational activity for Physicians and other health care professionals emphasised on the use, cutting-edge technologies and medical advances in child care.

The event was chaired by the Acting Secretary of the Health and Human Resource Secretariat FCTA who was ably represented by the Head of Planning, FCT Primary Health Board; Dr Sebastine Esomonu and co-chaired by Dr Udeoni – FCTA Health and Human Resource Secretariat. Also in attendance was a guest speaker from National Hospital Abuja.

Dr Sebastine Esomonu (Head of Planning, FCT Primary Health Board)

The Founder and Executive Vice-Chairman of Nisa Hospital referred to the workshop as ‘a networking system where practitioners from different hospitals in the FCT are brought together to address the issue of referral crisis and to improve on referral network and ease communication between the health practitioners’.

Dr Jaiyeola I.O, Group Head, Managed Care opened the workshop lecture with the topic ‘Challenges of childcare referral system’. Dr Audu L.I, a Chief Consultant Paediatrician/Neonatology at the National Hospital Abuja presented on ‘Optimising Child Care referral’ reiterated the fact that sick children will have more access to quality healthcare if there was a proper referral system. Dr Hananiah and Dr Eze of the Paediatric Department of Nisa Hospital educated the patients on ‘Infection in Sickle cell disease’ and ‘Survival of the under-5s’ respectively, while  Dr Olagunju of the Neonatology Unit spoke on the ‘Quality of care for the preterm baby’.

Dr Kike Olagunju (Neonatology Unit)                            Dr Antoniah Hananiah (Paediatrics Unit)

The high point of the event was the interactive Q&A session where the participants and speakers traded knowledge and experiences; some practical solutions to the challenges besieging the healthcare system in Nigeria were also proffered.

 

Certificate of participants was issued and the workshop ended with a group photograph.

 

What You Should Know About Meningitis

Meningitis is an inflammation of the meninges; the meninges are the three membranes that cover the brain and spinal cord. It stems from viral and bacterial infections. Other causes may include:

  • cancer
  • chemical irritation
  • fungi
  • drug allergies

Viral and bacterial meningitis are contagious. The symptoms may include fever, headache, stiff neck, and fatigue, rash, sore throat and intestinal symptoms may also occur.

They can be transmitted by coughing, sneezing, or close contact.

Some cases of meningitis improve without treatment (viral) in a few weeks. Others can be life-threatening (Bacterial) and require emergent antibiotic treatment.

The best way to protect yourself and your child of bacterial meningitis is to complete the recommended vaccine schedule and also maintaining a healthy lifestyle!

Glaucoma

What Is Glaucoma?

Glaucoma is a condition that causes damage to your eye’s optic nerve and gets worse over time. It’s often linked to a build-up of pressure inside your eye. Glaucoma tends to be inherited and may not show up until later in life. The increased pressure, called intraocular pressure, can damage the optic nerve, which transmits images to your brain. If the damage continues, glaucoma can lead to permanent vision loss. Without treatment, glaucoma can cause total permanent blindness within a few years.

What Causes Glaucoma?

It’s the result of high fluid pressure inside your eye. This happens when the liquid in the front part of the eye doesn’t circulate the way it should.

It’s  passed from parents to children.

Less common causes include a blunt or chemical injury to your eye, severe eye infection, blocked blood vessels inside the eye, and inflammatory conditions. It’s rare, but sometimes eye surgery to correct another condition can bring it on. It usually affects both eyes, but it may be worse in one than the other.

Who Gets Glaucoma?

You’re more likely to get it if you:

  • Are over 40
  • Have a family history of glaucoma
  • Have poor vision
  • Have diabetes
  • Take certain steroids medication, like prednisone
  • Have had trauma to the eye or eyes

In most cases, Glaucoma does not have any symptoms, until one starts experiencing vision lost, but some cases, you may feel the following symptoms ,which you would have to seek immediate medical care:

  • Seeing halos around lights
  • Vision loss
  • Redness in the eye
  • Eye that looks hazy (particularly in infants)
  • Nausea or vomiting
  • Eye pain
  • Narrowed vision (tunnel vision)

How Is It Diagnosed?

Through Glaucoma vision Screening

How Is Glaucoma Treated?

Your doctor may use prescription eye drops, laser surgery, or microsurgery.

Can You Prevent Glaucoma?

No. But if you diagnose and treat it early, you can control the disease.

What’s the Outlook?

Vision lost to Glaucoma can’t be restored,but the good part of the vision that is left can be maintained, and further damage prevented.

Hence,the need to go for a Glaucoma Screening!

Free Glaucoma screening available at Nisa Hospital 

Date: March 13th -18th

Time: 8:am – 4pm daily

You could contact us on any of these numbers: 07038891805, 08175754485

 

 

International Women’s day!

 International Women’s day!

Being  International Women’s day!, we are looking at infertility in women, so we could reduce if possible ,eradicate this issue completely by proffering solutions!

Infertility is a condition that affects approximately 1 out of every 6 couples. An infertility diagnosis is given to a couple that has been unsuccessful in efforts to conceive over the course of one full year. When the cause of infertility exists within the female partner, it is referred to as female infertility. Female infertility factors contribute to approximately 50% of all infertility cases, and female infertility alone accounts for approximately one-third of all infertility cases.

Female Infertility: Causes, Treatment And Prevention

What causes female infertility?

The most common causes of female infertility include problems with ovulation,  damage to fallopian tubes or uterus, or problems with the cervix. Age can contribute to infertility because as a woman ages, her fertility naturally tends to decrease.

Ovulation problems may be caused by one or more of the following:

  • A hormone imbalance
  • A tumor or cyst
  • Eating disorders such as anorexia or bulimia
  • Alcohol or drug use
  • Thyroid gland problems
  • Excess weight
  • Stress
  • Intense exercises that causes a significant loss of body fat
  • Extremely brief menstrual cycle

Damage to the fallopian tubes or uterus can be caused by one or more of the following:

  • Pelvic inflammatory disease
  • A previous infection
  • Polyps in the uterus
  • Endometriosis or fibroids
  • Scar tissue or adhesions
  • Chronic medical illness
  • A certain ectopic (tubal) pregnancy
  • A birth defect
  • DES syndrome (The medication DES, given to women to prevent miscarriage or premature birth can result in fertility problems for their children.)

Abnormal cervical mucus can also cause infertility. Abnormal cervical mucus can prevent the sperm from reaching the egg or make it more difficult for the sperm to penetrate the egg.

How is female infertility diagnosed?

Potential female infertility is assessed as part of a thorough physical exam. The exam will include a medical history regarding potential factors that could contribute to infertility.

Healthcare providers may use one or more of the following tests/exams to evaluate fertility:

  • A urine or blood test to check for infections or a hormone problem, including thyroid function
  • Pelvic exam and breast exam
  • A sample of cervical mucus and tissue to determine if ovulation is occurring
  • Laparoscope inserted into the abdomen to view the condition of organs and to look for blockage, adhesions or scar tissue.
  • HSG, which is an x-ray used in conjunction with a colored liquid inserted into the fallopian tubes making it easier for the technician to check for blockage.
  • Hysteroscopy uses a tiny telescope with a fiber light to look for uterine abnormalities.
  • Ultrasound to look at the uterus and ovaries. May be done vaginally or abdominally.
  • Sonohystogram combines an ultrasound and saline injected into the uterus to look for abnormalities or problems.

Tracking your ovulation through fertility awareness will also help your healthcare provider assess your fertility status

How is female infertility treated?

Female infertility is most often treated by one or more of the following methods:

  • Taking hormones to address a hormone imbalance, endometriosis, or a short menstrual cycle
  • Taking medications to stimulate ovulation
  • Using supplements to enhance fertility
  • Taking antibiotics to remove an infection
  • Having minor surgery to remove blockage or scar tissues from the fallopian tubes, uterus, or pelvic area.

Can female infertility be prevented?

There is usually nothing that can be done to prevent female infertility caused by genetic problems or illness.

However, there are several things that women can do to decrease the possibility of infertility:

  • Take steps to erase sexually transmitted diseases
  • Avoid illicit drugs
  • Avoid heavy or frequent alcohol use
  • Adopt good personal hygiene and health practices
  • Have annual check ups with your GYN once you are sexually active

When should I contact my healthcare provider?

It is important to contact your healthcare provider if you experience any of the following symptoms:

  • Abnormal bleeding
  • Abdominal pain
  • Fever
  • Unusual discharge
  • Pain or discomfort during intercourse
  • Soreness or itching in the vaginal area

Some couples want to explore more traditional or over the counter efforts before exploring infertility procedures. If you are trying to get pregnant and looking for resources to support your efforts, we invite you to check us out at Nisa Premier Hospital, Jabi, Abuja.

However, if you are looking for testing or options to increase your fertility chances of conception, you can find a fertility specialist her at Nisa Premier Hospital or call +2348172410027.

 

Open Day/Free Counseling

Nisa Premier Hospital IVF clinic features an Open Day/Free Counseling service, which include general talk on infertility and gynaecology. Presented and discussed by eminent Specialists. You will find answers to all your questions on these topics, and more:

Ovulatory problems
 Pelvic and tubal factor
 Cervical factor
Fibroid
 Male infertility
Unexplained infertility
 Endometriosis
This takes place every 1st Saturday of the month at our hospital premises.

Understanding Breast Cancer — Diagnosis & Treatment

How Is Breast Cancer diagnosed

Treatment of breast cancer work best when you find the disease early. So it’s important to get the right screening test at the right time.If you’re diagnosed with the disease, it helps to learn as much as you can about your treatment options before you choose the one you want.

Breast Self-Exams and Mammograms

Breast self-exams are a cancer screening option for women starting in their 20s. Experts don’t agree on whether every woman needs to do them, so talk to your doctor about the pros and cons of checking your breasts and if it’s a good idea for you to start. If you decide to do them, ask your doctor to show you the right way to do it and what to watch for.

To do a self-exam, you’ll need to look at and feel your breasts. Stand in front of a mirror to look for dimpling or changes in shape or symmetry. The rest of the breast self-exam is easiest in the shower, using soap to smooth your skin With light pressure, check for lumps near the surface. Use firm pressure to explore deeper tissues. Gently pinch all parts of your nipple and the colored area around it, called the areola. If there is any discharge from your nipple — especially if it is bloody — see a doctor.

It may be better to do a self-exam 3 to 5 days after your period ends. Premenstrual changes can make your breast tissue feel thicker in some places, but it goes away after your period is over. Any time you find a new or unusual lump in your breast, have your doctor check it.

Mammograms are the most effective way to detect breast cancer.They can find lumps up to 2 years before you or a doctor can feel them by hand. But medical experts don’t agree on how often women need them. It is recommended that women have one every year starting at age 45. But the U.S. Preventive services Task Force says women should have mammograms every 2 years between the ages of 50 and 74. The group says that there is not enough research to know whether screening after age 74 is a good idea. The decision about when to have a mammogram is personal. If you’re over 40, talk to you doctor about when you should begin.

If you do find a lump during a self-exam or your doctor sees one on a mammogram, remember that most lumps aren’t Cancer.But it’s still important for your doctor to test it. There are a few different tests she might use. Imaging tests such as digital mammography,3-D mammography ,and ultrasounds can help her see if the lump has the physical features of a tumor. The only way to confirm that it’s cancer is to take some of the cells from the lump and look at them under a microscope. Your doctor can do this with a biopsy that uses a very thin needle.

What Are the Treatments for Breast Cancer?

If you have breast cancer,the earlier you can get treatment, the better. But before you decide what to do, research your options. Ask questions of your doctor, other specialists, and people who’ve had breast cancer. Find a doctor you trust, and don’t feel you have to rush to make a choice. A brief delay between diagnosis and treatment won’t make your therapy less effective. The treatment options for breast cancer depend on the size of your tumor and how far it has spread in your body, your age, and how healthy you are.

Surgery for Breast Cancer

For most people, the first step is to remove breast cancer with surgery, followed usually by some mix of radiation therapy, chemotherapy hormone therapy. The standard surgery for breast cancer used to be the removal of the entire breast and lymph nodes nearby, called a modified radical mastectomy.But today, many women who find breast cancer before it has spread can remove just the lump.

This operation, called a lumpectomy has proven to work just as well as mastectomy and the physical changes it causes are much less drastic. After this type of surgery, most women also get radiation therapy, chemotherapy,or hormone therapy. For breast cancer that has spread in the body and for disease that has come back after treatment, surgery usually isn’t the main treatment option.

Chemotherapy for Breast Cancer

This treatment uses powerful drugs to kill cancer cells. Your doctor might recommend it after you have surgery to kill any remaining cancer that the operation left behind. It helps reduce the chance that breast cancer will come back. If your tumor is large, you might get chemotherapy before surgery to shrink it so it’s easier to remove. Chemotherapy or hormone therapy are the main treatments for women whose cancer has spread to parts of the body outside of the breast and lymph nodes.

Radiation Therapy for Breast Cancer

In this treatment, high-energy waves destroy cancer cells. Doctors usually give radiation therapy after a lumpectomy and sometimes after a mastectomy to reduce the risk of cancer coming back in the same breast. The treatments generally start a few weeks after the surgery so the area has some time to heal. They can last for several days or a few weeks. If your doctor recommends chemotherapy along with radiation therapy, you’ll have the chemo first.

The type of radiation that most people know about is called external beam radiation. A machine focuses a beam of radiation on the tumor. It’s the most common type of radiation therapy for breast cancer.

The other type is called brachytherapy. It delivers radiation to the cancer through radioactive seeds or pellets — as small as grains of rice — that doctors place inside the breast near the cancer. You can get brachytherapy by itself or with external beam radiation. Tumor size, location, and other things determine if this type of radiation is right for you.

Reconstructive Breast Surgery

After a mastectomy, reconstructive plastic surgery can replace breast tissue that doctors had to remove along with the cancer, including skin and the nipple. The goal of reconstruction is to give the two breasts the same size and shape again. You might get breast implants or doctors can move tissue from other parts of your body to your breast. Doctors can do it at the same time as the operation to remove the cancer or after you’re finished with chemotherapy or radiation.

Hormone Therapy for Breast Cancer

When your doctor diagnoses you with breast cancer, she’ll see if lab tests show that your tumor depends on your natural hormones, estrogen or progesterone grow. If they do, she’ll call your disease estrogen receptor-positive or progesterone-receptor-positive breast cancer.

Hormone therapy, also called endocrine therapy, blocks your body’s natural hormones from reaching the cancer cells that use them. There are a few types. You can take drugs to block the effects of estrogen, have surgery to remove your ovaries (which make estrogen), or take medicine or have radiation to make the ovaries stop making the hormone.

The estrogen-blocking drug tamoxifen (Soltamox) is one of the most common hormone therapy drugs. Studies show that it lowers the chance that some early-stage cancers will come back and prevents cancer in the opposite breast. Tamoxifen works by blocking estrogen from attaching to cancer cells, which keeps them from growing.

Tamoxifen works for women before and after menopause.Most people take it for 5-10 years. While you take it, you should have a pelvic exam once a year, and let your doctor know if you have any unusual pain or bleeding.

Other types of hormone therapy keep the body from changing testosterone into estrogen. These drugs are called aromatase inhibitors. Examples are anastrozole (Arimidex) ,exemastane (Aromasin), and letrozole (Fermara) They only work in postmenopausal women, but they work better than tamoxifen. Most people take them for 5-10 years.

For premenopausal women, doctors sometimes can treat breast cancer by making the ovaries stop working. The treatment, called ovarian ablation, means removing the ovaries with surgery, treating them with radiation, or blocking the hormone that makes them work with a group of drugs known as LHRH or GnRH agonists. Most of the time, doctors use this treatment for cancer that has spread beyond the breast.

Targeted Therapy for Breast Cancer

Targeted therapy is another way to fight cancer. About 25% of women with breast cancer have too much of a protein known as HER2, which makes the cancer spread more quickly. Several targeted therapies fight HER2-positive breast cancer. Options include ado-trasumab emtansine (Kadcyla), lapatinip(Tykerb) ,pertuzumab (Perjeta), and trastuzumab (Herception) You can take them along with other medicines. For HER2-negative breast cancers, everolimus (Afinitor) or palbociclip (Ibrance) can treat women with advanced, hormone-receptor-positive breast cancer.

At-Home Recovery

After breast cancer surgery, a regular routine of simple exercises can ease muscle stiffness and help you move your body normally again. If you’ve had radiation, avoid wearing a tight-fitting bra or clothes that may irritate your skin around the treatment area. Keep your skin clean and wear loose clothing, and use only the skin lotions, creams, and deodorants that your doctor recommends.

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