December 2018health blog,men health ,women health,children health

LONG-TERM COMPLICATIONS OF DIABETES

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Eye complications

Diabetic retinopathy is a leading cause of visual disability. Significant retinopathy is rarely encountered in the first five years of type 1 diabetes mellitus, nor before puberty. However, over the subsequent two decades, the vast majority of people with diabetes develop retinal changes.
DAN (Diabetes Association of Nigeria) recommends that initial eyes examination should be done:

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⦁ Within 5 years after the onset of type 1 diabetes,
⦁ Shortly after the diagnosis of type 2 diabetes.
The eye examination should be repeated annually for both type 1 & 2 diabetes. Less frequent examination (every 2-3 years) may be considered one or more normal eye exams.
Good control of diabetes results in the occurrence of retinopathy. Timely laser photo-coagulation has been gdemonstrated to prevent a major proportion of severe visual loss associated with proliferative retinopathy. It has also been shown to be of considerable benefit to patients with macular edema.
To prevent retinopathy and visual loss, the following are recommended:
⦁ Promoting good glycaemic control in all diabetic individuals
⦁ Controlling blood pressure
⦁ Detecting and treating glaucoma at an early stage
⦁ Detecting and treating cataract.
⦁ Detecting and providing timely treatment of potentially serious retinal changes
DAN guideline also states that Aspirin does not increase the risk of retinal haemorrhage and its use for cardioprotection is not contraindicated in retinopathy.

Nephropathy

Diabetic nephropathy is a major cause of death among people with diabetes and an important cause of morbidity and increased health care costs due to diabetes. It leads to end-stage renal disease requiring dialysis or renal transplantation.
This complication maybe prevented and progression can be slowed by:
⦁ Strict glycaemic control
⦁ Vigorous treatment of hypertension
⦁ Avoidance of nephrotoxic drugs and early and effective treatment of infection.

The onset of clinical nephropathy is manifested by proteinuria. However an earlier marker of the onset of nephropathy is the presence of microalbuminuria (defined as an overnight excretion of 20-200 ɥg/min or excretion of >30 mg/24-hr) on more than one occasion.
The following action should be taken:
⦁ People with diabetes should have their urine tested at initial assessment and periodically at annual reviews.
⦁ In the absence of proteinuria, a test for microalbuminuria is recommended where local resources permit.
⦁ In the presence of microalbuminuria or gross proteinuria:
⦁ Full assessment of renal function should be performed periodically
⦁ Treatment of hypertension should be instituted as early as possible and good control should be achieved. Emphasis should be given to:
⦁ Avoidance of nephrotoxic drugs and early and effective treatment of infection
⦁ Optimal diabetes control
⦁ Dietary modifications in the form of reduced protein intake and salt restriction If the need arises
DAN guideline recommends the use of ACE inhibitors, ARBs in treating non-pregnant patient with micro- or microalbuminuria. It further recommends reduction in protein intake and monitoring of serum creatinine and potassium levels in patients on ACE inhibitor, ARBs or diuretics.

Neuropathy

Neuropathy is a common complication of diabetes. It causes clinical manifestations and disabilities of diverse spectrum and considerable severity. Both peripheral nerves (sensory and motor) and the autonomic nervous system can be affected. Patients present with distal symmetrical polyneuropathy (DPN), focal neuropathy or manifestations of autonomic involvement such as gastroparesis, constipation, diabetic diarrhea, bladder dysfunction, impotence and orthostatic hypotension.
Peripheral nerve affectation together with peripheral vascular disease predispose to foot ulcers and infection. If not detected early, these lesions may progress to gangrene and result in amputation.
Neuropathic involvement can be prevented or delayed by good glycaemic control. Foot complications can be avoided by good foot care and detection of early lesions.

Foot Care

Severe foot lesions requiring amputation are one of the major complications of diabetes.
The two main approaches to prevention are: (1) identification of high-risk individual, and (2) early detection of foot lesions: for example, trauma, infection or ulcers.
Intensified foot care should be ensured for patients at high risk, such as those with:

⦁ Symptoms and/or signs of neuropathic involvement

⦁ Evidence of peripheral vascular disease
⦁ Nephropathy or significant retinopathy
⦁ Foot deformities and chronic orthopedic or rheumatic disorders, and
⦁ Poor hygiene
Instructions on foot care should be an integral part of any educational activity on diabetes.
They should focus on:
⦁ Self examination
⦁ Avoidance of trauma
⦁ Cessation of smoking, and
⦁ Wearing properly fitted shoes.

1. Screening for diabetes during pregnancy

A substantial proportion of women of child bearing age develop gestational diabetes mellitus (GDM). GDM is defined as diabetes which is first detected during pregnancy. In order to prevent maternal and prenatal complications of diabetes, early detection of glucose tolerance abnormalities during pregnancy is important. Another advantage is screening for GDM is the fact that women who develop glucose intolerance during pregnancy will run higher risk of developing diabetes in the future; thus, detection of this abnormality provides the possibility of preventive intervention.

⦁ Screening is recommended at two stages during pregnancy: All pregnant women should be screened for diabetes during the first antenatal visit by testing for glycosuria. A positive test is an indication for further assessment by a 75 g oral glucose tolerance test.
⦁ At 24-28 weeks of gestation, women at high risk of developing GDM or IGT should be screened by means of an oral glucose tolerance test, using 75 g glucose load.
Those at high risk include women with:
⦁ Previous GDM or IGT
⦁ A family history of diabetes
⦁ Obesity
⦁ Adverse obstetric history
⦁ History of giving birth to a big baby
⦁ History of congenital malformation affecting the newborn in previous pregnancy
The WHO criteria for the diagnosis of glucose tolerance abnormalities can be used during the pregnancy.

Management

Good glycaemia control has special importance during pregnancy. Maternal and prenatal complications can be reduced if good control is achieved before and during conception. Good biochemical control before pregnancy is important since hyperglycaemia seems to be a major factor in the development of congenital malformations and the risk of these malformations is highest during the first eight weeks of gestation.
Guidelines for the management of diabetes during pregnancy

⦁ Intensive education and management of the woman with diabetes should start several months before conception to ensure strict control during the early weeks of pregnancy.
⦁ Pregnancy may have to be deferred until optimal control is achieved.
⦁ Women well controlled on oral hypoglycemic drugs should be changed over to insulin and achieve optimal blood glucose control before conception.
⦁ Those controlled on diet alone may continue on such therapy as long as they are carefully monitored to assess the need for insulin.
⦁ Therapy targets, prior to conception, should be achieved. Treatment should aim at having pre-prandial and postprandial glucose levels which are close to normal as well as normal or near normal glycated hemoglobin levels (i.e., A1C, if such measurement is available).
⦁ Full clinical assessment is needed. Renal and retinal complications should be looked for.
⦁ During pregnancy frequent follow-up is needed to insure that therapy target is meet without significant hypoglycaemia. Review every two or four weeks is generally recommended but should be more frequent if required.
⦁ Early morning urine should be tested for ketones, if indicated, to rule out starvation. Urine glucose measurement, however, is no longer reliable during pregnancy because of change in the renal threshold Insulin is preferably given three to four times per day. Some patient may be controlled with two daily injections of a mixture of short- and intermediate- acting insulin.
⦁ Delivery should be planned jointly by the physician and the obstetrician. It can take place at term without surgical intervention but earlier induction of caesarean section may be needed for obstetric reasons.
⦁ Following delivery, frequent blood glucose monitoring is needed to avoid hypoglycaemia and to adjust the insulin dose which diminishes dramatically at this stage.
⦁ Postpartum follow-up and counseling will be needed in all cases.

You can’t do anything about your age or your genetic predisposition. On the other hand, the rest of the factors predisposing to diabetes, such as overweightness, abdominal obesity, sedentary lifestyle, eating habits and smoking are up to you. Your lifestyle choices can completely prevent type 2 diabetes or at least delay is onset a much greater age.
If there is diabetes in your family, you should be careful not to weight over the years. Growth of the waistline, in particular, increases the risk of diabetes, whereas regular moderate physical activity will lower the risk. You should also pay attention to your diet; take care to eat plenty of fiber-rich cereal products and vegetables every day. Omit excess hard fats from your diet and favour soft vegetable fats.
Early stages of type 2 diabetes seldom cause any symptoms. If you scored 12-14 points in the Risk Test, you would be well advised to seriously consider your physical activities and eating habits and pay attention to your weight, to prevent yourself from developing diabetes. Please contact your doctor for further guidance and tests.
If you score 15 points or more in the Risk Test, you should have your blood glucose measured (both fasting value and value after a dose of glucose or a meal) to determine if you have diabetes without symptoms.

Body-mass index: if your body-mass index is 25-30, you will benefit from losing weight; at least you should take care that your weight does not increase beyond this. If your body-mass index is higher than 30, the adverse health effects of obesity will start to show, and it will be essential to lose weight.

One study showed that out of 116 type 2 Diabetes Mellitus patient on hospital admission (aged 35-64 years), 19% of them died. Most common causes of deaths include hyperglycaemic emergencies, diabetic foot ulcer, cerebral vascular accident, hypoglycaemia, and chronic renal failure.
80% of diabetes death occurs in low and middle income countries like Nigeria.

In developed countries most people with diabetes are above the age of retirement, whereas in developing countries those most frequently affected are aged between 35 and 64.

In 2011, an estimated 14.7 million adults in the Africa Region were suffering from diabetes which resulted in 344,000 deaths. WHO estimates these numbers will more than double by 2030 without urgent action. This rising trend is driven by factors such as modernization, rapid urbanization and lifestyles marked by reducing physical activity and eating habits involving the higher intake of refined sugar and saturation fats.
According to the Diabetes Association of Nigeria (DAN), at least 5 million Nigerians (approx. 2.2% mean national prevalence) are living with diabetes. The prevalence varies from 0.65% in rural Mangu (North), 6.8% in Port Harcourt city (Niger Delta) to 11.0% in urban Lagos. WHO date indicates that Nigeria has the highest number of people living with diabetes in Sub-Saharan Africa.

Control and prevent of diabetes requires continuing access to medication, equipment (glucose - measuring meters and test strips) and trained healthcare professionals. In Nigeria, effort to achieve control of this rising pandemic is faced with numerous challenges: absent or poorly organized service for the care of chronic disease like diabetes; limited public awareness about diabetes; lack of national diabetes management & education program for patient and healthcare professional insufficient access to affordable drugs and devices for diabetes management.

Diabetes care is a term effort involving the patient, diabetes educators, and physician nurse and pharmacist. We know that diabetes education is essential for preventing and managing the disease. And here is the Good News. Patient that are risk for diabetes can be motivated with the knowledge that the onset of type 2 diabetes can be prevented or delayed through proper lifestyle modification:
⦁ Better food choices
⦁ Regular physical activity
⦁ Moderate weight loss (5-10% of body weight)
⦁ Medications

What is Hypoglycaemia

Hypoglycaemia

Hypoglycemia is a common complication of diabetes treatment particularly with Insulin and insulin secretagogues like sulfonylureas. It is more dangerous in the elderly and occurs consistently more often as glycaemic targets are lowered. It may lead to dysrhythmias, but can also lead to accidents and falls, dizziness (leading to falls), confusion (so other therapies may not be taken or taken incorrectly) or infection (such as aspiration during sleep, leading to pneumonia). Severe episode can lead to serious complications and may be potentially fatal if left untreated.
Hypoglycemia is more likely to occur under the following circumstances:

Omission of meals or inadequate food intake
With unaccustomed physical exercise
Overtreatment with insulin or sulfonylureas
Ingestion of alcohol particularly without food
Diminishing insulin requirement due to impaired renal function.

The Diabcare Nigeria study shows that hypoglycaemia is a leading cause of hospital admission and is associated with about 3% of deaths in the diabetes population.

Early Recognition & Treatment of hypoglycaemia: Patient Information

Hypoglycaemia, also known as low blood sugar, occurs when levels of glucose (sugar) in the blood are too low (less than 70mg/dL or mmol/L). Hypoglycemia is common in people who take insulin and some of the oral medications like insulin secretagogues (sulfonylurea & meglitinides). It can occur suddenly and can be a medical emergency. Know how to prevent, recognize and treat it.

Know the causes – some are avoidable

⦁ Taking too much medication – insulin or oral agents like sulfonylurea

⦁ Vigorous exercise or increased physical activities without adjusting the dosage of medication.

⦁ Drinking alcohol excessively and/or without food.

Know your symptoms

⦁ Symptoms from low blood sugar can vary from one person to anotNot eating on time or missing a scheduled meal; not eating enough her, and can also change with time. The early symptoms showing our blood is low may include:

⦁ Felling shaky, cold, clammy, sweaty, anxious, nervous, heart pounding or racing, unusual hunger, nausea, tingling

⦁ Then confused, irritable, drowsy, unsteady, blurred version, headache
If not treated immediately, there may be seizures and loss of consciousness

Know how to prevent it

The best way to prevent low blood sugar is to monitor your blood sugar levels frequently and be prepared to treat it properly at all times. You and a close friend or relative need to learn the symptoms and should always carry glucose tablets, hard candy, or other sources of fast – acting carbohydrate. Take your medications as prescribed. Keep to regular meal schedule. Do not skip meals.

Drinking alcohol in moderation only – that two units of alcohol per day for a woman and three units per day for a man. For example, a small glass of wine or half a pint of normal – strength beer in one unit. Never drink on an empty stomach, as alcohol can make hypoglycemia (low blood glucose levels) more likely to occur.

Whenever possible, check your blood sugar before driving, and before & after exercise.

Always carry a fast – acting sources of carbohydrate with you.

Know your treatment

Immediately you start experiencing any form of the symptoms of low blood sugar test your blood glucose (if possible). If it is less than 70mg/dL, eat or drink a fast – acting carbohydrate (15g) equivalent to about:

⦁ 3-4 glucose tablets.

⦁ ¾ cup of juice or regular soft drink (not diet coke or Pepsi).

⦁ 3 tea spoon of packet sugar.

⦁ 1 tablespoon of honey.

It is important not to over treat as that will raise your blood glucose level. Foods that contain fast (like candy bars) or protein (cheese) can show down your body ability to absorb glucose and should not be used for initial treatment of low blood sugar.

After taking the carbohydrate sources wait 15 minute and recheck your blood glucose. If it is still less than 70mg/dL, repeat treatment. You may need to repeat the same process if needed until your BG level is above 70mg/dL. Thereafter you should plan your next meal to eat or snack if it is more than one hour away.

Sometimes your blood glucose may go so low that you are unable to swallow. This may require you to get an injection of glucagon, or glucose infusion in the hospital.

See your doctor if:

You have nocturnal hypoglycaemia (low blood sugar that occurs while you are sleeping)

You are having low blood sugar very often

You experience vision changes, confusion, fainting or unconsciousness.

Definition of Diabetes Mellitus

Diabetes Mellitus
Diabetes is a metabolic disorder characterized by the presence of hyperglycemia due to defective insulin secretion insulin action or both. Chronic hyperglycaemia is associated with significant long term complications including damages, dysfunction and failure or various organs especially the kidneys’ eyes and nerves and is associated with markedly increased risk or cardiovascular morbidity and mortality.

Types of Diabetes
Type 1 Diabetes: " A chronic condition in which the pancreas produces little or no insulin "Formerly known as insulin dependent diabetes mellitus (IDDM). Occurs as a result of beta cell destruction, usually leading to absolute insulin deficiency. Individuals are prone to diabetic ketoacidosis, are usually lean and complain of weight loss, polyuria, polydipsia and fatigue at time of diagnosis. Tends to occur in younger people, under age 40, but can occur at any age. Include cases due to an autoimmune process or other unknown aetiology.

Type 2 Diabetes:"A chronic condition that affects the way the body processes blood sugar (glucose)."Formerly known as non-insulin dependent diabetes mellitus )NIDDM), a misnomer because some patients with this type of diabetes do require insulin therapy. Occurs as a result of a range of defects from predominant insulin resistance with relative insulin deficiency to a predominant secretory defect with or without insulin resistance. Individuals are often obese but can be lean.Many newly diagnosed patients are asymptomatic, but may present with polydipsia, polyuria and polyphagia. Ketoacidosis is usually a sign of advanced disease but is relatively uncommon. Tends to occur in older people over 40 but can occur at younger age especially in certain ethnic groups such as blacks Hispanics.

Gestational Diabetes:"A form of high blood sugar affecting pregnant women."Diabetes that is associated with glucose intolerance with onset
or first recognitions during pregnancy.

Prediabetes:"A condition in which blood sugar is high, but not high enough to be type 2 diabetes." It is usually associated with obesity, dyslipidaemia and high blood pressure. Individuals with prediabetes have increase risk of developing type 2 diabetes and cardiovascular disease

For Healthy Skin:

1. Drink plenty of water during the day (around

eight large glasses), to prevent dehydration

and assist the elimination of toxins.

2. Recent research has shown that smoking

destroys collagen, making skin age more rapidly.

3. Protect your skin from the drying effects of sun

and wind. Dermatologists recommend the daily

use of a moisturizer with a SPF 15 sunscreen.

4. Cleanse skin thoroughly every day, using either

a cream, or warm water and mild facial wash.

Avoid pulling the fine skin around the eyes.

5. Avoid touching your face too much as this can

spread bacteria. Squeezing blemishes can

cause facial scarring.

For Healthy Hair:

1. When washing always use warm water followed

by a cool rinse.

2. Excessive blow-drying can damage your hair.

Hold the dryer at least eight inches from your

hair and keep it moving.

3. Even when trying to grow hair, the ends should

should be trimmed every eight weeks. Splits can travel

right up the hair shafts if neglected.

4. Brushing stimulates circulation in the scalp and

distributes the hair’s natural oils to create shine.

Natural bristles with rounded ends, and wide

tooth combs are kinder to the hair.

5. Gentle scalp massage, using the finger pads,

Promotes circulation and reduces scalp tension.

Hair is nourished through the bloodstream, but is

Sometimes lower on the body’s priority list. Trauma,

stress or illness can switch nutrients away from the

hair’s roots, to where they are.

For Healthy Nails:

Nails are similar to hair in composition and rely on

nutrients from the bloodstream for their growth

and health.

1. To protect your nails, use the pads of your

fingers to type or dial the telephone.

2. Frequent wetting and dying of hands can leave

nails brittle. Use rubber gloves every time you

wash dishes.

3. never cut the cuticle or use any instrument

Underneath.

4. Manicurists recommend filing nails in one direction only.

5. Hands and nails are often dry. Keep a rich

cream with sunscreen in your bag or desk

drawer and re-apply during the day.

It works fast and it is suitable for children and adults.......

All you need to know about Apetamin :Apetamin contains a unique combination of Cyproheptadine , lysine and vitamin. Cyproheptadine and lysine being an essential and limiting amino acid helps to promote appitite. Besides helping in the Synthesis of collagen tissue. lysine also helps to improve immunity during infancy childhood and adolescence.

8 FACTS ABOUT YELLOW FEVER

Yellow fever is an acute viral haemorrhagic disease transmitted by infected mosquitoes. The "yellow" in the name refers to the jaundice that affects some patients.
Symptoms of yellow fever include fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue.
A small proportion of patients who contract the virus develop severe symptoms and approximately half of those die within 7 to 10 days.
The virus is endemic in tropical areas of Africa and Central and South America.
Large epidemics of yellow fever occur when infected people introduce the virus into heavily populated areas with high mosquito density and where most people have little or no immunity, due to lack of vaccination. In these conditions, infected mosquitoes of the Aedes aegypti specie transmit the virus from person to person.
• Yellow fever is prevented by an extremely effective vaccine, which is safe and affordable. A single dose of yellow fever vaccine is sufficient to confer sustained immunity and life-long protection against yellow fever disease. A booster dose of the vaccine is not needed. The vaccine provides effective immunity within 10 days for 80-100% of people vaccinated, and within 30 days for more than 99% of people vaccinated.
Good supportive treatment in hospitals improves survival rates. There is currently no specific anti-viral drug for yellow fever.

The Eliminate Yellow fever Epidemics (EYE) Strategy launched in 2017 is an unprecedented initiative. With more than 50 partners involved, the EYE partnership supports 40 at-risk countries in Africa and the Americas to prevent, detect, and respond to yellow fever suspected cases and outbreaks. The partnership aims at protecting at-risk populations, preventing international spread,and containing outbreaks rapidly. By 2026, it is expected that more than 1billion people will be protected against the disease.

Signs and symptoms

Once contracted, the yellow fever virus incubates in the body for 3 to 6 days. Many people do not experience symptoms, but when these do occur, the most common are fever, muscle pain with prominent backache, headache, loss of appetite, and nausea or vomiting. In most cases, symptoms disappear after 3 to 4 days.

A small percentage of patients, however, enter a second, more toxic phase within 24 hours of recovering from initial symptoms. High fever returns and several body systems are affected, usually the liver and the kidneys. In this phase people are likely to develop jaundice (yellowing of the skin and eyes, hence the name ‘yellow fever’), dark urine and abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Half of the patients who enter the toxic phase die within 7 - 10 days.

Prevention

1. Vaccination is the most important means of preventing yellow fever.

The yellow fever vaccine is safe, affordable and a single dose provides life-long protection against yellow fever disease. A booster dose of yellow fever vaccine is not needed.Several vaccination strategies are used to prevent yellow fever disease and transmission: routine infant immunization; mass vaccination campaigns designed to increase coverage in countries at risk; and vaccination of travellers going to yellow fever endemic areas.

2. Personal preventive measures such as clothing minimizing skin exposure and repellents are recommended to avoid mosquito bites. The use of insecticide-treated bed nets is limited by the fact that Aedes mosquitos bite during the daytime.

3. Always perform good hand hygiene including regular washing of hands with soap. this is especially important before eating and after using the toilet.Prepare your own food rather than buy cooked food from outside.As much as possible avoid shaking hands and hugging because it is so easily contactable. And do not be offended if others decline to shake your hand

4. Avoid large crowds, public transportation and funerals as much as possible especially funerals where the dead died as a result of a brief unexplained illness

Treatment

Good and early supportive treatment in hospitals improves survival rates. There is currently no specific anti-viral drug for yellow fever but specific care to treat dehydration, liver and kidney failure, and fever improves outcomes. Associated bacterial infections can be treated with antibiotics.

porstate cancer : symptoms , causes and prevention

Prostate cancer is cancer that occurs in the prostate — a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer in men. Usually prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer that's detected early — when it's still confined to the prostate gland— has a better chance of successful treatment

Symptoms

Prostate cancer may cause no signs or symptoms in its early stages.

Prostate cancer that's more advanced may cause signs and symptoms such as:

Trouble urinating
Decreased force in the stream of urine
Blood in semen
Discomfort in the pelvic area
Bone pain
Erectile dysfunction

Causes

It's not clear what causes prostate cancer.

Doctors know that prostate cancer begins when some cells in your prostate become abnormal. Mutations in the abnormal cells' DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can also break off and spread (metastasize) to other parts of the body.

Risk factors

Factors that can increase your risk of prostate cancer include:

Age. Your risk of prostate cancer increases as you age.
Race. For reasons not yet determined, black men carry a greater risk of prostate cancer than do men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced.
Family history. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.
Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.

Complications

Complications of prostate cancer and its treatments include:

Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, such as your bladder, or travel through your bloodstream or lymphatic system to your bones or other organs. Prostate cancer that spreads to the bones can cause pain and broken bones. Once prostate cancer has spread to other areas of the body, it may still respond to treatment and may be controlled, but it's unlikely to be cured.
Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. 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.
Erectile dysfunction. Erectile dysfunction can result from prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.

Prevention

You can reduce your risk of prostate cancer if you:

Choose a healthy diet full of fruits and vegetables. Avoid high-fat foods and instead focus on choosing a variety of fruits, vegetables and whole grains. Fruits and vegetables contain many vitamins and nutrients that can contribute to your health.

Whether you can prevent prostate cancer through diet has yet to be conclusively proved. But eating a healthy diet with a variety of fruits and vegetables can improve your overall health.
Choose healthy foods over supplements. No studies have shown that supplements play a role in reducing your risk of prostate cancer. Instead, choose foods that are rich in vitamins and minerals so that you can maintain healthy levels of vitamins in your body.
Exercise most days of the week. Exercise improves your overall health, helps you maintain your weight and improves your mood. There is some evidence that men who don't exercise have higher PSA levels, while men who exercise may have a lower risk of prostate cancer.

Try to exercise most days of the week. If you're new to exercise, start slow and work your way up to more exercise time each day.
Maintain a healthy weight. If your current weight is healthy, work to maintain it by exercising most days of the week. If you need to lose weight, add more exercise and reduce the number of calories you eat each day. Ask your doctor for help creating a plan for healthy weight loss.
Talk to your doctor about increased risk of prostate cancer. Men with a high risk of prostate cancer may consider medications or other treatments to reduce their risk. Some studies suggest that taking 5-alpha reductase inhibitors, including finasteride (Propecia, Proscar) and dutasteride (Avodart), may reduce the overall risk of developing prostate cancer. These drugs are used to control prostate gland enlargement and hair loss in men.

However, some evidence indicates that men taking these medications may have an increased risk of getting a more serious form of prostate cancer (high-grade prostate cancer). If you're concerned about your risk of developing prostate cancer, talk with your doctor.

1. Codeine is a pain killer but also an addictive opioid. Taken in excess, it can cause Schizophrenia and organ failure among other health related defects.
2. The massive patronage of the illicit codeine trade largely rests on the shoulders of teenagers, young adults insatiably looking for a quick high – the current growing trends in Nigeria. Surprisingly, young women take it more, including pregnant women.
3. Though codeine is mostly imported, the syrup is made in Nigeria by more than 20 pharmaceutical companies.
4. The price of a bottle of the syrup which used to be between N150-N200 has escalated to between N1,000 and N1,200 per bottle, depending on the syrup mixed with the codeine. Serious addicts can consume as much as four bottles per day.
5. Even though it is illegal to sell codeine cough syrups without a doctor’s prescription, the drug remains common. It addicts mix it with soft drinks like coke and this can be taken anywhere under the guise that the consumer is just taking a soft drink- it is not as soft as it seems.
6. The abuse of substance like codeine is more acute in the northern part of the country. A restriction on alcohol in the region has made youth in dire need of “highness” to turn to codeine, tramadol, rohypnol and other cheap opioid-based drugs.
7. Over three million bottles of codeine syrup are consumed daily in Kano and Jigawa States alone, according to the Nigerian Senate.
8. NDLEA is fighting this epidemic. In a recent raid, it seized 24,000 bottle of codeine syrup from a single lorry in Katsina.
9. The widespread abuse of codeine is also highly influenced by Nigerian musicians, who use their lyrics to promote the intake of such drugs as the ‘new cool’.
10. When taken, codeine addicts feel dizzy, slow, numb and even hallucinate.

Tramadol

Tramadol is an opioid analgesic. It was first manufactured in Germany with the generic name “Ultram”. It is prescribed to treat moderate to moderately sever pain and is considered a safer alternative to other narcotic analgesics like hydrocodone, and methadone.
It is delivered in two forms.
For medical purposes, such as surgeries or for severe pain, it is given intravenously as an injection or passed as drips.
It is sold in Nigeria in tablet form and green capsules of between 50mg to 400mg. When taken in pill form at high doses, some of its less desirous side-effects include nausea, diarrhea, loss of appetite and dry mouth.
In the inverse, tramadol, can produce a euphoric similar to another commonly abused opiate medication, oxycodone (OxyContin).

Although Tramadol is not the strongest of analgesics, it is a darling on prescription lists. That’s because unlike other opioids such as methadone and fentany1, Tramadol is not internationally regulated, hence it is cheap and readily available for patients. Doctors prescribe tramadol in case of post-surgical pains, bone deficiencies and cancer.

However, in the last decade, Nigeria has been a significant rise in the non-medical use of Tramadol, which produces similar effects to the “high” caused by heroin.

Reasons why Tramadol is been abused in Nigeria

In addition to its highness, it is also abused for the feeling of numbness from pain, lucidity and extreme alertness that it gives by heightening the senses.
The numbness that Tramadol brings is one of the main reasons why it has become a drug of choice. Users describe the feeling high on tramadol as “forgetting everything that does not matter”, especially when combined with alcohol.
The popularity of tramadol brings is not only for its pain relief. Abusers believe it enhances sexual performance in men, Researchers believe Tramadol’s aphrodisiac properties could stem from its anatagonism of serotonin receptors hence delaying ejaculation.

What Is Breast Cancer?

Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop.

Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor.

A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body.

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

Breast Anatomy
Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor (see the Stages of breast cancer below for more information).

Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. Instead, 85-90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.

There are steps every person can take to help the body stay as healthy as possible, such as eating a balanced diet, maintaining a healthy weight, not smoking, limiting alcohol, and exercising regularly While these may have some impact on your risk of getting breast cancer, they cannot eliminate the risk.

Developing breast cancer is not your or anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.

Stages of breast cancer

The stage of a breast cancer is determined by the cancer’s characteristics, such as how large it is and whether or not it has hormone receptors. The stage of the cancer helps you and your doctor:

figure out your prognosis, the likely outcome of the disease
decide on the best treatment options for you
determine if certain clinical trials may be a good option for you

Breast cancer stage is usually expressed as a number on a scale of 0 through IV — with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body.

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