Monday, November 13, 2017

Beware of this ‘blue pill’ embarrassment



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Syriacus Buguzi
More by this Author

It is being said that these days, men are ‘not quite getting up’. That men are now struggling with getting an erection and keeping it up in the bedroom.
I am talking about the cases of Erectile Dysfunction (ED), which some studies indicate are on the increase in Tanzania and elsewhere. Well, this problem exists in our society is no longer news.
Cases could have also grown bigger in diabetic patients ever since 2014 when I read a study, titled: Prevalence of erectile dysfunction and associated factors among diabetic men attending diabetic clinic at Muhimbili National Hospital in Dar-es-Salaam. The rise in diabetic cases could have aggravated ED.
Last week, however, there was some bad news in Tanzania. A rumor was making rounds on social media that a student; somewhere in Dodoma had died after taking high doses of sildenafil or popularly known as Viagra pills; to boost his sexual “energy.”
While it is a widely known concept that drug overdose is dangerous, I encountered a lot of questions from members of the public who were eager to know the science behind the “deadly nature’’ or rather the health risks associated with taking larger doses of the diamond- shaped “blue pills.”
These pills can help a man in need of them by increasing blood flow to his penis. Since sexual performance is something of high priority for men, there is a possibility of them falling in the trap of abusing the pills.
But, here comes a strong caution that taking more of the pills than directed by a physician could lead to a permanent painful erection, and other potential health risks that could damage the penis.
That means, too much of it can lead to what we call priapism—a very large erection that lasts for more than four hours. It’s such a prolonged erection that can lead to permanent damage to the penile tissues.
What usually happens is that the pill works by relaxing the muscles in the penis, and allowing blood to flow in, causing an erection. When this is too much, more blood will flow to the muscles and cause the penis to engorge and swell up.   At one point, surgery could be required to rescue the swelling penis.
This drug can also lower blood pressure, so an increased dose could lead to increased risk of blood circulatory system problems, ranging from blood pressure fluctuations to heartbeat irregularities.
How will you know you are in trouble? The victim may begin experiencing blurry vision, sudden loss of hearing, other problems may follow, such as dizziness and ringing in the ears.
 
So, always strive to stay safe, make informed health choices!
six.buguzi@gmail.com

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Monday, November 13, 2017

Answering common questions on treating irregular teeth order

Dr Emeria Mugonzibwa  is a lecturer of

Dr Emeria Mugonzibwa  is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences 

By Emeria Mugonzibwa

In my last week’s article in Your Health titled ‘Are your teeth, jaws in wrong position’, I talked of dealing with conditions that require movement of the teeth done under a specialty called orthodontics.
Like I had mentioned, improper position of teeth and jaws is a problem facing people in our society and many of them don’t know how to deal with it.
But those who might be aware of the treatment or practice, have several questions and misconceptions that I would like to answer and clear. This should serve as a lesson and tips for all.

Q. Is the orthodontic treatment only cosmetic?
A.  Many people view orthodontic appliances as a mere cosmetic treatment that is only for people who care about their appearance.
Besides straightening teeth and creating a beautiful smile, orthodontic intervention corrects unhealthy bites (deep bite, open bite, crossbite, increased overjet, impacted teeth and misalignment) that can lead to greater oral health concerns.

Q. Are the orthodontic issues treatable in children only?
A. One in five orthodontic patients is an adult.

Q. How many years does aligning an improper teeth or jaw take?
A. Orthodontic treatment requires careful, controlled movements of the teeth to ensure they are moving into proper positions.
Simple cases may only take a few months to treat while the most complex cases take longer.
Orthodontists have the training, experience, and skill to deliver excellent results in the shortest amount of time.

Q. Is it a painful process?
A.  The adjustment period  of the appliances used during treatment, is a comfortable process. Some orthodontic appliances may be worn for a few months, depending on the respective malocclusion. 
To date, the materials being used for orthodontic treatment are significantly more comfortable than it used to in the past. Orthodontic appliances work better than ever without causing the patient pain.

Q. Do the tools fitted on the teeth or jaw have to always be tight to correct the teeth position?
A. It is a common misconception that the tighter the orthodontic tools, the better they work and the faster an individual completes treatment.
The truth is that too much tightness is bad for the teeth and will not fix alignment issues any faster.

Q. I read somewhere that signals from orthodontic appliance link to the Internet to download songs onto an iPod. How true it this?
A. This is not possible right now.

Q. What’s fixed on the teeth, the appliances that we often refer to, can trigger metal security detectors?
A. Orthodontic appliances are made of materials that do not interfere with metal detectors.

Q. Can the tools used on the teeth during treatment increase the patients’ chance of getting struck by lightning?
A. Patients wearing orthodontic appliances have the same chance of being struck by lightning as those without appliances (1 in 700,000!)

The author is a lecturer of Dentistry at Muhimbili University of Health and Allied Sciences (MUHAS).

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Monday, November 13, 2017

Fitness isn’t just about ‘looking’ good, here’s why



A woman exercising. Photo | TheCogni

A woman exercising. Photo | TheCogni 

By Insiyah Amiji

Most of us tend to admire the beautiful bodies of television celebrities and models, hoping someday we can achieve that! Well, that’s too good to be true but nothing is impossible, isn’t it?
So, does it mean if we lose weight, we are fit? Or that people who are fat are unfit? Is fitness related to exercise and ‘looking’ fit only? I believe the question we should be asking is: ‘what is fitness?’
According to the American Academy of Nutrition and Dietetics, fitness is “your own optimal health and overall well-being. Being fit not only means physical health, but emotional and mental health, too. It defines every aspect of your health. Smart eating and active living are fundamental to fitness.”
It’s the little things we should do each day that adds up to being healthy and fit. It is always a “work in progress” since there are many elements to a healthy lifestyle. Fitness is therefore an outcome of good nutrition and proper conditioning.
A lot of people eat fairly well and exercise, yet they often experience injury, constant pain, struggle with weight, constipation, hard time digesting food, mood fluctuations and fatigue. Diet and exercise isn’t enough to keep your body stable or efficient.  We need to view a human body beyond just fat and muscle ratios.
The following tips can guide you to adopting a healthy living. Bear in mind that fitness is not only about the ‘size’ that matters but there’s more to it.

1. Kick your bad habits
Habits in the “quit” category would be smoking, drugs, unsafe sex and other unhealthy addictions. There isn’t a healthy turn or way in doing the above things.

2. Get your check-up
Have an annual checkup with your family doctor. For those who are known cases of medical illnesses should at least have 3-6 monthly visits for a baseline check-up. Do various screenings for breast, prostate or any new growing skin lesions. This way you will be aware of what is abnormal in your body.

3. Sleep
Good sleep helps our body to recover, repair and rejuvenate. Lack of sleep affects our metabolism, mood, concentration, memory, stress hormones, immune system and cardiovascular health. Therefore, sleep well and keep your worries for the next day.


4. Exercise
Even if it is just a walk, exercise helps to strengthen the heart, lungs, muscles and increases flexibility.
Cardio and strength training helps muscles to contract while yoga improves its flexibility. There is absolutely ‘no excuse’ to not workout. In this fast paced life many of us cannot go to the gym. But we need to stay physically fit, so workout from home or with a group of people at your own comfort zone, engage in household activities, use the stairs instead of the elevator. You will only see results when you accept your body the way it is and make practical goals to achieve something. Remember it is a slow process.

5. Eat right
Fitness and health comes with smart eating habits. Eating a little bit of everything and having few cheat foods occasionally is totally okay! Incorporate fruits, vegetables and whole grains to your diet. Make a habit of reading the nutritional value for the food you consume. Human body needs 45-65 per cent carbohydrates, 10-35 per cent proteins and 25-35 per cent fats per day from the required total amount of calories we consume per day. Nutritionist recommend small frequent meals. Avoid processed foods, artificial sugars and high fat food.

6. Consistency and moderation
Make changes one at a time. By making too many changes at once, you will relapse into old habits. Make these choices as part of your daily routine to reach your goals. Avoid doing extremes in any capacity.


The author is a Medical Doctor pursuing post-graduate studies in Paediatrics and Child Health at Muhimbili University of Health and Allied Sciences (MUHAS).

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Monday, November 13, 2017

Unsung heroes of TZ’s war on diabetes



Dr Omega L Edwards. Photo | Courtesy

Dr Omega L Edwards. Photo | Courtesy 

By Dr Omega Edwards

What we usually forget in our conversations on tackling diabetes are the vulnerable people and how to help them. Tanzanian women have been the victims and heroes of this devastating chronic illness.
As reported in The Citizen on July 12, 2017 - multiple studies have shown that Tanzania’s increased wealth, urbanisation, changing lifestyle, changes in eating habits, more sedentary work practices and an increasing aging population have all lead to an increased risk of Tanzanian women developing diabetes. Roughly 9 per cent of Tanzanian women have diabetes.
Out of these, only half are aware that they have the disease. Only 10 per cent of those who are aware, are actually on treatment.

Devastating impact on the body
Unfortunately, untreated diabetes is devastating to the human body. High levels of blood sugar damages the long nerves of the legs and feet.
As a result, diabetics lose feeling in their feet and often injure themselves unknowingly.
These wounds can become infected and the high levels of blood sugar impair wound healing. Diabetics often suffer from chronic slow healing wounds of the legs.  Far too often these festering wounds lead to lower extremity amputations.  
Chronic high levels of blood sugar often cause direct damage to organs. This is why diabetics are more likely to have heart disease and kidney failure. Direct damage to the small blood vessels of the eye will lead to blindness if left untreated. High blood sugar levels also impair the immune system.
This explains why malaria is more severe in diabetics. Diabetics are three times more likely to develop tuberculosis than non-diabetics.
Diabetes not only damages the body physically; the emotional impact of diabetes is equally if not more devastating.

Testimonies: Living as a diabetic
A group of researchers have done an excellent job of assessing the impact of diabetes in Tanzania in a study titled ‘Prevalence, Risk Factors, and Complications of Diabetes in the Kilimanjaro Region: A Population-Based Study from Tanzania.
These researchers conducted forty one in-depth interviews with diabetic patients and family members of diabetic patients.  
Their findings offer us a glimpse into the life experience of Tanzanian women living in rural areas suffering with diabetes. Some of the women they interviewed shared how having high blood sugar levels made them feel.
One women stated, “Sometimes even household chores such as washing and cooking becomes difficult. I feel ill all the time and my body gets weak. So I just lie down a lot waiting for my daughter to help me with all that.” Family members of those with diabetes are also impacted.
One woman shared about how a family member’s diabetes has impacted her work-load, “She [the diabetic] is not able to do anything tough. I mean she’s turned into someone we have to look after, just like a child. You have to find food and cook for her and only on rare occasions can she cook for herself but you need also to make sure everything is kept at reach for her. Honestly, this is a very strange/bad illness, it can make a person completely disabled.”
Another woman commented on the difficulty of managing her high blood sugar through making the necessary dietary changes.
She stated, “The main challenge I see is getting used to the food. I have diabetes and BP (blood pressure). I was advised to stop salted and sugary foods so you can imagine this is something that I had never thought about. But I had no choice. At first it was really difficult; I could not manage it and as a consequence I was always sick. The sugar was very unstable and the BP was rising all the time.”
Another woman during the interview confesses how her diabetic diet was a challenge during food preparation as well as to their food budget.
She states, “The fact that we have to differentiate my food from that of the rest of the family is already a challenge on our food budgeting. It means not only cooking two pots; also, the type of food that I am recommended to use is not easily accessible and again it is very expensive compared to that of the rest.”
Type 2 Diabetes is a devastating chronic illness that not only has physical consequences; the emotional and psychological impact can also be devastating to women and their families.   This is a disease that is not just about blood sugar levels, pills and insulin. This disease is about 9 per cent of Tanzanian women who are going through a challenging life experience that is new to them and their communities.
These women and their families are not passive; they are trying to manage a disease in the setting of limited resources that serves as a good lesson for us [non-diabetics].

The author is the Director of Curative Services, Sanitas Hospital, Dar es Salaam.

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Monday, November 13, 2017

How to know you’re a victim of social fears

A depiction of a man too shy to speak in

A depiction of a man too shy to speak in public. Photo | Web 

By Kenneth Kammu

A feeling of shyness or discomfort in some social situations is normal. For example, going on a date or giving a presentation before the mass may cause you to have that feeling of “butterflies in your stomach.”
However, when it happens everyday, it can cause significant anxiety, fear, self-consciousness and embarrassment. This is termed as Social Anxiety Disorder (social phobia).
It might be distressing affecting your daily activities, but here’s the good news; there are ways of dealing with it.
For children, anxiety about interacting with adults or peers may be shown by crying, tantrums, clinging to parents or refusing to speak in social situations.
Performance type of social anxiety disorder is said to happen when you experience intense fear and anxiety only during speaking or performing in public, but not in other types of social situations.
But you have to be aware that comfort levels in social situations vary, depending on personality traits and life experiences. Some people are naturally reserved and others are more outgoing.

How to know you have social anxiety disorder
You might be the victim if you dread everyday activities, such as meeting strangers, starting conversations, speaking on the phone, working or shopping, avoid or worry about social activities, such as group conversations or eating with company and parties.
If you always worry about doing something you think is embarrassing, such as blushing, sweating or appearing incompetent or you find it difficult to do things when others are watching you, then you are the victim.
Other signs are; if you may feel like you’re being watched and judged all the time, you fear criticism, avoid eye contact or have low self-esteem,  sweaty, tremble or a pounding heartbeat (palpitations) together with panic attacks (where you have an overwhelming sense of fear and anxiety, usually only for a few minutes).
Important to note is that majority of people with social anxiety also have other mental health issues, such as depression, generalised anxiety disorder or body dysmorphic disorder (which is anxiety disorder that causes one to have a distorted view of how he/she looks and to spend a lot of time worrying about his/her appearance).
 
Some quick facts
Did you know that social anxiety disorder is the third largest mental health care problem worldwide today?
 Large population-based surveys state that 33.7 per cent of the population are affected by an anxiety disorder during their lifetime. It typically begins in the early to mid-teens, though it can sometimes start in younger children or in adults.

How you physically appear if you experience social phobia
Blushing, fast heartbeat, trembling, sweating, upset stomach or nausea, trouble catching your breath, dizziness or lightheadedness, feeling of blank mind and muscle tension.

When to see your doctor
Have you ever thought of its impact, things that can put you into risk, complications brought about and the ways you can do away with it?  
See your doctor or mental health professional if you fear and avoid normal social situations because they cause embarrassment, worry or panic.
The author is based at Hubert Kairuki Memorial University.

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Monday, November 13, 2017

Dealing with stress in school - 2

A depiction of a stressed student trying to

A depiction of a stressed student trying to work on her notes. Stress among students is a less talked about issue which needs to be addressed. PHOTO | WEB 

By Rocky Amini

Last week I talked about how stress is one of the major factors affecting the performance of students at school.
Along with this, I wrote of how teachers can actively help students deal with stress. But if nothing is done then accumulation of stress among students can be unhealthy - to an extent of being dangerous. Let’s look at the bigger impact.

What are the effects of stress
• Majority of students under stress make bad decisions, of which at the end carry the negativity aspects of human personnel.
• Some of the students who face this problem and yet keep attending the school normally, get through their academic year being lonely and inactive. They fail to involve themselves in school activities.
• The further effects of stress to such students keep widening. At the end those who are affected by the stress build up negative attitude towards their teachers.
It is a fact that when the same teachers enter the class for the lesson, such students won’t understand the session if they are not settled psychologically.
• The other effect that may result from stress in students is feeding into negative behaviour. Such as being involved in street groups, skipping school, engaging in dangerous activities like theft, drug abuse and even ending up as street vendors.
I believe there has to be a way forward that psychology can play here in solving the problem of stress among students.

Helping a stressed student cope
We have seen how stress creates room for destruction to an individual in all aspects. In a normal situation, the student who is affected with such problem would be found with a negative attitude when in class or school compound.
When the problem keeps widening, it makes the minds of learners seize at working faster as they used to be when accomplishing their academic activities.
Here’s how we can help a stressed student:
1. There is a need for the teacher to create good psychological environments that favour the students to take their academic activities when at school.
2. Teachers need to keep their students close and study them so that they well understand the student’s behavioural affections, needs and the ways to help and cater to their needs. This helps teachers understand the good psychological environments needed and that which suits the development of students in making them feel comfortable when at school.
3. Reminding a student of something specific you have seen him/her do that shows an ability to function under stress can assist a student in overcoming what he/she might be feeling. This also includes complimenting on his/her strengths by giving specific examples.
4. A conversation usually matters. One of the most helpful things that one human can do for another is to listen in a calm and accepting way.
If the feeling of hopelessness continues to grip the student, then ask how he/she is managing to cope, a question such as “So, with all this going on, how on earth are you managing? What does it take to even get in here today?” This may surprise the student into mentioning a few of their strengths. Get them to elaborate as much as you can.
The ill-health and injuries inflicted by stress to the system of student’s academic arena if not prevented early may lead to suffering and loss of the student due to school dropout.
Let’s reach out to them today.
The author is an expert in the field of education.

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Monday, November 13, 2017

Cancer of the uterus stole the life of a woman I admired



Dr. Christopher Peterson

Dr. Christopher Peterson 

By Dr Chris Peterson

If you were to ask ‘who inspires me’, you’ll probably be surprised that none of them come from the medical background, as it might be expected.
An iconic American journalist, late Gwen Ifill has been my idol – she has not only touched people across various societies through her work of journalism but also the dedication towards her work has left an important footprint on my mind.
Ifill covered politics for several media and has also co-moderated a democratic debate between Hillary Clinton and Bernie Sanders during last year’s election prep.  That’s when I strongly applauded her. She’s probably the reason I’ve taken up a keen interest in doing what I do in this column; reflecting the truth through writing to help many make informed choices.   
This week marks a year since her death. Ifill was a victim of endometrial cancer, a type of cancer that begins in the uterus. Ifill’s inspiring nature had touched me to a great extent, the very reason why I want to pen down about endometrial cancer, a disease that stole life of this inspirational woman.
As I mentioned earlier, this cancer begins in the uterus. The uterus is the hollow, pear-shaped pelvic organ in women where foetal development occurs.
Endometrial cancer, also referred to as uterine cancer, starts in the layer of cells that form the lining of the uterus. Bear in mind that other types of cancer can also form in the uterus including uterine sarcoma but these are not common in Tanzania, including endometrial cancer itself.

Pay attention to the signs
In most cases, endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding, which prompts women to see their doctors. Like any type of cancer, endometrial cancer if detected early, treatment can be effective.
The majority of women with endometrial cancer have vaginal bleeding, although women who have not gone through menopause may experience irregular or heavy bleeding completely unrelated to cancer.
Women are advised to pay attention to symptoms like vaginal bleeding especially after menopause, bleeding between periods, an abnormal watery or blood-tinge from vagina and pelvic pain. These are common endometrial cancer warnings that women shouldn’t ignore.

Know your risks
There are plenty of risk factors for the diseases that women should be aware of and extreme body weight fits the bill. As obesity rates rise in Tanzania, doctors are seeing higher rates of endometrial cancer risks. Being obese increases your risk of endometrial cancer. This may occur because excess body fat alters your body’s hormonal balance.
Other risk factors include: more years of menstruation, to have never conceived, older age, hormone therapy for breast cancer and other inherited disorders.
It is possible to lower your risk of endometrial cancer. I recommend doing what you can do to maintain a healthy weight. It is also important to listen to your body and act if something seems strange, irrespective of your age.  
sonchrispeter@gmail.com

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Monday, November 13, 2017

Why diabetes still ruins people’s lives

A woman testing for blood sugar level. Photo |

A woman testing for blood sugar level. Photo | Web 

By Syriacus Buguzi

Warnings have come and gone, such as, “With extra sugar, you eat your way to the grave,” or “An apple a day keeps a doctor away,’’ meaning that  how we eat and live determines our health. Still, government, experts and the World Health Organisation (WHO) have continued warning.
However, the scourge of diabetes, a disease emanating from uncontrolled blood sugar, is still here with us—ruining people’s lives and economies whereas the cost of treatment continues to rise. Experts believe there is no other future—it’s now time to invest and tame the menace.
The global cost of the disease is now $825 billion per year, according to the largest ever study on diabetes levels across the world, published in Lancet Journal; comparing diabetes levels among adult men and women from 1980 to 2014.
By the year 2030, the cost of treating diabetes is projected to rise to $16.2 billion in Eastern Africa, namely Tanzania, Kenya and Ethiopia. This is an increase from $3.8 billion in 2015, says another study by Lancet Diabetes and Endocrinology Commission.
According to the commission, the current economic cost of diabetes in Sub-Saharan Africa is $19.5 billion or one per cent of gross domestic product (GDP).
However, it estimates that this could increase to one per cent of the GDP in 2030 if rates stay the same and to $47.3 billion (1 per cent of the GDP) if rates follow the projected increases, or to $59.3 billion (2 per cent of the GDP) if rates double.
But, trapped in a vicious cycle of the wanting lifestyles, several people still end up with the disease that should be largely preventable with low-cost interventions.

What are people doing about this?
On the brighter side, however, society is beginning to realise the costly nature of diabetes and other Non-Communicable Diseases (NCDs).
Ahead of the World Diabetes Day, marked November 14 (tomorrow), Your Health spoke to people who have decided to take up daily exercising as a strategy for keeping healthy and save their economies.
Every evening, the open spaces at the campus of the University of Dar es Salaam (UDSM) attract a number of people who take advantage of the landscape for exercising.
Ms Amina Jabir, 29, a resident of Sinza has decided to take up exercising after doctors cautioned her about the dangers of being obese.
“When I gave birth to my first child, a year ago, my doctor told me to cultivate the habit of exercising. He told me that I risked becoming obese. He said my body was potentially becoming morbidly fat. I heeded the call. Here I am now, I feel addicted to it,’’ she says.

Why people prefer jogging at UDSM campus
The UDSM surroundings have rolling grassy knolls and a relaxed landscape. According to a physiologist from Muhimbili University of Health and Allied Sciences (Muhas), Dr Omary Chilloi, this space for exercising is what universities across Tanzania should invest in now as NCDs, such as diabetes continue to pose a threat.
“Tanzania has about 70 universities and colleges. Most of these universities’ buildings are in major cities and do not have the required infrastructure to improve students’ health. The buildings put up in the 1990s lack essential facilities to support physical activities such as sports grounds and recreational spaces,’’ he says.
“Yet, those universities which were spacious enough and in a position to create such key facilities, are now haunted by another great challenge—of building more lecture theaters and staff offices to meet the growing demands of students who increase every year,’’ he points out.
Dr Chillo believes universities have to rethink about how to prevent NCDs, such as diabetes among the youth, including providing a spacious environment for exercising.
“I believe it’s time for universities to rethink on their health policies, be engaged fully in the content of food and the variety of choices that their food vendors offer to the varsity communities.”
“Also to preserve the existing facilities and build new supportive infrastructure for sports grounds, cycling and bicycle stands, gym areas, and bathrooms.”

Learning from examples
During the survey, Your Health witnessed several young men and women along the service roads of Sam Nujoma Road in the city, jogging. One of them was Mr Joachim Mzava, 28, a resident of Ubungo in the city.
He says that whenever he goes for a jogging session every evening, he is not worried about what it takes to invest in exercising.
“It has become my habit. By the way, it doesn’t cost anything, almost. What I fear is the amount of money I would have to spend on illnesses such as diabetes and heart disease, in case they came into my life,’’ he says.
“That’s what I am fighting against at the moment. Those diseases,’’ he says, brisking up his pace, panting and sweating as he goes ahead to exercise. “I do this every day, it’s for my health.”
Mzava says he learnt lessons after his father died of prostate cancer two years ago and his 60-year-old mother is battling diabetes.
“I am a shopkeeper. My mother depends on me for treatment. I know what it takes to take care of a diabetic patient,’’ he says and he narrates how he has been trying to raise medical bills for his ailing mother.
“It may cost me up Sh 50,000 treatment on a day. Since she is not on health insurance, just as I am not, I have to raise the money for treatment. She needs an insulin injection quite often,’’ he explains. For two years now, Mzava’s mother is struggling with this disease.
Mzava says he has learnt that diabetes can be prevented through regular physical exercises; maintain a healthy body weight and not eating processed food.

What do the health experts advice
Dr Fredrick Mashili, a specialist in body physiology and manager of a health organisation, JamiiHealth, says that people can do away with catastrophic health expenditures on diabetes treatment through low-cost interventions.
“Walking and cycling daily or what we call active commuting is simple. The World Health organisation proposes active commuting as a simple strategy for preventing Non-Communicable Diseases,’’ he explains.
“The rewards are robust. First and foremost, it cuts down healthcare costs through prevention. But also it increases productivity at work since absenteeism due to sick leaves will be avoided through this,’’ he points out.
Dr Deus Kitapondya, a medical doctor from Muhimbili National Hospital (MNH) says another cheapest strategy is through making the right food choices.
“One important and cheap strategy to prevent diabetes is by refraining from sedentary lifestyle and avoiding being obese. Obesity predisposes people to insulin resistance, and that’s how a person starts suffering from diabetes,’’ explains Dr Kitapondya.
Dr Sajjad Fazel, a Tanzanian public health advocate believes there is need for mindset change. That people should now start analyzing the economic implications of suffering from diabetes vis a vis the returns they can get from investing in preventive measures now.
My personal advice is, “Exercise for your health and your pocket, a small step today will save you a fortune tomorrow.”
Dr Fazel, who is now at the Schulich School of Medicine and Dentistry Western University in Canada, goes on to caution how diabetes is fast becoming an economically crippling disease.
“It not only causes the sufferer to bear huge medical costs for medication and treatment but also reduces productivity and hence income.”
 “A lot of diabetic patients spend large sums of money managing complications caused by uncontrolled sugar levels such as diabetic foot, retinopathy, and peripheral neuropathy, renal and cardiac problems,’’ cautions Dr Fazel.

sbuguzi@tz.nationmedia.com

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Monday, November 13, 2017

Why diabetes still ruins people’s lives

A woman testing for blood sugar level. Photo |

A woman testing for blood sugar level. Photo | Web 

By Syriacus Buguzi

Warnings have come and gone, such as, “With extra sugar, you eat your way to the grave,” or “An apple a day keeps a doctor away,’’ meaning that  how we eat and live determines our health. Still, government, experts and the World Health Organisation (WHO) have continued warning.
However, the scourge of diabetes, a disease emanating from uncontrolled blood sugar, is still here with us—ruining people’s lives and economies whereas the cost of treatment continues to rise. Experts believe there is no other future—it’s now time to invest and tame the menace.
The global cost of the disease is now $825 billion per year, according to the largest ever study on diabetes levels across the world, published in Lancet Journal; comparing diabetes levels among adult men and women from 1980 to 2014.
By the year 2030, the cost of treating diabetes is projected to rise to $16.2 billion in Eastern Africa, namely Tanzania, Kenya and Ethiopia. This is an increase from $3.8 billion in 2015, says another study by Lancet Diabetes and Endocrinology Commission.
According to the commission, the current economic cost of diabetes in Sub-Saharan Africa is $19.5 billion or one per cent of gross domestic product (GDP).
However, it estimates that this could increase to one per cent of the GDP in 2030 if rates stay the same and to $47.3 billion (1 per cent of the GDP) if rates follow the projected increases, or to $59.3 billion (2 per cent of the GDP) if rates double.
But, trapped in a vicious cycle of the wanting lifestyles, several people still end up with the disease that should be largely preventable with low-cost interventions.

What are people doing about this?
On the brighter side, however, society is beginning to realise the costly nature of diabetes and other Non-Communicable Diseases (NCDs).
Ahead of the World Diabetes Day, marked November 14 (tomorrow), Your Health spoke to people who have decided to take up daily exercising as a strategy for keeping healthy and save their economies.
Every evening, the open spaces at the campus of the University of Dar es Salaam (UDSM) attract a number of people who take advantage of the landscape for exercising.
Ms Amina Jabir, 29, a resident of Sinza has decided to take up exercising after doctors cautioned her about the dangers of being obese.
“When I gave birth to my first child, a year ago, my doctor told me to cultivate the habit of exercising. He told me that I risked becoming obese. He said my body was potentially becoming morbidly fat. I heeded the call. Here I am now, I feel addicted to it,’’ she says.

Why people prefer jogging at UDSM campus
The UDSM surroundings have rolling grassy knolls and a relaxed landscape. According to a physiologist from Muhimbili University of Health and Allied Sciences (Muhas), Dr Omary Chilloi, this space for exercising is what universities across Tanzania should invest in now as NCDs, such as diabetes continue to pose a threat.
“Tanzania has about 70 universities and colleges. Most of these universities’ buildings are in major cities and do not have the required infrastructure to improve students’ health. The buildings put up in the 1990s lack essential facilities to support physical activities such as sports grounds and recreational spaces,’’ he says.
“Yet, those universities which were spacious enough and in a position to create such key facilities, are now haunted by another great challenge—of building more lecture theaters and staff offices to meet the growing demands of students who increase every year,’’ he points out.
Dr Chillo believes universities have to rethink about how to prevent NCDs, such as diabetes among the youth, including providing a spacious environment for exercising.
“I believe it’s time for universities to rethink on their health policies, be engaged fully in the content of food and the variety of choices that their food vendors offer to the varsity communities.”
“Also to preserve the existing facilities and build new supportive infrastructure for sports grounds, cycling and bicycle stands, gym areas, and bathrooms.”

Learning from examples
During the survey, Your Health witnessed several young men and women along the service roads of Sam Nujoma Road in the city, jogging. One of them was Mr Joachim Mzava, 28, a resident of Ubungo in the city.
He says that whenever he goes for a jogging session every evening, he is not worried about what it takes to invest in exercising.
“It has become my habit. By the way, it doesn’t cost anything, almost. What I fear is the amount of money I would have to spend on illnesses such as diabetes and heart disease, in case they came into my life,’’ he says.
“That’s what I am fighting against at the moment. Those diseases,’’ he says, brisking up his pace, panting and sweating as he goes ahead to exercise. “I do this every day, it’s for my health.”
Mzava says he learnt lessons after his father died of prostate cancer two years ago and his 60-year-old mother is battling diabetes.
“I am a shopkeeper. My mother depends on me for treatment. I know what it takes to take care of a diabetic patient,’’ he says and he narrates how he has been trying to raise medical bills for his ailing mother.
“It may cost me up Sh 50,000 treatment on a day. Since she is not on health insurance, just as I am not, I have to raise the money for treatment. She needs an insulin injection quite often,’’ he explains. For two years now, Mzava’s mother is struggling with this disease.
Mzava says he has learnt that diabetes can be prevented through regular physical exercises; maintain a healthy body weight and not eating processed food.

What do the health experts advice
Dr Fredrick Mashili, a specialist in body physiology and manager of a health organisation, JamiiHealth, says that people can do away with catastrophic health expenditures on diabetes treatment through low-cost interventions.
“Walking and cycling daily or what we call active commuting is simple. The World Health organisation proposes active commuting as a simple strategy for preventing Non-Communicable Diseases,’’ he explains.
“The rewards are robust. First and foremost, it cuts down healthcare costs through prevention. But also it increases productivity at work since absenteeism due to sick leaves will be avoided through this,’’ he points out.
Dr Deus Kitapondya, a medical doctor from Muhimbili National Hospital (MNH) says another cheapest strategy is through making the right food choices.
“One important and cheap strategy to prevent diabetes is by refraining from sedentary lifestyle and avoiding being obese. Obesity predisposes people to insulin resistance, and that’s how a person starts suffering from diabetes,’’ explains Dr Kitapondya.
Dr Sajjad Fazel, a Tanzanian public health advocate believes there is need for mindset change. That people should now start analyzing the economic implications of suffering from diabetes vis a vis the returns they can get from investing in preventive measures now.
My personal advice is, “Exercise for your health and your pocket, a small step today will save you a fortune tomorrow.”
Dr Fazel, who is now at the Schulich School of Medicine and Dentistry Western University in Canada, goes on to caution how diabetes is fast becoming an economically crippling disease.
“It not only causes the sufferer to bear huge medical costs for medication and treatment but also reduces productivity and hence income.”
 “A lot of diabetic patients spend large sums of money managing complications caused by uncontrolled sugar levels such as diabetic foot, retinopathy, and peripheral neuropathy, renal and cardiac problems,’’ cautions Dr Fazel.

sbuguzi@tz.nationmedia.com

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Monday, November 13, 2017

Fitness isn’t just about ‘looking’ good, here’s why



A woman exercising. Photo | TheCogni

A woman exercising. Photo | TheCogni 

By Insiyah Amiji

Most of us tend to admire the beautiful bodies of television celebrities and models, hoping someday we can achieve that! Well, that’s too good to be true but nothing is impossible, isn’t it?
So, does it mean if we lose weight, we are fit? Or that people who are fat are unfit? Is fitness related to exercise and ‘looking’ fit only? I believe the question we should be asking is: ‘what is fitness?’
According to the American Academy of Nutrition and Dietetics, fitness is “your own optimal health and overall well-being. Being fit not only means physical health, but emotional and mental health, too. It defines every aspect of your health. Smart eating and active living are fundamental to fitness.”
It’s the little things we should do each day that adds up to being healthy and fit. It is always a “work in progress” since there are many elements to a healthy lifestyle. Fitness is therefore an outcome of good nutrition and proper conditioning.
A lot of people eat fairly well and exercise, yet they often experience injury, constant pain, struggle with weight, constipation, hard time digesting food, mood fluctuations and fatigue. Diet and exercise isn’t enough to keep your body stable or efficient.  We need to view a human body beyond just fat and muscle ratios.
The following tips can guide you to adopting a healthy living. Bear in mind that fitness is not only about the ‘size’ that matters but there’s more to it.

1. Kick your bad habits
Habits in the “quit” category would be smoking, drugs, unsafe sex and other unhealthy addictions. There isn’t a healthy turn or way in doing the above things.

2. Get your check-up
Have an annual checkup with your family doctor. For those who are known cases of medical illnesses should at least have 3-6 monthly visits for a baseline check-up. Do various screenings for breast, prostate or any new growing skin lesions. This way you will be aware of what is abnormal in your body.

3. Sleep
Good sleep helps our body to recover, repair and rejuvenate. Lack of sleep affects our metabolism, mood, concentration, memory, stress hormones, immune system and cardiovascular health. Therefore, sleep well and keep your worries for the next day.


4. Exercise
Even if it is just a walk, exercise helps to strengthen the heart, lungs, muscles and increases flexibility.
Cardio and strength training helps muscles to contract while yoga improves its flexibility. There is absolutely ‘no excuse’ to not workout. In this fast paced life many of us cannot go to the gym. But we need to stay physically fit, so workout from home or with a group of people at your own comfort zone, engage in household activities, use the stairs instead of the elevator. You will only see results when you accept your body the way it is and make practical goals to achieve something. Remember it is a slow process.

5. Eat right
Fitness and health comes with smart eating habits. Eating a little bit of everything and having few cheat foods occasionally is totally okay! Incorporate fruits, vegetables and whole grains to your diet. Make a habit of reading the nutritional value for the food you consume. Human body needs 45-65 per cent carbohydrates, 10-35 per cent proteins and 25-35 per cent fats per day from the required total amount of calories we consume per day. Nutritionist recommend small frequent meals. Avoid processed foods, artificial sugars and high fat food.

6. Consistency and moderation
Make changes one at a time. By making too many changes at once, you will relapse into old habits. Make these choices as part of your daily routine to reach your goals. Avoid doing extremes in any capacity.


The author is a Medical Doctor pursuing post-graduate studies in Paediatrics and Child Health at Muhimbili University of Health and Allied Sciences (MUHAS).

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Monday, November 13, 2017

Unsung heroes of TZ’s war on diabetes



Dr Omega L Edwards. Photo | Courtesy

Dr Omega L Edwards. Photo | Courtesy 

By Dr Omega Edwards

What we usually forget in our conversations on tackling diabetes are the vulnerable people and how to help them. Tanzanian women have been the victims and heroes of this devastating chronic illness.
As reported in The Citizen on July 12, 2017 - multiple studies have shown that Tanzania’s increased wealth, urbanisation, changing lifestyle, changes in eating habits, more sedentary work practices and an increasing aging population have all lead to an increased risk of Tanzanian women developing diabetes. Roughly 9 per cent of Tanzanian women have diabetes.
Out of these, only half are aware that they have the disease. Only 10 per cent of those who are aware, are actually on treatment.

Devastating impact on the body
Unfortunately, untreated diabetes is devastating to the human body. High levels of blood sugar damages the long nerves of the legs and feet.
As a result, diabetics lose feeling in their feet and often injure themselves unknowingly.
These wounds can become infected and the high levels of blood sugar impair wound healing. Diabetics often suffer from chronic slow healing wounds of the legs.  Far too often these festering wounds lead to lower extremity amputations.  
Chronic high levels of blood sugar often cause direct damage to organs. This is why diabetics are more likely to have heart disease and kidney failure. Direct damage to the small blood vessels of the eye will lead to blindness if left untreated. High blood sugar levels also impair the immune system.
This explains why malaria is more severe in diabetics. Diabetics are three times more likely to develop tuberculosis than non-diabetics.
Diabetes not only damages the body physically; the emotional impact of diabetes is equally if not more devastating.

Testimonies: Living as a diabetic
A group of researchers have done an excellent job of assessing the impact of diabetes in Tanzania in a study titled ‘Prevalence, Risk Factors, and Complications of Diabetes in the Kilimanjaro Region: A Population-Based Study from Tanzania.
These researchers conducted forty one in-depth interviews with diabetic patients and family members of diabetic patients.  
Their findings offer us a glimpse into the life experience of Tanzanian women living in rural areas suffering with diabetes. Some of the women they interviewed shared how having high blood sugar levels made them feel.
One women stated, “Sometimes even household chores such as washing and cooking becomes difficult. I feel ill all the time and my body gets weak. So I just lie down a lot waiting for my daughter to help me with all that.” Family members of those with diabetes are also impacted.
One woman shared about how a family member’s diabetes has impacted her work-load, “She [the diabetic] is not able to do anything tough. I mean she’s turned into someone we have to look after, just like a child. You have to find food and cook for her and only on rare occasions can she cook for herself but you need also to make sure everything is kept at reach for her. Honestly, this is a very strange/bad illness, it can make a person completely disabled.”
Another woman commented on the difficulty of managing her high blood sugar through making the necessary dietary changes.
She stated, “The main challenge I see is getting used to the food. I have diabetes and BP (blood pressure). I was advised to stop salted and sugary foods so you can imagine this is something that I had never thought about. But I had no choice. At first it was really difficult; I could not manage it and as a consequence I was always sick. The sugar was very unstable and the BP was rising all the time.”
Another woman during the interview confesses how her diabetic diet was a challenge during food preparation as well as to their food budget.
She states, “The fact that we have to differentiate my food from that of the rest of the family is already a challenge on our food budgeting. It means not only cooking two pots; also, the type of food that I am recommended to use is not easily accessible and again it is very expensive compared to that of the rest.”
Type 2 Diabetes is a devastating chronic illness that not only has physical consequences; the emotional and psychological impact can also be devastating to women and their families.   This is a disease that is not just about blood sugar levels, pills and insulin. This disease is about 9 per cent of Tanzanian women who are going through a challenging life experience that is new to them and their communities.
These women and their families are not passive; they are trying to manage a disease in the setting of limited resources that serves as a good lesson for us [non-diabetics].

The author is the Director of Curative Services, Sanitas Hospital, Dar es Salaam.

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Monday, November 13, 2017

Cancer of the uterus stole the life of a woman I admired



Dr. Christopher Peterson

Dr. Christopher Peterson 

By Dr Chris Peterson

If you were to ask ‘who inspires me’, you’ll probably be surprised that none of them come from the medical background, as it might be expected.
An iconic American journalist, late Gwen Ifill has been my idol – she has not only touched people across various societies through her work of journalism but also the dedication towards her work has left an important footprint on my mind.
Ifill covered politics for several media and has also co-moderated a democratic debate between Hillary Clinton and Bernie Sanders during last year’s election prep.  That’s when I strongly applauded her. She’s probably the reason I’ve taken up a keen interest in doing what I do in this column; reflecting the truth through writing to help many make informed choices.   
This week marks a year since her death. Ifill was a victim of endometrial cancer, a type of cancer that begins in the uterus. Ifill’s inspiring nature had touched me to a great extent, the very reason why I want to pen down about endometrial cancer, a disease that stole life of this inspirational woman.
As I mentioned earlier, this cancer begins in the uterus. The uterus is the hollow, pear-shaped pelvic organ in women where foetal development occurs.
Endometrial cancer, also referred to as uterine cancer, starts in the layer of cells that form the lining of the uterus. Bear in mind that other types of cancer can also form in the uterus including uterine sarcoma but these are not common in Tanzania, including endometrial cancer itself.

Pay attention to the signs
In most cases, endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding, which prompts women to see their doctors. Like any type of cancer, endometrial cancer if detected early, treatment can be effective.
The majority of women with endometrial cancer have vaginal bleeding, although women who have not gone through menopause may experience irregular or heavy bleeding completely unrelated to cancer.
Women are advised to pay attention to symptoms like vaginal bleeding especially after menopause, bleeding between periods, an abnormal watery or blood-tinge from vagina and pelvic pain. These are common endometrial cancer warnings that women shouldn’t ignore.

Know your risks
There are plenty of risk factors for the diseases that women should be aware of and extreme body weight fits the bill. As obesity rates rise in Tanzania, doctors are seeing higher rates of endometrial cancer risks. Being obese increases your risk of endometrial cancer. This may occur because excess body fat alters your body’s hormonal balance.
Other risk factors include: more years of menstruation, to have never conceived, older age, hormone therapy for breast cancer and other inherited disorders.
It is possible to lower your risk of endometrial cancer. I recommend doing what you can do to maintain a healthy weight. It is also important to listen to your body and act if something seems strange, irrespective of your age.  
sonchrispeter@gmail.com

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Monday, November 13, 2017

How to know you’re a victim of social fears

A depiction of a man too shy to speak in

A depiction of a man too shy to speak in public. Photo | Web 

By Kenneth Kammu

A feeling of shyness or discomfort in some social situations is normal. For example, going on a date or giving a presentation before the mass may cause you to have that feeling of “butterflies in your stomach.”
However, when it happens everyday, it can cause significant anxiety, fear, self-consciousness and embarrassment. This is termed as Social Anxiety Disorder (social phobia).
It might be distressing affecting your daily activities, but here’s the good news; there are ways of dealing with it.
For children, anxiety about interacting with adults or peers may be shown by crying, tantrums, clinging to parents or refusing to speak in social situations.
Performance type of social anxiety disorder is said to happen when you experience intense fear and anxiety only during speaking or performing in public, but not in other types of social situations.
But you have to be aware that comfort levels in social situations vary, depending on personality traits and life experiences. Some people are naturally reserved and others are more outgoing.

How to know you have social anxiety disorder
You might be the victim if you dread everyday activities, such as meeting strangers, starting conversations, speaking on the phone, working or shopping, avoid or worry about social activities, such as group conversations or eating with company and parties.
If you always worry about doing something you think is embarrassing, such as blushing, sweating or appearing incompetent or you find it difficult to do things when others are watching you, then you are the victim.
Other signs are; if you may feel like you’re being watched and judged all the time, you fear criticism, avoid eye contact or have low self-esteem,  sweaty, tremble or a pounding heartbeat (palpitations) together with panic attacks (where you have an overwhelming sense of fear and anxiety, usually only for a few minutes).
Important to note is that majority of people with social anxiety also have other mental health issues, such as depression, generalised anxiety disorder or body dysmorphic disorder (which is anxiety disorder that causes one to have a distorted view of how he/she looks and to spend a lot of time worrying about his/her appearance).
 
Some quick facts
Did you know that social anxiety disorder is the third largest mental health care problem worldwide today?
 Large population-based surveys state that 33.7 per cent of the population are affected by an anxiety disorder during their lifetime. It typically begins in the early to mid-teens, though it can sometimes start in younger children or in adults.

How you physically appear if you experience social phobia
Blushing, fast heartbeat, trembling, sweating, upset stomach or nausea, trouble catching your breath, dizziness or lightheadedness, feeling of blank mind and muscle tension.

When to see your doctor
Have you ever thought of its impact, things that can put you into risk, complications brought about and the ways you can do away with it?  
See your doctor or mental health professional if you fear and avoid normal social situations because they cause embarrassment, worry or panic.
The author is based at Hubert Kairuki Memorial University.

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Monday, November 13, 2017

Answering common questions on treating irregular teeth order

Dr Emeria Mugonzibwa  is a lecturer of

Dr Emeria Mugonzibwa  is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences 

By Emeria Mugonzibwa

In my last week’s article in Your Health titled ‘Are your teeth, jaws in wrong position’, I talked of dealing with conditions that require movement of the teeth done under a specialty called orthodontics.
Like I had mentioned, improper position of teeth and jaws is a problem facing people in our society and many of them don’t know how to deal with it.
But those who might be aware of the treatment or practice, have several questions and misconceptions that I would like to answer and clear. This should serve as a lesson and tips for all.

Q. Is the orthodontic treatment only cosmetic?
A.  Many people view orthodontic appliances as a mere cosmetic treatment that is only for people who care about their appearance.
Besides straightening teeth and creating a beautiful smile, orthodontic intervention corrects unhealthy bites (deep bite, open bite, crossbite, increased overjet, impacted teeth and misalignment) that can lead to greater oral health concerns.

Q. Are the orthodontic issues treatable in children only?
A. One in five orthodontic patients is an adult.

Q. How many years does aligning an improper teeth or jaw take?
A. Orthodontic treatment requires careful, controlled movements of the teeth to ensure they are moving into proper positions.
Simple cases may only take a few months to treat while the most complex cases take longer.
Orthodontists have the training, experience, and skill to deliver excellent results in the shortest amount of time.

Q. Is it a painful process?
A.  The adjustment period  of the appliances used during treatment, is a comfortable process. Some orthodontic appliances may be worn for a few months, depending on the respective malocclusion. 
To date, the materials being used for orthodontic treatment are significantly more comfortable than it used to in the past. Orthodontic appliances work better than ever without causing the patient pain.

Q. Do the tools fitted on the teeth or jaw have to always be tight to correct the teeth position?
A. It is a common misconception that the tighter the orthodontic tools, the better they work and the faster an individual completes treatment.
The truth is that too much tightness is bad for the teeth and will not fix alignment issues any faster.

Q. I read somewhere that signals from orthodontic appliance link to the Internet to download songs onto an iPod. How true it this?
A. This is not possible right now.

Q. What’s fixed on the teeth, the appliances that we often refer to, can trigger metal security detectors?
A. Orthodontic appliances are made of materials that do not interfere with metal detectors.

Q. Can the tools used on the teeth during treatment increase the patients’ chance of getting struck by lightning?
A. Patients wearing orthodontic appliances have the same chance of being struck by lightning as those without appliances (1 in 700,000!)

The author is a lecturer of Dentistry at Muhimbili University of Health and Allied Sciences (MUHAS).

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Monday, November 13, 2017

Beware of this ‘blue pill’ embarrassment



Dr Syriacus Buguzi

Dr Syriacus Buguzi 

By Syriacus Buguzi
More by this Author

It is being said that these days, men are ‘not quite getting up’. That men are now struggling with getting an erection and keeping it up in the bedroom.
I am talking about the cases of Erectile Dysfunction (ED), which some studies indicate are on the increase in Tanzania and elsewhere. Well, this problem exists in our society is no longer news.
Cases could have also grown bigger in diabetic patients ever since 2014 when I read a study, titled: Prevalence of erectile dysfunction and associated factors among diabetic men attending diabetic clinic at Muhimbili National Hospital in Dar-es-Salaam. The rise in diabetic cases could have aggravated ED.
Last week, however, there was some bad news in Tanzania. A rumor was making rounds on social media that a student; somewhere in Dodoma had died after taking high doses of sildenafil or popularly known as Viagra pills; to boost his sexual “energy.”
While it is a widely known concept that drug overdose is dangerous, I encountered a lot of questions from members of the public who were eager to know the science behind the “deadly nature’’ or rather the health risks associated with taking larger doses of the diamond- shaped “blue pills.”
These pills can help a man in need of them by increasing blood flow to his penis. Since sexual performance is something of high priority for men, there is a possibility of them falling in the trap of abusing the pills.
But, here comes a strong caution that taking more of the pills than directed by a physician could lead to a permanent painful erection, and other potential health risks that could damage the penis.
That means, too much of it can lead to what we call priapism—a very large erection that lasts for more than four hours. It’s such a prolonged erection that can lead to permanent damage to the penile tissues.
What usually happens is that the pill works by relaxing the muscles in the penis, and allowing blood to flow in, causing an erection. When this is too much, more blood will flow to the muscles and cause the penis to engorge and swell up.   At one point, surgery could be required to rescue the swelling penis.
This drug can also lower blood pressure, so an increased dose could lead to increased risk of blood circulatory system problems, ranging from blood pressure fluctuations to heartbeat irregularities.
How will you know you are in trouble? The victim may begin experiencing blurry vision, sudden loss of hearing, other problems may follow, such as dizziness and ringing in the ears.
 
So, always strive to stay safe, make informed health choices!
six.buguzi@gmail.com

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Monday, November 13, 2017

Dealing with stress in school - 2

A depiction of a stressed student trying to

A depiction of a stressed student trying to work on her notes. Stress among students is a less talked about issue which needs to be addressed. PHOTO | WEB 

By Rocky Amini

Last week I talked about how stress is one of the major factors affecting the performance of students at school.
Along with this, I wrote of how teachers can actively help students deal with stress. But if nothing is done then accumulation of stress among students can be unhealthy - to an extent of being dangerous. Let’s look at the bigger impact.

What are the effects of stress
• Majority of students under stress make bad decisions, of which at the end carry the negativity aspects of human personnel.
• Some of the students who face this problem and yet keep attending the school normally, get through their academic year being lonely and inactive. They fail to involve themselves in school activities.
• The further effects of stress to such students keep widening. At the end those who are affected by the stress build up negative attitude towards their teachers.
It is a fact that when the same teachers enter the class for the lesson, such students won’t understand the session if they are not settled psychologically.
• The other effect that may result from stress in students is feeding into negative behaviour. Such as being involved in street groups, skipping school, engaging in dangerous activities like theft, drug abuse and even ending up as street vendors.
I believe there has to be a way forward that psychology can play here in solving the problem of stress among students.

Helping a stressed student cope
We have seen how stress creates room for destruction to an individual in all aspects. In a normal situation, the student who is affected with such problem would be found with a negative attitude when in class or school compound.
When the problem keeps widening, it makes the minds of learners seize at working faster as they used to be when accomplishing their academic activities.
Here’s how we can help a stressed student:
1. There is a need for the teacher to create good psychological environments that favour the students to take their academic activities when at school.
2. Teachers need to keep their students close and study them so that they well understand the student’s behavioural affections, needs and the ways to help and cater to their needs. This helps teachers understand the good psychological environments needed and that which suits the development of students in making them feel comfortable when at school.
3. Reminding a student of something specific you have seen him/her do that shows an ability to function under stress can assist a student in overcoming what he/she might be feeling. This also includes complimenting on his/her strengths by giving specific examples.
4. A conversation usually matters. One of the most helpful things that one human can do for another is to listen in a calm and accepting way.
If the feeling of hopelessness continues to grip the student, then ask how he/she is managing to cope, a question such as “So, with all this going on, how on earth are you managing? What does it take to even get in here today?” This may surprise the student into mentioning a few of their strengths. Get them to elaborate as much as you can.
The ill-health and injuries inflicted by stress to the system of student’s academic arena if not prevented early may lead to suffering and loss of the student due to school dropout.
Let’s reach out to them today.
The author is an expert in the field of education.

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Monday, November 6, 2017

My confession as a chain smoker for 25yrs

Mr Paulo Bagara tells his story while in

Mr Paulo Bagara tells his story while in hospital. He agreed that his photo be published as he intends to educate and caution people on the dangers of cigarette smoking. PHOTO | SYRIACUS BUGUZI 

By Syriacus Buguzi

For over 25 years, Paulo Bagara, 64, was smoking tobacco, mainly in the form of cigarettes—a habit he repeatedly thought of quitting but in vain.
“Each time I visited a clinic due to some chest problems; medics were quick to tell me to stop smoking. I was warned. I was really warned,’’ he recalls, with regrets.
“Sometimes I promised doctors that I would quit, but upon stepping out of their offices, my mind couldn’t really resist it.  The cigarette was everything to me,’’ he says.
“In the year 2015, I remember to have been at loggerheads with a certain doctor who lives in our neighbourhood…he always asked me to quit, I could just appease him that I had stopped smoking…’’ Bagara recalls further.
Today, as he recounts his story, Mr Bagara, the resident of Karatu District in Arusha Region, is fighting for his health at the Ocean Road Cancer Institute (ORCI).
“I wish all the public hears me out, that cigarette smoking is bad for their health and their life.”
He is among the 6,338 Tanzanians who sought treatment for cancer at the facility by the year 2016, according to recent data obtained from ORCI.
But Bagara is also among several people in the country who may have always been exposed to the product—tobacco—known to contain more than 50 substances that can cause cancer.
“Cigarette smoking is one of the key things we enquire from suspected cancer patients whenever we are taking their medical history,” says Dr Crispin Kahesa, the ORCI’s Director of Cancer Preventive Services.
In Tanzania, cigarette smoking has continued to flourish, fueled by the growing tobacco industry, says Ms Lutgard Kagaruki, the Executive Director of Tanzania Tobacco Control Forum (TTCF).
“Tobacco business is also booming. This is because of the belief that the crop is an economically important. It is believed that putting tough control policies would lead to loss of revenue by the government,’’ she says.
Across the country, shops continue to sell cigarettes and for people such as Mr Bagara, the number of cigarettes smoked depends on where one lives and financial capacity.
About 14.1 per cent of all Tanzanians smoke tobacco daily while the product remains a major risk factor for Non-Communicable Diseases (NCDs), data from the Ministry of Health, Community Development, Gender, Elderly and Children show.

Ups and downs in my journey of smoking
“When I was in the village, I could smoke raw tobacco, but when in town, I could buy cigarettes…’’ recalls Bagara as he goes ahead to tell his story.
“I used to smoke about two packets on a day. At times three...later on, doctors advised me to scale down the number…I tried to reduce them to one packet a day…’’ he says.
In the market in Tanzania, a packet contains 20 cigarettes. In this case, it means Bagara could smoke up to 40 cigarettes day.
 “As far as I can remember, there was a time I reduced to 5 cigarettes a day, I felt so relieved…it was a moment of great success for me…but still, I couldn’t stop completely,’’ he narrates.
 “When I started getting sick, I tried to stop completely…but it was only too late, I was already too weak...”

Success in quitting alcohol, not cigarettes
 “I used to drink a lot of alcohol too. But I was able to quit. Not with smoking though. Before I knew what my life would turn into, doctors were already telling me I have a cancer. That’s when I got back to my senses,” he tells Your Health.
 “When I look back, I realise that my family and I have spent a lot of money to secure my health. I have been admitted here for about three months now,’’ he says.
 His son, Mr Chrisent Paulo, who is a shopkeeper in Karatu District, tells Your Health he had to leave his shop closed in order to stay at the hospital to take care of his ailing father, Mr Bagara.
 “Until today [as he spoke], I have spent over two million shillings from my pocket. At one moment, we had to mobilise funds from the family because drugs are expensive,’’ he says.
 “It’s now a year since my dad started getting on and off sickness. All that time, I have never settled. Being the first born, I have a big responsibility.”
 “My dad can’t feed on his favourite food normally anymore. He has to use a special tube. But also, he has to eat special food, I have to spend over Sh100, 000 on three days to secure his food. Imagine now, if he will continue to be admitted for more months,’’ says Bagara’s son.

 New turn in my life
 Mr Bagara’s illness began from simply failure to swallow.
 “At first, I could not swallow ugali. Then later; porridge couldn’t go past my throat. That’s when I realised things were turning from bad to worse. I began starving.”
 “I was referred to Karatu District Hospital,’’ he says as he recalls his early struggles in finding healthcare for a problem he had initially treated with contempt.
 “My family began getting worried when they heard that I have to go to a District Hospital. But we had to go anyway. On arrival, the doctor asked that I should be referred to a Regional Hospital in Arusha. That was, about one year ago,’’ says Mr Bagara.
 “At the regional hospital, a doctor looked at me in the eyes and told me frankly that I could have cancer. So a decision was made to refer me to Muhimbili National Hospital and later at the Ocean Road Cancer Institute. That’s when it became clear to me that my oesophagus had been affected by cancer.”
 “Being diagnosed with cancer has come as a big set back to my family. I used to work as a technician…now I can’t do it anymore…”
 “I became weaker. I later went for lighter activities in the shamba…I did that only for some time before my illness became worse. As we speak now, most of my crops haven’t been harvested…may be they are rotting in the shamba…”
 He continues, “…most of the time I’m at the hospital. I pray that my children are doing all they can to save my crops,’’ says a father of 10 children.
 “Now I see no meaning of smoking…I think tobacco farmers should be given alternative crops to grow….the companies that sell cigarettes should re-think about what they are trading in…they are harming society,” he sighs with regret.
 And he says, “I know cigarette factories make a lot of money…and it’s difficult to stop doing business, but they should know what they are doing is harmful to us. Now, I know, I can’t advise anyone to take up smoking cigarettes…”
 About 16 percent of male cancer patients who report to the ORCI are suffering from Cancer of the Oesophagus, Dr Kahesa tells Your Health.
 “You see, cigarette smoking is a risk factor for many cancer cases. How that directly or indirectly leads to cancer of the oesophagus, it’s a question for research,’’ he says.
 In 2010, a study published in the Journal of National Cancer Institute found that cigarette smoking was associated with increased risk of cancer of the esophagus in white men and women.
 “Smoking cessation was associated with reduced risks,’’ says the study titled: Cigarette Smoking and Adenocarcinomas of the Esophagus and Esophagogastric Junction.
 “We may need to conduct similar studies here on cancer of the oesophagus. But what we already know is that most cigarette smokers in Tanzania end up with lung cancer,’’ he explains.
 
Challenges in advising smokers
Dr Kahesa says, “The most difficult part is usually on convincing the smoker to stop the habit when he/she hasn’t started getting problems. Most of them come to realise that they should quit smoking when it’s too late.”
He adds, “But also, I do believe healthcare practitioners have a moral responsibility to stop smoking so that they set an example,’’ he says as he challenges health workers.
“Imagine a scenario where a healthcare provider who preaches the health hazards of smoking but he/she goes ahead to smoke…this has a huge impact on how the smokers respond to calls by health experts on stopping the habit,’’ he says.
Over a decade ago, Tanzania ratified the Framework Convention on Tobacco Control, under the World Health organisation (WHO FCTC 2007), which was touted as a tool that would effectively control harmful use of tobacco.
However, until to date, the country has not yet enacted a legislation that would control tobacco use. Anti-tobacco campaigners have been pushing for the inaction of the law to control tobacco use and production.
Dr Sarah Maongezi from the department of Non-Communicable Diseases at the Ministry of Health, Community Development, Gender, Elderly and Children, says plans are on by the government to set the agenda on the Tobacco Control Bill in Tanzania.
“I can assure you that there is the political will as for our part and the Ministry of Health is working on taking this Tobacco Control Bill forward,’’ she said.

sbuguzi@tz.nationmedia.com

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Monday, November 6, 2017

Why some women go through early menopause

A woman with a sanitary napkin. PHOTO |

A woman with a sanitary napkin. PHOTO | WISEGEEK 

By Devotha John

Menopause varies from one individual to another in terms of age and timing, also bearing in mind that the period for its occurrence is gradual and not spontaneous.  
Dr Efrem Mrema, a gynaecologist with the Muhimbili National Hospital explains to Your Health that menopause actually means your last menstrual period. ‘Meno’ refers to your menstrual cycle and ‘pause’ literally means stop.
“The menopause occurs when your ovaries stop producing eggs and as a result the levels of your hormones called oestrogen and progesterone hormone fall,” says Dr Mrema.  These hormones work together to regulate your menstrual cycle and also the production of eggs.
So why do we use the term pre-menopause? According to Dr Mrema, the term pre menopause is often used as this is the time in which one experiences menopausal symptoms but are still having periods. These periods are often more irregular and scanty than they used to be.
“During your pre-menopause, the levels of these hormones fluctuat greatly and it is often the imbalance of these hormones which leads to symptoms of the menopause occurring.
For some women these symptoms only occur for a few months and then their periods completely stop. However, other women experience symptoms for many months or even many years before their periods stop.”
Oestrogen protects a number of different systems in your body; your brain, skin bones, heart and vagina, hence low levels can affect all these parts of your body.

When can it occur
Dr Mrema tells Your Health that the average age of the menopause is 51 years as it varies from 45 to 55 years. Some may have premature menopause even at the age of 38 years. If the menopause occurs before the age of 40 it is classed as Premature Ovarian Failure.
“If the menopause occurs when you are under 45 years of age then it is called an early menopause,” adds the specialist.
Although the menopause is a normal event in a woman, certain conditions can bring about an early menopause.
These include if you have had your ovaries removed during an operation. If you have radiotherapy to your pelvic area as a treatment for cancer or if you have received certain types of chemotherapy drugs that treat cancer. Then this might lead to have an early menopause.

Changes
Dr Mrema said when women experience period around menopause, there are some changes she will see including irregular menses, mood changes (depression), hot flushes, sleep disturbance and others. Bleeding and clots can also occur during this period. This is due to hormonal changes during that period.

Diagnosing menopause
Some women bleed profusely, from which they may end up with life threatening haemorrhage case causing death if immediate action is not taken. Consulting with a specialist on this matter is the wisest thing to do, advises Dr Mrema.
If you are over 45 years of age and have irregular periods with symptoms of the menopause, then you do not need to have any tests to diagnose the menopause. If you are taking contraception or have a coil, then it may be difficult to know what your periods are like.
However, if you are younger than 45 years of age then you may need to have tests. The most common test is a blood test measuring the level of a hormone called follicle stimulating hormone.

djohn@tz.nationmedia.com

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Monday, November 6, 2017

Let not diabetes ruin your life, take action



Ali   Khatau

Ali   Khatau 

By Ali Khatau

In a recent health screening I had participated in, I witnessed quite many from those who turned out had significantly higher blood sugar levels than normal. Majority of them weren’t aware about it and of those who knew, chose to ignore to take their prescribed medication regularly.
Unfortunately, one of the patients who stopped taking her diabetes medication for a while had started developing ulcers on her leg and foot.  This would eventually lead to the need for a leg amputation if she were still not willing to continue taking her diabetes medication.

Burden of the disease
One of the most common non-communicable diseases in the world and in Tanzania is diabetes. Diabetes is a group of metabolic disorders characterised by high levels of sugar in the blood for a long period.
If left untreated, diabetes can cause severe complications in the long term including heart disease, leg ulcers and amputation, blindness, stroke, kidney disease and even death.
Diabetes.co.uk reveals that 46 per cent of patients suffering from diabetes are undiagnosed. Being unaware of this condition for a long time can lead to serious complications as discussed earlier and will eventually lead to an early death.
The World Health Organisation (WHO) also reports that the prevalence of diabetes has been rising more rapidly in low and middle-income countries. 
It also states that the number of diabetic patients has risen from 108 million in 1980 to 422 million in 2014. In 2015, around 1.6 million people lost their lives because of this condition.
Understanding the types
Diabetes is divided into two types. Type 1 is due to the inability of the pancreas to produce enough insulin while Type 2 is due to the failure of body cells to correctly respond to insulin.
Insulin is a hormone which maintains a normal sugar level in the blood.
Type 1 usually occurs in children and makes up around 10 per cent of diabetes cases while Type 2 mostly occurs in adults and comprises of approximately 90 per cent of diabetes cases. In terms of physical stature, Type 1 diabetes can occur in normal or thin individuals with healthy body weight while Type 2 often occurs in obese individuals.

How can one know he/she is a diabetic?
Diabetes can be identified by various signs, which include increased urination, increased hunger, weight loss and increased thirst. Other signs include fatigue, blurred eyesight, itchy skin, rashes and headache. Sadly, many people find out they are suffering from the condition when visiting the hospital for a routine check-up or undergoing tests for an unrelated disorder.

Here are the causes
The cause for type 1 diabetes is currently not known but genetic factors are partly implicated in its development. In people with a family history of diabetes, certain environmental factors such as infections or diet might trigger the development of diabetes but we are not completely sure of the causes.
On the other hand, we can confidently say that type 2 diabetes is mainly caused by lifestyle choices and inheritance. Obesity, stress, unhealthy diet, high cholesterol levels as well as an inactive lifestyle are major contributors to the development of type 2 diabetes. Dietary factors like excess sugar consumption and also consumption of a lot of white rice may increase your chances of developing type 2 diabetes.

Prevent it now
Currently, there is no known cure for diabetes and hence, it is essential to try to prevent development of the condition while you can. Several general measures exist which can be implemented in order to avoid developing diabetes. These include:
• Maintaining healthy body weight
• Engaging in regular exercise
• Limiting intake of beverages with excess sugar
• Smoking has also been linked to development of diabetes and hence, quitting it would be advisable if you’re trying to protect yourself from developing diabetes.
For people who already have the disease, certain medication exist which can manage your condition and keep your sugar levels in check. These medication must however be prescribed by a qualified medical professional.

The author is a medical student at Hubert Kairuki Memorial University

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Monday, November 6, 2017

Caught in ‘cage’ of cigarettes? Time to quit



Syriacus Buguzi

Syriacus Buguzi 

By Dr Syriacus Buguzi

Today’s story in Your Health is about a man who has finally confessed that smoking tobacco in the form of cigarettes is dangerous to health. Unfortunately, he confesses when it’s too late.
However, it may not be too late for you to make a decision. Mr Bagara, 64, had attempted to quit, several times, as he narrates but, he lacked enough will-power to do so—he was  in some sort of a ‘cage.’
Deciding that you are now ready to quit smoking is only half the battle and for Mr Bagara it was a battle half-achieved because, there is a time he scaled down to about 5 cigarettes a day, from the 40 he was smoking.
Nevertheless, he did not sustain the battle, not until he started getting sick and doctors gave him the shocking news that he had actually developed cancer of the oesophagus. According to the story, medics had repeatedly warned him against the habit.
The challenge in quitting cigarettes, as I have observed among many smokers, is usually on knowing where to start from.  These can be effective ways, if you start today.
Experts advise that you first of all make an honest list of all the things you like about smoking, according to rd.com.
Then, make another list of why quitting won’t be easy, they say. Set the date to quit. Write all your reasons for quitting on an index card.
• As you’re getting ready to quit, stop buying cartons of cigarettes.
• Keep a list of when you smoke for a week before quitting.
• Prepare a list of things to do when a craving hits.
• Quit when you’re in a good mood.
• When your quit date arrives, throw out anything that reminds you of smoking.
• Put all the money you’re saving on cigarettes in a large glass jar.
• Think of difficult things you have done in the past.
• Instead of a cigarette break at work, do something else interesting. You can play a game on your computer or something else to keep you happy. • Tell your friends, coworkers, boss, partner, and kids how you feel.
• If you relapse, just start again the process. You haven’t failed. Some people have to quit as many as eight times before they are successful.
If you do all this, you will have avoided much health risks in your life.
This is because, there are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer, according to The World Health Organisation (WHO). Stay safe, make informed health choices!

six.buguzi@gmail.com

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Monday, November 6, 2017

Dealing with stress in school - 1

A depiction of a stressed student trying to

A depiction of a stressed student trying to work on her notes. Stress among students is a less talked about issue which needs to be addressed. PHOTO | WEB 

By Rocky Amini

The development of student’s academic arena involves several issues combined together.
Despite of the struggles made by the teacher in instructing students in matters concerning academic issues, still, students need to be free in their mind-set both physically and psychologically.

Let’s break the ice
Stress is one of the things that affect students in more cases at school.
In a normal sense, stress can be expressed as the condition that happens to an individual and bring great affections in psychological aspects and bring out negative affections in the core behaviours of an individual.
What do I mean by this? This means, which is one of the problems, makes instability of one’s way of thinking and affects the brain to work in a sufficient condition.
It is, thus, the psychological problem that recently has been affecting the academic development of students in schools.
In order for the students to grow well, both morally and in a sufficient manner at schools, they need to get a good psychological foundation within the specific environment where studies are carried out by their teachers.
Access to good foundations of psychological set up of the students towards their environment strengthens up their developments in academic affairs.
When it happens that the psychological set up of the students is not well settled, obviously, whatever the teacher would teach such students in the classroom, never would any kind of understanding take place among these students.
Understanding of students when at school needs the good psychological set up that favours the growth of student’s mind and intellect. Students have to grow in the foundation that favours their psychological affections towards learning.

Dear teachers, hear this
Stress is a behaviour, which, as it gets strengthened to any individual, weakens him or her, and definitely brings exposes them to the psychological problems.
The duty of the teachers at school is to make sure that the environment set for the student’s development gives a fair pull towards academic improvement to the students.
When it happens that there is lack of such kind of good psychological environment, it’s true that the teacher may be in the classroom teaching the students and fails to determine whether the students have well understood the lesson.
The teacher here plays the role of understanding the good psychology that may handle students to get rid of stress towards their academic arena.

Associated effects that stress poses among students
Great accumulation of stress to the students can lead to more problems in the aspect of academic performance. This is due to the fact that stress affects students. In a great manner, affects the whole condition of an individual both physically and psychologically.
Some of the problems which most students with stress involve the restrain of the students from going to school.
In Tanzania the tendency of dropping from going to school in most cases has been reported as the problem and recently has been affecting a large number of students. Most stressed people do come with bad decision making which at the end carry the negativity aspects of human personnel.
In my second part of the series, we will go in depth about the effects and prevention of stress.
The author is an expert in the field of education.

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Monday, November 6, 2017

Here’s what you should know about the cancer risk factors



Dr. Christopher Peterson

Dr. Christopher Peterson 

By Dr Chris Peterson

The real reason why people develop cancer is yet to be known. But we do know some of the things that cause or influence the risk of developing cancer.
You can reduce the risk of getting cancer by making positive lifestyle choices. Abstaining from smoking, eating a healthy diet and keeping physically active are some of the ways you can do this.
But there are some of risk factors you cannot control, age being one of them. Generally, people above 60 years of age are more likely to develop cancer than younger people (those under 50). But this doesn’t necessarily mean that younger people don’t stand the chance of getting cancer.
Cancer develop because of plenty of factors, many of which we cannot even control. This makes checking your body and taking part in cancer screening programs really important. Your general physician can give you more information about it. But remember having a particular risk factor doesn’t mean you will ‘definitely’ get cancer.

Let’s talk of each risk factor in a little detail:
• Smoking will greatly increase your risk of getting lung cancer. About 9 out of 10 people who develop lung cancer are smokers. But not everyone who smokes will develop cancer.
• Cancer is very common and most of us have relatives who have had cancer. People often worry that a history of cancer in their family greatly increases their risk of developing it. But as few as 3 in 10 cancers are associated with a strong family history of cancer.
• One of the biggest risk factor is increasing age. Cancer can occur at any age but the risk of developing cancer increases as we get older. More than three out of five people who get cancer are over the age of 65 and more than a third are over 70.
• Other lifestyle risk factors can play an important role in the development of cancer. Around 4 in 10 cancers in Tanzania could be prevented by lifestyle changes.
However, making these changes doesn’t guarantee that you won’t get cancer at some point in life but they will make it less likely and will improve your general health.

What can you do
• If you smoke, giving up is the single most important thing you can do for your good health. Although data are yet to be actualised in Tanzania, more than 1 in 5 cancer deaths are linked to smoking. Smoking increases the risk of many cancers including cancer of the mouth, throat, lung, bladder, kidney, pancreas, bowel, stomach and cervix.
Breathing in other people’s smoke (passive smoking) also increases your risk of developing cancer. If you are worried about passive smoking, talk to your doctor. Help is available if you need to quit smoking.
• A healthy diet can reduce several factors of cancer too. Particularly bowel cancer. It can also lower your risk of other health problems such as heart diseases and diabetes.
You should eat foods that are high in fibre, such as whole grain bread and pasta, beans and oatmeal. Try to eat five portions of fruits and vegetables every day.
Limiting how much salt, red meat and processed meat you eat is also important.

sonchrispeter@gmail.com

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Monday, November 6, 2017

Are your teeth, jaws in wrong position?

Dr Emeria Mugonzibwa  is a lecturer of

Dr Emeria Mugonzibwa  is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences 

By Emeria Mugonzibwa

You do not have to worry. We, experts in dentistry have the responsibility of taking care of your teeth and jaws, in terms of supervision, guidance and correction.
We deal with conditions that require movement of the teeth or correction of mal-relationships and malformations of their related structures.
This is usually done under a specialty called orthodontics. Here,   we  diagnose, prevent, intercept and treat  all forms of the teeth, which are thought not to be aligned well in your  mouth.
In short, orthodontics is the branch of dentistry that corrects teeth and jaws that are positioned improperly.
Improper position of teeth and jaws is  a problem facing people in our society but not everyone knows where and how to deal with it. But, experts in Tanzania  are always ready to intervene.

Not a new practice
Orthodontics has been practiced since the days of the ancient Egyptians. However,  methods of treatment involving the use of bands, removable appliances and the current popular braces have become prominent only since the beginning of the 20th century.
In very general terms, orthodontic work aims at solving many problems including the following:
1. Where the upper front teeth lie too far forward (stick out) over the lower teeth
2. Appearance where the lower teeth are too far forward or the upper teeth too far back
3. When the upper teeth do not come down slightly in front of the lower teeth when biting together
4. When space between the biting surfaces of the front and/or side teeth when the back teeth bite together
5. When the center of your upper front teeth does not line up with the center of your lower front teeth
6. When there are gaps, or spaces, between the teeth as a result of missing teeth or teeth that do not fill up the mouth
7. When there are too many teeth for the dental ridge to accommodate

Types of orthodontic problems
Orthodontic misalignments, called malocclusions, can indicate a number of different conditions.
Inherited malocclusions include jaw growth problems, missing teeth, extra teeth, crowded or protruded teeth and spacing problems.
However, the premature loss of baby teeth, retention of baby teeth, thumb or finger-sucking, accidents, and congenital malformations like the cleft lip and/or palate as well as certain types of orofacial diseases can also result in a need for orthodontic intervention.

Importance of orthodontic treatment
Correcting orthodontic problems is not just about cosmetics and improving self-confidence.
There are very important oral health reasons as well. Malocclusions can cause difficulty in chewing and speaking while wearing away enamel on healthy teeth and putting excess stress on gum tissues and surrounding bone(s).
In addition, teeth that are overlapping are difficult to clean, which can put them at risk for tooth decay and gum disease.
Just like in engineering, an orthodontist works on structural integrity of the orofacial structures. In this case, instead of cement blocks, tiles, steel and fiberglass, for orthodontics, it is teeth, muscles, blood vessels, nerves, and bones.
General dentists can diagnose orthodontic problems that they might not necessarily have the particular training to treat on their own.
For this reason, it is usually incredibly important that dentists and orthodontists work together closely.
Like an architect calling an engineer to solve the particulars of a structural problem, a dentist will refer his or her patients to a specialised orthodontist for help that might involve braces, aligners, and sometimes surgery.

The author is a lecturer of Dentistry at Muhimbili University of Health and Allied Sciences (Muhas).

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Monday, October 30, 2017

Testimonies: how beauty products wrecked my skin

A make-up brush with broken cosmetic products.

A make-up brush with broken cosmetic products. Photo | Web 

By Lightness Mndeme & Jonathan Musa

Make-up is no doubt most women’s daily morning routine, with the intention of improving appearance before kick-starting a day. But with fine aesthetics comes the other side of the story, are these beauty products safe?
One such case who spoke to Your Health is a 54-year-old woman, Mariam Said, who confessed that beauty products ruined her skin health.
She has been using a variety of such products, including bleaching agents and mixing of different products. Mariam’s skin now looks burnt.
So where did Mariam go wrong? She began using such products without consulting an aesthetician, instead she was led into trying different products by her friends and social netwoks, to get the results she wanted. But as the days went, her skin got a lot worse.  
Upon asking her where she used to buy the products from, “I sometimes bought the products from small beauty kiosks which claimed that the products were imported from cross borders.”
She went on saying, “I always chose to ignore the labels because the chemical composition of the product never mattered to me, what was important at that time was only appealing results.”
Victims like Mariam at some point are influenced to use beauty products advertised through media, social networks and friend circles.

Why does the content in the beauty product matter
Speaking to health practitioner Dr Mwamvua Gugu on this subject, “Some of the beauty products, which are unauthorised are dangerous because of the chemical composition that have long term effects and can take years to show its effect on human body or skin.”
For instance, Dr Gugu exemplifies, skin lightning creams contain ingredients like chloroquinone, hydroquinone and mercury that  specialists despise their use.
In trying to understand how the biology works in damaging the skin, Dr Gugu explains, “Our skin contains melanin which gives human skin its natural look. Dangerous chemical compositions and combinations reduces this pigment that makes the skin prone to altered look and diseases. The other factor is that human skin is said to contain normal flora (bacteria) that actually protects our skin from diseases, but long term use of such products kills these protective flora and the consequences are known.”
If people are aware, why do they still buy? A brief survey done by Your Health showed that most of the beauty products bought by the consumers are sold on the street whose minds are sullied by cheap prices and fair skinned models on the products.
According to Dr Sylvester Mathias, a retired officer from Tanzania Food and Drugs Authority (TFDA) based in Tabora region, says counterfeit drugs including cosmetics pose a public health hazard, waste consumer income, and reduce the incentive to engage in research and development and innovation.
Stronger state licensure supervision of drug suppliers would be helpful.

Let’s talk lipstick
The most important component in a woman’s make-up kit is undoubtedly the lipstick. No make-up kit is complete without one or many lipsticks, considering the different shades and brands.
In big cities like in Mwanza for example, there are specific shops commonly known as boutiques meant for selling ladies’ cosmetics.
Sophia Nyange, 29, a boutique owner in Mwanza city, says she makes quite a profit, bearing in mind that most of her customers are working ladies.
 “Before opening this business, I was selling baby clothes. I came to realise that the business was not moving as expected and therefore got a clue from a friend over opening a make-up boutique,” she informs.
 Sophia says she orders her goods from Nairobi after every one week. The goods sometimes get over before even the ordered ones arrive. “I spend about Sh2.5 million to make a single order from Nairobi but this does not hinder me because when a customer is in hurry, especially the wholesalers who take the lipstick and lip gloss varieties, can make advance payments,” she confesses.
 While there are those who cannot go a day without wearing a lip shade, some don’t even own one.
24-year-old Pamela Juma, a resident of Geita region, tells Your Health she has been prohibited to use lipstick by her doctor, “Two years ago, I began using lipstick almost on an everyday basis of different brands but recently the area around my mouth developed rashes who advised me to stop using lipstick completely.”
But Pamela ridicules the advice by her doctor. She says that despite not applying the lipstick, her lips crack with blood. “My assumption is that over usage of lipstick makes the lip weak making its immunity low,” she says.
Pamela’s hypothesis is highlighted by Perpetua Hillary, a retired dermatologist based in Arusha who says that lipsticks come with its own inevitable side effects.
Women like Pamela wear lipstick when they leave home and continue wearing it all day long and sometimes even to bed.
“Altogether lipstick can cause allergy, irritation and chapping on the lips and the surrounding skin. Certain harmful chemicals and heavy metals can also cause cancer. Many lipsticks have petrochemicals as a common ingredient, which have harmful side-effects, for example these petrochemicals are a by-product of crude oil and natural gas. It can cause endocrine disruption that works as an obstacle for growth, development, reproduction and intelligence,” Dr Hillary cautions.

An expert’s outlook
Your Health had an opportunity to share the contradicting issue with Dr Mundil Trasi, a dermatologist at Hindu Mandal Hospital based in Mwanza. Dr Trasi discloses that lipsticks contain many harmful ingredients. These include chiefly toxic heavy metals like lead, cadmium, mercury and antimony.  In addition to lead, lipsticks may contain formaldehyde, a preservative and known carcinogen, mineral oil substances are also known to block pores while parabens like carcinogens are often used as preservatives. Lipstick manufacturers are also using harmful petrochemicals to produce such lip formulas.
“Lead is the commonly found harmful content in lipsticks. It mainly affects the nervous system and harms the hormonal system. Lipsticks are known to cause allergy and irritation over the lips and the surrounding skin,” he informed.
 He cited other harmful effects that are the blockage of pores, drying and chapping of lips. Certain harmful ingredients are known to cause cancer, also, heavy metal poisoning are present in minute quantities in our lipsticks.
 Dr Trasi adds that lipstick pigments contain harsh chemicals that irritate the skin and lead to blackening of lips or on can even cause leukoderma due to melanocyte destruction.
 
Can one die if she digests the pigments on lipstick or lip gloss?
 Lip formulas tend to be ingested after long hours of application, so the impact of the present toxins increases.
Researchers have found that average lipstick or lip gloss use resulted in women exceeding daily intake guidelines for aluminum, cadmium, chromium and manganese.
 “These accumulate in your body over time and cause toxicity. Also, sleeping with lipstick increases the chances of all the harmful effects mentioned and hence, is to be strictly avoided,” warned Dr Trasi.

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Monday, October 30, 2017

Separating dental facts from its myth - 10

Dr Emeria Mugonzibwa  is a lecturer of

Dr Emeria Mugonzibwa  is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences 

By Emeria Mugonzibwa

A lot of my patients that I have encountered cannot easily link or differentiate between oral health and overall health.
It’s important to ask questions and for that reason, in this week’s article, I’ve combined some of the preconceived notions on dental health that I’ve come across.
This is the tenth of the oral health myth series and its related facts.

Myth 1:
Oral health does not affect overall health.
Fact
When the gums are infected, bacterial byproducts can enter the blood stream and travel to major organs and cause other problems.
Research findings suggest that such scenario may contribute to the development of heart disease; one of the leading causes of death, increase the risk of stroke, increase a woman’s risk of having a pre-term or low birth weight baby and pose a serious threat to people whose health is compromised by diabetes, or respiratory diseases or osteoporosis.

Myth 2:
Stress does not cause problems in the mouth.
Fact
High levels of financial stress and poor coping abilities increase the likelihood of developing periodontal disease.
Researchers found people who dealt with financial strain in an active and practical way (problem-focused) rather than with avoidance techniques (emotion-focused) had no more risk of severe periodontal disease than those without money problems.

Myth 3:
The primary reason for tooth brushing is to remove food debris.
Fact
Brushing twice daily and flossing will in addition keep the formation of plaque to a minimum. If not removed every 26 hours, plaque will irritate gums, which can lead to serious (periodontal) disease.

Myth 4:
The more sugar one eats, the more teeth cavities she/he may get.
Fact
Teeth cavities depend on how long the sugar is in contact with the teeth in the presence of relevant bacteria, not the amount that was eaten.

Myth 5:
Sugar free or diet sodas are better for the teeth.
Fact
Carbonated beverages are highly acidic and are worse for the teeth than sugar.
 The best and healthier drink and beverage is plain water.

Myth 6: An individual should use a particular toothbrush as long as she/he wants.
Fact
Often the plastic tooth brush bristles become soft and furry from consistent use, therefore becoming less effective in cleaning the teeth.
But also if the tooth brush looks brand new after 3-4 months, there is something wrong. One is advised to brush at least two times a day for a minimum of two minutes.

Myth 7:
Everyone needs to use mouth rinse
Fact
Preferably, everyone should brush the teeth and floss between them. Before starting a mouth rinse, one should consult with an oral health care provider.

Myth 8:
Hard bristle toothbrushes are best.
Fact
Hard bristles or brushing too hard can wear down the tooth surface and cause gum recession leading to tooth loss.

 Myth 9:
If an individual does not have teeth cavities, she/he will not get gum disease.
Fact
Extreme sugar consumption, habits such as smoking, being too stressed, certain medication, obesity, heart disease, family history and poor nutrition can all cause gum disease. Treating gum disease early can help lower the risk of tooth loss.

The author is a dentist and a lecturer of Dentistry at Muhimbili University of Health and Allied Sciences (Muhas).

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Monday, October 30, 2017

An overlooked health condition: hypertension



Ali   Khatau

Ali   Khatau 

By Ali Khatau

Not many people know this, but hypertension is a very common health condition in Tanzania.
Recently, I volunteered to be part of an eye camp where citizens were checked for eye complications and then referred for surgery if it was found to be necessary, such as the cases of cataracts.
Patients referred for surgery had to be first checked for hypertension and diabetes by medical professionals. Being one of the volunteers who was checking the blood pressure of the patients, I noticed quite a significant number had elevated blood pressure.
Upon asking if they knew about it prior, they did not have the slightest idea that they had the condition. It was quite alarming especially considering long term hypertension eventually would lead to heart disease and death.
Hypertension also known as high blood pressure is a medical condition where the pressure of the blood flowing through the arteries is constantly higher than normal.
If not treated early on, the condition may lead to other complications including heart disease, kidney disease, stroke, heart failure and even vision loss.

Understanding the numbers
 Hypertension is divided into two categories, primary and secondary. Primary hypertension comprises of more than 90 per cent of the cases as it’s caused by unspecific lifestyle and genetic factors while secondary hypertension comprises of the remaining 10 per cent and is due to an underlying illness that elevates the blood pressure for example kidney disease.
The normal blood pressure at rest ranges from 100-140mmHg systolic and 60-90mmHg diastolic in adults. The ideal pressure in adults is 120/80 mmHg. An individual is diagnosed with hypertension if his blood pressure is above 140/90mmHg while anything below 100/60mmHg is considered hypotension (low blood pressure), the opposite of hypertension.
According to the World Health Organisation (WHO), hypertension affects a massive 1.1 billion people worldwide equivalent to around 14 per cent of the global population. WHO also mentions that hypertension causes around 7.5 million deaths worldwide, which is equivalent to 12.8 per cent of all deaths.
Sadly, the WHO mentions that the prevalence of hypertension was highest in Africa where it was 46 per cent for both sexes combined. Men usually have higher prevalence of hypertension than women. Hypertension, according to the World Heart Federation is the single most important risk factors for strokes and causes around 50 per cent of ischemic strokes.

Why Tanzanians need to pay attention to this
Hypertension and hypotension are both serious health problems in Tanzania.
Also according to WHO, hypertension deaths in Tanzania reached around 3,400 or 0.96 per cent of total deaths.

Are there any visible signs?
Hypertension in adults is rarely accompanied by any signs and symptoms and it is usually identified during routine health check-ups and when checking the pressure during treatment of an unrelated medical condition.
Occasionally, patients with hypertension might report of headaches, vertigo, buzzing in the ears, altered vision and possibly fainting. In children, hypertension can cause headache, irritability, blurred vision and bleeding from the nose.

What’s the cause?
Primary hypertension arises due to environmental and genetic factors. The condition commonly develops in aging and older people. It can also be caused by high salt intake, lack of exercise or prolonged inactivity, depression and obesity.
Certain events and activities during pregnancy and birth might also contribute to a person developing the condition.  
Secondary hypertension as earlier described is due to an underlying medical condition.

Here’s how to prevent it
As with any disease, you would rather prevent it from developing in the first place than to let it develop and seek for treatments.
This is especially true considering some diseases and conditions don’t have any cure and require the patient to be on medication for the rest of their lives.
In order to prevent developing this condition, an individual must maintain a normal and healthy body weight, he must reduce dietary salt intake and must limit alcohol consumption if he cannot quit it altogether.
An individual must also engage in regular physical exercise and must also consume a diet rich in fruits and vegetables. For people who have already developed the condition, seek further advice from your doctor.

The author is a student at the Hubert Kairuki Memorial University.

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Monday, October 30, 2017

Secrets of people who don’t fall sick easily



A happy couple. Photo | File

A happy couple. Photo | File 

By Devotha John

My father always used to preach to us this particular saying when we were young: ‘early to bed and early to rise, makes you healthy, wealthy and wise.’ I might not have paid attention to it then, but now that can translate into one of the many secrets healthy people abide by.
In an interview with Your Health, Dr Mwamvua Gugu from Lindi Regional Hospital emphasises that being healthy means decreasing the risk of developing different conditions including heart disease, stroke, cancers and injuries.
But she also contradicts the fact that there are people who don’t fall sick at all. She says, “It is very rare to find such people nowadays because factors such as ‘junk food’ have become our lifestyle.”
But Dr Gugu has witnessed people outside the hospital who have not visited a physician throughout the year. And here are the aspects one can learn from them on what needs to be done to stay healthy.

Food choices matter
Dr Gugu says that by making healthier food choices, one can prevent or treat some conditions. These include heart disease, stroke, and diabetes. “A healthy diet can help you lose weight and lower your cholesterol,” she adds.

Be fit and fab
Routine yourself to be active and exercising at least 30-60 minutes a day, five times a week. Any amount of exercise is better than none. Dr Gugu adds, “Exercise can help treat depression, high blood pressure and keeps diabetes and weight under control.”

Power down 
Getting eough sleep is good for keeping your heart healthy and if you don’t sleep enough you may be at the risk of getting cardiovascular disease, no matter what your age is, explains Dr Gugu. “Adults should at least sleep for 8 hours and the young ones should have longer sleep hours, about 10 to 12 hour per day,” Dr Gugu advises.

Stay sun safe
Sun exposure is linked to skin cancer. This is the most common type of cancer in every place. It’s best to limit your time spent in the sun.
Be sure to wear protective clothing and hats when you are outside. Use sunscreen year-round on exposed skin, like your face and hands, cautions Dr Gugu.

Practice safe sex
Safe sex is good for your emotional and physical health, advises Dr Gugu. Use protection, like condoms, to prevent sexually transmitted diseases (STDs).

Don’t smoke or use tobacco
Smoking and tobacco use are harmful habits. They can cause heart diseaseincluding mouth, throat or lung cancer. They also are leading factors of emphysema and chronic obstructive pulmonary disease (COPD). The sooner you quit, the better.
In addition, you should make time for full body health check-ups. Visit your doctor for regular checkups, including  a dentist and an eye doctor.
djohn@tz.nationmedia.com

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Monday, October 30, 2017

Important lessons to take home as pink October comes to an end



Dr. Christopher Peterson

Dr. Christopher Peterson 

By Chris Peterson

Tomorrow marks the end of the month Pink October (breast cancer awareness month), but the war against breast cancer should not end. And in order to win a victorious fight, we have to consider these two weapons: early detection and awareness; and I am sure I don’t need to remind you on these two essentials in depth.
A lot of women fall into being victims of breast cancer by neglecting these two factors and of course, that’s when the hidden truths of the disease remain undercover.
We are not guaranteed to make it safely in next year’s October, so let’s discuss some of the breast cancer’s common misconceptions.

1. Some women with small breasts assume they have got nothing there for cancer to grow in. Whether you think your breasts are small or large and whatever the shape, you still have breast tissue. And any breast tissue puts you at risk for cancer. Even men get breast cancer.

2. Women are left “puzzled” when their medical reports say their breasts are dense after their mammogram test. Breasts are made up of glandular tissue (which produces breast milk), connective tissue (to support the breast) and fatty tissue.
The ratio of these three components determines whether you have dense breast or not. Over 50 per cent of women aged above 45 have dense breasts.  You cant actually feel if you have dense breasts. This is a radiology term to describe your mammogram results. Dense breasts doesn’t mean you have cancer, but because of how dense a breast look on a mammogram, it can make it more difficult to read them.
3. Women don’t know the perfect time (interval) to get a breast screening done. According to recent recommendations from Tanzanian Cancer Society, these are the  guidelines every woman should know.

• Women with ages from 25 to 45 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
• Women from ages 45 to 55 should get mammogram screening every year.
• Women aged 55 and older can switch to mammograms every two years or can continue yearly screening. Screening should continue as long as woman is in good health.
If you look closely, these are guidelines for a women of “average” risk. Average is a vague term, so it’s important to discuss these recommendations with your health care provider. Determine if you have any risk factors, and decide what makes sense for you.

4. Some women believe they don’t stand a chance to get breast cancer because no one in their families had one. So they don’t need screening at all. This is wrong!
Only 5 to 10 per cent  of breast cancers are familial (someone in your family has it), that means, 90 to 95 per cent are spontaneous, with NO family history. So don’t let your lack of family history of cancer lull you into thinking you have no risk and no reason for screening.
Finally, talk to your health care provider. Make an informed decision about what is the best for you, when and what type of screening you need.

The author is a doctor with the Muhimbili National Hospital in Dar es Salaam.

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Monday, October 30, 2017

Battling life-threatening illness at 18

This is not a real photo pf Fatuma*. It's an

This is not a real photo pf Fatuma*. It's an illustrating picture of the agony and pain of the subject. Photo | Beyond Black & White 

By Lugano Wilson

A teenager named Fatuma* (real name not revealed due to ethical reasons), aged 18, was referred from Singida with the main complaints of general body swelling, difficulty in breathing, cough, easy fatigability and itching.
Upon physical examination she looked sick, with high blood pressure, puffy face, legs and feet were swollen, her abdomen was distended with signs of water therein  (ascites), a heart murmur was heard and abnormal lung sounds were heard.
The reasons for referral were; a heart investigation, kidney function investigation and for advanced management including possible dialysis.
Fatuma came at the centre dressed in pink gown that looked somehow dowdy as I attended to her.
She stays with her aunt since her mother’s divorce more than a decade ago. Her mother remarried, thus she most often felt so despondent since she does not enjoy motherly care as others do, and moreover she is a standard seven leaver.
She had been sick for so long. She has had a history of hypertension during pregnancy.
When I asked her grandpa who brought her to the hospital as to why they didn’t bring her in earlier, he responded in Swahili, “tulikuwa hatujui kama atakuja kuumwa sana kama hivi, lakini hata tungejua hatuna pesa za kumtibia.” (Loosely translated to mean that they did not know she would get really sick and they did not have money to treat her.)
Thus after carrying out a battery of tests, we came to realise that the teenager had chronic kidney failure stage 5 and heart failure.

Did she know anything about the disease?
 You know sometimes in Bongo, patients are not interested to know what they suffer from, rather they are  more interested in quick symptomatic recovery.
Fatuma never indicated any sign of wanting to know her problem, however her grandpa eventually asked me about what ailed his granddaughter.
Thus I had to explain to this old man as he bombarded me with a lot of questions.
Then I expounded, “Mzee, one of the important role of the kidney is to clean your blood. As the blood moves throughout your body, it picks up extra things like fluid, chemicals and wastes,” he interrupted and laughed, “wastes!?”
Then I continued, “Now, the kidney separates these materials (including wastes) from the blood it has carried out of the body in urine, but Fatuma’s kidneys can no longer do that,” he then looked shocked!
Chronic kidney failure or chronic kidney disease (CKD) as many doctors in Tanzania prefer to use, can be fatal if not detected early.
Therefore CKD can be described as gradual loss of kidney function and in its early stages, one with the disease may be asymptomatic. Sadly, CKD may become apparent when and if your kidney function is significantly impaired, and those symptoms are non-specific. CKD can progress to what doctors describe as “ESRD” (end stage renal disease), which is fatal without artificial filtering (dialysis) or kidney transplant.
Symptoms  include, nausea, vomiting, loss of appetite,  fatigue, sleep problems, decreased urine output, muscle twitch and cramps, swelling of feet and ankles, persistent itching,  chest pain and shortness of breath if fluid builds up around the lining of the heart and lungs respectively, and high blood pressure that is difficult to control.

What caused Fatuma’s CKD?
This is one of the questions that I was asked by her grandpa. CKD occurs when a disease or a medical conditions impair kidney function bringing forth kidney damage. The causes can be one  of these;  diabetes mellitus, hypertension, glomerulonephritis, glomerula inflammation, interstial nephritis, polycystic kidney disease, vesicoureteral reflux, recurrent kidney infections, but for this teenager high blood pressure was considered as the major cause.
Risk factors include, diabetes, hypertension, heart and blood vessel diseases, smoking , obesity, family history of kidney disease, abnormal kidney structure, and older age (though Fatuma was just 18).

Did she develop any complications?
Of course. Fatuma had some complications like, anaemia. Mind you she had a low levels of haemoglobin, she had electrolytes/body minerals imbalance, and fluid buildup in the lungs and other parts of the body as narrated above.
So other complications for CKD can be blood and heart diseases, bone and muscle weakness, damage to nervous system, decreased immune response and reduced fertility.

Was Fatuma treated accordingly?
Till now Fatuma is still getting dialysis service in Dodoma, however she is facing financial challenges of which doctors, some good Samaritans and the social affairs department are part of endeavours to give her a boost.
Her grandpa did a commendable and tremendous task to look for funds and is currently negotiating with the hospital and UDOM/ Benjamin Mkapa Hospital Dialysis centre and social affairs departments.
Fatuma’s treatment involves dialysis and when we explained to her grandpa about this kind of treatment he even panicked. Dialysis is very expensive and she needs 156 dialysis sessions per year, three times a week. A single session costs Sh400,000 up to Sh600,000 and on top of that she will have to do that for the rest of her life unless she undergoes kidney transplant, a service that is not even available in Tanzania.
The author is a medical doctor, public health activist and a researcher based in Dodoma.

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Monday, October 30, 2017

Watch your sleep in this smartphone era



Syriacus Buguzi

Syriacus Buguzi 

By Syriacus Buguzi

The era of smartphones has come with a price to pay. People’s fingers are on the key pad almost everywhere they go.
 Even at bed time, people use smartphones, they delay sleep for many hours as they scroll, browse, text and so on.  
 Because of this, people sleep less and less and this has a huge impact on their health.

Why is sleep important?
 For a healthy lifestyle, adequate sleep is part and parcel and doing this can avert many health challenges arising from the lack of it.
 Modern-day health challenges such as diabetes have been associated with lack of enough sleep.
 When you have enough sleep, it means that your brain can process and consolidate memories. People who tend not to sleep well also have difficulty learning and focusing during their day time activities.
 Some studies have shown that a 30-minute nap can boost brain power and reduce fatigue at the work places
 People with insomnia--difficulty falling asleep have resorted to seeking medication. Unfortunately, many drugs that are prescribed for insomnia can impair memory.
 Doctors usually advise people to work the sleep challenges before turning to medication. They can prepare well for a sleep. This is something people tend to ignore.
 Our bodies, in order to function well, require a consistent time to sleep, that also includes an uninterrupted one.

Tips to get a good night’s sleep
• Switch off smartphones as when going to bed. The light from the phone screen and colourful LED lights keep the brain active when it shouldn’t be.
 • As we enter our rooms to sleep, it also advisable to switch off all the lights. The darkness in the room can be conducive enough for one to sleep. A bright lit room has never been a perfect place to have deep night sleep.
 • Caffeine and similar drinks that increase heart rate are not the best of beverages at bed time. Such drinks are good for noon; evening outings.
 • Keeping away from arguments in the evening times can be a good trick in achieving a good night sleep.The aim of this is to  reduce the adrenaline that comes with it.
 • But more important is the stress associated. Actually stress of any kind should be mitigated to ensure a good night sleep.
 • One needs to switch to a relax mode a few minutes before bed so as to achieve the best results of sleep.
 As usual, always read this platform to stay safe and make informed health choices.

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Monday, October 30, 2017

Testimonies: how beauty products wrecked my skin

A make-up brush with broken cosmetic products.

A make-up brush with broken cosmetic products. Photo | Web 

By Lightness Mndeme & Jonathan Musa

Make-up is no doubt most women’s daily morning routine, with the intention of improving appearance before kick-starting a day. But with fine aesthetics comes the other side of the story, are these beauty products safe?
One such case who spoke to Your Health is a 54-year-old woman, Mariam Said, who confessed that beauty products ruined her skin health.
She has been using a variety of such products, including bleaching agents and mixing of different products. Mariam’s skin now looks burnt.
So where did Mariam go wrong? She began using such products without consulting an aesthetician, instead she was led into trying different products by her friends and social netwoks, to get the results she wanted. But as the days went, her skin got a lot worse.  
Upon asking her where she used to buy the products from, “I sometimes bought the products from small beauty kiosks which claimed that the products were imported from cross borders.”
She went on saying, “I always chose to ignore the labels because the chemical composition of the product never mattered to me, what was important at that time was only appealing results.”
Victims like Mariam at some point are influenced to use beauty products advertised through media, social networks and friend circles.

Why does the content in the beauty product matter
Speaking to health practitioner Dr Mwamvua Gugu on this subject, “Some of the beauty products, which are unauthorised are dangerous because of the chemical composition that have long term effects and can take years to show its effect on human body or skin.”
For instance, Dr Gugu exemplifies, skin lightning creams contain ingredients like chloroquinone, hydroquinone and mercury that  specialists despise their use.
In trying to understand how the biology works in damaging the skin, Dr Gugu explains, “Our skin contains melanin which gives human skin its natural look. Dangerous chemical compositions and combinations reduces this pigment that makes the skin prone to altered look and diseases. The other factor is that human skin is said to contain normal flora (bacteria) that actually protects our skin from diseases, but long term use of such products kills these protective flora and the consequences are known.”
If people are aware, why do they still buy? A brief survey done by Your Health showed that most of the beauty products bought by the consumers are sold on the street whose minds are sullied by cheap prices and fair skinned models on the products.
According to Dr Sylvester Mathias, a retired officer from Tanzania Food and Drugs Authority (TFDA) based in Tabora region, says counterfeit drugs including cosmetics pose a public health hazard, waste consumer income, and reduce the incentive to engage in research and development and innovation.
Stronger state licensure supervision of drug suppliers would be helpful.

Let’s talk lipstick
The most important component in a woman’s make-up kit is undoubtedly the lipstick. No make-up kit is complete without one or many lipsticks, considering the different shades and brands.
In big cities like in Mwanza for example, there are specific shops commonly known as boutiques meant for selling ladies’ cosmetics.
Sophia Nyange, 29, a boutique owner in Mwanza city, says she makes quite a profit, bearing in mind that most of her customers are working ladies.
 “Before opening this business, I was selling baby clothes. I came to realise that the business was not moving as expected and therefore got a clue from a friend over opening a make-up boutique,” she informs.
 Sophia says she orders her goods from Nairobi after every one week. The goods sometimes get over before even the ordered ones arrive. “I spend about Sh2.5 million to make a single order from Nairobi but this does not hinder me because when a customer is in hurry, especially the wholesalers who take the lipstick and lip gloss varieties, can make advance payments,” she confesses.
 While there are those who cannot go a day without wearing a lip shade, some don’t even own one.
24-year-old Pamela Juma, a resident of Geita region, tells Your Health she has been prohibited to use lipstick by her doctor, “Two years ago, I began using lipstick almost on an everyday basis of different brands but recently the area around my mouth developed rashes who advised me to stop using lipstick completely.”
But Pamela ridicules the advice by her doctor. She says that despite not applying the lipstick, her lips crack with blood. “My assumption is that over usage of lipstick makes the lip weak making its immunity low,” she says.
Pamela’s hypothesis is highlighted by Perpetua Hillary, a retired dermatologist based in Arusha who says that lipsticks come with its own inevitable side effects.
Women like Pamela wear lipstick when they leave home and continue wearing it all day long and sometimes even to bed.
“Altogether lipstick can cause allergy, irritation and chapping on the lips and the surrounding skin. Certain harmful chemicals and heavy metals can also cause cancer. Many lipsticks have petrochemicals as a common ingredient, which have harmful side-effects, for example these petrochemicals are a by-product of crude oil and natural gas. It can cause endocrine disruption that works as an obstacle for growth, development, reproduction and intelligence,” Dr Hillary cautions.

An expert’s outlook
Your Health had an opportunity to share the contradicting issue with Dr Mundil Trasi, a dermatologist at Hindu Mandal Hospital based in Mwanza. Dr Trasi discloses that lipsticks contain many harmful ingredients. These include chiefly toxic heavy metals like lead, cadmium, mercury and antimony.  In addition to lead, lipsticks may contain formaldehyde, a preservative and known carcinogen, mineral oil substances are also known to block pores while parabens like carcinogens are often used as preservatives. Lipstick manufacturers are also using harmful petrochemicals to produce such lip formulas.
“Lead is the commonly found harmful content in lipsticks. It mainly affects the nervous system and harms the hormonal system. Lipsticks are known to cause allergy and irritation over the lips and the surrounding skin,” he informed.
 He cited other harmful effects that are the blockage of pores, drying and chapping of lips. Certain harmful ingredients are known to cause cancer, also, heavy metal poisoning are present in minute quantities in our lipsticks.
 Dr Trasi adds that lipstick pigments contain harsh chemicals that irritate the skin and lead to blackening of lips or on can even cause leukoderma due to melanocyte destruction.
 
Can one die if she digests the pigments on lipstick or lip gloss?
 Lip formulas tend to be ingested after long hours of application, so the impact of the present toxins increases.
Researchers have found that average lipstick or lip gloss use resulted in women exceeding daily intake guidelines for aluminum, cadmium, chromium and manganese.
 “These accumulate in your body over time and cause toxicity. Also, sleeping with lipstick increases the chances of all the harmful effects mentioned and hence, is to be strictly avoided,” warned Dr Trasi.

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Monday, October 30, 2017

Important lessons to take home as pink October comes to an end



Dr. Christopher Peterson

Dr. Christopher Peterson 

By Chris Peterson

Tomorrow marks the end of the month Pink October (breast cancer awareness month), but the war against breast cancer should not end. And in order to win a victorious fight, we have to consider these two weapons: early detection and awareness; and I am sure I don’t need to remind you on these two essentials in depth.
A lot of women fall into being victims of breast cancer by neglecting these two factors and of course, that’s when the hidden truths of the disease remain undercover.
We are not guaranteed to make it safely in next year’s October, so let’s discuss some of the breast cancer’s common misconceptions.

1. Some women with small breasts assume they have got nothing there for cancer to grow in. Whether you think your breasts are small or large and whatever the shape, you still have breast tissue. And any breast tissue puts you at risk for cancer. Even men get breast cancer.

2. Women are left “puzzled” when their medical reports say their breasts are dense after their mammogram test. Breasts are made up of glandular tissue (which produces breast milk), connective tissue (to support the breast) and fatty tissue.
The ratio of these three components determines whether you have dense breast or not. Over 50 per cent of women aged above 45 have dense breasts.  You cant actually feel if you have dense breasts. This is a radiology term to describe your mammogram results. Dense breasts doesn’t mean you have cancer, but because of how dense a breast look on a mammogram, it can make it more difficult to read them.
3. Women don’t know the perfect time (interval) to get a breast screening done. According to recent recommendations from Tanzanian Cancer Society, these are the  guidelines every woman should know.

• Women with ages from 25 to 45 should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
• Women from ages 45 to 55 should get mammogram screening every year.
• Women aged 55 and older can switch to mammograms every two years or can continue yearly screening. Screening should continue as long as woman is in good health.
If you look closely, these are guidelines for a women of “average” risk. Average is a vague term, so it’s important to discuss these recommendations with your health care provider. Determine if you have any risk factors, and decide what makes sense for you.

4. Some women believe they don’t stand a chance to get breast cancer because no one in their families had one. So they don’t need screening at all. This is wrong!
Only 5 to 10 per cent  of breast cancers are familial (someone in your family has it), that means, 90 to 95 per cent are spontaneous, with NO family history. So don’t let your lack of family history of cancer lull you into thinking you have no risk and no reason for screening.
Finally, talk to your health care provider. Make an informed decision about what is the best for you, when and what type of screening you need.

The author is a doctor with the Muhimbili National Hospital in Dar es Salaam.

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Monday, October 30, 2017

Separating dental facts from its myth - 10

Dr Emeria Mugonzibwa  is a lecturer of

Dr Emeria Mugonzibwa  is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences 

By Emeria Mugonzibwa

A lot of my patients that I have encountered cannot easily link or differentiate between oral health and overall health.
It’s important to ask questions and for that reason, in this week’s article, I’ve combined some of the preconceived notions on dental health that I’ve come across.
This is the tenth of the oral health myth series and its related facts.

Myth 1:
Oral health does not affect overall health.
Fact
When the gums are infected, bacterial byproducts can enter the blood stream and travel to major organs and cause other problems.
Research findings suggest that such scenario may contribute to the development of heart disease; one of the leading causes of death, increase the risk of stroke, increase a woman’s risk of having a pre-term or low birth weight baby and pose a serious threat to people whose health is compromised by diabetes, or respiratory diseases or osteoporosis.

Myth 2:
Stress does not cause problems in the mouth.
Fact
High levels of financial stress and poor coping abilities increase the likelihood of developing periodontal disease.
Researchers found people who dealt with financial strain in an active and practical way (problem-focused) rather than with avoidance techniques (emotion-focused) had no more risk of severe periodontal disease than those without money problems.

Myth 3:
The primary reason for tooth brushing is to remove food debris.
Fact
Brushing twice daily and flossing will in addition keep the formation of plaque to a minimum. If not removed every 26 hours, plaque will irritate gums, which can lead to serious (periodontal) disease.

Myth 4:
The more sugar one eats, the more teeth cavities she/he may get.
Fact
Teeth cavities depend on how long the sugar is in contact with the teeth in the presence of relevant bacteria, not the amount that was eaten.

Myth 5:
Sugar free or diet sodas are better for the teeth.
Fact
Carbonated beverages are highly acidic and are worse for the teeth than sugar.
 The best and healthier drink and beverage is plain water.

Myth 6: An individual should use a particular toothbrush as long as she/he wants.
Fact
Often the plastic tooth brush bristles become soft and furry from consistent use, therefore becoming less effective in cleaning the teeth.
But also if the tooth brush looks brand new after 3-4 months, there is something wrong. One is advised to brush at least two times a day for a minimum of two minutes.

Myth 7:
Everyone needs to use mouth rinse
Fact
Preferably, everyone should brush the teeth and floss between them. Before starting a mouth rinse, one should consult with an oral health care provider.

Myth 8:
Hard bristle toothbrushes are best.
Fact
Hard bristles or brushing too hard can wear down the tooth surface and cause gum recession leading to tooth loss.

 Myth 9:
If an individual does not have teeth cavities, she/he will not get gum disease.
Fact
Extreme sugar consumption, habits such as smoking, being too stressed, certain medication, obesity, heart disease, family history and poor nutrition can all cause gum disease. Treating gum disease early can help lower the risk of tooth loss.

The author is a dentist and a lecturer of Dentistry at Muhimbili University of Health and Allied Sciences (Muhas).

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Monday, October 30, 2017

Secrets of people who don’t fall sick easily



A happy couple. Photo | File

A happy couple. Photo | File 

By Devotha John

My father always used to preach to us this particular saying when we were young: ‘early to bed and early to rise, makes you healthy, wealthy and wise.’ I might not have paid attention to it then, but now that can translate into one of the many secrets healthy people abide by.
In an interview with Your Health, Dr Mwamvua Gugu from Lindi Regional Hospital emphasises that being healthy means decreasing the risk of developing different conditions including heart disease, stroke, cancers and injuries.
But she also contradicts the fact that there are people who don’t fall sick at all. She says, “It is very rare to find such people nowadays because factors such as ‘junk food’ have become our lifestyle.”
But Dr Gugu has witnessed people outside the hospital who have not visited a physician throughout the year. And here are the aspects one can learn from them on what needs to be done to stay healthy.

Food choices matter
Dr Gugu says that by making healthier food choices, one can prevent or treat some conditions. These include heart disease, stroke, and diabetes. “A healthy diet can help you lose weight and lower your cholesterol,” she adds.

Be fit and fab
Routine yourself to be active and exercising at least 30-60 minutes a day, five times a week. Any amount of exercise is better than none. Dr Gugu adds, “Exercise can help treat depression, high blood pressure and keeps diabetes and weight under control.”

Power down 
Getting eough sleep is good for keeping your heart healthy and if you don’t sleep enough you may be at the risk of getting cardiovascular disease, no matter what your age is, explains Dr Gugu. “Adults should at least sleep for 8 hours and the young ones should have longer sleep hours, about 10 to 12 hour per day,” Dr Gugu advises.

Stay sun safe
Sun exposure is linked to skin cancer. This is the most common type of cancer in every place. It’s best to limit your time spent in the sun.
Be sure to wear protective clothing and hats when you are outside. Use sunscreen year-round on exposed skin, like your face and hands, cautions Dr Gugu.

Practice safe sex
Safe sex is good for your emotional and physical health, advises Dr Gugu. Use protection, like condoms, to prevent sexually transmitted diseases (STDs).

Don’t smoke or use tobacco
Smoking and tobacco use are harmful habits. They can cause heart diseaseincluding mouth, throat or lung cancer. They also are leading factors of emphysema and chronic obstructive pulmonary disease (COPD). The sooner you quit, the better.
In addition, you should make time for full body health check-ups. Visit your doctor for regular checkups, including  a dentist and an eye doctor.
djohn@tz.nationmedia.com

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Monday, October 30, 2017

Battling life-threatening illness at 18

This is not a real photo pf Fatuma*. It's an

This is not a real photo pf Fatuma*. It's an illustrating picture of the agony and pain of the subject. Photo | Beyond Black & White 

By Lugano Wilson

A teenager named Fatuma* (real name not revealed due to ethical reasons), aged 18, was referred from Singida with the main complaints of general body swelling, difficulty in breathing, cough, easy fatigability and itching.
Upon physical examination she looked sick, with high blood pressure, puffy face, legs and feet were swollen, her abdomen was distended with signs of water therein  (ascites), a heart murmur was heard and abnormal lung sounds were heard.
The reasons for referral were; a heart investigation, kidney function investigation and for advanced management including possible dialysis.
Fatuma came at the centre dressed in pink gown that looked somehow dowdy as I attended to her.
She stays with her aunt since her mother’s divorce more than a decade ago. Her mother remarried, thus she most often felt so despondent since she does not enjoy motherly care as others do, and moreover she is a standard seven leaver.
She had been sick for so long. She has had a history of hypertension during pregnancy.
When I asked her grandpa who brought her to the hospital as to why they didn’t bring her in earlier, he responded in Swahili, “tulikuwa hatujui kama atakuja kuumwa sana kama hivi, lakini hata tungejua hatuna pesa za kumtibia.” (Loosely translated to mean that they did not know she would get really sick and they did not have money to treat her.)
Thus after carrying out a battery of tests, we came to realise that the teenager had chronic kidney failure stage 5 and heart failure.

Did she know anything about the disease?
 You know sometimes in Bongo, patients are not interested to know what they suffer from, rather they are  more interested in quick symptomatic recovery.
Fatuma never indicated any sign of wanting to know her problem, however her grandpa eventually asked me about what ailed his granddaughter.
Thus I had to explain to this old man as he bombarded me with a lot of questions.
Then I expounded, “Mzee, one of the important role of the kidney is to clean your blood. As the blood moves throughout your body, it picks up extra things like fluid, chemicals and wastes,” he interrupted and laughed, “wastes!?”
Then I continued, “Now, the kidney separates these materials (including wastes) from the blood it has carried out of the body in urine, but Fatuma’s kidneys can no longer do that,” he then looked shocked!
Chronic kidney failure or chronic kidney disease (CKD) as many doctors in Tanzania prefer to use, can be fatal if not detected early.
Therefore CKD can be described as gradual loss of kidney function and in its early stages, one with the disease may be asymptomatic. Sadly, CKD may become apparent when and if your kidney function is significantly impaired, and those symptoms are non-specific. CKD can progress to what doctors describe as “ESRD” (end stage renal disease), which is fatal without artificial filtering (dialysis) or kidney transplant.
Symptoms  include, nausea, vomiting, loss of appetite,  fatigue, sleep problems, decreased urine output, muscle twitch and cramps, swelling of feet and ankles, persistent itching,  chest pain and shortness of breath if fluid builds up around the lining of the heart and lungs respectively, and high blood pressure that is difficult to control.

What caused Fatuma’s CKD?
This is one of the questions that I was asked by her grandpa. CKD occurs when a disease or a medical conditions impair kidney function bringing forth kidney damage. The causes can be one  of these;  diabetes mellitus, hypertension, glomerulonephritis, glomerula inflammation, interstial nephritis, polycystic kidney disease, vesicoureteral reflux, recurrent kidney infections, but for this teenager high blood pressure was considered as the major cause.
Risk factors include, diabetes, hypertension, heart and blood vessel diseases, smoking , obesity, family history of kidney disease, abnormal kidney structure, and older age (though Fatuma was just 18).

Did she develop any complications?
Of course. Fatuma had some complications like, anaemia. Mind you she had a low levels of haemoglobin, she had electrolytes/body minerals imbalance, and fluid buildup in the lungs and other parts of the body as narrated above.
So other complications for CKD can be blood and heart diseases, bone and muscle weakness, damage to nervous system, decreased immune response and reduced fertility.

Was Fatuma treated accordingly?
Till now Fatuma is still getting dialysis service in Dodoma, however she is facing financial challenges of which doctors, some good Samaritans and the social affairs department are part of endeavours to give her a boost.
Her grandpa did a commendable and tremendous task to look for funds and is currently negotiating with the hospital and UDOM/ Benjamin Mkapa Hospital Dialysis centre and social affairs departments.
Fatuma’s treatment involves dialysis and when we explained to her grandpa about this kind of treatment he even panicked. Dialysis is very expensive and she needs 156 dialysis sessions per year, three times a week. A single session costs Sh400,000 up to Sh600,000 and on top of that she will have to do that for the rest of her life unless she undergoes kidney transplant, a service that is not even available in Tanzania.
The author is a medical doctor, public health activist and a researcher based in Dodoma.

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Monday, October 30, 2017

Watch your sleep in this smartphone era



Syriacus Buguzi

Syriacus Buguzi 

By Syriacus Buguzi

The era of smartphones has come with a price to pay. People’s fingers are on the key pad almost everywhere they go.
 Even at bed time, people use smartphones, they delay sleep for many hours as they scroll, browse, text and so on.  
 Because of this, people sleep less and less and this has a huge impact on their health.

Why is sleep important?
 For a healthy lifestyle, adequate sleep is part and parcel and doing this can avert many health challenges arising from the lack of it.
 Modern-day health challenges such as diabetes have been associated with lack of enough sleep.
 When you have enough sleep, it means that your brain can process and consolidate memories. People who tend not to sleep well also have difficulty learning and focusing during their day time activities.
 Some studies have shown that a 30-minute nap can boost brain power and reduce fatigue at the work places
 People with insomnia--difficulty falling asleep have resorted to seeking medication. Unfortunately, many drugs that are prescribed for insomnia can impair memory.
 Doctors usually advise people to work the sleep challenges before turning to medication. They can prepare well for a sleep. This is something people tend to ignore.
 Our bodies, in order to function well, require a consistent time to sleep, that also includes an uninterrupted one.

Tips to get a good night’s sleep
• Switch off smartphones as when going to bed. The light from the phone screen and colourful LED lights keep the brain active when it shouldn’t be.
 • As we enter our rooms to sleep, it also advisable to switch off all the lights. The darkness in the room can be conducive enough for one to sleep. A bright lit room has never been a perfect place to have deep night sleep.
 • Caffeine and similar drinks that increase heart rate are not the best of beverages at bed time. Such drinks are good for noon; evening outings.
 • Keeping away from arguments in the evening times can be a good trick in achieving a good night sleep.The aim of this is to  reduce the adrenaline that comes with it.
 • But more important is the stress associated. Actually stress of any kind should be mitigated to ensure a good night sleep.
 • One needs to switch to a relax mode a few minutes before bed so as to achieve the best results of sleep.
 As usual, always read this platform to stay safe and make informed health choices.

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Monday, October 30, 2017

An overlooked health condition: hypertension



Ali   Khatau

Ali   Khatau 

By Ali Khatau

Not many people know this, but hypertension is a very common health condition in Tanzania.
Recently, I volunteered to be part of an eye camp where citizens were checked for eye complications and then referred for surgery if it was found to be necessary, such as the cases of cataracts.
Patients referred for surgery had to be first checked for hypertension and diabetes by medical professionals. Being one of the volunteers who was checking the blood pressure of the patients, I noticed quite a significant number had elevated blood pressure.
Upon asking if they knew about it prior, they did not have the slightest idea that they had the condition. It was quite alarming especially considering long term hypertension eventually would lead to heart disease and death.
Hypertension also known as high blood pressure is a medical condition where the pressure of the blood flowing through the arteries is constantly higher than normal.
If not treated early on, the condition may lead to other complications including heart disease, kidney disease, stroke, heart failure and even vision loss.

Understanding the numbers
 Hypertension is divided into two categories, primary and secondary. Primary hypertension comprises of more than 90 per cent of the cases as it’s caused by unspecific lifestyle and genetic factors while secondary hypertension comprises of the remaining 10 per cent and is due to an underlying illness that elevates the blood pressure for example kidney disease.
The normal blood pressure at rest ranges from 100-140mmHg systolic and 60-90mmHg diastolic in adults. The ideal pressure in adults is 120/80 mmHg. An individual is diagnosed with hypertension if his blood pressure is above 140/90mmHg while anything below 100/60mmHg is considered hypotension (low blood pressure), the opposite of hypertension.
According to the World Health Organisation (WHO), hypertension affects a massive 1.1 billion people worldwide equivalent to around 14 per cent of the global population. WHO also mentions that hypertension causes around 7.5 million deaths worldwide, which is equivalent to 12.8 per cent of all deaths.
Sadly, the WHO mentions that the prevalence of hypertension was highest in Africa where it was 46 per cent for both sexes combined. Men usually have higher prevalence of hypertension than women. Hypertension, according to the World Heart Federation is the single most important risk factors for strokes and causes around 50 per cent of ischemic strokes.

Why Tanzanians need to pay attention to this
Hypertension and hypotension are both serious health problems in Tanzania.
Also according to WHO, hypertension deaths in Tanzania reached around 3,400 or 0.96 per cent of total deaths.

Are there any visible signs?
Hypertension in adults is rarely accompanied by any signs and symptoms and it is usually identified during routine health check-ups and when checking the pressure during treatment of an unrelated medical condition.
Occasionally, patients with hypertension might report of headaches, vertigo, buzzing in the ears, altered vision and possibly fainting. In children, hypertension can cause headache, irritability, blurred vision and bleeding from the nose.

What’s the cause?
Primary hypertension arises due to environmental and genetic factors. The condition commonly develops in aging and older people. It can also be caused by high salt intake, lack of exercise or prolonged inactivity, depression and obesity.
Certain events and activities during pregnancy and birth might also contribute to a person developing the condition.  
Secondary hypertension as earlier described is due to an underlying medical condition.

Here’s how to prevent it
As with any disease, you would rather prevent it from developing in the first place than to let it develop and seek for treatments.
This is especially true considering some diseases and conditions don’t have any cure and require the patient to be on medication for the rest of their lives.
In order to prevent developing this condition, an individual must maintain a normal and healthy body weight, he must reduce dietary salt intake and must limit alcohol consumption if he cannot quit it altogether.
An individual must also engage in regular physical exercise and must also consume a diet rich in fruits and vegetables. For people who have already developed the condition, seek further advice from your doctor.

The author is a student at the Hubert Kairuki Memorial University.

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Monday, October 23, 2017

How cement dust puts lives at risk silently

A local bricksman in Mwanza  handling the

A local bricksman in Mwanza  handling the cement without any protective gear. Photo | Jonathan Musa 

By Jonathan Musa

Cement is one of the basic components when building a modern house. But the very same cement can be harmful to people’s health if not well handled, experts say.
 It is advised that those handling cement should use protective gears such as facial masks and gloves but it isn’t the case for 43- year-old Justine Rioba.
 He is a resident of Kishiri ward in Nyamagana district in Mwanza region who spoke to Your Health on how cement dust ruined his life.
 Rioba is a casual labourer at a local cement site and has been handling cement for three years and eight months now.
 “Besides carrying bags of cement, I sometimes have to measure it for customers who do not want to buy a full bag. I inhale cement dust every day and by the end of the day, it feels like the dust is logged in my throat. When I spit, the mucus is dark,” he says.
 Rioba began to note that things were not normal when his breathing mechanism started to change, especially at night when he gradually developed the habit of snoring. This change was not noticed by his wife who initially thought that her husband had some kind of flue.
 “My wife would at times buy for me some pain killers to calm the snoring noise at night but unfortunately, this seemed to trigger the habit more,” he recalls.
 Rioba says it reached a point where he would stop going to work as it was the only opportunity he had to make ends meet. He came from a low income status and had no choice but to continue going to the cement site.  
 “We get paid Sh6000 per day, and out of that money, food and transport would be spent from the same amount and therefore take back home Sh2000,”he discloses.
 Rioba said the more he stayed at home, the more his health condition deteriorated. So one fine day he was advised to go for medical checkup. He first visited a local dispensary from where he was referred to Bugando Medical Center for further medical attention.
 He was diagnosed with on-and-off acute bronchitis due to prolonged exposure to cement dust.
 Acute bronchitis inflames the lungs and causes coughing, wheezing and shortness of breath. Bronchitis is a warning sign that a condition in the lungs could later develop into cancer.
Rioba is now under medication.
 
 Health experts speak
 According to Dr Murthy Venkateswaran based at the Sanitas hospital, most workers handling cement digest the dust with the food they eat. He exemplifies by saying that for instance in hardware shops, it is very rare for the workers to close the shop and go for meal breaks.
So what usually happens is that food is brought into the shop and have no time to eat separately from the site but instead eat in the shop with the dust blowing, thus, risking their health.
“When cement dust is swallowed, it puts organs such as the stomach, kidney, and heart at risk. Prolonged exposure could also lead to stomach cancer,” he warns.
 He adds that constant exposure to cement can lead to dry skin and itching. Wet cement also burns the skin. The dust blocks skin pores.
 On his side, Mwanza’s Regional Medical Officer (RMO), Dr Leonard Subi, the cement dust causes lung function impairment and chronic obstructive lung diseases.
He informs Your Health that cement dust may enter into the systemic circulation and thereby reach all the organs of the body and affect different tissues including heart, liver, spleen, bone, muscles and hairs.
This ultimately affecting their micro-structure and physiological performance.
 “Cement dust irritates the skin, the mucous membrane of the eyes and the respiratory system.
Its deposition in the respiratory tract causes a basic reaction leading to increased Hydrogen Ion Concentration, pH values that irritates the exposed mucous membranes,” says Dr Subi.

They’ve become common cases
The doctor in-charge of Nyamagana district hospital, Agnes Mwita, says that the dust arising from cement can cause great damages on human health, which can as well lead to death.
 She says in a week, they can refer about five to ten patients to national hospitals with lungs and skin problems, a big percent of these people come from the background of brick makers and cement handlers, ‘fundi ujenzi’.
 “For example there are people under this field who are allergic to dust but they do not understand until it is too late. At our hospital, at least five to eight people are admitted daily with skin related complications and as well as lung problems,” she added.
 One of the health experts at Bugando Medical Centre who preferred anonymity, said that in a duration of two weeks they can admit about 20 patients with skin and lung complications, adding that many are local builders, brick makers and those from cement processing factories.
He [the source] said the incremental individual risk due to emissions of the cement dust is very low, not only with regards to health effects, but also in relation to toxicological and cancer risks produced by pollutants emitted by the cement forge.
 “Studies show that adverse respiratory health effects seen in the people exposed to cement dust, exemplified in increased frequency of respiratory symptoms and decreased ventilatory function, observed among cement workers could not be explained by age and smoking, thus are likely to be caused by exposure to cement dust,” he said.
 
Surveying around town

 In a random survey carried out by Your Health in Mwanza city, it was found  that a big number of informal constructors  and brick makers wear no protective gear to protect themselves from the cement dust.
 This was witnessed at Igoma Street, within the city of Mwanza, where a big space is occupied by cement related activities. Some are busy making bricks while others constructing culverts which are later connected on drainages for better infrastructure.
 During all these processes, the labourers do not put on the protective gear, perhaps because they cannot afford them or are ignorant of their consequences.
But if you observe closely, most of the faces of these builders seem old and tired despite their ages. When you go closer to them, you will note some marks on their skin especially hands and legs.
 On his side, Masasi Mlagaja, a local chairman leader in Nyamagana district, says that most youth have turned to construction activities as helpers due to the nature of life. He says some have ventured into brick making where cement is involved at a high rate.
 “It’s hard to convince a youth that without protective gear, cement can easily affect his or her health status. They justify by saying that it is the only place they can make a living  from despite of its tough manual work,” says Mr Mlagaja.
While it is compulsory under the labour law for factory workers to be accorded with protective gears such as thick gloves, safety caps and gum boots, those who work in hardware shops or on building sites are not accessing those gears.
 
So what should be done?
 Dr Thomas Nyakoba, a principal therapist at Bugando Medical Centre tells Your Health that corporate entities are mandated to disseminate information about the dangers of exposure to cement but small businesses are ignorant of these laws.
 Because the effects of inhaling and swallowing cement dust manifest over a period of time, it is not easy to peg an illness to a direct exposure incident.
 “The disease may come after the person has moved on and settled into another job,” he informs.
Construction materials in Tanzania include cement and cement products, bricks and building blocks, wood building columns, and others.
 Currently Tanzania’s cement production amounts to more than 2 million tons, compared to only 900,000 tons in 2009.

jonathanmusa54@gmail.com
 

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Monday, October 23, 2017

Being HIV positive is my secret, not yours

 

By Dr Lugano Wilson

I met a patient - a widow from Singida who was referred to Benjamin Mkapa hospital in Dodoma region for a CT scan after she fell down abruptly.
The reason being was that the doctors at the peripheral hospital wanted to rule out whether she had any internal bleeding [in her brain].
Being kept at liberty, the her relatives asked that she be tested for other issues like HIV, though they spoke of it indirectly but I was able to take in what they actually meant.
What I observed and it was quite sad to see that the relatives were more interested to know about the patient’s HIV status than the patient herself, but she couldn’t argue back in the open.
This sounded astounding to me but I tried hard to thwart myself from saying anything that would tread on their toes whilst constantly sticking to my guns as a medical doctor.
Then, when results came out, I sat down with the patient, briefing her on the investigation results.
On the spur of the moment, she allowed me to disclose them to her relatives except for the HIV test results but then relatives questioned furiously, “tulikuambia umpime kila kitu kwanini, hujampima?” [we asked  you to test her for everything, why didn’t you?]
One of the relative even went on to the extent of saying, “I am her blood sister, I am one among the relatives who settles her bill at the hospital. I must know her HIV results, so that she can start taking medication at the earliest.”
It can be a challenge sometimes as a medical doctor to be in such a tug of war.
 I had to tell them in detail what they ought to understand with regards to the matter. It is no wonder that I had to even allude to some of the formalities as well.
Professional and humane rationales whilst constantly being non-committal about the patient’s HIV results as per her humble request.

To whom did she disclose?
In confidentiality, I asked the patient whether she knew beforehand that she was HIV positive.
In a quick rejoinder, she revealed her issues to me, “Yes, I know and I have already started taking antiretroviral (ARV) drug but I do not want them to know about that, I have decided to inform only my young sister since I know she is the only person who can keep my secret.”
Mind you, disclosure of HIV status is an important approach in VCT (Voluntary Counselling and Testing) services especially in preventing infections.
Of course there is a satisfying trend that in Tanzania the rate of HIV status disclosure to the partners is increasing, however, many do not disclose to the general public.
Studies done in Tanzania have indicated that age, level of education, and financial independence particularly for women were found to be important factors in predicting HIV status disclosure.
In a study done by Kiula and others in Morogoro, Tanzania, it was found that HIV positive women with higher level of education, younger and financially independent were likely to disclose their status. But what about men? Do they disclose their status to their respective partners?
Perhaps I have to look for the data and do my research before I answer this.

Was the doctor abiding by the Tanzanian laws?
It was really an arduous task to work with her relatives. Of course the relatives insisted that they were going to make sure that she goes and tests somewhere else in Singida, regardless of my professional advice.
I recall one of the relatives of the widow saying, “tunaenda kumpima, watoto wake lazima wajue, huyu lazima anao, sasa kama hana kwanini hataki kupima?” [we are going to make sure that she gets tested at a nearby home centre. Her children must know the results, she must be HIV positive, if not,  why is she refusing to be tested?]
In Tanzania, HIV Testing is being fulfilled through VCT, PITC (Provider Initiated Testing and Counselling) and CBT (Community Based HIV Testing campaign). Therefore within these modalities, the HIV status disclosure is practically emphasised.
When you peruse Tanzania’s constitution document, you will be enchanted to find that there is a clause that grants Tanzanians a general right to the privacy of his/her own personal life, family and of matrimonial life that includes respect and protection of his/her residence and private communication, to protect the right to privacy.
It further highlights that “the state authority shall lay down legal procedures regarding the circumstances, manner and the extent to which the right to privacy may be encroached upon without prejudice to the provisions of this article.”
Additionally, The Tanzania National guidelines for management  of HIV/ AIDS states that a health facility providing HIV services must have, a confidential consultation room, a locked area for medical  records with limited access and  a proper  patient records and reporting system.
World Health Organisation recommends a clear legal framework for collection, storage, disclosure, and use if the health information to protect individual patient data.
After reading this article you can at least be able to fathom out  that doctors do their part wherever possible to discourage stigma and unlawful HIV/AIDS status disclosure.
The author is a medical doctor, public health activist, a scientist and researcher.

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Monday, October 23, 2017

A lump isn’t always breast cancer

A breast exam on yourself should be performed

A breast exam on yourself should be performed at least once every month. Photo | Sister Hood Agenda 

By Tasneem Hassanali

I’ve always been amazed by this woman whom I met few years ago in Dar es Salaam. Her wisdom, outlook and life story has had a positive impact on the young generation like myself.
 Meet Lulua Jamali, a 65-year-old lady who agreed to speak to Your Health about her journey on fighting the fear on breast cancer. She wants to share her journey to help many women out there to choose hope instead of fear and to help them gain confidence on takling the step.  

It’s never too late
I’ve heard many women harp about the fact that age ‘50’ is too late to get a breast exam done. But for Mrs Jamali, it was different.
13 years ago, she underwent her first mammogram during her full body routine check-up. “Though I have a history of cancer in my family and also of benign cysts, I showed no signs hence never got myself checked. But at the age of 52, I decided to get one done and thankfully all my reports were clear,” Mrs Jamali tells.
She was advised to thoroughly do a self-breast exam regularly.
In 2008, she felt a lump in her left breast during one of her routine self breast exam. “There was neither pain nor tenderness but I still decided to get it checked. An ultrasound showed a mass which needed further investigation,” she says. The specialist who investigated further revealed that the lump was benign, meaning non-cancerous.

You got to be brave
Nine years down the lane, when Mrs Jamali had almost forgotten about her lump, she felt a sudden sharp pain in the left breast where the lump was located, few months back.  “It felt as warm as a slight fever and a rush of thoughts streamed, what if it is cancerous!” Mrs Jamali confesses that it did freak her out.
Mrs Jamali was lined up the next day for yet another mammogram, ultrasound and a biopsy. She wasn’t new to the two tests but biopsy was something she was uncomfortable with as to how it would be conducted.
“The doctor inserted a syringe and sucked out about 5-10 ml of creamy/milky fluid. After removing the needle, they applied a little pressure on the area, and plastered the aread with a band-aid. The whole process was done with minimum pain, not even slight discomfort, I would say, and when I came out I had a relieved and happy bounce in my walk , which I did not have when I went in. Then the rest of the day, I was driving around with a childhood friend of mine who was visiting Tanzania. As good as if nothing had happened,” Mrs Jamali narrates her experience.
Her results showed normal but she was prepared for the worst case scenario. How? She says, “You got to be super brave in the fight against a worst case scenario. Yes it’s easier said than done, but the brave state of mind and your strong will power makes you win the war with this nasty disease.”

What she has to tell women who fear the tests
“My sincerest advice to every woman reading this article is to start by doing regular breast examinations on your own on a monthly basis to start with.
Also pay special attention to your breast if you are breast feeding, and if suspicious, get a doctor to check you, without any delay. Remember, any kind of cancer, especially breast cancer if caught in early stages is completely treatable and curable”.

thassanali@tz.nationmedia.com

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Monday, October 23, 2017

Society needs a constant reminder

An illustration showing the complication of one

An illustration showing the complication of one of the lifestyle disease, hypertension. Photo | Pixabay 

By Saliha Dawood

Today’s world revolves around extreme tobacco use, physical inactivity, alcohol abuse and unhealthy diets, all of which contribute to grave conditions called Non communicable diseases (NCDs). There is need to constantly remind the society on how to prevent such diseases.
At present, NCDs occur to be the world’s most prevalent cause of death and disease burden worldwide, according to the World Health Organisation (WHO).
WHO says NCDs kills about 40 million people each year, equivalent to 70 per cent of all deaths globally. Thirty-eight million people die each year from NCDs, mainly from cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes.
Over 14 million deaths from NCDs occur between the ages of 30 and 70, of which 85 per cent are in developing countries, hence the urgency of addressing it.
NCDs are chronic in nature and this has a huge impact on the economy of people who suffer from the diseases because they require long-term medical care.
Diseases such as hypertension, diabetes, cancers and lung diseases like asthma and bronchitis are among the main types of NCDs.
They are often associated with older age groups, mostly between the ages of 30 and 69 years.

A closer look at high blood pressure
Also known as hypertension, is one of the key challenges here and I will explore it at length.
First, it is important to understand that blood pressure is the force exerted by blood against the walls of blood vessels.
How great the pressure is, depends on the work being done by the heart and the resistance to blood flow in the arteries.
The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. Hypertension, therefore can be defined as blood pressure higher than 140 over 90 millimeters of mercury (mmHg).
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach at dangerously high levels.
A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms are not specific and usually do not occur until high blood pressure has reached a severe or life-threatening stage.
However, even without symptoms, damage to blood vessels and the heart continues! Uncontrolled high blood pressure increases the risk of serious health problems, including heart attack and stroke.
“Prevention is better than cure” - If we lessen the global impact of risk factors, we can go a long way to decreasing the number of deaths worldwide.
The author is a medical student at Hubert Kairuki Memorial University

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Monday, October 23, 2017

False buzzers on bad breath - 9

Dr Emeria Mugonzibwa  is a lecturer of

Dr Emeria Mugonzibwa  is a lecturer of Dentistry at Muhimbili University of health and Allied Sciences 

By Dr Emeria Mugonzibwa

Oral malodour is not today’s problem. Several studies have been done in Tanzania in an effort to address such a problem.
People are out there with the problem but have no idea about it and therefore don’t really turn up for treatment, instead become victims of stigma.
This week I have highlighted on this issue of bad breath, also known as halitosis and its associated fables. Here’s the ninth edition of oral health myths and realities.

Myth 1: An individual can tell if she/he has bad breath or halitosis.
Fact
People cannot tell whether their breath smell or not. In fact, 95 per cent of the people have no idea about it.

Myth    2: Bad breath comes from the stomach.
Fact
Not true. Normally, there are a series of valves that block the regurgitation of our food. These valves also block any stomach smells or odours from going back up the oesophagus, throat and back into the mouth. Only in rare cases of certain illnesses can this occur.

Myth 3: Bad breath or halitosis is only caused by an individual not brushing the teeth correctly.
Fact
Most of bad breath (halitosis) cases (up to 90 per cent) are caused by bad oral hygiene.
Regular brushing, flossing, eating and drinking healthily as well as taking plenty of exercises are the best ways to keep away from bad breath. However, in some cases of certain systemic illnesses may cause bad breath.

Myth    4: If an individual brushes or scrapes the tongue, bad breaths will disappear.
Fact
Scraping the tongue only removes the top layer of a deep accumulation of bacteria, dead skin cells, dead blood cells, food, and debris which make up the cause of the odour of bad breath.


Myth 5: Bad breath is caused by the foods and what individual eats.
Fact
While it is true that some foods like coffee, fish, onions and garlic, just to mention a few, will pollute one’s breath, they are not responsible for the occurrence of bad breath (halitosis). The foods give a short term bad breath which goes away quite quickly.

Myth    6: There is no cure for bad breath.
Fact
There is a total cure for bad breath (halitosis).

Myth    7: Mouthwashes, mints, and gums can keep an individual’s breath smell-free.
Fact:
Most of the mouthwash, mint and gum products simply cover-up the bad breath (halitosis) with stronger and more pleasant smelling odour temporarily.

Myth    8: Better oral hygiene will solve the breath problem.
Fact
To an extent, that is true, particularly when there is gingivitis or gum disease present. However, oral hygiene will not solve more complex systemic causes for bad breath.

Myth    9: Brushing your teeth after breakfast gets rid of breakfast breath.
Fact
Cleaning the teeth after breakfast does not help bad breath (halitosis). Breakfast foods like fruits and fruit juices are acidic, so brushing the teeth after consuming such foods, increases the risk of abrasions and the wear of your teeth.

Myth    10: If you have good dental hygiene, you won’t have bad breath
Fact
In rare cases of certain systemic illnesses, bad breath (halitosis) may not originate from the mouth.

The author is a lecturer of Dentistry at Muhimbili University of Health and Allied Sciences (Muhas).

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Tuesday, October 24, 2017

Understanding the concept of asthma attacks



Ali   Khatau

Ali   Khatau 

By Ali Khatau aliKhatau@hotmail.com

‘It’s like an elephant sitting on my chest’, ‘feeling breathless’, ‘it is as if I need to force air in’, ‘my chest tightens up to an extent I feel jailed in my own body’ – these are some of the ‘feelings’ narrated by asthmatic patients.
While for some people, asthma is just a minor nuisance, for others it can be severe enough to interfere with daily activities and may eventually lead to a life-threatening attack requiring immediate medical attention.
In normal circumstances, the airways allow air to come in and out of the lungs. What happens during an asthma attack, is that the airway gets inflamed, leading to obstruction of the airflow to the lungs. The condition occurs in people of all ages but usually starts during childhood.
According to the World Health Organisation (WHO), asthma is the most common chronic disease among children. The episodes may occur few times a day or few times a week.  
The organisation further quotes, the condition affects a massive 235 million people worldwide and caused more than 330,000 deaths in 2015. the health centers and many more.

Causes
There are different causes of asthma, the most common one associated with a pregnant mother. According to asthma.co.uk, a child is more likely to develop asthma if he/she was born prematurely, had a low birth weight or if the mother smoked during her pregnancy.
Having a family history of asthma also increase the chance of a person developing the condition.
Asthma attacks are usually sudden and spontaneous and can be very dangerous if you don’t have medication near you. An asthma attack can be triggered by a variety of factors including environmental factors and certain medication as well.
Environmental factors include exposure to dust, allergens and low air quality due to traffic pollution. Certain medication such as aspirin and paracetamol may also trigger asthma attacks.
Other causes include certain antibiotics, perfumes, stress, emotional excitement, smoking and certain medical conditions like eczema, bronchiolitis and hay fever.
 
Signs
The signs of an asthma attack are quite evident in the patient during the attack.
A mild asthma attack is characterised by recurrent episodes of breathlessness, coughing, chest tightness and wheezing.
The symptoms usually become worse at night and in the early morning hours and usually occur in response to certain triggers like cold air, dust or exercise.
In a life-threatening asthma attack, the patient will have an altered level of consciousness, which usually includes drowsiness, confusion, exhaustion and even loss of consciousness.
There should be prompt and immediate action taken in this case and it should be handled like a medical emergency.
Any delay in caring for a patient with a life-threatening attack may easily lead to the death of that patient.

Prevention
As with any medical condition, the best advice would be prevention is better than cure.
Asthma doesn’t have any cure but you can take certain measures to prevent developing the condition.
The WHO recommends decreasing risk factors of asthma which include:
• Polluted air
• Tobacco smoke
• Pets
• Certain medication like aspirin
•Respiratory infections

Yoga has been shown to reduce symptoms in asthma patients. For those who have already developed the condition, certain medication can be used to reduce symptoms and prevent attacks.
Since it is a chronic condition, the patient might have to be on medication for a very long time and might even potentially be advised to take the drugs for the rest of his or her life.
However, these medication must always be prescribed by a qualified medical professional and should never be self-prescribed.
 Consider leading a healthy lifestyle consisting of a balanced diet, regular exercise and enough sleep.

The author is a student at the Hubert Kairuki Memorial Hospital.

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Monday, October 23, 2017

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