Jul 7, 2022 | Uncategorized
Sickle cell disease is a genetic blood disorder inherited from one’s parents and characterised by the inheritance of two abnormal genes with one of the abnormal genes being haemoglobin “S.” It’s commoner in blacks’ although it is a global disease. It is said to have originated from Sub-Saharan Africa and #Nigeria still has the highest burden of sickle disease in the world.
#Sicklecelldisease (SCD) is one of the most common genetic diseases worldwide and its highest prevalence occurs in the #MiddleEast, Mediterranean regions, Southeast #Asia, and Sub-Saharan #Africa especially Nigeria.
Although significant progress has been made in the national prioritisation of SCD in a handful of these countries in the region, a larger population is still left behind. That goes even more so for those living in countries that lack equitable access to SCD care and for the vulnerable poor populations who bear the greatest inequities from the disease. They lack access to early diagnostics and care, education, financial and social protection, food security and opportunities to live their lives to the fullest potential.
The degeneration of untreated #SCD can be linked to organ damage. This is either caused by addiction to some pain relief medication (usually caused by self-medication) or untreated SCD. This makes #Nutrition of utmost importance in the management of SCD.
Nutrition is reported to impact many chronic health conditions associated with SCD, including chronic baseline inflammation, and vaso-occlusive crisis (VOC), which is accompanied by frequent pain and greater occurrence of stroke, particularly in young children. Other severe manifestations of SCD are pulmonary hypertension; cardiovascular and renal disease.
It is becoming more apparent that current dietary recommendations for SCD should include more emphasis on adequate amounts of macronutrients. Intervention with macronutrients, (proteins carbohydrates and fats) showed measurable improvement in clinical condition and reduced hospital admissions in growth-delayed children with SCA.
It was reported that adults and children with sickle cell anaemia have a relative energy shortage. In SCD patients, nutrients from the diet and amino acids from body protein catabolism channel towards rapid red cell production, are replacing hemolysed sickle red cells being constantly removed from the circulation. This metabolic irregularity drastically increases the energy requirement and reduces the availability of nutrients for growth and development in children and for maintaining adequate muscle mass in adults. The primary clinical manifestation of this relative nutrient deficiency is severe undernutrition.
Hydration plays an essential role in sickle cell anaemia. It is crucial to promote proper hydration by frequent intake of water and other fluids and to avoid physical activity and extreme weather that result in excessive sweating.
Note this! Avoiding dietary sodium intake can help to maintain appropriate hydration status by preventing water from leaving the erythrocytes (William-Hooker et. al., 2013). Dietary recommendations for maintaining good hydration status include limiting high sodium, processed foods, and snacks while consuming water and fluids throughout the day. (Umeakunne K, 2019).
Emphasis should be on high dietary requirements for macronutrients (protein-carbohydrate and fat). With the use of food sources of polyphenolic phytochemicals, flavanols and gut microbial required prebiotics these components in combination with the vitamins, minerals, and omega-3 fatty acids routinely use in standard treatment, may provide adjuvant therapy for the SCD-associated chronic disease burden, and promote sustainable health, quality of life and increase longevity for this patient population (Umeakunne K, 2019).
Courtesy; #Dietitian Unit, Rays of Hope Support Initiative
Jul 7, 2022 | Healthy Moves
SHINE THE LIGHT ON SICKLE CELL
Today is World Sickle Cell Day with the theme ‘Shine the Light on Sickle Cell’. June 19th every year has been set aside as an important day by the United Nations to recognise sickle cell anaemia as a public health problem and to promote education about this genetic condition.
Sickle cell anaemia is a condition in which there are not enough healthy red blood cells to transport adequate oxygen throughout the body. Sickle cell disease affects nearly 100 million people worldwide and is responsible for over 50% of deaths among those with the most severe form of the disease.
It is estimated that each year over 300,000 children are born annually with sickle cell disease (SCD) in Africa. SCD is a significant contributor to NCD-related child mortality globally, causing up to 15% of deaths in children aged less than 5 years. Without appropriate intervention, up to 90% of those born with the condition die before their fifth birthday.
According to Dr Oluwatosin Adeoye in her article in the Punch Newspapers, titled ‘’ Challenges in Nigeria’s management of sickle cell disease,’’ she made us understand that ‘Sickle cell disease is a genetic blood disorder inherited from one’s parents and characterised by the inheritance of two abnormal genes with one of the abnormal genes being haemoglobin “S.” It’s commoner in blacks although it is a global disease. It is said to have originated from Sub-Saharan Africa and Nigeria still has the highest burden of sickle disease in the world’
Nigeria leads the world in the number of cases of sickle cell disease (SCD). An estimated 150,000 babies are born annually in Nigeria with SCD, a heredity disorder, and 70-90% die before age 5.
Experts say sickle cell anaemia can lead to many complications such as stroke, acute chest syndrome, pulmonary hypertension, organ damage, blindness, leg ulcers, and pregnancy complications, among others.
For instance, it is believed that sickle cells can block blood flow to an area of the brain, igniting stroke signs such as seizures, weakness or numbness of arms and legs, sudden speech difficulties, and loss of consciousness.
The World Health Organization (WHO) estimates that 70% of deaths could be; prevented with a low-cost diagnostic and treatment plan, but what else can we do to reduce sickle cell disease among our people?
- Screening of sickle cell disease among our newborns. Which is one of the best ways to tackle the surge of SCD.
- Promote effective education about sickle cell disease and its management
- Increase awareness programmes that will help in reducing ignorance about the disease.
- Providing affordable healthcare for people living with sickle cell disease is another means by which there can be effective management of sickle cell disease in this part of the world.
- Availability of medical therapies in the management of sickle cell disease to the people at an affordable price; and under a conducive atmosphere.
- Like other NCDs, managing sickle cell anaemia is expensive in terms of getting the needed drug therapies. So we are asking that the government and other international organisations/donors (like WHO) should make SCD drugs and treatment available to our people like what they did with HIV/AIDS and TB.
- Nigeria government through her health agencies, concentrate more on the treatment of SCD complications than preventive/ management of sickle cell disease. There should be awareness among our youth who are yet to be married or about to on the importance of knowing their blood genotypes
- We must remove the stigmatisation associated with the people living with sickle cell disease. We must see them as people with special needs and not see them as cast out with ‘names’.
Lastly, our salute to our born warriors in the battles against Sickle Cell anaemia in Nigeria, keep the fights on! Hold on to your hopes and dreams you can all achieve whatever you ever dream of, if you believe.
SCD, it’s a war that will be won very soon through proper enlightenment and collaborations.
Courtesy: #ROHSI3 Team members.
May 17, 2022 | Healthy Tips
Today, the number of the people living with hypertension has doubled to 1.28 billion, says World health Organisation (WHO), and nearly half of these people did not know they had it (More than 700 million people with untreated hypertension).
As an organisation working within the NCDs space, we know some of the effects of hypertension on our people! That hypertension significantly increases the risk of heart, brain, and kidney diseases that has caused many sudden death and disease among our people.
That, about 25-30% of medical emergencies at our medical centres got to do with issues related to high blood pressure and other Non-Communicable diseases (NCDs). That hypertension does not show signs or symptoms, but it can be detected through checking of ones’ blood pressure either at home or in a health centre. That hypertension can often be treated effectively with medications that are low cost (but not often affordable).
From our field experience and conversations with our community people, we saw the prevalence of hypertension to be so high. We are asking our policymakers, international organisations such World Health organisation (WHO), International Hypertension Federation and community influencers to arise and help with a framework that can help in reducing the risk and burden that come with this ailment among our people.
We ask that they make our primary health centres a working one (be equipped to meet up the need of the people as the first point of contact) where our people can have access to the best treatment and possible medical referrals in case.
The cost of hypertension treatment per person in Nigeria is on the high side. It has led majority of our people to source for alternative means or abandoning treatments due to the high cost of treatment and medications with little family income (that is to tell us that there is poverty in the land). For people to access medical treatments and medications in a month, it cost; them over #5000 (in a population where the majority survive on less than a few hundred Naira per day).
We are asking, let there be an increase in awareness, screening, treatment, and control of hypertension among our people. They must be encouraged to visit our Primary Healthcare Centres (PHCs) with the assurance of having access to best of medical treatment.
Let there be considerations to the cost of procuring high blood pressure medications. If they can do it with HIV/AIDS and TB something like that can be done with hypertension treatment and other NCDs.
We must know that hypertension and other NCDs worsen our people’s poverty levels since it would not allow them to make a viable contribution to national income that can lead to growth and development.
We at the Rays Of Hope Support Initiative -ROHSI are saying; we can stop the surge of hypertension among our people if we all do our part.
We care for the health and wellbeing of our people. That is why we are #ROHSI3.
Mar 17, 2022 | Healthy Tips
WHAT DO YOU KNOW ABOUT CHRONIC KIDNEY DISEASE?
Chronic kidney disease (CKD) is known as a ‘silent killer’ as most people live with the disease for years before they have any symptoms. By the time the disease is detected, for many people it’s already too late. Hypertension and diabetes are the most common causes of CKD. Other much fewer common conditions that can cause CKD include inflammation, infections, genetics, or longstanding blockage to the urinary system (such as enlarged prostate or kidney stones
In an advanced stage, CKD can only be treated with regular dialysis or through a kidney transplant making it very expensive to manage. Early detection and prevention are essential. However, it can usually be prevented by controlling key risk factors but, most countries have no strategy for chronic kidney disease.
Left untreated, CKD progresses from Stage 1 through to Stage 5. Stage 5 is also known as End-Stage Renal Disease (ESRD), which means regular dialysis treatment, or a kidney transplant is needed to survive.
Fast Facts about Chronic Kidney Disease
- Early chronic kidney disease has no signs or symptoms – many people living with CKD don’t even know it until the disease is in an advanced stage.
- About 10% of the adult population is living with some degree of CKD, and every year millions die prematurely from CKD and related complications.
- CKD is a major risk factor for cardiovascular diseases, which are the primary cause of death for all people living with CKD.
- If CKD is detected early and managed appropriately, the deterioration in kidney function can be slowed or even stopped, and the risk of associated cardiovascular complications can be reduced.
- CKD is largely preventable and can be detected early with simple blood and urine tests.
Symptoms and complications of CKD may include:
- High blood pressure
- Anaemia (low blood count)
- Weak bones
- Poor nutritional health
- Nerve damage
- Swollen ankles
- Fatigue
Another consequence of CKD is that it increases the risk of early death from associated cardiovascular disease (i.e., heart attacks and strokes). People living with CKD therefore have an increased risk of dying prematurely from cardiovascular disease, regardless of whether they ever develop kidney failure.
How can we prevent chronic kidney disease?
There are several ways to reduce the risk of developing kidney disease.
- Be active
- Eat a healthy diet
- Reduce your salt intake
- Don’t smoke
- Check and control your blood sugar and blood pressure as part of your regular check-ups
- Get your kidney function checked if you have one or more of the ‘high risk’ factors: diabetes, hypertension, obesity, a family history of CKD.
Blood and urine tests can easily detect CKD and simple, low-cost treatments can slow the progression of the disease, reduce the risk of associated heart attacks and strokes, and improve quality of life.
The early detection of failing kidney function can be lifesaving because it allows CKD to be treated through medications, diet, and lifestyle changes rather than dialysis or a kidney transplant, which are economically inaccessible for most people around the world. These treatments are known as renal replacement therapies (RRT) because they attempt to “replace” the normal functioning of the kidneys.
When you have kidney failure, wastes and fluids accumulate in your body and you need regular dialysis treatments for life to remove these wastes and excess fluid from your blood. For patients who can access it, a kidney transplant combined with medications and a healthy diet can restore normal kidney function.
Note this! About 1.3 million people die from kidney disease each year, with an additional 1.4 million deaths from cardiovascular disease that are attributed to impaired kidney function.
CKD is increasing in prevalence – and at an alarming rate. CKD deaths increased by 41.5% from 1990 to 2020, rising from the 17th leading cause of death to the 10th. Now, it is expected that CKD will climb to the fifth leading cause of death globally by the year 2040.
This is primarily due to changes in the way we eat, drink and move – as the junk food industry reaches virtually all corners of the world with its health-harming products and aggressive marketing techniques, diabetes and hypertension – the key risk factors for CKD – are skyrocketing. Most of this increase is occurring in low- and middle-income countries (LMICs) and among more marginalised communities in all countries.
CKD can occur at any age but becomes more common with increasing age and is more common in women. Although about half of people aged 75 or more have some degree of impaired kidney function, many of these people do not actually have diseases of their kidneys; they have normal ageing of their kidneys.
The cost of treating CKD represents an enormous burden on healthcare systems worldwide. In developed countries, kidney failure is a major cost driver for patients, their families and governments. For instance:
- According to a recent report published by NHS Kidney Care, in England, CKD costs more than breast, lung, colon and skin cancer combined.
- In the US, treatment of CKD is likely to exceed USD 48 billion per year, and the Stage 5 program consumes 6.7% of the total Medicare budget to care for less than 1% of the covered population.
In middle-income countries such as Nigeria, access to life-saving therapies has progressively increased, yet renal replacement therapy (dialysis or transplant) remains unaffordable for the vast majority of patients. Developing countries cannot afford dialysis or transplants at all—resulting in the deaths of over 1 million people annually from untreated kidney failure.
It is clear that we are not all equal with regard to kidney disease and access to treatment.
Courtesy: Rays of Hope support Initiative, NCD Alliance, National Kidney Foundation Et al
Feb 27, 2022 | Healthy Tips
AMBIEN ADDICTION AND TREATMENT
What is Ambien
Ambien is one of the brand names for zolpidem, along with Edluar, Zolpimist, and Intermezzo. It is a prescription drug used to temporarily treat insomnia and is one of the top-selling insomnia drugs in the United States. Ambien is available in two forms: Ambien, a quick-release tablet that helps initiate sleep, and Ambien CR, an extended-release form that also helps maintain sleep.
Ambien was developed to help treat insomnia short-term, with the same efficacy as benzodiazepines but as a seemingly less addictive alternative. However, Ambien’s addictiveness comes not from a physical dependency to the drug, but from the sudden dependency on the drug to sleep. From just some short-term abuse, user can find themselves with a real inability to fall asleep without higher and higher doses.
Street names for Ambien include:
- No-gos
- Zombie pills
- Sleepeasy
- Tic-Tacs
- A-minus
- Z-drug
How Does Ambien Affect the Brain?
Working as a sedative-hypnotic, Ambien activates the neurotransmitter, GABA. GABA slows down brain and central nervous system activity, and results in a strong sedative effect. This helps put insomnia sufferers to sleep quickly and effectively.
Is Ambien Addictive
Although created to have the same medical effect as benzodiazepines, and reportedly without the same addictive properties, users are still at risk of developing an addiction.
If taken exactly as prescribed, for a very brief period, Ambien is relatively safe. However, with long-term use, there is a potential for abuse and addiction. Once the user takes Ambien for longer than prescribed by their physician, they will need higher doses to feel the same effects. Eventually, they will be unable to sleep without using Ambien.
Ambien dependence can form in as little as two weeks. Because it is a prescription drug, there is a misconception that Ambien is safe. However, it is becoming clearer that Ambien is just as addictive as benzodiazepines. As with many other types of sleeping pills, Ambien can be very addictive.
Signs of Ambien Addiction
It can be hard to tell if a person is abusing Ambien, especially if they have a legitimate prescription from their doctor.
Here are some warning signs of Ambien addiction to look out for:
- Taking Ambien in a way other than prescribed, such as crushing and snorting pills
- Taking Ambien that was prescribed to someone else
- Repeatedly taking larger and more frequent doses than prescribed
- Appearing overly sleepy or tired during the day
- Frequently requesting refills on the prescription or finding a new doctor to get a new prescription
- Lying about Ambien use
- Noticeable changes in behaviour like isolating oneself from family and friends
- Spending large amounts of money on Ambien, or unexplained spending
- Experiencing cravings for Ambien
- Engaging in dangerous situations without any memory of them later
- Taking the drug in conjunction with other mind-altering substances
Taking Ambien without a prescription or in any way that is not directed by a doctor is considered abuse. Even taking a slightly higher dose than recommended, to help with sleep, is abuse. Once someone builds up a tolerance to Ambien, they need higher doses to fall asleep. This strengthens their dependence on the drug and causes individuals to up their doses without any medical guidance.
Side-Effects of Ambien Addiction
Ambien is supposed to be taken right before bed, but people abusing this sleeping pill will take it at any time of day. When not used as a sleep aid, Ambien produces calming effects and feelings of euphoria.
As a potent central nervous system depressant, Ambien, in large doses, can slow a user’s breathing and heart rate to a point where respiratory failure occurs. This could result in a fatal overdose. An unusually slow heartbeat or breathing is a strong indication that the user is in trouble.
One SAMHSA study showed that in 2010 alone, there were 20, 793 visits to the emergency department of hospitals throughout America due to Ambien overdose.
Some additional side-effects of Ambien include:
- Dizziness
- Daytime drowsiness
- Memory loss
- Mood and behavioural changes
- Rare allergic reactions
- Trouble breathing
If your doctor has prescribed Ambien, it is because they have judged that the benefit is greater than the risk of side-effects. Many people using Ambien do not experience any serious side-effects. Unpleasant and dangerous side-effects of Ambien use are usually only seen in cases of abuse or addiction.
Ambien and Alcohol
There are many prescriptions and illicit drugs that have adverse reactions when taken with Ambien. However, alcohol is the substance most commonly abused alongside Ambien. People who consume alcohol and Ambien together are more likely to end up in intensive care.
When mixed together, alcohol and Ambien can enhance each other’s intoxicating effects to result in the following:
- Dizziness
- Confusion
- Difficulty concentrating
- Impaired cognition
- Loss of physical coordination
- Impaired judgment
- Sleepiness or drowsiness
- Sleepwalking
- Depressed breathing
- Sleep apnea
Combining Ambien and alcohol can also have more dangerous effects as a result of reckless behaviour, and the loss of coordination that results from this combination. Users are more likely to be involved in accidents or hurt themselves losing consciousness.
Ambien Addiction Treatment
In order to recover from Ambien addiction, the user needs to fight physical and psychological dependence. The first step in any treatment for recovery from addiction is medical detox. This is then followed by a range of therapy types, often to treat any co-occurring mental health disorders and to ensure a minimized risk of relapse.
To stand the greatest chances of success in recovery, the user should receive treatment as an inpatient at a registered rehab centre. The centre will provide the support and environment the patient needs to undergo detox safely and receive the therapy they require to make a full recovery.
Detox from Ambien
To begin Ambien addiction treatment, the patient will need to undergo a medically assisted detox. This usually involves tapering down dosage of the drug until it is stopped entirely. Ambien detox should only be done in an inpatient rehab facility, to prevent the risk of relapse caused by uncomfortable withdrawal symptoms.
Ambien Withdrawal
Ambien withdrawal can cause unpleasant symptoms as the brain tries to function normally once again. As with any drug abuse, the withdrawal effects are usually opposite to its effects when used.
Symptoms of Ambien withdrawal begin within 48 hours of the last dose and includes:
- Fatigue
- Nervousness
- Panic
- Uncontrollable crying
- Flushing of the skin
- Nausea
- Vomiting
- Stomach cramps
- Seizures (rare)
- Delirium
- Irritability
- Sweating
Stopping Ambien abruptly will lead to more severe withdrawal symptoms. This is why inpatient medical detox is recommended, to ensure that the user is weaned off Ambien in a measured and safe way.
Ambien Withdrawal Timeline
Withdrawal symptoms usually lessen or disappear within 1-2 weeks. The most acute withdrawal symptoms kick in within the first 3-5 days, while the psychological withdrawal symptoms last up to two weeks. In rare cases, symptoms can occur months after stopping Ambien use.
Ambien withdrawal symptoms vary for each individual due to several factors and includes:
- The length of Ambien abuse
- The dosage
- Whether or not the Ambien was the extended-release version
- If the individual took other drugs in addition to Ambien
Medication for Ambien Withdrawal Symptoms
A doctor may prescribe psychiatric treatments for depression or anxiety related to Ambien withdrawal, but there are also a few drugs that treat symptoms caused as a direct result of Ambien withdrawal. In some cases, anti-seizure medication is given to reduce the risk of seizures.
Those experiencing severe anxiety or suicidal thoughts are likely to receive short-term prescriptions for mood-stabilizing medications.
Therapies Used in Ambien Addiction Treatment
After completing detox, therapeutic treatment will commence. The right treatment centre will create a tailored plan for the patient’s individual needs. Talk therapy will be provided, as well as group, and even family therapy.
- Cognitive-behavioural therapy (CBT): A common type of individual psychotherapy that helps patients recognize, avoid, and cope with the situations in which they are likely to use drugs.
- Dialectical behavioural therapy (DBT): Another type of one-on-one psychotherapy that helps individuals learn new skills and strategies for coping with life outside of addiction. The goal of this therapy is to create positive and impactful change.
- Family therapy: Used to help families support the recovery of the patient, as well as to help heal the damage caused by addiction within the family unit.
- Group therapy: Programs such as Narcotics Anonymous are used to provide ongoing support for the patient, in a supportive environment. Group therapy sessions will usually be ongoing, in order to prevent relapse and to foster a sense of community with likeminded people.
Recovery from Ambien Addiction
Inpatient rehab at a specialized treatment centre will ensure the patient has the biggest chance of success. Rehab will be cantered on a strict routine, including therapy and other types of treatment.
It is crucial that the right treatment centre, offering a personalized treatment plan, is provided to the addict. One where the individual’s unique needs are addressed, and the nuances of their addiction are taken into account.
