PATIENT EDUCATION

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DIET

FAMILY PLANNING / CONTRACEPTION

DIABETES MELLITUS

HYPERTENSION

MALARIA

TYPHOID FEVER

ASTHMA

ACID REFLUX DISEASE

PEPTIC ULCER

PNEUMONIA

TUBERCULOSIS

HEPATITIS B

BREAST CANCER

CERVICAL CANCER

UTERINE FIBROID

ECTOPIC PREGNANCY

HIV / AIDS

JAUNDICE

PROSTATE CANCER

ARTHRITIS

Diet
Your understanding of nutrition is a key to optimal health. The food we consume can either make or mar our health. The food we eat must contain the six essential nutrients: carbohydrate, protein, fat and oil, mineral salt, water and vitamins. A balanced diet contains these nutrients in correct quality and quantity. Not only this since these nutrients contain molecules that are sensitive to changes in environmental condition (temperature, humidity, exposure to ultraviolet rays from sunlight e.t.c) food need to be preserved appropriately else the nutritive value is lost before consumption. The kind of diet you take is dependent on age, health status and condition like pregnancy may necessitate modification of diet. You should be particularly careful with consumption of processed food, alcoholic drinks and smoking. Every new food product must be carefully discussed with a doctor or a dietician before consumption. Family Planning / Contraception
Family planning is the medical method that allows you to decide how many children you want, when you want the children and how to space them. These are scientific and time – honoured technique of having control over your procreative ability. These techniques even afford you the opportunity of deciding your children’s birthday! In addition, some of the methods of contraception protect against sexually transmitted infections including HIV. We encourage you and your partner should make decision on family planning method after due consultation with a doctor. Various contraceptive methods include: • Combined Oral Contraceptive Pills: The pill contains two hormones (a progestin and estrogen). It works by preventing the release of eggs (ovulation). A pill is taken every day. Effectiveness is about 92 – 99 percent. It is good for women who : • will remember to take the pill every day • Are breastfeeding a baby at least 6 weeks old. • Want effective short or long term child spacing • Injectables
Injectables are contraceptives that come in injection form. There are two types commonly available: there is one taking every three month ( Depoprovera) and there is another type taking every two month(Noristerat). The injectables work by preventing the release of eggs. Effectiveness is about 99 percent; the risk of pregnancy is greatest when a woman misses an injection. Fertility returns in an average of about 4 months of stoppage of the injection. It is good for women who: • Not obese • Do not have history of hypertension • Do not have history of varicose veins • Breastfeeding a baby at least 6 weeks old • Patch
Patch is a small adhesive plastic worn on the body. It contains both a progestin and estrogen. A new patch is put on each week for three weeks. This is followed by a week with no patch worn. Patch works by continuously releasing hormones through the skin into the bloodstreams; these hormones then prevent the release of eggs. There is no delay in the return of fertility after patch is stopped. • Combined Vaginal Ring
Combined vaginal ring is a flexible ring placed in the vagina that continuously releases two hormones into the bloodstream. Hormones are absorbed directly into the bloodstream through the vaginal wall. This method works primarily by preventing release of egg from the ovaries.
The ring is kept in place for three week and removed on the fourth week. • Implant
Implants are small plastic rod or capsules which are placed under the skin of the woman upper arm. Once inserted they can last for 5 years. It contains progestin and it works by making the cervical mucus thick (this blocks the sperm meeting the eggs) and by disrupting the menstrual cycle thereby preventing eggs from being released. It can be used all throughout breastfeeding. Fertility returns without delay. • Copper – bearing intrauterine contraceptive devices(IUCD)
This is a T – shaped copper – bearing device with two springs dangling at its tail. This device should be inserted by a trained provider inside the woman uterus. The woman can feel the springs if she inserts her fingers into her vagina. IUCD works by causing chemical changes that damage the sperm and eggs before they can meet. • Bilateral Tubal Ligation
This is permanent form of contraception in which the two fallopian tubes are cut off. This method is good women who have completed their family size and do not expect to reverse the operation or for women who should not have children for health reasons. • Vasectomy This is the form of contraception done for men. The vas deferens are ligated. It is permanent form of contraception. It is good for men who have completed their family size and who do not expect to reverse the operation. • Condom and diaphragm
Condoms are barrier method of contraception. There is both male and female condom. It is a form of contraception that offers some degree of protection against STI. Users of condom must learn to use it properly to guarantee optimal effectiveness. • Spermicides
These are chemical that kills sperm cell. They are usually used together with the barrier methods.
The efficacy of all contraception is based on correct and consistent use. Diabetes Mellitus
Diabetes mellitus is a disease condition in which there is impairment in the body’s ability to control the sugar (glucose) level as a result the sugar level becomes elevated. This elevation causes a disturbance of the chemical processes and reactions in the body; this leads to dysfunction of the cell and organs in the body. The body primarily controls the sugar level through the functions of two hormones: insulin and glucagon. When food is taken and the sugar level increases insulin is released from the pancreas and the insulin works to reduce the sugar level. During fasting the blood sugar level becomes low, glucagon is release and the release of insulin is lowered; because of this the glucose level gradually returns back to the normal level. Diabetes mellitus is mainly classified into two types: type 1 and type2. For type 1, the insulin – secreting cells are gradually destroyed by the body’s immunity because of a dysfunction in the immunity provoked by some factors. As the number of destroyed insulin – secreting cell get to a critical level, the concentration of insulin in the body becomes insufficient to handle the sugar load; at this point the symptoms of diabetes begin to appear. In type 2 diabetes, there is adequate insulin secretion but there is impairment of the action or potency of the secreted insulin so glucose control is affected. Symptoms of diabetes are: frequent urination, increase in urine volume, excessive thirst, excessive eating, sweating, weight loss, numbness in some part of the body especially the hands and legs, visual impairment.
Whether someone will develop diabetes is influenced by genetic, environmental, dietary habit and lifestyle. Hypertension
Hypertension just as the word implies is an increase in tension (above normal) in the blood vessels. The normal blood vessel is always under some pressure due to the blood flowing through them. This pressure varies with the pumping activities in the heart. When the heart contracts the blood pressure goes up and when the heart muscles relax the pressure goes down. The walls of the blood vessels are elastic and accommodate well such variation in blood pressure. When there is a disease in the heart or in the blood vessels, the pumping and /or the elastic properties of the heart and the blood vesseare affected. If the elasticity becomes less the blood vessels become rigid and as a result any normal increase in blood pressure become heightened at the level of the blood vessels. Conditions can also arise in which the heart is not pumping well. When this happens, blood start accumulating in the heart chambers and pressure increases as a result. Accumulation of blood in the heart makes the heart muscle overwork and over time the muscle become weak. Also, blood accumulation predisposes to clotting of the blood; chunks of clot can break off and be transported elsewhere to block some tiny blood vessels supplying some vital tissues in the body. This leads to cutting off of the blood supply to these tissues: over time the tissue’s function will be disrupted. A vessel under tension can also rupture and cause damage to the tissues receiving blood from it. Hypertension is complicated with multi- organ damage. When the brain is involved there is a stroke; kidney involvement causes a kidney failure. Liver dysfunction and outright failure could also happen. The symptoms include: throbbing headache, palpitation, fatigue, blurring of vision, difficulty in breathing
What are the risk factors of hypertension? Lifestyle, dietary intake and other environmental factors can predispose to hypertension. Some disease conditions can also result in hypertension.
All in all, hypertension can adversely damage one’s health. Malaria
Malaria is a disease caused by Plasmodium species. This protozoa is transmitted by female anopheles mosquitoes during a bite. There are four types of parasites: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae. During a mosquito bite the Plasmodium parasite is transmitted as sporozoite into the human bloodstream; it immediately leaves the bloodstream and enter the liver. In the liver cells the sporozoites divide and increase in size to become merozoite; eventually the liver cells rupture and the merozoites are released into the bloodstream. They invade the red blood cell, consume the heamoglobin in the red blood cell and increase in size to occupy the whole of the space in the red cell. The red cell ruptures, releasing substances into the blood that cause the symptoms and signs of malarial fever. The symptoms of malaria include weakness, joint pain, headache, fever, vomiting and abdominal pain.
Malarial fever can be life – threatening if not promptly taken care. Malaria can best be prevented by: • Sleeping under insecticide treated net • Applying insecticide • Maintaining a clean environment • Prevent water collection in uncovered can and bucket. • Tree around the house should be regularly trimmed. If at all you feel symptoms of malaria visit the hospital as soon as possible. Please don’t practise self – medication! Typhoid Fever Typhoid fever is caused by a bacterium called Salmonella typhi. The bacteria are transmitted through food and water, and remotely through unwashed hand. Once the bacteria enter the digestive system, it settles in a part of the intestine called the Peyer’s patch; here the bacteria multiply and eventually invade the bloodstream and spread round the body. The symptoms are continuous fever, persistent headache, and abdominal pain, vomiting and stooling.
Typhoid fever when not promptly or properly treated can lead to perforation of the intestine which will have to be corrected by a surgical operation. Asthma
Asthma is an allergic disease of the respiratory system. Following an exposure of the allergen, there is widespread narrowing of the air passages with secretion and accumulation of thick mucus in the airway. As a result of this air cannot flow out freely during expiration. The affected person then experiences shortness of breath, chest constriction, inability to speak clearly, weakness and dizziness.
The precipitating factors include dust, pungent smell, change in weather, emotional state to mention a few. Acid reflux disease (GERD)
Acid reflux disease is caused by back flow of the content of the stomach into the oesophagus . The content of the stomach is acidic so it may cause irritation of the oesophagus. Heartburn is the most common symptom of GERD. Peptic Ulcer
Peptic ulcer is an erosion or a wound in the inner layer of the stomach and duodenum. This wound is caused by excess acid secretion and the effect of a bacterium (Helicobacter pylori) on the wall of the stomach. Some drugs have also been implicated in causing ulcer. The main symptom of ulcer is upper abdominal pain (relieved or aggravated by food). Pneumonia
Pneumonia is an infection of the respiratory airway. The infection is usually airborne. Once the causative organism gets into the body it causes inflammation of the air passages. Absorption of oxygen and carbon dioxide is affected. The symptoms of pneumonia include chest pain, cough, production of foul smelling sputum, difficulty in breathing and fever. Tuberculosis
Tuberculosis is a respiratory infection caused by Mycobacterium tuberculosis. The bacteria destroy the lung tissues causing cavitations and pus formation in the lung. It is a serious respiratory disease that needs urgent expert attention. The symptoms are fever, weight loss, coughing out blood or blood stained sputum, excessive night sweating, chest pain and difficulty in breathing. There are government sponsored tuberculosis treatment program which give adequate treatment for tuberculosis patients. Hepatitis B
Hepatitis is a viral infection of the liver. It is transmitted through contact with blood and blood product. The symptoms are yellowness of the eyes (jaundice), upper abdominal pain, dark – coloured urine and generalized body itching. Breast Cancer
Breast cancer is a group of abnormal cells in the breast tissue with excessive and uncontrolled growth pattern. The cancer cells grow rapidly beyond their normal border with tendency to invade other body’s tissues. Early breast cancer is usually painless; it may be detected on physical examination, mammography or breast scan. Every woman should know how to do a self breast examination and if any lump is detected medical consultation should be sought promptly. Breast Self – Examination
It is important for women aged 20 years and above to do a monthly self – examination of the breast. There are three main methods: Facing the Mirror
Stand before a mirror and compare both breasts noting differences in size, nipple turning in, bulging, or dimpling. Note any skin or nipple change or discharge. • Using two imaginary line( one above – downward, the other across right to left; both crossing at the nipple)divide your breast into four quadrants; inspect your breasts in the four quadrants in the following 4 steps: • With your arms at your sides • With your arms overhead • With your hands on hips - Press firmly to flex your chest muscles. • Bent forward - Inspect your breasts. • In these positions, the muscles of your chest are contracted, and a subtle dimpling of the skin may appear if a growing cancer has affected the tissues under the breast. Lying down • Right breast • Place a pillow under your right shoulder. • Put your right hand under your head. • Check the entire breast area with the finger pads of your left hand. • Use small circles and follow an up-and-down pattern. • Use light, medium, and firm pressure over each area of the breast. • Feel the breast with the surfaces of the second, third, and fourth fingers, moving systematically and using small, circular motions from the nipple to the outer margins. • Gently squeeze the nipple for any discharge. • Left breast • Repeat these steps on your left breast using your right hand.
In the shower • A self – examination can easily be performed while you're in the bath or shower. Some women discover breast masses when their skin is moist. • Raise your right arm. • With soapy hands and fingers flat, check your right breast. • Use the same small circles and up-and-down pattern described earlier. • Repeat on the left breast. Cervical Cancer
The cervix is the lowest portion of a woman's womb. It connects the womb with the vagina. Cancer of the cervix occurs when the cells of the cervix change in a way that leads to abnormal growth and invasion of other tissues or organs of the body. Like all cancers, cancer of the cervix is much more likely to be cured if it is detected early and treated immediately. One of the key features of cervical cancer is its slow progression from normal cervical tissue, to precancerous changes in the tissue, to invasive cancer. • The slow progression through numerous precancerous changes is very important because it provides opportunities for prevention and early detection and treatment. Uterine Fibroid
A uterine fibroid is the most common benign (not cancerous) tumor of a woman's uterus (womb). Fibroids are abnormal excessive growth of the smooth muscle that is normally found in the wall of the uterus. They can develop within the uterine wall itself or attach to it. They may grow as a single tumor or in clusters. Fibroids grow in response to stimulation by the hormone estrogen, produced naturally in the body. These growths can show up as early as age 20 and shrink after menopause when the body stops producing large amounts of estrogen. Uterine fibroids can cause excessive menstrual bleeding, pelvic pain, and frequent urination; so even though they are termed benign (not cancerous) tumors, fibroids potentially can cause many health problems. Ectopic Pregnancy
An ectopic pregnancy is a pregnancy that develops outside a woman's uterus (womb). This happens when the fertilized egg from the ovary does not implant itself normally in the uterus. Instead, the egg develops somewhere else in the abdomen. The products of this conception are abnormal and cannot develop into fetuses. One of main complication of ectopic pregnancy is severe bleeding. HIV/AID
HIV stands for the human immunodeficiency virus. It is one of a group of viruses known as retroviruses. After getting into the body, the virus kills or damages cells of the body's immune system. The body tries to keep up by making new cells or trying to contain the virus, but eventually the HIV wins out and progressively destroys the body's ability to fight infections and certain cancers. The virus structure has been studied extensively, and this has helped scientists develop new treatments for HIV/AIDS. Although all HIV viruses are similar, small variations or mutations in the genetic material of the virus create drug-resistant viruses. Larger variations in the viral genes are found in different viral subtypes. Currently, HIV-1 is the predominant subtype that causes HIV/AIDS. AIDS stands for the acquired immunodeficiency syndrome. It is caused by HIV and occurs when the virus has destroyed so much of the body's defenses that immune-cell counts fall to critical levels or certain life-threatening infections or cancers develop. Jaundice
Jaundice is a yellow discoloration of the skin, mucous membranes, and the whites of the eyes caused by increased amounts of bilirubin in the blood. Jaundice is a sign of an underlying disease process. Bilirubin is a by-product of the daily natural breakdown and destruction of red blood cells in the body. The hemoglobin molecule that is released into the blood by this process is split, with the heme portion undergoing a chemical conversion to bilirubin. Normally, the liver metabolizes and excretes the bilirubin in the form of bile. However, if there is a disruption in this normal metabolism and/or production of bilirubin, jaundice may result. Prostate Cancer
Prostate is an organ that is found only in male. It lies around the lower portion of the bladder, in front of the rectum. Prostate cancer develops when the cells of the prostate begins to grow abnormally without control, invading the cell of adjacent tissues. The symptoms include difficulty in urination, bloody urine and weight loss. Arthritis
Arthritis is an inflammatory disease of the joint. Joints are the area of the body where two bones meet. Due to the inflammatory process the bone ends, the joint space and the fluid in the joint are affected. Because of this, friction is not reduced during joint movement hence the pain and the degenerative changes that follow over time. Arthritis is a chronic disease, common in old age.