chatwithketch

Q: Good evening doctor,please I would like to know the cause of hepatitis B and how can someone knows that if infected also what are the symptoms and treatment to it.

A: Hello dear, thanks for writing in. Please see below a post I had made on Hepatitis A to E. I’m sure it will answer your question.

Hepatitis refers to inflammation (a situation that causes swelling, redness, heat and pain of affected area) of the liver cells caused by a viral infection or damage to the liver as a result of drinking too much alcohol. The liver is an organ in the body which is usually found on the right side of your abdomen, just under the rib cage. Its job is to ensure that toxins taken into the body are rendered harmless, food is digested properly and the nutrients available in it, properly absorbed. There are different types of hepatitis and some of them will not cause serious problems while others will cause long lasting damage to the liver and could lead to cancer.

The symptoms of liver disease include yellowness of the eyes and/or skin, dark urine, pale (light coloured) stool, itching, abdominal pain, abdominal swelling etc. You are more at risk of this if you work in a center where you handle body fluids (so this list includes healthcare workers). Other people who are more at risk include diabetics, obese people, people who take a lot of alcohol, drug abusers (this includes people who use illicit drugs and those who abuse prescription drugs), people who are in the habit of indiscriminate and unsafe sex etc

Hepatitis A: This is caused by eating food or drinking water contaminated by the faeces of someone who already has the infection. This is usually common in areas with poor sanitation. This infection would usually resolve after a couple of months but sometimes it could be very serious and life-threatening. Treatment is focused on symptoms like pain, itching etc Prevention is vaccination with the Hepatitis A vaccine. Hepatitis B:

Hepatitis B infection is caused by the Hepatitis B virus (HBV) and it can cause very serious symptoms in people or it could very well pass unnoticed and be discovered by chance as in this question. The infections that occur in adults are usually acute and the body is able to clear the infection within 6 months. However, in a small proportion of adults and in a lot of infections occurring in children, the infection remains the body for a long time (chronic) leading to complications like liver failure and cirrhosis (long term liver disease in which there is scarring of the liver due to different types of liver disease) of the liver. The symptoms include yellowness of the skin and eyes, dark urine, fatigue, body and joint aches etc. These symptoms vary in severity and appear about 3 months after infection. Causes of HBV infections include contact with infected sharps like needles, sexual contact with an infected person, having multiple seal partners, sharing needles used for intravenous drug use. If one suspects exposure to HBV infection, an immunoglobulin injection if taken within 24 hours can prevent the infection. Treatment depends on the type of HBV infection…whether acute or chronic. To confirm whether the infection is acute or chronic, the doctor runs a couple of tests.

The Hepatitis B surface antigen. A positive test result confirms that an infection is present but does not tell us if it is acute or chronic.

The Hepatitis B surface antibody. A positive test confirms that an infection had occurred but the body had developed antibodies to fight off the infection. This person is no longer contagious.

The Hepatitis B core antibody. A positive result tells us that a past or present infection exists. This is mainly interpreted in conjunction with the other two tests.

If the core antibody is positive and the surface antibody is positive, it means that the body had encountered this infection and fought it off in the past. This is likely to be an acute infection. If the core antibody is positive and the surface antigen positive, it is more likely to be a chronic infection. Treatment for acute infections focus on alleviating the symptoms noted above.

Treatment for chronic infections focus on use of antiviral drugs and other medications that improve liver function. If liver function Is badly affected, transplant might be an option. So, the first focus for you is to confirm if this is an acute or a chronic infection. That will determine the way forward.

Remember that you can improve liver function by staying off alcohol, exercising, eating a lot of fruits and vegetables and not self-prescribing. To avoid this infection, reduce your risk factors: Know the Hepatitis status of partner and be faithful to that person, where necessary, use condoms, stop the use of illicit drugs, do not share needles and other sharps, be careful with tatooing et al. Vaccines are available for this virus and is now listed on the National Program on Immunization schedule. All adults who also have risk factors as noted above should also take this vaccine. Hepatitis C: This is spread through blood to blood contact eg sharing needles. In a few cases, people can fight off the infection, but in most people, the virus survives and causes chronic (long standing) infection which can lead to cirrhosis and liver failure. There is no vaccine for this infection.

Hepatitis D: This is caused by Heaptitis D virus and only occurs in people already infected by the Heaptitis B virus as it requires the latter to survive in the body. It is spread through blood to blood and sexual contact. Long term infection with this can put one at risk of liver failure and cirrhosis. There is no vaccine against this but given its relationship with Hepatitis B, vaccination against Hepatitis B can provide some protection against this as well.

Hepatitis E: This is caused by eating food or drinking water contaminated by the faeces of someone who already has the infection. This infection is usually mild and would usually resolve without treatment but sometimes it could be very serious and life-threatening. It can also become long term especially in people with suppressed immune systems. There is no vaccine for this infection. Focus is on ensuring good hygiene. Other types of hepatitis include: Alcoholic hepatitis due to taking excessive amounts of alcohol over years. This can lead to liver failure, cirrhosis or liver cancer.

Prevention is reducing your alcohol intake or stopping completely Auto-immune hepatitis is is a situation in which the body begins to attack its own liver cells for no reason. Treatment is the use of drugs to suppress the body’s immune system. What foods should a hepatitis patient take? A healthy balanced diet, really. Stay off alcohol though as this causes further damage to the liver. Be sure to drink sufficient amounts of water daily and discuss all drugs you’re taking with your doctor.

I hope this helps.

Have a great night, y’all

What do you do when you are trying to meet a deadline but really, really tired? Do you reach for a cup of coffee or head to the gym? I’m sure the gym probably never featured in your thoughts! Well, maybe it should. Read this!

http://www.health.harvard.edu/blog/exercise-versus-caffeine-which-is-your-best-ally-to-fight-fatigue-2017060811843?utm_campaign=shareaholic&utm_medium=facebook&utm_source=socialnetwork

And for more on my thoughts on coffee and energy drinks, click on this: https://chatwithdrketch.com/2014/01/17/daily-health-tips-coffee-energy-drinks-et-al/

Have a fabulous evening, y’all 😀

Q: Doc good morning please I would like to know what is the best treatment for yeast urinary tract infection as my girl friend has been suffering from this infection, which according to her started last month and then resurfaced again during her period. And what could be the cause and how to prevent future infection

A: Urinary Tract Infections occur anywhere in the urinary tract (Genius me, right? :D) and include infections of the kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder (the reservoir or store house for the urine) and the urethra (the tube that transports the urine from the bladder to the outside).

So, who is more likely to have an infection and why? Women are more likely to have infections and this is because they have short urethrae (those tubes that transport the urine outside) and because the opening of this tube is very close to the opening of the anus. And so, if a woman urinates and has not quite mastered the art of cleaning from the front to the back, she could transfer bacteria from her anus to her urethra and this in turn travels up and infects the bladder. Women who also use the birth control method, diaphragm appear to also be at risk as it may cause the bladder not to empty completely when they urinate. Indeed, not urinating immediately after sexual intercourse in women may also predispose to this as the urethra may have may have become irritated, making it easier for germs to move in. People with depressed immune systems, frequent constipation and some people born with some disorders of their uro-genital system are also prone to UTIs.

In men, narrowing of the urethra which may happen in men who have had straddle injuries (eg falling astride {with legs apart} on a pole…ouch!), history of STIs or prostrate problems may make a man open to UTIs. Recurrent and chronic urinary tract infections (UTI that keeps recurring) may be due to changes in hormone (estrogen) level as one gets to menopause, problems with the urinary tract in terms of function or shape, kidney or bladder stones, bacteria getting into the urinary tract during sexual intercourse etc What symptoms does a person with UTI have? They would complain of feeling they have to urgently urinate often and then when they do get to the toilet, they can only pass out very little urine, pain or burning sensation during urination, pain in the flank (just under the ribs at the back), the urine may be cloudy or reddish or coke coloured, fever with chills and rigours etc. UTIs have to be treated because these infections could keep back tracking from the urethra to the bladder to the ureters and then to the kidneys…we don’t want that do we?! 😀

Treatment is focused on eradicating the infection…of course 😀 Usually a urine sample is taken to the lab. Part of the lab work is a culture and sensitivity test to find out the organisms causing the infection and the specific antibiotic that is active against it. Your doctor may also order other tests as he sees fit eg checking out for congenital defects etc. Apart from the preventive tips above, be sure to drink lots of water which help dilute your urine and help flush out the bacteria.

If placed on antibiotics, please take your prescription for the right period of time even if your symptoms disappear before you finish. And don’t go taking antibiotics without prescription. If you do, you could come down with a yeast infection (candidiasis), which may have symptoms similar to UTI but is a different entity.

Candidiasis is caused by an organism called Candida, a fungus (yeast). This infection can result in cheesy white (like ground melon/egusi seeds) vaginal discharge and vaginal itching. This itching can lead to irritation in the vagina, which can become further infected, by bacteria. Candidiasis is very common in diabetics (the sugar in their urine makes the vagina a rich culture medium for them) and pregnant women who have altered glucose tolerance. This infection is also common in people people whose immune systems are compromised and people who wear tight panties that do not allow their delicate inner selves to ‘breath’. Preferred materials for undies would be cotton and should be loose (I see my fashionistas frowning :D). It also happens in people who take a lot of antibiotics. Normally, some bacteria and fungi (yeast) co-exist peacefully 😀 in the vagina. To encourage this peaceful co-existence, the bacteria produce some acid that hold the yeast in check and prevent their over-growth. When antibiotics are abused, this leads to a situation where the yeast takes over 😀 (almost like a coup, right?). Though this infection can be passed on through sexual intercourse…especially oral-genital contact, it’s not really called an STI because women who are not sexually active can be infected with this.

Treatment is with anti-fungal vaginal tablets and/or anti-fungal cream which can be used for between 1-3 days depending on drug of choice. A single course dose of Fluconazole can also be taken orally. Any of these regimen may be extended if the infection is complicated…let your doctor be the best judge of that 😀 Prevention is targeted at causes: • Wear loose fitting cotton undies

• Stay away from or limit time spent in hot tubs or saunas

• Stick strictly with the prescription for antibiotics in terms of quantity and duration

• Change out of wet clothes eg swim suits as soon as possible

I hope this helps.

Have a good night, everyone ☺

Q: Hello doc. Thanks for your usual support. What could be the cause of discharge from the ear? It comes and goes like once or twice a year for like five years now. There is neither fever nor pain but a tingling sensation. What could be d underlying problem?

A: Ear infections could lead to discharge of pus from the ear. Examples include:

• Otitis media
• Otitis media with effusion
• Otitis externa (swimmer’s ear)

In otitis media, there is an infection of the middle ear and happens when an upper respiratory tract infection introduces bacteria into the ear. The infection could also be viral. Fluid builds up in the middle ear.

In otitis media with effusion, pus forms as the body tries to fight the infection. This leads to more fluid collection and this pushes against the ear drum. This pressure can build up to the extent that the ear drum ruptures, leading to drainage of pus. With this, the symptoms of pain and problems hearing disappear and the infection clears.

Middle ear infections are common in children between the ages of 6 months and 2 years, children who drink from a bottle while lying down, people who are exposed to tobacco smoke and the infection occurs more during the flu season…when ‘everyone’ is down with a cold or flu. This infection could lead to tearing of the ear drum, hearing problems, spread of infection to surrounding tissues. Most infections would clear up on their own within a week or two, but antibiotics could reduce the duration of symptoms. Be guided by the doctor. Pain medication and a warm compress over the affected ear may help control pain.

In otitis externa, water that remains in your ear for a while can create the sort of moist and warm environment that germs require to grow and multiply. This is very common in people with allergies, swimmers, people who stick their fingers into their ears (yes you! 😀 Don’t look back), use cotton buds (cotton tips) and other objects (tooth picks, pens etc) to clean their ears. The skin of the outer ear canal is very delicate such that sticking things in it to clean it or scratch an itch can lead to bruising making it easy for germs to take over. Young people who use ear phones a lot are at risk of this (for obvious reasons) and also children because of their narrow ear canals. I almost banned y second daughter from swimming because of this. She always got water in her ear while swimming and would be in pain for a while.

Usual symptoms are ear pain, itching, discharge of clear fluid, pain on pulling the outer ear. This may progress to more intense itching, discharge of pus, some degree of temporary hearing loss and may progress to complete blockage of ear canal. This is usually not very serious and resolves with treatment but if complicated may even lead to infections that spread to other parts of the body and could lead to perforated ear drums.
If this infection remains for more than three months, it is then called chronic otitis externa. This can be due to infections caused by a combination of bacteria and fungi, an allergy, a rare strain of bacteria etc

Treatment is usually with ear drops that reduce the swelling in the ear canal, help fight the bacteria or fungi (depending on the infection present) and other medications to fight pain. To help the ear drops make travel to the desired location, trying lying down with the affected ear up.

The Valsalva maneuver is a means of equalizing pressure in the ears by exhaling against a closed mouth and nose. You can try this out when you have ‘airplane ear’. This happens on flights as the planes starts to ascend or begins its descent. Close your mouth, pinch your nose and then try to blow out air against your closed mouth. It works like magic.

I suggest you go see an Ear Nose and Throat (ENT) specialist who will evaluate you. He may take swabs from your ear too to get an idea of what infection is there before proceeding to treat. In instances where treatment has not responded to eardrops, oral antibiotics may be prescribed.

Have a good night, y’all 😀

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Q: Hi doc and good morning to you, doc how can I maintain my weight of 60kg? Am I obese weighing 60kg?

A: Hi dear, thanks for writing in. The issue of obesity cannot be answered without having an idea of your height. So, I will say that you should be guided by your Body Mass Index (BMI). Your BMI is a quick way to tell whether or not you might be underweight or overweight, and what health problems you might have or develop because of your weight.

It is actually a measure of weight to height. It is calculated by dividing your weight in kg by your height squared in meters (that is height x height). Eg, if one weighs is 80kg and is 1.6m tall, the person’s BMI is 31.25. Different BMI readings have different meanings.

Here are 5 things you should know about your BMI

• If you’re under age 21, your age and gender need to be factored into your BMI to account for the different speeds at which guys and girls develop.

• If your BMI is less than 18.5, you are in the underweight category. Talk to your doctor to find out if your weight is a symptom of a medical problem. A registered dietitian can help you learn about healthy eating.

• If your BMI is between 19 and 24.9, you are in the recommended weight range for your height. But your health may still be at risk if you are not getting regular physical activity and practicing healthy eating. So, don’t start rejoicing just yet 🙂

• If your BMI is 25 to 29.9, you are in the overweight category. This may or may not be unhealthy, depending on some other things, like your waist size and other health problems you may have.

• If your BMI is 30 or higher, you’re in the obese category. You may need to lose weight and change your eating and activity habits to get healthy and stay healthy

Apart from your BMI, your waist measurement also plays a significant role in your health status. So, keep those tummies flat by eating healthy, y’all 🙂

Have a good night, everyone 🙂

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