chatwithketch

Hi doc, please is it safe to use chloroquine tab during pregnancy? Thanks

A: Is chloroquine safe in pregnancy? Well, there’s no clear evidence that it is unsafe in pregnancy when taken in the normal therapeutic doses. But there is, of course, the issue of chloroquine resistance.

You didn’t mention if you wanted to take chloroquine for prevention or for treatment I will address both.

Fansidar, which is a specific brand of the drug Sulphadoxine-Pyrimethamine (SP) is used for the prevention of malaria in pregnancy. Its use for this is referred to as Intermittent Preventive Treatment of Malaria in pregnancy (IPTp-SP). In the first trimester, it is not recommended for use but from the second trimester, it is considered appropriate and indeed is recommended by World Health Organization (WHO) for administration to pregnant women. If you live in a malaria endemic area like Nigeria, your doctor will ensure that you get your Intermittent Preventive Treatment (IPT) courses for malaria (sulphadoxine-pyrimethmine) during your pregnancy, as your doctor has already done. The assumed rule before was for pregnant women to receive 2 doses of this drug (full dose of 3 tablets) but WHO has since clarified that the appropriate regimen is for women to receive the full dose of Sulphadoxine-Pyrimethamine from week 13 of pregnancy. She should get a full dose at every antenatal visit provided the last dose was taken at least one month before. There is evidence that women who received 3 or more doses of IPTp had children with higher average birth weights than those who got 2 doses.

Your doctor will ensure that the Folic Acid dose you’re getting in your prenatal drugs is not more than 0.4mg (the usual amount in most over-the-counter folic acid tablets). Doses of Folic Acid higher than or equal to 5mg affects the efficacy of the anti-malarial, SP. So, be sure to check with your doctor before you start buying other non-prescribed prenatal vitamins.

If you do have malaria Quinine, Clindamycin, Proguanil are considered safe by the WHO treatment guideline in the first trimester. But, don’t be quick to go take any of them without prescription. Remember that every drug is a potential toxin and your doctor is really in the best place to weigh potential risks of taking any drug against the potential benefits. To put this in perspective, a recent study appears to now suggest that acetaminophen (the main ingredient in paracetamol) may lead to Attention Deficit Disorder in children! And yet, we refer to it as ‘ordinary’ paracetamol. There is nothing ordinary about any drug, my friends J

Doing all of the above will be meaningless if you do not pay any attention to the environment.

Those anopheles mosquitoes that are associated with malaria need a place to lay eggs so they can muster the right army to wreak havoc. So deprive them of a breeding camp. Who would know the conditions necessary for a terrorist camp to be set up and make their homes or environment, the right one for that? Nobody…in their right minds at least        

If you have to go out in the evenings, depending on whether you will be out in mosquito infested areas, wear protective clothing that cover arms and legs, preferably in light colours. Mosquitoes love dark colours and the dark….no wonder their deeds are evilInsect repellent creams used on exposed areas are also not a bad idea.

Have a good night y’all 😀

Q: Please Dr. Help me out. I am addicted to using tampons instead of sanitary pads, how dangerous is this for me? Thank you and God bless your work.

A Hi dear. Thanks for writing in. I can understand your ‘addiction’ as tampons are convenient to use. The focus should be on using them right. Tampons are products like sanitary pads used to absorb menstrual flow. A tampon is cylindrical in shape and has a string at one end that can be used to pull the tampon out. Sometimes, this string may go inside your body but you can usually feel the tampon and pull it out.

There is a dangerous infection that can occur in females who use tampons. It’s called Toxic Shock Syndrome (TSS). It is not caused by tampons but because tampons in the vagina create a perfect environment for bacteria (staphylococcus aureus in this case) to thrive, a toxin is created that causes severe illness. Young teens with fewer antibodies to the infection are more likely to experience this than older females.

Symptoms of TSS include  sudden high fever, headaches, redness of the eyes, mouth and throat, vomiting, diarrhea, seizures etc. If you experience any of these, while wearing a tampon, remove it immediately and contact your doctor.

Here are general rules for using tampons safely:

·      Be careful when inserting tampons. Remember that , Staphylococci, Staph for short, are bacteria which can be found in people’s noses or skin all over the body, minding their own business until a cut or injury occurs giving the germs access into the body. So, introducing an injury while inserting the tampon, increases the chances of TSS.

·      Keep your hands squeaky clean especially when changing tampons

·      Change your tampons every 4 to 6 hours

·      Do NOT let it stay inside you for more than 8 hours.

·      Do NOT use tampons to absorb any fluid other than your menstrual flow. Don’t use it as you would use a panty liner.

·      Alternate between tampons and sanitary pads eg tampons during the day and pads at night.

·      Ensure the tampon is removed very quickly if you observe any of the following:

·      Pelvic pain

·      High temperature

·      Unpleasant smell

·      Vaginal discharge

I hope this helps.

Have a good night, y’all 😀

November 25^th every year marks the International Day for the Elimination of Violence against Women. Violence can be physical, psychological and/or sexual. In honour of this day, I repeat a post on female genital mutilation (FGM), a very ‘good’ example of violence against women.

Q: Good day Dr, please I need more enlightenment on child circumcision: is it also for female child? And what is the reason for it? Is there any negative effect?

A: Thank you so much for writing in. Circumcision is a no-no for the female child. This procedure called Female Genital Mutilation has been recognized as a violation of the fundamental human rights of the girl child and it has absolutely no medical benefit. Indeed, it subjects poor, defenseless and innocent children to needless pain and torture!

For those who don’t know, Female Genital Mutilation (FGM), also referred to as female circumcision is a procedure in which there is partial or complete removal of the female genitals or any other injury to the female genital organs for reasons other than medical. So, practices like cutting off all or part of the clitoris, cutting off the surrounding lips of the vagina, narrowing the vaginal opening, any harmful procedure to the female genitals like piercing, pricking etc in any combination, all form part of this very terrible act. Why do people do this? It is wrongly assumed in some quarters that this prevents a woman from being promiscuous in future (removal of the clitoris would greatly reduce sexual pleasure and for those that have the vaginal opening reduced, the sheer pain of having any object pass through that opening is enough to discourage sexual intercourse), it is culturally accepted as a means of showing modesty in some cultures, it is thought to be religiously appropriate (no one can show where any religion specifically states this) and others just do it, because everyone in their circle does this!

In the olden days, this was practiced by village birth attendants who would use unsterilized instruments, aiding the spread of diseases like HIV/AIDS. Today, this is still a concern but even more discomforting is the fact that some medical personnel (???qualified) also participate in this.

FGM causes immediate and long term complications. Immediate complications are not far-fetched. The child is subjected to terrible pain, she could bleed heavily and could even end up in shock. There may be injury to surrounding genital tissue and there could be introduction of infection, especially if the conditions are not hygienic or when unsterilized instruments are used.

Long term complications include difficulty with sexual intercourse especially if the vaginal opening was reduced. This also presents a challenge during childbirth. Other complications include recurrent urinary tract infections and infertility.

So, my advice is to all mothers who wonder about female circumcision is ‘leave your daughter’s genitals well alone! Love and care for her and as she grows, encourage her to take pride in herself and who she is. Encourage her to go out and conquer the world.’ The reasons usually given for FGM really boil down to wanting to control the girl child. Why is it wrong for her to enjoy sexual intercourse when it’s time? Several homes have been wrecked by the fact that the lady who’s been circumcised cannot enjoy sexual intercourse and/or has to go through several episodes of pain (sometimes, even her partner suffers pain too) before she can finally settle into it.
Finally, join the fight against this horrible act. Tell every mother you know about what you have learnt. Together, we can stamp this act out.

For more on this subject, please click on https://chatwithdrketch.com/2016/11/27/daily-health-tips-domestic-violence-in-the-news/

Have a good night, everyone!

• Q: You once helped me regarding my son’s issue when he was born. Now I am in-boxing you with my own issue. I am in my early 30s, and have incredibly strong erections almost every day to a point where my penis becomes a bit uncomfortable. They last almost 2 to 4 hours, it has been happening since the last time I tried to have sex, about 2 months ago. I no longer know if I am horny or they are just happening on their own… Many men out there are desperate for erections because of Erectile Dysfunction etc, and right now, I am desperate to stop these erections because they are getting to me. Well, I can say I am not sexually active, because I hardly have sex. Sometimes I think if I can have sexual intercourse always this will stop. Now I do not know what to think of it. I just want to be able to control my erections. I can’t even masturbate because I waste my energy when I do as I don’t reach the end. Dr. Ketch, tell me, is there a way I can stop these erections? My testosterone hormones are killing me. I become moody sometimes. Thank You. I will be looking out for the response on your page.

   

  A: Hello dear. Thanks for writing in.

   

  You will definitely need to see your doctor for proper evaluation and diagnosis, but it does sound like this is priapism. This condition, in which there is a sustained and oftentimes, painful erection of the penis, continues for hours beyond sexual stimulation (I suspect that ‘magun’ falls into this category 😀 I couldn’t resist that. Only Nigerians and Yorubas, specifically will get this joke!) or even when there is no sexual stimulation as described in your case. It is more common in men in their 30s.

   

  There are three types of priapism (ischaemic, non-ischaemic and recurrent) but to understand this, we’ll take a look at the mechanism of erection. An erection occurs in response to stimulation, physical or psychological. As a result of this stimulation, the blood vessels and smooth muscles of the penis relax, allowing increased blood flow to the penis. This is what causes erection. When the stimulation is over, the vessels and smooth muscles constrict causing the blood to flow out of the penis and become flaccid. In priapism, the order of events causing the blood to flow out of the penis is changed such that the

   

  In ischaemic priapism which is the more common type due to inability of blood to leave the penis, there is pain, rigid penile shaft but flaccid glans (penile tip) and the erection lasts more than 4 hours! Causes include blood disorders like sickle cell anaemia and injuries to the penis and/or pelvis, alcohol, cocaine and other illicit drug use, some medications like blood thinners and antidepressants, cancer of the penis etc.

   

  Non-ischaemic priapism is usually due to an injury to the perineum or genitals that results in poor regulation of penile blood flow. It is not usually painful and manifests as erection that lasts for more than 4 hours but the penile shaft is not fully rigid.

   

  In recurrent priapism, situation is similar to ischaemic priapism with erections that are painful, recurrent but ease after 2 to 3 hours. These erections may subsequently progress to become more frequent and more prolonged. It is common in males with sickle cell anaemia

   

   

  Any sort of priapism should be checked out with a medical doctor (urologist) to determine type, cause and management. Erection lasting more than 4 hours is an emergency and may led to damage of the penis and subsequent erectile dysfunction

   

  Treatment depends on cause and should be started as soon as possible.

  Options include aspiration (in which blood is drained out of the penis with a syringe), use of medications to constrict the penile blood vessels, treatment of underlying medical condition like sickle cell anaemia and surgery in some cases. Note of warning, though it sounds very simple to use a syringe to drain out the blood in the penis, you must never attempt it on your own. You must visit a hospital and let a doctor work out the best treatment option(s) for you.

  So, I suggest you see your doctor asap to get a proper evaluation and start on your journey to recovery.

  All the best!

  Have a great weekend y’all 😀

   

If you’ve ever heard the coconut oil hype, then you should read this! Is it healthy or not? You be the judge!

https://www.health.harvard.edu/heart-disease-overview/coconut-oil-heart-healthy-or-just-hype

Q: Good evening, Doc. Please is anything wrong with you lying on your tommy with 8 weeks pregnancy and I am always having upper back pain. Thanks in anticipation.

A: Congratulations on your pregnancy! In early pregnancy, there’s nothing really wrong with lying on your tummy….that’s if you feel comfortable. As your pregnancy progresses, you will definitely not be able to do so again. So, if this is your guilty pleasure, enjoy it while it lasts. Generally, in the first trimester, if you’re used to sleeping on your back or tummy, you can continue. However, as you get into your second trimester, it is fact that pregnant women should not sleep on their backs especially close to term. This is because the woman may feel dizzy as the growing uterus puts pressure on the vein that returns blood from the body making the woman feel dizzy on getting up and the baby may also not get enough nutrients from the placenta in that position.

As pregnancy proceeds, you may start to experience more backaches as the weight you have put on starts to take its toll. Be sure to sit up straight on chairs with proper back support to help with this. Sleeping on your side with a pillow between your legs will also help. This may be the cause of your backaches but if they are very discomforting, please see your doctor. Better safe than sorry.

Have a good night, everyone 😀

A: Thanks for writing in. Congratulations on your new baby! 😀 Well, my first question is whether you are practicing any form of contraception? Not just now but before you resumed sexual relations with hubby after your baby? Well, if you were not on any contraceptive, then you could very well be pregnant…and hey, indeed you are, as the pregnancy test has shown 😀

So, how can I help you out? Some advice: go see your doctor and let him carry out a pregnancy test in the hospital…just to confirm your result. He will also examine your scar to see if there are any problems. Barring that, I suggest you start getting ready for the next baby, physically, emotionally and otherwise.

It’s important for every woman who’s had a baby or is going to have one to know that pregnancy soon after having a baby is most definitely possible whether your period has ‘returned’ or not if you’re not using contraception…and this applies to you even if you’re breastfeeding exclusively! 😀 So, watch out ladies 🙂

For more on this subject, please click on the link below:
https://chatwithdrketch.com/2014/11/06/daily-health-tips-how-soon-after-a-c-section-can-i-try-for-a-new-baby/

Have a good night, y’all 😀

‘The never-ending advertisements for erectile dysfunction drugs seem to suggest that popping a pill is all it takes to guarantee a great sex life for men dealing with this challenging problem.’ But is that really all that is needed? Should you be doing more to improve your sex life? You should read this!

https://www.health.harvard.edu/healthbeat/a-better-sex-life-requires-more-than-popping-a-pill

Q: Hello ,doctor..is it ok to eat spicy foods when pregnant?

A: I love spicy foods! When pregnant, I crave it even more. Most people find it difficult to eat with me when I’m preggie…because the food is just that spicy! Unfortunately, this has a challenge associated with it. Eating spicy foods in pregnancy can cause your esophageal sphincter to stay open for prolonged periods leading to heartburn.

Heartburn really has nothing to do with the heart…I bet all of you knew that, aye? It is usually felt as a burning sensation in the chest which feels worse on bending down or lying down. Okay, why and how does this happen? You know that the stomach produces acid to help with food digestion, right? Have you ever wondered, how come this acid isn’t all up in your mouth all the time? Well, that’s because there’s a ‘lock’ or control at the junction of the esophagus and the stomach which prevents the acid in the stomach from coming back up into the esophagus. This ‘lock’ is called the Lower Esophageal Sphincter. This lock can get strained if the esophagus opens too often or if there is too much food in the stomach…so, if you regularly over-eat, you might want to re-think that 😀 A major no-no is a very heavy meal just before you lie down. It’s almost certain you may have a heart burn 😀

There are also conditions like pregnancy (like in your case) and obesity that make this sphincter stay open for prolonged periods as a result of pressure on the abdomen and there are also foods that encourage this. Examples of these ‘foods’ are fatty foods, alcohol, orange juice, chocolate and coffee, onions, tomatoes, peppermint and as already mentioned, spicy foods. In pregnancy, the hormonal changes and the pressure of the growing womb on the stomach contribute to heartburn.

Heart burn in pregnancy is more likely to occur in women who had heart burn before pregnancy, women who have been pregnant before and women in the last stages of their pregnancy.

So, I suggest you keep a food diary over a period of time and try to figure out the trigger foods. Remember that being over-weight could be a problem or even over-eating.

Prevention involves trying to avoid your trigger foods (quite a number are actually healthy 😀 ) maintaining a healthy weight, avoiding heavy meals just before bedtime, avoiding alcohol or smoking, sitting up straight when eating, try eating smaller meals and avoid tight clothes that may also put pressure on your abdomen.

Treatment is targeted at the acid and healing the esophagus. So, drugs used can stop acid production, reduce acid production and cause healing of the esophagus or neutralize the effect of the acid. Your doctor will prescribe what works best for you.

Have a fabulous evening and remember…no heavy meals before bedtime.

Have a good night y’all 😀