chatwithketch

Q: What kind of food that you must eat when you’re H.I.V positive.

A: Thanks for writing in.

Being diagnosed with HIV does not have to be seen as the end of the world. Here are a couple of tips on how to keep you healthy:

• First ensure that you are taking your medications regularly. See your doctor as often as required and be sure to discuss any issues you have.

• Diet: Aim to eat a balanced diet in the right portions. If you’re not eating enough, your doctor may prescribe some supplements to ensure your body receives the right nourishment.
  • Eat a lot of fruits and veggies. They have anti-oxidants that help boost the immune system
  • Focus on white meat and lean protein. Trim off fat from beef or chicken. Fish is very good. Include dairy products too.
  • Aim for quality carbs like complex carbs. Good examples are wheat, brown rice, oats. Limit the amount of foods high in refined sugar that you consume. You want your energy source to come from nutritional foods.
  • Use healthy fats when cooking. Olive oil is a good example but I always hasten to add that even this should be taken in moderation as it is filled with calories. Other heart healthy oils can be found in nuts and avocado
  • Stay hydrated by drinking sufficient amounts of water.
• Exercise: This improves heart health, builds your bones and also helps you burn fat. For those who lose significant muscle bulk due to the disease, this can help you add to the bulk. Be guided by your doctor as to the extent of your fitness regimen.

Generally, keep a positive disposition. Create goals, if you never had them and work towards them. Remember that having this infection is no longer the death sentence it used to be. With the right care and loads of common sense (to avoid situations that can lead to infections like even poor kitchen hygiene), you can live to a ripe old age.

All the best!

Have great night y’all 😀

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Q: Hello Dr., I wish to ask why some women menstruate during pregnancy

A: People do not menstruate when pregnant. Remember that menstruation happens when fertilization of eggs released during ovulation by sperm does not occur. And so, if fertilization and pregnancy occur, menstruation is ruled out.

Bleeding can occur in early pregnancy though, close to or about the same time as the menstruation would and thus be mistaken for a period. This bleeding could be due to implantation as the fertilized egg implants itself in the uterus (womb). Other causes of bleeding in early pregnancy include ectopic pregnancy, miscarriage and infections.

Bleeding in pregnancy may not necessarily be an emergency but because there are other causes of these episodes of bleeding, which are potentially life threatening like ectopic pregnancy, bleeding in pregnancy should always be checked out in the hospital. Better safe than sorry J

By the way, did you catch the news that Ebola has reared its ugly head again in Democratic republic of Congo? If you live there, don’t forget how we all beat the disease last time. Hygiene! Hygiene! And more hygiene! If you do not live in DRC, the same rules of hygiene apply to you. Remember that last time, it was from one place that it spread to other places. So, when you keep yourself safe, you keep others safe by extension!

Have a fabulous weekend y’all 😀

Q: Thank you. My son has ringworm on his private part, I put antifungal cream almost a month already. There was time I thought it was already cured but until now it is not yet healed

A: Thanks for writing in.

Ringworm is a fungal infection. Below is a post I had made on this subject previously.

Fungi are invisible (to the naked eye) micro-organisms that are plant-like. They love and thrive in dark, warm, moist areas and can attack skin in situations of low immunity or when there is an injury to the skin or nail. Examples of fungi are mushrooms (yes…the same one we eat :D), mildew (the one that grows on that towel that didn’t dry well :D) and mold (the type that grows on bread that is left for too long :D). Yep! So, we all know this guy FUNGUS! Ever since my son heard that mushroom was a fungus, he refuses to eat it again. We’ve always had a running battle with it anyways, so this was just convenient! So far, it is, ‘no winner, no vanquished’. We’re still at it though…the battle:D But I digress…

Back to our fungi gist, there are typically three common fungi infections: Ringworms (which most people have heard about), athlete’s foot and jock itch.

Ringworms are small, round, ring shaped rashes/patches on the skin…but are absolutely not worms 😀 They usually happen when people have minor injuries on skin, scalp or nails and when people sweat a lot. Keeping personal things personal can prevent this: don’t share towels, clothing, and undies, head coverings (caps, hats etc.). Keep your skin nice, clean and dry. This process can be helped by taking a bath regularly J and toweling off. Be sure to shampoo after a haircut and dress for the weather. With our hot sun, those fungi have no hiding place! Let them bring it on J

You know those sores between toes that happen especially if you are fond of walking around barefoot in wet areas, wear tight shoes and synthetic socks (that don’t allow your feet to breath) and if you don’t clean properly between your toes after a bath? That’s called athlete’s foot. So, to prevent it, avoid the above. Wipe between toes et al after a bath, wear socks made from fabrics that ‘breath’ like cotton, take a break from tight footwear and try not to share your shoes. Buy shoes that suit our weather too. For instance, while a pair of boots may make sense in winter, it may not be such a great idea in these hot climes (Africa) where the weather is hot and our feet need to breath J If you can get away with it, wear sandals.

Have you ever seen anyone closing their eyes and intensely scratching their crotch area? Well, they could have jock itch! This again happens when people sweat excessively…the groin area is not spared. Prevention involves not sharing towels and under-garments, keeping them clean and washed, wearing clean socks and keeping it cool down there by wearing under garments made with cotton, which are not tight fitting J A bath after a hectic exercise or sport session will also not go amiss.

Treatment of these fungal infections will involve the use of anti-fungal creams and where the infection is significant, oral anti-fungal creams are added. Antibiotics may also be indicated where there are bacterial infections…as can occur from the scratching of jock itch.

Fungal infection of the scalp, called Tinea Capitis, is often found in children and is commonly called ringworm too. If you’re a parent and your child has had this, the embarrassment factor alone is significant enough to seek therapy J Parents try all sorts from the conventional to the not-so conventional to take care of this. Anti-fungal creams, lotions and powders applied to the scalp for ages, don’t quite work. Creative solutions like rubbing petrol on the scalp, leaves a screaming child who still has holes and patches in his hair from the fungal infection. Where on earth, did that therapy come from? Petrol??? Seriously???? (like my daughter would say :D)

Tinea Capitis may involve all or some parts of the scalp. The involved areas may look bald and patchy with small, round spots from broken off hair, swollen and inflamed etc. As is typical of fungal infections, they love moist and warm areas and will be encouraged to grow when one has a cut or bruise on the scalp, does not wash his/her hair regularly, sweats a lot and does not wash this off quickly and/or shares personal items of clothing like caps, hats, head scarves, towels etc The infection can also be spread by coming in contact with ringworm on someone else’s body or even contacted from a pet.

Treatment is not achieved on the surface by using anti-fungal creams. This is achieved by taking anti-fungal drugs orally. This will usually be for a significant period of time, between 6 to 8 weeks. Using anti-fungal shampoos may limit the spread of the infection but does not get rid of it. Again, even if signs of quick results are seen, this does not mean therapy should be stopped immediately. The drug should be taken for the full period prescribed by the doctor.

During the course of treatment, pillowcases, combs, towels et al which are probably infected, should be disposed of, where possible. If not, they should be disinfected with bleach and washed in warm water.

Moving forward, personal things should be kept personal and not shared with other people:D Personal hygiene is key… children should be taught to take a bath and frequently too, especially after sweating. They should also stay away from stray dogs or those that have the infection (a bald patch on the dog’s fur may be observed)

So, there you have it. In this instance, an ounce of hygiene is certainly worth a pound of cure! And in treating fungal infections, patience is key as it could take months!

Have a good night, people 😀

https://www.instagram.com/p/BT6xSIjFPo9/?taken-by=ddrketch

Until the advent of artificial lighting, the sun was the major source of lighting, and people spent their evenings in (relative) darkness. Now, in much of the world, evenings are illuminated, and we take our easy access to all those lumens pretty much for granted.

We are surrounded by gadgets within and outside of our bedrooms and some of us fall asleep while gazing at these devices. For more on the effects of blue light on your health, please click on this link: http://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side

Have a good night, y’all 😀

Q: Good evening doctor, please what cause boils on the armpit, breast, vagina, inside nose and buttock and thighs…very big ones at that matter? And what drug can one use? Thanks.

A: Your question is not very clear. Are the boils in multiple places occurring at the same time…or different times? While we consider that question, a few basics….

A boil, also called a skin abscess, is an infection of a hair follicle deep in the skin. Boils can occur in any part of the body, but most frequently in the armpits, groin, around the vagina/anus areas, around a tooth and at the back. They are often swollen, painful, and after a few days collect as a head of pus and debris (this explains what you noticed) which can rupture on their own when soft or ‘ripe’ or may require a health expert to cut it open and drain it (if it’s quite large).

The more common causes/triggers of painful lumps (which could be boils) in the armpits, include:
• Deodorants: These can cause skin irritation which can lead to boils. The delicate and sensitive skin of the underarms and the sweat that can accumulate there making it a rich culture medium for germs are factors that have been implicated. Solution: You may have to try another one…find one without fragrance or perhaps, formulated for sensitive skin. Reading the labels will provide this information J

• Shaving: A lot of people can identify with this…bumps in the underarm after shaving. This can happen if you do not shave properly. Try shaving after taking a bath when the hair is moist and the skin hydrated. If this does not suffice, you may have to find alternative means of removing underarm hair eg depilatory cream.
• Infection of the hair follicles from cuts or injuries to the underarm, or from friction caused by wearing tight clothing. So, be careful while shaving and try to wear clothes that are more loose fitting (especially under the arms) and/or focus on fabrics that can ‘breathe’ like cotton
• Dirt or debris from excessive sweating can clog up hair follicles leading to painful lumps. Personal hygiene is key. Don’t be miserly with bathing and be sure to ‘take care’ of the underarms and other areas like the groin that tend to accumulate sweat and raise a stink J
• Infections due to viruses or bacteria.
• Cancer of the breast may also present like this.

Boils in the pubic region, can be caused by an ingrown hair (the hair instead of growing upwards, grows inwards into the skin, this may occur following shaving), blocked hair follicles (from sweat, or a damp unclean environment), a sexually transmitted infection (herpes, when it’s just starting) a sign of some other disease like diabetes, or problems with the immune system, poor hygiene (especially during menses for women) and poor nutrition.

As much as you may want to, avoid squeezing or scratching it, allow it rupture on its own. This would help prevent further infection of deeper structures and skin, and also prevent spread to other areas. Apply warm water with a cloth on the boil for about 10-15 minutes, 2-3 times a day. Avoid sharing towels and washcloths with other people and keep the area clean and dry as much as you can. An antibiotic cream or mupirocin cream can also be applied (ask for this in a pharmacy shop). You may require antibiotics, which would be prescribed by your doctor, if he thinks you need them.

Further evaluation may be necessary if you have boils in multiple areas (as could be the case here), recurrent boils over several months, a very large boil, or boils on your face (including the nose that appears to be affected here) and anus.

I hope this helps.

Have a good night, y’all 😀

Q: Please doctor, can tooth decay/toothache cause miscarriage? What can someone do if pregnant and have toothache?

A: Forcing dental floss in between your teeth can cause periodontal disease, which can cause a dull toothache. Where periodontal disease is not caused by wrong ‘hygiene’ techniques, it could be due to gum disease. Gum disease arises due to lack of good dental hygiene, which causes plaque forming bacteria to accumulate in the mouth and lead to swollen and bleeding gums. If this happens and is noticed early, it can be reversed before it starts causing tooth loss and weakening of the gum and bone structure holding the teeth (periodontitis). Other culprits could be hormones (during pregnancy or menstruation) and chemotherapy.

In pregnancy, the high level of hormones can make gums become more sensitive than usual and thus prone to gingivitis. If this is untreated, it can progress to periodontal disease with release of bacterial toxins that cause infections in the gums. As a result, the teeth may become loosened with subsequent loss of bone and entry of bacteria into the blood stream. The bacteria can potentially be transported to the placenta where pre-term labour may be precipitated.

A systematic review of about 25 cases, some years back suggested an association between periodontal disease and adverse pregnancy outcomes like miscarriage, pre-term labour etc. While no evidence for a causal relationship between periodontal disease and pregnancy exists (that is, it has not been proven that periodontal diseases causes pre-term labour or miscarriage), good oral hygiene improves general health of mother and ultimately, baby.

So, if you’re pregnant and you have toothache, please see your dentist and also let your obstetrician know. Don’t go taking painkillers by yourself. Remember that every medication is a potential toxin and when pregnant, you have to be even more careful as whatever you take in could affect your baby. Your medical team will weigh benefits of immediate treatment against that of potential risk to pregnancy, if any.

For more on this topic, pleased click on this link: https://chatwithdrketch.com/2015/11/06/daily-health-tips-what-causes-bleeding-gums/

I hope this helps.

Goodnight, y’all 😀