Daily Health Tips: What Are My Options After Ectopic Pregnancy And Failed IVF?

Q: Good morning Doctor and Happy New Month. Please advice a woman that lost both fallopian tubes due to ectopic pregnancy and just had a failed IVF. Thank you, ma’am

A: This must have been a trying period for you…first a pregnancy and then finding out that it’s ectopic and then a failed IVF. My heart goes out to you. But you are strong, because only a strong woman will come through it and look at the way forward. You will be fine. Keep your chin up and be open to possibilities.

To summarize for those who don’t know, ectopic pregnancy is a situation in which a pregnancy implants outside of the womb (uterus). Usually, fertilization of the egg by the sperm happens in the fallopian tube and then this fertilized egg travels to the uterus where it is implanted. In ectopic pregnancy, this doesn’t happen. The fertilized egg may attach to the ovary, remain in the fallopian tube (tubal pregnancy), attach to another organ in the abdomen or the cervix. None of these places are ideal for supporting a growing life and so there is a great threat of serious bleeding.

Ectopic pregnancies are usually discovered in the first couple of weeks of pregnancy (it would have been discovered by the 8th week of pregnancy). The patient would usually come into hospital with complaints of light abdominal bleeding, abdominal pain or cramps, extreme dizziness from the bleeding. If the tube ruptures (bursts), patient could faint from profuse bleeding into the abdomen.

The risk factors for ectopic pregnancy include history of previous ectopic pregnancy and/or Pelvic Inflammatory Disease, STIs, failed tubal ligation (tying up of the fallopian tubes for people who no longer want to have more babies), congenital abnormality of the fallopian tubes, pregnancy while on Intra Uterine Contraceptive Device (IUCD) etc

Once the doctor makes a diagnosis of this, he will choose from either giving a drug to dissolve the pregnancy tissues, if the pregnancy has not progressed too far and the fallopian tube is not ruptured; pin-hole surgery (laparoscopy) is also an option here. However, if rupture of the fallopian tube is suspected, the whole fallopian tubes and ovary may have suffered significant damage needing their removal.

This may have been what happened in the case above. I do not know if both tubes were damaged or how much damage was done to the tube(s), but I trust that for IVF to have been undertaken, this is the situation. IVF by the way, means Invitro Fertilization and is the process of fertilizing a woman’s egg with a man’s sperm cell outside the human body. In the early days they were called test tube babies. Unfortunately, IVF is not a cheap procedure and you do need deep pockets and loads of patience because it may take a while. But, if you can afford it, please go for it. Give your body time to heal and do everything that improves your chances of having a successful pregnancy and healthy baby. Eat well (more fruits and vegetables) and try to work out daily…even if that means taking a walk for about 30 days. Get support from family and friends and remain positive…pregnancy is more likely to happen if you’re relaxed and focused on living a full and happy life as opposed to fretting about it.

Remember that adoption is also an option to consider.

I wish you all the best and I’m giving you a huge hug with my heart right now 😀

Good night y’all 🙂

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Daily Health Tips: For How Long Can I Remain A Virgin?

Q: Good day ma’am, I am a young lady in her 20s. I will like to know how long can one keep her virginity and what are the challenges one might face, if possibly, there is a speculative time for this.

A:I’m not sure I understand the last bit of your question.

How long can you keep your virginity? For as long as possible 🙂 Until you get married 😀 The challenges you face if you leave it that long? Well, with age the vagina and its opening get smaller and the lining of the vagina, also gets thinner. Thus, it may take a while longer for sufficient lubrication and sexual arousal to happen for the woman. These are easily handled by a mix of sufficient foreplay and the use of lubricants. The place of emotional connection between the man and woman cannot be over-emphasized and can improve sexual intimacy and arousal for the woman.

The issues of needing extra lubrication and foreplay when one abstains, pale in significance when you consider the alternative of potentially contracting STIs, HIV/AIDS and having children that one is not prepared for, if one decided to go the other way.

So, like Human Resource Managers would say, ‘please be guided’ 😀

Good night y’all 🙂

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Daily Health Tips: Depression, Masturbation and Over-Protective Parenting

Hello y’all. I hope your day has been splendid

It’s one of those days…brace yourselves 🙂 This is a long one!

Q:Good Day, Dr Ketch. Thanks a lot for advice you offer daily on this page. I’m a 25 year old graduate. I have a problem that I would like you to kindly discuss or treat. I’ve been suffering from Depression since 2010, after 2years of gaining admission into university. I later went to a NeuroPyschiatric Hospital in Lagos, where the diagnosis was confirmed. But I’m now on Medications, Antidepressants and Mood stabilizers. I’m taking the Drugs: Zoloft or Sertraline, Risperidone and Vitamin B Complex.

So, I’m feeling a lot better now that I’m on these meds. But sometimes I do feel so sad, even with taking those drugs. Another problem is that I was addicted to Masturbation right from my teenage years, so after each time that I masturbated, I will start feeling sad, guilty, withdrawn and bad. So I’m having this feeling that the masturbation led to me being depressed and all that. I’m still a virgin, because I’m always shy around girls and also due to my addiction to Masturbation, which I still practice sometimes, when the urges are too much. Also, I have a very strict dad, who doesn’t want me and my siblings to socialize with peers right from our childhood with the fear that we will get “corrupted”. We are always indoors and rarely play with kids of my age then. I think that resulted to my being shy, withdrawn and being an introvert. So, please I will be so grateful if you can advise me on what to do in order to overcome this illness.
Thank you Ma’am.

A: Hmm, three issues: depression, masturbation and strict parenting. Wow! Where do I start?
Let’s start with depression. Depression is a mood disorder that is beyond the ordinary ups and downs experienced daily. It is a serious health concern. Some people have described depression as “living in a black hole” or having a feeling of impending doom. Can you imagine how that feels? Surprisingly though, some depressed people actually don’t feel sad at all—they may feel lifeless, empty, and apathetic; men are more likely to feel angry, aggressive, and restless.
Depressed people usually lose interest in daily activities. They have no interest in former hobbies, pastimes, social activities, or sex. This person clearly loses the ability to feel joy and pleasure.

There is a bleak outlook on life. It appears that everything is bad, getting worse and will never get better. There is an increasing feeling of helplessness and hopelessness

There is a change in weight or appetite. This could be in either direction as a result of differing effects in people: it could lead to increased appetite and subsequent weight gain in some and reduction in appetite and subsequent weight loss in others.

Depression again affects different people differently here and thus could lead to inability to sleep or over-sleeping.

Tolerance level of depressed people is usually low and so they tend to snap at little issues, feel irritable, restless, angry and oftentimes, violent.

Some issues that can lead to this black hole of depression include conflict, death or a loss of a loved one, genetics (Studies have not been able to conclusively show how this contributes to the disease, but a family history of depression may increase the risk), major events like losing a job, starting a new job, getting divorced, getting married or retiring.

Other personal problems can lead to depression and they include, the feeling of social isolation for whatever reason

In the case above, any number of the issues above may be the issue. However, I will focus on the personal problems…having a very strict dad who was/is very strict with you because he doesn’t want you mixing with the wrong crowd. Your feeling towards your controlling dad and shyness as a result could actually be contributory to your excessive masturbation…as you seek to escape from the pressures of your everyday life. This leads to feelings of guilt which now further exacerbates the ‘black hole’ symptoms. There’s just no winning 😦

I’m glad that you feel much better with the drugs that you’re taking. However, if masturbating evokes depressive feelings, then no amount of drugs can help. We need to handle the root of the matter.

In our environment, in Africa, especially, it is difficult to find appropriate people and avenues to discuss some of the deep and oftentimes embarrassing issues we want to discuss. We are worried the world will judge us, shout us down, send us for deliverance or just ostracize us…none of which solve the problem. Indeed, it just makes the people involved retreat into their shells and do more of what they are afraid to talk about, talk to their friends (especially teenagers) who will give them the wrong advice or just become anti-social.

And so, this is a great opportunity to talk to parents…I am one too. Just like you, I would like to have the perfect child who is a show piece at prize giving days and does everything he’s told while loving it. Unfortunately, the journey to that perfection is not by screaming them down and not allowing them to have a voice or to have friends., no matter how much we want to shield our children from bad influence, we are very limited. In this jet age, unless you are going to migrate to the mountains and live there, our children are going to mix up with all sorts of children. They will hear all sorts of things and perhaps, witness even more. How can we be sure they are safe? By constantly communicating with them. Hear their opinions and learn what they feel about different situations. Help them understand what’s right and what’s wrong by giving practical examples and whatever you do, don’t be judgmental or compare them with other children. If you do, they stop telling you things and end up in the exact place you don’t want them.

Excessively curtailing their social interactions just makes them pine for that which looks ‘unattainable’ and so at the slightest chance of freedom, they go really crazy or they become anti-social.

We can’t fight our children’s life battles for them, no matter how much we want to. We can only trust that we have brought them up right and that they will make the right decisions…while we maintain watch from a respectful distance at the appropriate time.
Now, away from parents/guardians to the person in this situation: please speak with your doctor and find out if there is any support group you could join.
Find out your triggers and try to avoid them, stick to your treatment plan and find healthier outlets for your sexual ‘energy’. Developing a strong social and spiritual support system could be very helpful. Join activities in clubs, churches, art centers etc.

Other coping mechanisms include exercising regularly and reducing your stress. If the latter is not readily viable, improve on your stress coping mechanisms.

Get treatment for alcohol and drug abuse if this is a problem for you. Eat healthy and get the necessary amount of sleep daily (7 – 8 hours daily)

Remember, the world is waiting for that special ‘something’ that only you can bring to the table. You are an original with loads of great ideas to unleash  So, focus on the future. The past is…past. You can change what happens today and tomorrow. Focus on dealing with the drivers of your depression and masturbation and deal with them as noted above. You can rise above these.

Please write in from time to time and let me know how it’s going. I will make enquiries as to what support groups are available and let you know.

Have a good night y’all 🙂 As the second case of Ebola in Lagos is announced, remember that this virus cannot do more than what we allow. Stay off raw bush meat and body fluids and then: keep your hands clean and keep them to yourself!

I think that will become my new sign-off mantra: Keep your hands clean and keep them to yourself 🙂

Sleep tight and don’t let the bed-bugs bite ;D

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Daily Health Tips: Can I Get HIV From Oral Sex?

Q: Hi Doctor, may I ask: is it possible to get HIV from oral sex, whereby the female is HIV positive giving the blow job to a HIV negative guy? Cheers

A: Well, HIV infection through oral sex is not the usual route of HIV infection. However, it is possible. There may be small cuts in the mouth of the female who is HIV-positive from which the virus will gain entrance into the body of the male through the urethra (the opening at the top of the penis from where sperm and urine come out) or anus. In the same way, if an HIV-positive person receives oral sex, the virus can gain entrance into the partner’s body when semen and vaginal fluids get into the mouth.

This risk of contacting HIV through oral sex is increased in the presence of already existing Sexually Transmitted Infections, mouth ulcers, bleeding gums and sores in the genital area.

This risk of HIV infection through oral sex may be reduced by the use of barriers like condoms and avoiding ejaculation in the mouth. Use of pre-exposure drugs (prescribed for people at risk) and ensuring that anti-retroviral drugs (drugs used for the treatment of HIV) are being used correctly by partners who are HIV positive may also reduce risk of HIV infection through oral sex.

Generally for HIV/AIDS, remember the ABCs. Abstain…which is always the best bet if you’re not married, be faithful to one partner (who is hopefully being faithful to you) or use condoms.

For more on HIV prevention, please click on the link below:

Daily Health Tips: Should I Use Emergency Contraception As My Regular Means Of Contraception?

Have a productive week ahead 🙂

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Daily Health Tips: Hyperthyroidism! What’s That?

Q: Greetings to you Madam. I tried to post on your website but unfortunately I have not received any response from you, so I thought I would send you this private email. I was recently diagnosed of hyperthyroidism and I’m currently on medication called neo-mercazol 5mg. I have been taking the medicine for some days now and I’m so scared of taking drugs! I would really appreciate if you can recommend any diet or natural medicine that can help me cure this illness because it has really affected me physically and mentally. When I was in Nigeria, I have never seen or heard any of my family members having this illness. I don’t know why me. I would really appreciate if you can give me a comprehensive advice that would help me in regards to this illness.

May the good lord continue to bless you and the work of your hands.

A: Amen to all your prayers. I apologize for the challenges you had reaching out to me and how long it took me to respond. I receive quite a number of mails and I try to get around to answering the questions as sequentially as I can. I know I don’t succeed all the time 😀 Forgive me.

Hyperthyroidism is a condition that occurs when your body produces too much thyroid hormones. These hormones are usually produced by a butterfly shaped organ located at the front of your neck, called the thyroid gland. These thyroid hormones produced typically control the rate at which the body converts food t energy (metabolic rate) and also controls a whole lot of other cells and tissues like your bones (the hormones determine how your body incorporates calcium into your bones), the rate of your heart beats, your muscle contraction, cholesterol levels etc

Most cases of hyperthyroidism is caused by Graves’ Disease in which the body no longer recognizes the thyroid gland as part of it and produces antibodies to fight it. In response, the thyroid gland produces excessive amounts of thyroid hormones.

As in the case above, there may not be any family history though it is known to run in families.

Thus in hyperthyroidism, you may have no symptoms (leading to a chance discovery) or symptoms would include fast heart beats/palpitations, swelling of the thyroid gland which is seen as a neck swelling (goiter).The higher than normal metabolic rate would lead to symptoms like increased appetite, weight loss, sweating and increased sensitivity to heat, restlessness, tremors, tiredness, difficulty sleeping etc. In Graves’ Disease, there are also eye symptoms which include protrusion of the eyeballs, red and swollen eyelids, watering of the eyes and double vision.

The doctor will examine the person with symptoms and run blood tests to check for the level of thyroid hormones. Treatment could be with medications or through surgery or a combination of both.
The drug you have been prescribed has the active ingredient carbimazole which stops the thyroid gland from making new thyroid hormones but does not affect the hormones already produced. As a result, it may take a while to notice an improvement in symptoms. The use of this drug may be for about 12-18 months in the first instance. This may be sufficient to deal with the situation. In some instances though, this may recur needing more treatment, probably with a different drug.

You will need blood tests regularly though to monitor the level of your thyroid hormones.

Depending on your degree of weight loss, you may need to have a dietician walk you through your diet paces and ensure that you are getting enough calcium and vitamin D. Wearing sunglasses, using eye drops that moisten the eye (artificial tears) and ensuring that the head is elevated when sleeping or lying down will help reduce the symptoms of Graves’ Disease. If you smoke, stop…this may help prevent developing Graves’ Disease or prevent the eye problems associated with it, if you already have the disease.

Treatment for hyperthyroidism is usually effective and so you should be able to live a normal life. You’ve got to focus on the positives and take on each day as it comes. You may not have to take drugs all your life but then again, depending on the outcome of your initial therapy, you may have to. This may sound daunting but really shouldn’t be. Lots of people take ‘self-imposed’ vitamin supplements every day 🙂

Just have a positive attitude about it and learn to look at this cup as half full rather than half empty. Keep your chin up and keep me posted.

All the best 🙂

Remember to tune into Silverbird TV by 7.20pm tomorrow (immediately after the news)to watch the premiere of our season 3.

Good night, y’all 🙂

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Daily Health Tips (video): Hand Washing

Washing our hands is the easiest way to prevent infecting ourselves with germs that are all around us. Watch the video here and get the 5 steps.

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Tips For Healthy Living With Dr Ketch: Season 3 Is Here!

Hello y’all 🙂

Season 3 of our 5-minute show, ‘Tips For Healthy Living With Dr Ketch’ starts airing on Monday, 4th of August. This season is proudly brought to you by ‘Loya, your Calcium enriched milk’. To ensure that more people in Nigeria have a chance of watching it, we have also partnered with AIT (Africa Independent Television) and STV (Silverbird Television).

On Mondays and Wednesdays, the show will air on Silverbird Television by 7.20pm immediately after the 7pm news.

On Tuesdays and Fridays, the show will air on AIT Kakaaki by 8.20am immediately after the newspaper review.

It will also air on DSTV several times during the day.

We’re almost concluding discussions with another broadcaster to air the show in Tanzania on local channels too.

As we conclude with more broadcasters in various countries, I will let you all know.

Thank you all for being faithful fans of the show and the public health message/awareness we have been spreading via social and electronic media. We wouldn’t be here without y’all.

Here’s blowing kisses to each and everyone of you. May your shadows never grow less 😀

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Daily Health Tips: Ebola – Facts and Fiction

I have been asked a lot of questions about Ebola since the outbreak. And so, here I reproduce some of those questions with answers.

Ebola facts and fiction

What does the name mean?
It was discovered in 1976 in DRC close to the Ebola River. So it is named after the Ebola River

How can I get Ebola?
It is spread through direct contact with the body fluids (blood, stool, urine, saliva, semen etc) or organ of an infected dead or living person.

Symptoms?
Headache, fever, sore throat, intense weakness and muscle pain. Later, diarrhea, vomiting, kidney and liver failure and bleeding internally or externally

How long before we know if someone has Ebola?
2-21 days. During this period, the person is not infections, that is, he cannot infect other people. The person becomes infectious when the symptoms appear.

Can I get Ebola by eating bush meat, even when properly cooked?
It is transmitted through improperly cooked bush meat like monkeys and fruit bats. Contact with these infected animals or their raw meat too poses the same danger. Generally, use gloves when handling raw meat of animals.

Can it be spread by rats?
No. Rats cause another type of viral haemorrhagic fever but not Ebola.

What about chicken? Can I get it from chicken?
Nope. Infections from chicken and beef, even if not properly cooked, have not been reported. Eating raw meat can cause poisoning, though, eg raw chicken can cause Salmonella food poisoning

Can I get it by biting my finger nails?
Biting your nails provides a platform for introducing germs into your mouth and you could also inflict yourself with wounds or cuts after a biting spree. These cuts can become a source of entry of infections, including Ebola into the body.

This is not limited to nail biting…if you have any cuts or abrasions, please make sure they are properly dressed and covered up to avoid giving any infection, quick access into your body.

Do I need to wear face masks while going about my normal duties?
Nope…at least not on account of Ebola, except you’re nursing an Ebola patient. It is not spread by inhaling the same air as the infected person. There has to be body contact between one and the infected body fluids or between the cut skin of one and the infected clothings, bed dressings or body fluids of a patient

Can I get Ebola virus from money?
You can’t get it from handling money. Again, there has to be body contact with the body fluids from one who is infected.

If it can be spread through body fluids, then it means mosquitoes can spread the disease?
Nope. Mosquitoes have not been implicated in the spread of this.

Can we get it through sexual intercourse since it’s like HIV?
Well, men who have been infected can still transmit the virus for up to 7 weeks after recovery from the illness. It can also be transmitted by prick with infected needles and sharp objects

Should we stop going to burial ceremonies?
If the burial ceremony is for one who died from Ebola, avoid having any contact with the corpse, if you must attend.

What can I do?
Personal hygiene (wash your hands and use hand sanitizers when that’s not possible), Food hygiene (wash and disinfect fruits and veggies before eating), keep wounds and bruises covered and dressed. Also avoid contact with infected people and barrier nursing (wearing masks and gloves) has to be the rule for those that care for Ebola patients.

Anyone with the symptoms should please check their country’s Ministry of Health website for available treatment centers. I am working to see if I can get a list to put up here.

What was the Liberian’s mission in Nigeria?
Honestly, I don’t know and I sincerely don’t care! 😀 Let Sherlock Holmes and James Hardly Chase… and whoever ranks as the greatest crime solver of all times, figure that out. All I know is, he came and we’re here now and that’s all that matters. Let’s focus on the important issues and leave the conspiracy theories alone 😀

Hand Sanitizer tip
Buy one with at least 60% alcohol.
Rub all over your hands and be sure to keep rubbing until it all dries up. Try and touch all the places you would when you’re washing your hands normally.
And…you’re germ free:)

Remember that this virus does not survive for long outside of its host and so if we generally keep our hands clean and keep them to ourselves, we may be more than half way to winning the fight 🙂

Have a great day people 😀

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Daily Health Tips: What Does Body Mass Index Mean?

How are you all doing? I hope you all had a great day.

I’d promised to put up a post on Body Mass Index (BMI) two days ago. So here goes…

For those who wonder whether they are overweight or underweight, there is a measure that helps give you an objective assessment of this. It is called Body Mass Index (BMI) estimation.

A lot of people cannot believe the information they receive from their BMI rating. And quite a number of people don’t understand what it means. If you belong to the last group, well, don’t worry. You are not alone! However, you do need to understand what the BMI measures and what it says about you.

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 practising 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 restful evening 😀

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Daily Health Tips: When Should I Wash My Hands?

Hello y’all

I hope you all had a restful holiday, if you’re in Nigeria.

After I put up my post on how to wash your hands, someone asked the question, ‘when should we wash our hands?’ And really that’s a valid question, even if it’s one that we all take for granted.

So, I reproduce below, a post I had written last year on hand washing which includes when to wash those hands.

It will be global hand washing day on the 15th of October. A friend of mine jokingly said to me, ‘seriously?!’ WHO has time! Hand washing day indeed! Why can’t they face more important issues?’ Are you in the same boat with my friend? Well here’s news for you!

Diseases like respiratory infections and diarrhea cause up to 20 percent of the burden of disease in children. It has been found that in places where hand washing was instituted, this burden of disease has been cut by about 50%. This is a huge number…from hand washing alone! In hospitals, it was also found that the spread of hospital acquired infections was encouraged by lack of hand washing and so WHO instituted a global campaign for health workers clearly specifying when hands have to be washed.

So, practical lessons: mums wash your hands before you make your baby’s/family’s food, after you change baby’s diaper, after you blow your nose, after cleaning etc. Ensure that people don’t come in from the market (or wherever) and head straight to pick up your baby and kiss your baby…no matter how well meaning their gestures might be. Encourage them to wash their hands before they do so…or you could buy a hand sanitizer and get them to use it on their hands before picking up your precious bundle of joy. It may be awkward when you start off insisting on these, but pretty soon everyone gets used to it…trust me, I know from personal experience (I probably got away with more because my in-laws probably just thought I was a weird Okoro girl). Tips: remember that sanitizers are only useful for hands that are not visibly dirty. For visibly dirty hands, you’ve got to wash! Also remember that when choosing the sanitizer, look for products that have up to 60 percent alcohol and ensure that when you use it, you rub until your hands are dry.

We should ensure that we teach children and indeed remind ourselves to wash hands after playing or doing stuff outside the house, before eating, after using the toilet, after playing with pets or disposing of their wastes (in fact children should not be encouraged to play too close to their kennels or sheds), before cooking and even after handling dirty laundry! The list is endless…but that’s also because the possible means of contaminating our hands are endless and the germs find easy routes into the body once we touch our hands, mouths, eyes etc. So we can’t be too careful…and just in case you wondered, ‘no, you don’t have to wear a face mask like dear Michael Jackson and/or gloves all the time’ to protect you from the many germs that exist! That might be…well, for want of a better word, perhaps just a teensy weensy bit extreme!

Finally, remember that hand washing, to be done right, has to be with soap! If you haven’t washed with soap, you haven’t really done much. Tips for effective hand washing: wet your hands with water, apply soap, then scrub thoroughly paying attention to your nail beds, in between fingers, palms and back of hands. Then rinse thoroughly before drying your hands.

Borrowing very liberally from WHO’s hand washing campaign, I say ‘save lives: clean your hands!’

Other useful posts include:

Back-to-school tool kit

The Blame Game

Here’s to a healthier you!

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