chatwithketch

Q: What causes hepatitis disease?

A: 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 J

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.

‘What are the facts about the glycemic load of foods? If you have diabetes, you probably know you need to monitor your carbohydrate intake. But different carbohydrate-containing foods affect blood sugar differently, and these effects can be quantified by measures known as the glycemic index and glycemic load. You might even have been advised to use these numbers to help plan your diet. But what do these numbers really mean — and just how useful are they? ‘

Read! https://www.health.harvard.edu/healthbeat/the-lowdown-on-glycemic-index-and-glycemic-load

Q Hello Dr Ketch! I have an issue that’s troubling me and I just want to know if I should be worried. Before I became sexually active, I had a manhood I was proud of in terms of length and girth even without erection. But, I discovered that it has shrunk. It’s now the size of a 7-year-old if not erected. I sometimes can’t feel it down there if am not aroused. I’m somehow comfortable it the size only when I’m sexually aroused. Anything to worry about?

A: The issue of penile length has been a problem forever and people generally think that bigger is better. Is it? The average penile length is about 8 to 13cm when not erect and this can be pushed up to 13 to 18cm when erect, give or take a few. Does the penile size determine whether a man can father a child or not? Absolutely not…penile size does not affect fertility.

A woman’s vagina is about 7.5cm and would lengthen to about 10cm when aroused and so, generally, there should be no problems with sexual intercourse as the average length of a penis can adequately cover this gap.

Now the challenge…a lot of men who think they are small in this area are actually within the average measures but perception can make them think otherwise. For instance, the only way they can assess the size is by looking down at it and this automatically makes it look smaller. If you looked sideways in a mirror, you might just think, it looks longer. Men who are fat also appear to have smaller penises because the fat around the stomach may hide part of the base of the penis, making it look shorter.
It does appear that guys with small penises achieve about 100% increase in length during sexual excitement, probably nature’s way of compensating as opposed to men with longer ones who may achieve about 75% increase in length.

There are all sorts of touted treatments that help increase penile length including surgery, vacuum pumps, extenders, creams, pills etc. There is little evidence that people who go through this are satisfied with the result or that they work. Indeed, some can cause permanent damage.

So, what to do?

Take charge…lose weight if you’re overweight and have a heart-to-heart chat with your partner about this. You just may be surprised to hear that she doesn’t care. If you still feel bad about this, you may try talking with your doctor.

That’s it, guys 😀  Have a good night y’all 😀

Q: Can I be cured naturally if I have cervical lesion?

A: Hello! Thanks for writing in.

I assume you mean precancerous cervical lesions. As the name implies, this is not a cancer but indicates an abnormality in the cells of the cervix that could, ultimately, become a full-blown cancer.

Common types of precancerous cervical lesions are:

Atypical squamous cells: This refers to abnormalities in cells of the cervix, referred to as squamous cells. Squamous cells are thin, flat cells that resemble fish scales. They are found in the tissue that forms the surface of the skin, lining of hollow organs in the body, and lining of respiratory and digestive tracts. Atypical squamous cells could be due to Human Papilloma Virus (HPV), which is a common sexually transmitted infection that is spread through sexual, skin-to-skin contact. There is a vaccine to prevent this cancer now. Please ask your doctor where you can get it. Health conditions associated with HPV include genital warts, cervical pre-cancer and other cancers. A repeat pap smear is usually recommended after some months

Atypical glandular cells, which could be suggestive of a precancerous lesions in the uterus or upper cervix. Glandular cells are located in the inner part of the cervix or the lining of the uterus

Squamous intraepithelial lesion refer to changes in the cervix that could be precancerous. High grade squamous intraepithelial lesions are more likely to progress to cancer of the cervix.

Pap smears can detect cervical pre-cancers before they become actual cancers. If pap smear is suggestive of precancerous cervical lesions, further testing procedures will be indicated. Further tests that could be requested include repeat pap smear, cervical biopsy, HPV testing, colposcopy (using a magnifying device to get a better look at the cervix).

Now to the crux of your question, can you be cured naturally? I guess the question you really want to ask, if there are treatment procedures that exclude surgery. Yes. Available treatment procedures involve destroying the abnormal lesions in the cervix using a cold probe to freeze them (cryotherapy) or using an electrically charged wire or using laser.  The surgical option, conization, involves surgically removing the area with the abnormal cells.

You need to have a long chat with your doctor to find out what options are available to you. Remember that the fact that you have precancerous cervical lesion does not mean that you will end up The earlier you get treatment, the better your chances of avoiding cervical cancer.

All the best!

Have a good night y’all 

Every year, lots of people ring in the New Year with resolutions but then end the year hardly making a dent in that list of plans. Well, if you want this year to be different, you have to go about your resolutions differently. This time, with an actual action plan! Read what Harvard Health suggests: https://www.health.harvard.edu/healthbeat/seven-steps-for-making-your-new-years-resolutions-stick

Q: Please Doctor find time to give me a response. God bless you

I am 29 after an active sexual life I stopped having sex but just last year after 11 months the last time I had sex, resuming sex practice has been painful for me which after having sex I have pain and my vagina suffers inflammation on the body of the two inner closure of my private part and it is becoming disturbing to me and my partner. Please what could be the cause or prevention to it?

A: Pain during sexual intercourse is more common with women but can also happen in men. The first question above was sent in by a woman and the second one was sent in by a man. This condition is called dyspareunia in medicine.

Dyspareunia is a condition in which one experiences pain during or after sexual intercourse. In women, the cause may be due to:
• Vaginismus: a condition in which the vaginal muscles go into spasms when an attempt is made at penetration.
• Lack of adequate lubrication eg due to hasty foreplay etc. This will be discussed some more at the end of this post.
• Infections of the vagina (like candidiasis as mentioned in the question) or urinary tract can also cause pain during sexual intercourse.
• Injuries/wounds to the vagina
• Emotional issues like stress or emotional disconnect from partner.
• Fibroids around the vagina or cervix

In men, the cause of this problem could be due to:
• Infection of the urethra (the tube which conveys urine from the bladder out of the body and also conveys semen out during ejaculation)
• Infection of the prostate gland.
• Infections, some of which may be due to STI
• Emotional issues may also be involved eg feelings of guilt.

Treatment depends on cause. If due to infections, they have to be treated. If it’s due to lack of lubrication, that has to be handled. Some lubricating gels may be suggested. If no physical cause can be seen and the problem appears to be emotional, some counseling may be required. Understanding that when people get married, they are actually two ‘strangers’ trying to get to know each other, should form part of the incentive for slowing down and trying to find out what pleases each member of the union.

For related topics, please click on https://chatwithdrketch.com/2014/08/22/daily-health-tips-why-am-i-not-into-my-husband/

I will spend a little time on vaginal dryness or inadequate lubrication. Vaginal dryness can occur due to variety of reasons and at any age. Usually the vagina has a thin film of fluid that coats it. This fluid helps lubrication during sexual intercourse, maintains the normal environment of the vagina preventing the overgrowth of organisms like fungi, flushing out dead cells and menstrual blood. The level of this fluid/moisture varies with the level of estrogen released in the body. During sexual intercourse, there is increased blood flow to the vaginal area leading to an increase in the volume of moisture. During menopause, however, the level of estrogen is very low leading to vaginal dryness, loss of elasticity and thinning.

The main consequence of vaginal dryness is the fact that it affects sex life such that these women experience significant pain and sometimes, bleeding. Other problems that vaginal dryness could cause include soreness, itching and burning around the vaginal area, recurrent urinary tract infections and frequency of urinating etc.

There are other conditions, other than menopause that can lead to low estrogen and consequent vaginal dryness. They include childbirth, breast feeding, cigarette smoking, some medications (like anti-estrogen drugs used to treat cancer) and douching. Douching refers to the practice of cleaning the vagina with a ‘cleansing’ fluid. For more on this topic, please click on this link: https://chatwithdrketch.com/…/daily-health-tips-what-is-dou…/

Other very common causes of vaginal dryness include a lack of foreplay during sexual intercourse, feelings of guilt, relationship issues, allergy etc

Treatment depends on cause. If it’s due to low estrogen, the focus would be on replacing this either through Hormone Replacement therapy or through the insertion of estrogen pessaries (tablets, cream or ring) into the vagina) should help. If due to rushed foreplay, there should be a conscious effort to slow down allow enough time for foreplay and sometimes, discussion with the partner may be helpful. Avoid heavily perfumed products like sanitary towels, tissues etc which may lead to irritation of the vagina and subsequent dryness etc.

Use of vaginal moisturizers can also help. Vitamin E may be useful as a vaginal moisturizer with the gel rubbed on the vagina.

Please discuss these with your doctor and don’t be embarrassed to discuss your symptoms with him 😀

I hope this helps.

‘A study shows that, for many people, less is more when it comes to vitamin D.‘ Now what do you think about that?! Read!

https://www.health.harvard.edu/staying-healthy/too-much-vitamin-d-may-harm-bones-not-help

Dear all, it is the season for the sniffles again. it always boggles my mind how the hygiene practices that we take for granted are not really known and practiced by everyone. For instance, sneezing or coughing into ones hands and then going around touching doors, shaking hands and touching other surfaces is a quick way of sharing ones germs with others. Please don’t do that! A reminder class below on how not to share your germs with others:

Okay…so no one loves to have the sniffles; carrying tissues around and sneezing/blowing our noses into tissues and just feeling miserable! We hate even more when we are in the uncomfortable position of ‘rejecting’ a handshake because we want to avoid getting infected by someone who has the flu.
Here are top tips for escaping the cold and flu as it makes its rounds:

• Wash Your Hands: Wash your hands with anti-bacterial soap for at least 20 seconds…time taken to sing happy birthday twice. Use safeguard soap and this will not only remove millions of bacteria but stop their re-growth for at least 12 hours. Dry your hands thoroughly.

Get a flu shot: This may not be perfect and certainly does not protect everyone, but you do have more of a chance of beating the flu with it than without it

• Live healthy: A balanced diet, regular sleep and exercise work wonders for your immune system and helps you resist the flu.

• Cover your cough: Don’t sneeze into your hands…you’re more than likely to see someone you know and shake them soon enough…spreading your germs. Rather sneeze or cough into the crook of your arms. This limits significantly the spread of germs.

• Give that immune system of yours some extra boost by:Taking a break from stress. Stress messes with your ability to stay healthy, especially during cold and flu season. Try taking a mini meditation break during the day – just close your eyes and focus on breathing in and out for a few minutes.

Trying to stick with a bedtime. Consistently getting eight hours of sleep a night gives your body the chance to repair cells and build up your immune system.

Please spread this news and let’s stop the spread of these nasty viruses 😀