Where Are The Emergency Contraceptives | By: Dr Femi Ajose

Bisola a 22 year-old 200L Economics student in a reputable Nigerian University, a promising emerging professional in the finance sector  was accompanied into the hospital by her friend. 
She looked too frail. It was obvious she needed urgent help. We admitted her immediately and ran some laboratory and radiological investigations. Her PCV came out so bad,10% (normal is between 38-50%). The scan revealed massive putrefaction in the uterus (rottened baby). She knew she was doomed!

I asked her few questions and she revealed she got pregnant for a sugar daddy who ran away immediately he found out. She consulted some seemingly ignorant friends who gave her two options. 

To get rid of the pregnancy or keep it. 

The thoughts of keeping it drove her crazy. She opted for the other option. Too bad, she did it the wrong way. She reportedly took several doses of Ampiclox and unguided doses of hot gin (ogogoro) for over a week. The pregnancy didn’t come down but the baby had died inside of her. 

You know what it feels carrying a dead baby in your womb? The dead foetus had given a good medium for overwhelming infections all over her body and killing her softly too.  

Three things could save Bisola:
*Money to buy more blood
*Money to get high grade antibiotics 
*And God!

Unfortunately she couldn’t get a dime to bail herself. All efforts to reach her relatives kissed the dust. 
Bisola died after rigorous rescucitative efforts. We lost another captain of industry!

Where are the Emergency contraceptives?

Contraceptives are also know as birth control methods or devices used to prevent unwanted pregnancies and some by extension STDS.  

Emergency contraceptives are therefore birth control methods or devices that prevents unwanted pregnancies during, immediately after and few days after sexual intercourse. 

Contraceptives have been in use since ancient times but some cultures limit or discourage access to birth control because they consider it to be morally,religiously or politically undesirable. 

WHAT ARE THE TYPES/DEVICES/METHODS OF EMERGENCY CONTRACEPTIVES?
1. Post-Coital Contraception “After intercourse” – ‎After a single act of unprotected intercourse, the risk of pregnancy can be as high as 30% depending on when in the menstrual cycle the intercourse occurs amongst other factors. Post coital contraception sometimes referred to as “morning after” provides a second chance for a woman who has had unprotected sexual intercourse and who’s afraid of unwanted pregnancy.  

The popular one is the postinor and postinor 2. Kindly consult your doctor for dosage. 

The merits of the pills outweigh the demerits but like the proverbial dictum; Let everything be done in moderation. 

2. Barrier Method Of Contraception. ‎

Male Method:
Globally, condoms are the most common method of contraception. Modern condoms often made from latex have been available since the 19th century. They are also popular in reducing both unwanted pregnancy and STDS. 

Couples using condoms should also be aware of the need for emergency contraceptive pills should the condom break or slip during sex of potentially fertile period. The major drawback is that it may interfere with spontaneity of sexual act,reduce sensation during intercourse. But the perils of STDS and unwanted pregnancies outweigh the drawbacks. 

Female Condoms  ‎
The female barrier condom, femidom,though not popularly in use is a disposable,polyurethane sac with an outer ring at level of introitus and a looser inner vaginal ring. Their typical failure rate is about 21% hence need for pills. The female condom can be inserted up to 2-3hrs before sex to allow more spontaneity. It is cheap and readily available like the male condom. 

3. Coitus interrupts “The withdrawal method”
This is the practise of ending sexual intercourse “pulling out” the erect penis before ejaculation. The main risk of the withdrawal is that the man may get carried away with the pleasure as most times is the case,not to perform the maneuver correctly in a correctly or in a timing manner. This is a risky one as the sperm content of the pre-ejaculatory fluid is still arguably to be connected to fertility. If the timing is right,then the chances are increased,but not absolutely. 

4. Abstinence ‎
This method is without a device. It is practised such that the persons abstain either totally from intercourse or during the unsafe period. 

But if you no fit hold body,go wear raincoat. 

Conclusively some young ladies have abused contraception,even some have formed their own contraception. 

Hot gin is NEVER a form of contraception. This act leads to danger has we have read. If you MUST have unprotected sex, pls be “protected”. 

Please direct all correspondence to: [email protected]
08150335136. 
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Dr.Ajose Oluwafemi is a Medical Doctor, an international Public Speaker, Best Selling Author/ Columnist, International Human Development Coach. He’sAfrica’s leading voice on Diabetes and Hypertension Care and Management and Principal Consultant, Ambassador’s Consult,
Lagos,Nigeria. 

STDs: clearing the erroneous myth of toilet diseases | By: Dr Femi Ajose

Mr. Banjo a manager in one of the new generation banks came to the clinic with his beautiful wife with complaint of inability to get a child after 2 years marriage. Thorough investigations and‎ physical examination later revealed that Mr. Banjo had been having recurrent penile discharge. He confessed to have been diagnosed of an STI 4 years back and did not bother getting treatments. The chronic situation had prevented him from putting his wife in the family way.  

Mr. Banjo confided in us to hide that information from as it may cause some problems in their home. The lady on the other hand became worried as her husband’s family members had started calling her names. Should we inform Mr Banjo’s wife of her husband’s predicament?

You see how negligence nearly  ruined Mr Banjo’s home?

What then are STDs?

 STDs are infections that are commonly spread by sexual activities, especially vaginal intercourse, oral sex and anal sex.
Most STDs sometimes are without symptoms which result in greater risk of passing the diseases to others and pushing towards fatal complications.

CAUSES OF STDs

Different organisms are culprits in the spread of these diseases. They include, but not limited to:
BACTERIA: Gonorrhea, Syphilis, and Chlamydia.
FUNGAL: Candidiasis, (yeast infection)‎
VIRAL: Hepatitis B that is contacted via saliva and venereal fluid of infected persons
              HSV-Herpes Simplex Virus
               HPV-Human Papilloma Virus, which like the HPV are transmissible from skin and mucosa of an infected person with or without body blisters.

The Major route of transmission is via unprotected sexual intercourse with infected persons. Let us take a brief look at few of the major STDs.
GONORRHEA;

 This is one of the two most common sexually transmitted infections, alongside syphilis. It is caused by a bacterium- Neisseria gonorrhea. When it is left untreated or poorly treated it can lead to myriad of complications and it can go as far as affecting the heart valves which may result to death. I wish to say emphatically that Gonorrhea is not spread by sharing toilets or bathrooms. As it is erroneously believed. The infection can be spread via all means of sexual activities that involves exchanging body fluids.

The signs and symptoms, management and complications are same with the other STDS which shall be dealt with in later chapters.
SYPHILIS;

This is another distinct STD caused by another bacterium- treponema pallidum. The primary route of transmission is through sexual contacts. Another myth that needs to be corrected is the belief that STDs are transmitted sexually alone. NO! It may also be transmitted from an infected pregnant woman to the foetus or at birth resulting in congenital syphilis.

The signs and symptoms of syphilis in addition to the other STDS include a CHANCRE, a firm, painless ,non-itchy skin ulceration seen majorly on the shaft of the penis and vulva in women and some other parts of the skin, infact some affects the whole skin.

Let us spell out the causes of the STDS;
  • Sexual activities with infected persons
  • Multiple sexual partners
  • Oral sex; fellatio, cunnilingus and anilingus
  • Transmission from infected woman to fetus in pregnancy
SIGNS AND SYMPTOMS

It is pertinent to start this page with this salient information. NOT all STDS have signs and symptoms, and that there’s level of delay of appearance of these signs and symptoms in every individual. They appear faster in female than male because of the variation in length of the urethra.

These signs and symptoms include, but not limited to;
  • Vaginal discharge which sometimes may be yellowish and foul (fishy) smelling
  • Penile discharge
  • Genital ulcers
  • Burning sensation when urinating
  • Lower abdominal pain
  • Itching
  • Bleeding in between menstrual cycle
  • Dark colored, thick, foul smelling menses
  • Oral thrush
  • Fever
  • Weight loss
  • Sore throat
  • Corneal ulcer (eyes)
DIAGNOSIS

Diagnostic measures for STDS is very useful in modern day medical practice, and for the sake of these reasons.
  1.  To check the status of prospective partners.
  1. Precision sake
  2. To determine the cause of the disease
  3. Screening to prevent complications

The specimen to be used include;
  1. Blood
  2. Urine
  3. Sputum
  4. Discharge from the genitals
  5. Skin scrapings
TREATMENTS

Early detection and prompt treatment result in lesser chances of spreading the diseases and some conditions may have good outcome and also prevent fatal complications.

There’s often a window period after the initial infection during which an STD test comes out negative. During this period, the infection may be transmissible
Consult a Doctor for proper investigations and solution.
DO NOT stop the treatment halfway. Even at disappearance of symptoms, please complete your prescribed medications.
COMPLICATIONS.

When STDS are left unattended to, or poorly treated it can lead to;
  • Infertility in both male and female
  • Low sperm count
  • Recurrent miscarriage in female
  • Ectopic pregnancy
  • Kidney diseases in both male and female
  • Cancers of the cervix, penile anal and mouth cancer
  • Blindness
  • Dementia
  • Heart problems
  • Liver and spleen enlargements

Please direct all correspondence to: [email protected]
08150335136. 
******************************************
Dr.Ajose Oluwafemi is a Medical Doctor, an international Public Speaker, Best Selling Author/ Columnist, International Human Development Coach. He’sAfrica’s leading voice on Diabetes and Hypertension Care and Management and Principal Consultant, Ambassador’s Consult,
Lagos,Nigeria. 

Diabetes Mellitus: The Silent Killer | By: Dr. Femi Ajose

The General Outpatient Department (GOPD) of our health facility had in attendance Mrs Williams, a 53 year old mother of 2 who just rose to the peak of her career in the Academic field (Professorship).
She greeted the consulting room presenting complains of recurrent throbbing headache, blurred vision, excessive urination, pin and needle-like sensation on both legs and gradual but significant weight loss.
Prof. Williams was thoroughly examined physically and subjected to series of laboratory investigations which include but not limited to Random Blood Sugar(RBS), Urinalysis, Full Blood Count, MP/Widal et al.
The results were pointing to a diagnosis of Diabetes Mellitus, amidst other signs and symptoms.
Like most patients would do, she quickly rejected the diagnosis in the name of God and blamed it on some of her colleagues who are envious of her new status in her career.
Prof. went traditional in a bid to fight back at the enemies that never existed.
Just barely 3weeks after we diagnosed Prof.(Mrs), she was rushed into our Emergency unit, but this time looking frail,with a damaged brain-stroke, total blindness, leg swelling. Before any life saving attempts, she died! It was a disheartening scenario to see a learned fellow die of complications of Diabetes, that are not beyond medical management. #sigh.
WHAT THEN IS DIABETES MELLITUS (DM)?
Diabetes is a group of Non-Communicable (can’t be transferred by contact), Metabolic diseases in which a person has high blood sugar either because the pancreas are not producing enough insulin or because the cells aren’t responding to the insulin produced.
After a meal, the level of glucose in the blood rises. In response to the increase blood glucose level, the pancreas normally release insulin into the blood stream to help glucose enter all cells of the body.
In Diabetes,because the pancreas cannot produce enough insulin,sugar from the food is not properly used throughout the body. Instead, glucose is passed out of the body in urine form.
WHAT ARE THE TYPES OF DIABETES?
Diabetes are of different types as these help with the line of medical care and management.
TYPE 1 DM (Juvenile onset or Insulin dependent)
This type of DM affects the children more and some adults. It was traditionally termed juvenile diabetes as it affects children more.
People usually develop Type 1 before 40yrs, often in early adulthood or teen age years.
This type of DM isn’t as common as the other types. The sufferers will need insulin injections for the rest of their lives and will also be following a modified diet.
TYPE 2DM (Adult onset, Non-insulin dependent)
This is the most common type of diabetes. Approximately 90% of all cases of diabetes worldwide are of this type. This type of DM is typically a progressive disease,it gradually gets worse and patient will probably end up taking insulin in tablet form.
GESTATIONAL DM
This occurs when pregnant women without a previous diagnosis of DM develop a high blood glucose level. This resembles Type 2 DM in several ways. It most times disappears after delivery and sometimes may precede to a typical Type 2DM. There are associated risks to the baby too which will be managed by a physician.
Other types include: Pre-diabetes, Latent Autoimmune Diabetes Of Adult(LADA),and Maturity Onset Dibates Mellitus Of the Young (MODY)
Who’s is at risk of DM?
1. Anyone with a positive family history of Diabetes. That is anyone with a family member with DM. Especially the parents.
2. Overweight and Obese person have a much higher risk of developing Type 2DM. (Belly fat especially)
3. Sedentary life style. Physically inactive people, those who don’t do exercise at al.
4. Diet: Eating and drinking wrongly! Alcohol, high carbohydrate food and high fatty food are culprits.
5. Men with low Testosterone are at risk too.
6. Any co-existing cardiovascular diseases. For instance anybody with history of long standing hypertension, especially the poorly treated ones.
What are the warning signs?
1. Polyuria: Excessive urination,especially during sleep at night till the next morning and during the day too. 
2. Polydypsia: Excessive thirst,even in cold environment.
3. Polyphagia: Eating more than normal.
4. Significant weight loss irrespective of heavy food intake.
5. Feeling of dehydration
6. Blurring of vision
7. Easy fatigue
8. General body weakness
9. Any sore/wound in the body that have refused to heal
10. Feeling of numbness of any part of the body
11. Ants seen around urine.
WHAT ARE THE COMPLICATIONS?
It is pertinent to note that Diabetes affects all the vital organs of the body.
1. BRAIN: infections or any other insult to the brain leading to paralysis,coma and or death.
2. EYES: Glaucoma,cataract and blindness( Retinopathy)
3. HEART: when blood supply to the heart is altered,there’s a possibility of cardiac arrest and or death when not given immediate attention.
4. KIDNEYS
5. Erectile dysfunction in male (Loss of libido/ premature ejaculation)
6. FOOT. Gangrenous ulcer that may lead to amputation
7. Poor wound healing
8. Recurrent infections.
9. Recurrent miscarriage in women.
10. Big baby syndrome (Macrosomia) in pregnancy,which may lead to operative delivery. (C/S)
HOW DO I SCREEN MYSELF?
This simple act can prevent future regrets.
Just walk into any hospital or laboratory and request to do a diabetes screening.
HOW DO I THEN MANAGE MYSELF AS A DIABETIC PATIENT?
Sadly,but the truth! DM has no known cure.. The good news also is that it can be managed optimally under strict physician supervision.
You can as well manage your DM from home, under strict instructions too.
THE FOLLOWING WILL HELP MANAGEMENT OF DM
1. Get your own Glucometer to have an up to date check of your blood sugar which averts the complications of diabetes.
2. DIET: Be conscious of what goes into your mouth. It’s the basis of sound health. Stay put whatever dietary prescriptions you’ve been given.
3. REGULAR EXERCISE: Don’t just sit in a place. Take a walk, it aids metabolism. You burn the fat and the glucose too.
4. Most importantly, don’t throw to the bin the instructions of your physician. 
Religion is good but don’t juxtapose its place in health issues. Wisdom is profitable to direct.
We conducted a research on Diabetes and some people told us Diabetes is a punishment from the witches. Funny isn’t it?
If professor (Mrs) Williams hadn’t neglect medical advice, she would probably be alive today.
I hope I have been able to give an overview of this societal evil called Diabetes Mellitus.
Please direct all correspondence to: [email protected]
08150335136. 
 
******************************************
Dr.Ajose Oluwafemi is a Medical Doctor, an international Public Speaker, Best Selling Author/ Columnist, International Human Development Coach. He’s Africa’s leading voice on Diabetes and Hypertension Care and Management and Principal Consultant, Ambassador’s Consult,
Lagos,Nigeria. 
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