Cancer of the Liver

THE HUMAN LIVER

Liver cancer affects liver cells.Liver  is the largest internal organs in the body. It’s function includes detoxification,protein synthesis and production of biochemicals for digestion. It is necessary for survival.The liver lies to the right of the stomach and lies over the gall bladder

WHAT IS LIVER CANCER

It is the types of cancer that begins in the cells of the liver. This is called primary liver cancer. It affects more men than women and usually affects people of age 50 and over. Liver cancer is one of the most common types of cancers. There are other types of cancers that affects the liver. They may not have originated from the liver but have spread from other organs to the liver. This is metastasized or secondary cancer even though it is found in the liver.

CAUSES

Liver cancer is caused by uncontrolled growth of liver cells. This may be caused by genetic mutation in the DNA of these cells. The abnormal cells do not die and eventually form a mass called a tumor. Various chronic liver diseases, alcohol abuse, overweight and chemical may all be a contributing factor to liver cancer

RISK FACTORS

Cirrhosis This severe liver disease causes a scar tissue to form on your liver and increases your chances of liver cancer

Sex This disease is more common in men than women

Age. In places like north america, the disease usually affects adults whereas in africa it is more common in the young population ages between 20 and 50 years.

Diabetes. Diabetes increase your chance of liver cancer.

Inherited liver disease. Certain inherited  liver disease like Wilson’s disease make you more prone to liver cancer

Chronic infection with  hepatitis B virus (HBV) or hepatitis C virus (HCV) increases your risk of liver cancer.

Obesity This gives your higher risk for the disease

Alcohol abuse. Excessive alcohol abuse damages your liver making you more susceptible to liver cancer

Aflatoxins Foods contaminated with aflatoxins increases your risk for this type of cancer.

Other factors include Inflammation of the liver that is long-term (chronic),Iron overload in the body (hemochromatosis), Autoimmune diseases of the liver and anabolic steroid use

TYPES OF LIVER CANCER

Hepatocellular carcinoma (HCC)  This types of cancer starts from the main liver cells, hepatocytes and it the most common primary liver cancer. Older people, men and people with cirrhosis are more susceptible to this types of liver cancer.A subtypes of this is fibrolamellar HCC and this is more common among young people who do not have cirrhosis. It is much more easily treated.

Cholangiocarcinoma. Cancer can begin anywhere on the bile duct. This cancer develops in section of the bile duct inside the liver. It is therefore called intrahepatic cholangiocarcinoma. Sometimes though cancer may develop on the section of the bile duct outside the liver. This is called bile duct cancer.

Angiosarcoma It is a very rare cancer. It begins in the blood vessels of the liver.

Hepatoblastoma It is a very rare liver cancer that affects infants and young people.

SYMPTOMS

Symptoms of liver cancer mainly shows when the cancer is well active and quite advanced. The main symptom is jaundice, which is the yellowing of skin and white part of the eye. Other symptoms include

• intense loss of weight
• loss of appetite
• darker urine
• nausea and vomiting
• intense pain or discomfort on the right side of the abdomen
• uncomfortable pain on the right shoulder area
• weakness and fatigue
• abdominal swelling
• enlarged liver
• white chalky stool

STAGING OF LIVER CANCER

Staging describes how advanced the cancer has spread

TNM System

This uses three codes to describe the location and size of cancer, whether cancer has spread to the lymph nodes and if cancer has spread to other organs.

T is used to describe size and location of tumor

TX  Primary tumor cannot be evaluated due to incomplete information

T0 There is no evidence of a primary tumor

T1 Just one tumor found. The tumor can be any size and have not spread to blood vessels

T2 – One tumor of any size has spread into the blood vessels. It could also indicated several tumors in the liver . Tumor size is 5cm or smaller

T3 – Several tumors larger than 5 cm (about 2 inches).It may also indicate one tumor involves a major branch of the major liver blood vessels, that is the portal or hepatic veins.

T4 – The cancer has spread to organs near the liver  or into the abdominal lining. The gall bladder however has not been affected.

N stands for node

NX  Surrounding  lymph nodes cannot be evaluated because of incomplete information.

N0 – Cancer has invaded the surrounding lymph nodes.

N1 – The cancer has invaded surrounding lymph nodes near the tumor.

M stands for if the cancer has metastasized to other parts of the body.

MX– Distant metastasis cannot be evaluated .

M0 – The cancer has not spread to distant lymph nodes or other parts of the body.

M1 – The cancer has metastasized to distant lymph nodes or other parts of the body.

The doctor will then  use the TNM staging information to assign stage (I to IV) to  the cancer

• Stage I– The liver has one tumor that has not invaded  nearby blood vessels or lymph nodes
• Stage II – A single tumor of any size has spread to nearby blood vessels or several tumors that are not bigger than 5 cm .
• Stage IIIA -Several tumors and at least one is bigger than 5 cm, or the liver has one tumor that has invaded the branch of the hepatic vein
• Stage IIIB – The tumor has spread to organs near the liver or it has spread into lining of the abdomen. Gall bladder not affected
• Stage IIIC – One or more tumors of any size have invaded surrounding lymph nodes
• Stage IV – One or more tumors of any size have spread to other parts of the body, such as the lungs or bones.

TEST AND DIAGNOSIS

Blood test. This is done to check for liver functions such as high alpha-fetoprotein (AFP) . High AFP in adults may indicate liver cancer but babies have high AFP and it becomes normal as they grow. Therefore high AFP in children does not mean  liver cancer

Liver Biopsy A sample of tissue is removed from your liver and examined under a microscope for cancer cells

Imaging tests  such as an ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI) is done to check the liver and see if it has spread to other organs . It is also used in staging the cancer.

TREATMENT

Treatment for liver cancer depends on the stage of the cancer, your overall health,age and preference. The main goal of treatment is to eliminate the cancer cells completely. In some cases of advanced cancer when cancer can’t be cured, comfort care is the only option.

Surgery Partial hepatectomy is when a portion of your liver is removed. This is recommended when your tumor is small and liver is not damaged. The part of the liver along with some healthy tissues may be removed.

Liver transplant surgery. This is removing cancerous liver and replacing it with a healthy liver from a donor.

Radiation therapy High-powered energy beams  are used to destroy cancer cells and shrink tumors. Side effects include nausea , vomiting and fatigue

Chemotherapy  This is when strong anti cancer drugs are directed to the kidney. This is done through an injection into the hepatic artery. This procedure kills the cancer cells

Radiofrequency ablation Electric current is used to heat and destroy cancer cells. This is done by inserting needles through abdominal incision to the tumor. When the needle reaches the tumor, electric current is used to heat the needle to kill the tumor.

Cryoablation Extreme cold is used to freeze the cancer cells.Cryoprobe containing liquid nitrogen is directed onto liver tumors to freeze it. This kills the tumor.

Targeted drug therapy Sorafenib (Nexavar) is a targeted drug that  interferes with a tumor’s ability to generate new blood vessels. It slows down or stops the growth of the cancer cells.

Injecting alcohol into the tumor. Pure alcohol is injected directly into tumors to kill the cells

PREVENTION

• get vaccinated against hepatitis B
• drink alcohol in moderation
• control your weight
• avoids direct contact with chemicals
• consider liver cancer screening

IF

 

 

If you can keep your head when all about you
Are losing theirs and blaming it on you,
If you can trust yourself when all men doubt you,
But make allowance for their doubting too;
If you can wait and not be tired by waiting,
Or being lied about, don’t deal in lies,
Or being hated, don’t give way to hating,
And yet don’t look too good, nor talk too wise:

If you can dream – and not make dreams your master;
If you can think – and not make thoughts your aim;
If you can meet with Triumph and Disaster
And treat those two impostors just the same;
If you can bear to hear the truth you’ve spoken
Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to, broken,
And stoop and build ‘em up with worn-out tools:

If you can make one heap of all your winnings
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
And never breathe a word about your loss;
If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: ‘Hold on!’

If you can talk with crowds and keep your virtue,
‘ Or walk with Kings – nor lose the common touch,
if neither foes nor loving friends can hurt you,
If all men count with you, but none too much;
If you can fill the unforgiving minute
With sixty seconds’ worth of distance run,
Yours is the Earth and everything that’s in it,
And – which is more – you’ll be a Man, my son!

Ovarian Cancer

WHAT IS OVARIAN CANCER

Ovarian cancer is the type of cancer that begins in the ovaries.The ovary is the female reproductive organ that produces eggs.Women have two ovaries, one on each side of uterus. The exact cause of ovarian cancer is unknown. Most ovarian cancers in women under age 30 are benign fluid filled cyst. There are no routine screening test for ovarian cancer. The prognosis, treatment and survival rate of the disease depends on the stage and the overall health of the woman. The cancer may go undetected until it has spread to the pelvis and abdomen and this makes the disease difficult to treat. It is the fifth most common cancer among women and causes death than any other female reproductive cancer.

THE HUMAN OVARY

 

RISK FACTORS

Certain factors increase your risk of getting ovarian cancer. Some of the factors include

Family history  . If women in your family have been diagnosed with ovarian cancer,then you have a high risk of getting it too.Women with family history of breast, rectum, uterus and colon cancer have high risk too.  You may want to talk to a geneticist as certain test can be done to show the presence of specific gene changes that may increase your risk.

Age over 55  Your risk of having cancer increases as you age. Ovarian cancer is common in women after age 55 or mostly developed after menopause.

Inherited gene mutation.  Breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2) are known to increase the risk of having ovarian cancer.These genes are mostly found in families with multiple cases of breast cancer. An inherited syndrome called hereditary nonpolyposis colorectal cancer (HNPCC) increases  a woman’s chance of getting cancer of the ovaries, uterine lining , colon and stomach.

Never pregnant Older women who have never been pregnant have increased risk of this type of cancer.

Personal history of cancer If you’ve had cancer of the breast, colon , rectum or uterus, you have a higher chance of getting ovarian cancer.

Hormone replacement therapy for menopause  Studies suggest that women who take estrogen replacement only, that is without progesterone have increased chances of getting ovarian cancer.

Other risk factor include obesity,taking certain fertility drug. Having a risk factor does not however mean that you will get the disease, it increases your chances of getting the disease.

The exact cause of ovarian cancer is not known. The cancer begins in healthy tissues that have acquired genetic mutations. The cancer cells then grow and multiply and invade nearby tissues.

TYPES OF OVARIAN CANCER

Epithelial ovarian tumors This is the most common form of ovarian cancer and occurs mostly in adults. This cancer begins in a thin layer of tissue that covers the outside of the ovary.

Gem cell ovarian tumors They begin in egg producing cells and is much more common in younger people.It is rare in comparison to epithelial ovarian tumors.

Sex cord stromal ovarian tumor . They begin in ovary tissues that produce hormones estrogen, progesterone and testosterone.

SYMPTOMS

Ovarian cancer symptoms are mostly vague and  tend to mimic other conditions.When symptoms are present, they tend to be persistent and gets worse. Symptoms include

• blotting or swollen belly area
• pelvic or lower abdominal pain
• changes in bowel habit such as constipation
• trouble eating or feeling full quickly
• urinary problems like urinating frequently or urinating more than usual.
• feeling tired all the time
• nausea, indigestion or diarrhea
• abdominal pressure, fullness,swelling or bloating
• back pain
• change in menstrual cycle such as heavy bleeding, bleeding in between periods  or bleeding after menopause
• pain with sexual intercourse
• shortness of breath
• weight gain or loss
• excessive hair growth that is coarse or dark

STAGES OF OVARIAN CANCER

Staging of ovarian cancer depends on if the cancer has invaded other tissues, if the cancer has spread and if so to which organ. Doctors usually use surgery to determine the stage of the cancer.Your doctor will use information from imaging tests, such as computerized tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET), to determine whether  the cancer has spread within the abdomen. Staging helps determine your prognosis and best treatment options.

Stage I Cancer is found in one or both sides of the ovaries

Stage II Cancer has spread to other location like the pelvis, uterus  or fallopian tube.Cancer cells may be found in fluid  collected from the abdomen.

Stage III Cancer has spread to tissues outside the pelvis or to the lymph nodes within the abdomen.Cancer cells may be found on the outside of the liver.

Stage IV   Cancer has spread to organs beyond the  abdomen like the lungs and liver.

TEST AND DIAGNOSIS

Pelvic examination A pelvic exam is done to check the woman’s pelvic organs.During a pelvic exam, your doctor feels the ovaries and nearby organs for lumps  or other changes in their shape or size.Your doctor inserts a device called a speculum into your vagina to open up your vagina. This is to enable him visually check for any abnormalities of ovaries and cervix. He may also feel your pelvic  organs to check their size and texture by inserting one or two gloved fingers  into the vagina and pressing on the lower abdomen with the other hand.

Ultrasound It aims sound waves at organs inside the pelvis. It helps doctors check the size, shape and configuration of the ovaries. Your doctor can also use an ultrasound probe inserted into your vagina to create pictures of your ovaries and structures near the ovary. This is called transvaginal ultrasound.

Blood Test. CA 125  is a protein on the surface of most ovarian cancer cells and some healthy tissue. The protein is high in people with ovarian cancer and other diseases.Women with early stages of ovarian cancer may have normal CA 125 protein. It is therefore not used for diagnosing ovarian cancer but to check the progress of the disease.

Surgery  When your doctor suspects you have ovarian cancer, surgery (laparotomy) is done to confirm it.The surgeon may collect fluid samples from the abdomen and an ovary to be examined by a pathologist. If cancer is confirmed, the surgeon will immediately do surgery to remove the all the cancer cells. The surgery may also be used to check for whether cancer has spread.

A pelvic or abdominal CT scan or MRI may be done to check if the cancer has spread.

TREATMENT

Ovarian cancer treatment involve a combination of surgery and chemotherapy.

Surgery  There are different types of surgery options

• A total hysterectomy is done to remove the uterus and cervix
• An omentectomy is done to see if cancer has spread by removing fatty tissues attached to some organs in the belly.
• A unilateral salpingo-oophorectomy is done to remove one ovary and fallopian tube
• A bilateral salpingo-oophorectomy is surgery done to remove both ovaries and fallopian tubes
• A lymph node biopsy Lymph nodes nearby are removed and checked for cancer cells.

Your surgeon also removes as much cancer as possible from your abdomen (surgical debulking).  Women with early stages of ovarian cancer may have just one ovary and fallopian tubes removed. It is therefore possible for such patients to have babies in future.

Chemotherapy  Chemotherapy is administered as an initial treatment for patients with advanced ovarian cancer or as the next treatment after surgery to kill the remaining cancer cells. It may be given intravenously or by mouth (systemic chemotherapy). In this case the drug enters the blood stream and kill or control the cancer cells throughout the body. It may also be given directly into the abdominal cavity or pelvis (Intraperitoneal chemotherapy ) to destroy  cancer in these areas or both ways. Chemotherapy drugs are given alone or in combination.

Some of the chemotherapy medicines used for ovarian cancer include:

• Carboplatin
• Cisplatin
• Paclitaxel
• Docetaxel

 

Radiation therapy uses high energy rays to kill the cancer cells. It is rarely used as an initial treatment for ovarian cancer but can be used to relieve pain and other issues caused by the disease.Side effects of this include  nausea, vomiting, diarrhea, or bloody stools.

PREVENTION

Women who take birth control pills have reduced risk of ovarian cancer. Talk to your doctor about taking birth control pills. If you have a family history of ovarian and breast cancer, discuss with your doctor to find your risk. BRCA testing may be done in women at high risk for ovarian cancer.

DIARRHEA

 

By Kemboi Kibet.  Eldoret August 11, 2012

Diarrhea describes loose watery bowel movement that usually last 2 or 3 days. This often means more frequent trips and a greater stool volume. It may be accompanied by nausea, bloating and urgent need to use the toilet. This is a very common condition and it’s usually not serious except in rare cases and may be treated with Over The Counter medication or may be even go away without treatment. Diarrhea  may be caused by a bacteria, virus or parasites. It may also be caused by food intolerance, certain medication or certain conditions like diseases of the stomach and intestines. It may also be a sign of serious trouble especially if there is blood in the stool or strong rectum and abdominal pain.  You should see a doctor if you get signs of severe dehydration or if diarrhea lasts for weeks.

TYPES OF DIARRHEA

Diarrhea may be classified as secretory, osmotic and exudative.

Secretory diarrhea – This may be caused by certain medical condition, drugs and a lot of infections. With this type of diarrhea, the body releases water into the bowel when it’s not suppose to.

Osmotic diarrhea – This is when something in your bowel draws water from your body into the bowel. This could be a sugar substitute like sorbitol that does not get absorbed by the body but gets into the bowel and draws water from the body.

Exudative diarrhea – This occurs with conditions like inflammatory bowel disease (ulcerative colitis and crohn’s disease

CAUSES

A number of disease and conditions can cause diarrhea. But most likely it may be common causes like :

• viruses
• bacteria
• medication
• food allergy
• radiation therapy
• lactose intolerance
• fructose
• artificial sweeteners
• some cancers
• diabetes
• hyperthyroidism
• disease of the intestine (crohn’s disease, celiac disease and ulcerative colitis)
• alcohol abuse
• laxative abuse
• eating foods that upset your stomach

SYMPTOMS

There are both complicated  and uncomplicated symptoms of diarrhea. Uncomplicated symptoms of diarrhea may include:

• Frequent, loosewatery stools
• vomiting
• nausea
• abdominal pain
• abdominal cramp
• headache
• bloating
• loss of appetite

However in serious cases, there may be more complicated symptoms like

• blood in the stool
• mucus in the stool
• fever – 102 F (39 C)
• loss of weight

You must see a doctor if the diarrhea persist for more than 3 days or if you get any of these  complicated symptoms. Also if you show sign of dehydration – very dry mouth, extreme thirst, little or no urine.

In children diarrhea could be more severe and lead to dehydration. Call a doctor if the child’s diarrhea does not improve in 24 hours or if the child is very sleepy, irritable and unresponsive. Also if the child has not had a wet diaper for over 3 hours and has sunken eyes and stomach  and dry tears you should call a doctor. If the child’s skin does not flatten after being pinched  or child has a fever of 102 F (39C) and black or bloody stools you must call a doctor immediately

TEST AND DIAGNOSIS

Test and diagnosis for diarrhea may include :

PHYSICAL  EXAMINATION – A physical examination will be done to check for abdominal pain. Your doctor will also use a stethoscope to  listen to your stomach.

MEDICATION REVIEW – Your doctor may ask about any medications you’re taking, including over-the-counter drugs and any supplements you take.

STOOL TEST – A stool test will be done to determine the cause of the diarrhea – bacterium or parasite

BLOOD TEST – A complete blood count may also be done to check for the cause of the diarrhea.

SIGMOIDOSCOPY – A sigmoidoscopy may also be performed. This involves introducing a thin fiber-optic tube that has a viewing lens through the rectum to look into the intestine.

TREATMENT

Most cases of diarrhea resolve themselves within a couple of days without medication however if the diarrhea persist for more than 3 days consult your doctor for treatment.

Treatment of mild cases of diarrhea:

Absorbents – These are compounds that absorb water. They bind to water in the small intestines and colon and make stools less watery. These are over the – counter medication and can be grouped into 2 categories

Attapulgite – Examples of these are Kaopectate Advanced Formula, Donnagel, Diasorb etc

Polycarbophil – Examples include Polycarb,  Mitrolan, Equalactin etc

Anti-motility medication – These are drugs that relax the muscles of the small intestines and colon which results in slowing the flow intestinal content. This allows more time for water to be absorbed from the intestine and colon and hence decreases the water content in the stool. Two main anti-motilty medication are loperamide (Imodium), which is available without a prescription, and diphenoxylate (Lomotil), which requires a prescription.Anti-motility medication should not be given to children younger than 2 years and it should always be used under a doctor’s guidance.

Bismuth compounds – These are available worldwide. They contains bismuth and salicylate (aspirin), hence people allergic to aspirin should not take it. In general it is very well tolerated. It should not be taken with other aspirin containing medication as this can lead to aspirin toxicity. Do not give this medication to children younger than 2 years. Examples include Pepto-Bismol

Treatment to replace fluid – It is important to replace fluid and salt lost during diarrhea. You must drink enough water, juice or both to replace the fluid. You may replace the fluid intravenously through a vein in your arm if drinking liquid upsets your stomach. Water is good for replacing the fluid but because it has no salt and electrolyte, you may be required to drink fruit juices for potassium and soup  for sodium.

Adjusting medication – Diarrhea may be caused by a medication you are taking. In this case your doctor may lower the dosage or switch you to another medication.

Treatment for severe diarrhea

Antibiotics – These are often needed for people with severe or persistent diarrhea and also for people with additional debilitating disease like AIDS, heart disease etc. Also if your stool examination showed parasites, more serious bacterial infections (Shigella), or C.difficile and traveler’s diarrhea you will need antibiotics. Antibiotics may help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics will not  help.

Treatment of underlying condition – If your diarrhea is caused by a more serious condition, such as inflammatory bowel disease, your doctor will work to control that condition.

PREVENTION

Wash hands frequently to prevent viral diarrhea. Wash hands after using the toilet, handling uncooked meat, sneezing, coughing, blowing your nose and changing diapers. Lather with soap for at least 20 seconds and use hand sanitizer where necessary. Do not eat contaminated food. Serve cooked food immediately or refrigerate. Thaw frozen food in a refrigerator and wash work surfaces frequently. Also when you travel watch what you eat or drink.

 

High Blood Pressure

Hypertension also known as high blood pressure is defined as a consistently elevated blood pressure exceeding 140/90 mm Hg. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. Hypertension occurs when your heart pumps more blood resulting in narrowed arteries. It affects millions of people every year, even children and teens. It is called the silent killer because it usually does not show any symptoms for years even decades until it has damaged vital organs. Uncontrolled or poorly controlled hypertension can damage blood vessels in the eye, harden heart arteries leading to arteriosclerosis and can ultimately cause heart attacks and stroke. High blood pressure in pregnancy can lead preeclampsia or eclampsia (toxemia of pregnancy) which can harm the baby or mother. Pregnant women should be monitored closely by their obstetrician for complications of hypertension. For more information on preeclampsia go to http://yourhealth-check.com/2012/06/26/preeclampsia-in-pregnant-women/

CAUSES, INCIDENCE AND RISK FACTORS

The exact cause of hypertension is not known but several factors may contribute to its development. These include:

• obesity
• smoking
• chronic disease like kidney failure
• genetics
• alcoholism
• stress
• too much salt intake
• adrenal and thyroid disorder
• old age
• family history
• Forms of hypertension

There are 2 main forms of high blood pressure – primary (essential) hypertension and secondary hypertension

Primary (essential) hypertension

This is this the most common for of the disease and it accounts for about 95% of all cases. This form is usually caused by a combined effect of several factors. Essential hypertension is greatly influenced by diet and life style and tends to develop gradually over many years. It is known to be very common in people with high salt intake. This link between salt and high blood pressure is alarming. People with hypertension are  sensitive to salt, meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other risk factors includes sex (affect men more than women), race (prevalent in people with african american background), age, obesity, family history, genetics, diabetes and inactive lifestyle.

Secondary hypertension

Secondary hypertension accounts for 5% of hypertension and it’s caused by a specific abnormality in one of the organs or systems of the body. The abnormality could be kidney disease (this is ranked the highest), a tumor, adrenal gland malfunction and birth control (those containing estrogen). This type of hypertension occurs suddenly.People with this type tend to have higher blood pressure than those with primary.

SYMPTOMS OF HYPERTENSION

The dangerous thing about hypertension is you may have it but will not know for years or even decades. Almost one-third of people who have hypertension don’t know it. There are signs of extremely high blood pressure. These include headaches, dizzy spells, a few more nose bleeds than normal and blurred vision. At this time significant damage has been done to several vital organ. It is important to have regular physical examinations to make sure your blood pressure is within the normal range especially if your blood pressure has ever been high, if you have a family history of hypertension, or if you are obese or have medical conditions like diabetes.

SIGNS AND TESTS

Blood pressure is most often measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve. A blood pressure reading is given in millimeters of mercury (mm Hg). Blood pressure is measured in two ways: systolic and diastolic.   The upper number measures the pressure in your arteries when your heart beats (systolic pressure). The lower number measures the pressure in your arteries between beats (diastolic pressure).

The are 4 general categories of blood pressure reading and these are:

Normal: < 120/80

Prehypertension: 120 -139 over 80-89

Stage 1 HBP: 140-159 over 90-99

Stage 2 HBP: 160 and above over 100 and above

If you’re diagnosed with high blood pressure, your doctor may recommend other tests, such as:

Electrocardiogram (EKG or ECG) – This test measures the electrical activity, rate, and rhythm of your heartbeat through electrodes attached to your arms, legs, and chest. The results are recorded on graph paper.

Echocardiogram – This test uses ultrasound waves to provide pictures of the heart’s valves and chambers. These waves allow the healthcare professional to study the pumping action of the heart. In addition measurement of the chambers  and wall thickness of the heart can be made.

TREATMENT AND DRUGS FOR HYPERTENSION

Treating hypertension can take a multi-prolonged approach including diet changes, medication, and exercise. Blood pressure treatment goal depends on how healthy the individual is. For a healthy adult, blood pressure treatment goal is 140/90 mm Hg or lower . If you have a heart that does not pump properly or you have a heart malfunction like left ventricular dysfunction or heart failure or a chronic kidney disease your treatment goal will be 120/80 mm Hg or lower. Lastly for individuals with chronic kidney disease, diabetes or coronary artery disease or people who are at high risk of coronary artery disease, their treatment goal is 120/80 mm Hg or lower. If lifestyle changes are not enough to lower blood pressure, your doctor will prescribe medication to lower it. The category of medication depends on the severity of your condition and other medical problems.

MEDICATION

Thiazide diuretics – These are also called water pills and often the first choice of medication for hypertension. They act on your kidney to eliminate water and salt from your body are reduce blood volume.

Beta blockers – These work to reduce the workload on your heart and open your blood vessels. This makes your heart beat slower and with less force. These work better when combined with diuretics.

Angiotensin-converting enzyme (ACE) inhibitors – They work to relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

Angiotensin II receptor blockers (ARBs) – These medications block the action (not the formation) of a natural chemical that narrows blood vessels resulting in relaxation of the blood vessel.

Calcium channel blockers – They help relax the muscles of your blood vessels and may slow heart rate.

CAUTION – Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects,

Renin inhibitors – Aliskiren (Tekturna) slows down the production of renin that starts a chain of chemical steps that increases blood pressure.

If your blood pressure goal is not reached with the above medication, your doctor may prescribe:

Alpha blockers – These work to reduce nerve impulses to blood vessels which in turn reduces the  effects of natural chemicals that narrow blood vessels.

Alpha-beta blockers – Alpha-beta blockers slow the heartbeat to reduce the amount of blood pumped through vessels and also reduce nerve impulses to blood vessels.

Central-acting agents – These prevent your brain from signaling the nervous system to increase  heart rate and narrow your blood vessels.

Vasodilators – They work directly on the muscles in the walls of your arteries to prevent them from tightening and narrowing your arteries.

Your doctor may ask you to take a daily aspirin once your blood pressure is under control.This helps to reduce your risk of cardiovascular disorders.

Even if you are taking medication it is recommended to have lifestyle changes to maintain a healthy blood pressure. A healthy diet and less salt intake is advised. It is also important to lose weight, exercise more and quit smoking.

COMPLICATIONS

If uncontrolled, hypertension can lead to;

• heart failure
• stroke
• aneurysm
• thickened, torn or narrowed blood vessels of the eyes
• weakened and narrowed blood vessels of your kidney
• memory problems

SUPPORT

High blood pressure(hypertension) isn’t a problem that you can treat and then ignore. It’s a life-time condition. Join support groups and interact with people who share your pain. Manage your stress, take your medication the right way, exercise and eat healthy.

 

ICC grants former Raila aide interview

Officials from the International Criminal Court have agreed to a preliminary interview with a former aide to Prime Minister Raila Odinga, we can report.

Mr Tony Gachoka, who served as Raila’s Chief of Protocol for ten months, claims he has “very damaging information” about the ODM leader’s actions during the 2008 post-election violence.

He has also claimed to have proof the PM struck a deal with unnamed local and international powerbrokers in exchange for immunity from prosecution.

“The Prime Minister has not been forthcoming about what he knows and what he did during the turbulent days of 2007 and 2008,” Gachoka has charged. He says he came to learn all this while managing the PM’s diary and sitting in on key meetings between May 2008 and March 2009.

Raila has, however, denied Gachoka was in charge of his diary or sat in on the alleged meetings. The PM’s office says Raila had no role in either the crimes against humanity that followed the election or the naming of ICC suspects.

The Standard On Saturday has exclusively established plans are under way for a secure interview between Gachoka and a high-ranking staffer at the Office of the Prosecutor. The development came hours after the former protocol officer complained of a “stony silence” from Ms Fatou Bensouda’s office in response to a letter he wrote ten days ago.

In the letter, dated August 1 and published as an advert in the media, Gachoka offered to provide evidence or testify as a witness, if necessary, to help the ICC “get the culprits behind the post-election violence”. It is not clear how his alleged evidence relates to either of the Kenya cases awaiting full trial at the ICC. “The information I hold is extremely prejudicial to some of the most powerful and influential personalities in Kenya,” Gachoka said, expressing fears he and his family were in danger. At a press conference in Nairobi on July 26, ICC officials confirmed they are still gathering evidence on “the Kenya situation”. On Thursday night, they reached out to Gachoka with a proposal on how he could provide the information safely.

The Hague-based court plans to hold two trials in April 2013 on PEV in Kenya, with four accused in the dock: The Deputy Prime Minister Uhuru Kenyatta, Eldoret North MP William Ruto, former Head of Public Service Francis Muthaura, and radio personality Joshua arap Sang.

While the ICC holds a list with dozens of alleged perpetrators, it is not expected to pursue any other individuals. Former Chief Prosecutor Luis Moreno-Ocampo ruled out charges against either President Kibaki or PM Raila Odinga.  His successor Fatou Bensouda has not indicated she plans to depart from these positions. Her investigations could, however, be affected materially if Gachoka provides credible evidence to ICC investigators to support his claims.

Gachoka will draw investigators’ attention to alleged changes made to a key report provided to the ICC to help with its investigations. At a press conference on Thursday, Gachoka accused Raila of conspiring with several people to have his name deleted from a list of alleged perpetrators of various PEV crimes.

Gachoka says questions were raised during closed sessions of the Commission of Inquiry into Post- Election Violence (the Waki Commission) over the existence of more than one report from the Kenya National Commission on Human Rights.

He says ODM had a hand in the changes made to the final report and fingers Hassan Omar, then a Kenya National Commission on Human Rights official, as the man behind the changes. The former KNCHR commissioner, now aspiring to run for a seat in the Senate, is an ODM member and an official of the Friends of Raila lobby group.

This is not the first time KNCHR has been accused of removing certain names and even entire paragraphs from its report on post-election crimes.

Similar claims were made immediately after the release of the public version of the report. Following accusations of political interference, KNCHR chairperson Florence Jaoko explained that there were some omissions in the body of the report due to a rush to finish the job.

The Waki Commission accepted On The Brink of the Precipice, Final Report, dated August 15, 2008 into evidence as Exhibit 125 after considering KNCHR’s explanation in a closed session. All other versions of the document were embargoed.

 A version given to journalists this week shows references to alleged incitement to violence a public gathering by a senior ODM official. Moreno-Ocampo has also been clear the ICC did not rely entirely on the Waki and KNCHR report or any of the other thousands of documents submitted to them.

fantastische

ELGEYO+MARAKWET©

Coe salutes record breaker Rudisha – London 2012 Olympics.

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Bee Propolis, also called “bee glue,” is a resinous, gummy substance that bees combine with wax to construct and maintain their hives. In laboratory tests, bee propolis has exhibited a variety of interesting antimicrobial and anti-tumor properties.

What’s in this superfood?
Propolis is a mixture of resin, essential oils and waxes mixed with bee glue. It it contains amino acid, minerals, ethanol, vitamin A, B complex, E, pollen and highly active ingredients known as flavonoids or bioflavonoids.

Bee Propolis Extract 500 mg pill

Propolis has been traditionally used for its natural disinfecting properties. Valued for centuries, these products are used for energy enhancement and support of general health. bee products are stringently tested for purity and potency and gently processed to retain delicate nutrients.

Benefits

it is effective for use in treating

1. bacterial infections
2. fungal infections
3. Antioxidant…can protect against cancer
   
4. Aphthous stomatitis
5. Ear infection
6. Genital herpes.
7. Giardia infection
8. Gout
9. Hepatitis and liver diseases
10. Immune enhancement
11. Multiple sclerosis
12. Stomach ulcer
13. Warts in the skin

 

Harvesting of Propolis

• Propolis is collected from the beehive.
•  Pure propolis is deposited above the top hive box, on the hive floor, or near the entrance.
• Bees can be induced to deposit propolis through the use of a slotted sheet that covers the top or sides of the hive box.
• The sheets can be nylon, net, gauze or plastic

  Propolis Processing

  There are many methods of propolis extraction depending on the desired end product.

  Propolis Extract

  Method

  • Add 50gms of raw propolis to 1 litre 70% ethanol (cover to prevent evaporation).
  • Shake the content intermittently, and allow it to stay for 4-5 days.
  • The solution will turn brown or dark colour.
  • Filter to remove residue and evaporate to reduce the ethanol content.

  Propolis Granules:

  • Place hive scrapings containing propolis on a heat-proof container, add enough water to cover propolis and heat this in a 200°F oven.
  • The wax will melt and float on the water, while the propolis will stick to the bottom of the container.
  • Stir often to help release the wax and maintain the heat for at least two hours.
  • Remove the container from the oven and let it cool.
  • Remove the waxy layer that forms on the surface of water.  Pour off the water and save the coloured mass beneath it.
  • Place the container of propolis in a freezer, when the propolis is brittle, chip the granules from the container.
  • Spread the granules on paper to dry.  Store them in a sealed container.

  Marketimg

  According to Farmbiz Africa

  http://farmbizafrica.com/index.php?option=com_content&view=article&id=187&catid=25&Itemid=144

  Locally, companies like Tego Foods, Dotino Pharmaceuticals and Lightshade Cosmetics are now sourcing propolis from local farmers in newly lucrative business. According to Euro Monitor, the price of propolis has risen by up to 70 per cent since the 1990’s, when its uses were limited to food technology, now selling for as much as Sh4,750 per kilo in the international market

  This is stimulating new beekeeping enterprises across the country. In Mwingi, 20 bee keepers have come together as a group to supply propolis to a Canadian cosmetic firm which has been scouting for suppliers in Kenya.  Due to “the high quality of honey and bee products we have had from Kenya, we felt that propolis must be of high quality,” said Lindsay Bitt the Marketing Manager at Hererra Cosmetics Inc in Canada.

  The 20 beekeepers, who hastily registered their group to be able to export, have since been approached by other international companies and now manage to export about 50 kgs of propolis every week. “But even this doesn’t come close to the huge demand these companies have for this commodity.

  “We are trying to mobilise every household now to have at least three bee hives to at least make sure that by coming together, we can manage to reach the export target of 1,000 kgs that the exporters are demanding,” said Lameck Mutua, the leader of the bee keeping initiative in Mwingi.

  So, what are you waiting for??

Bee Propolis,…

From the Doc

What is Ebola hemorrhagic fever?

Electron micrograph of Ebola virus

Ebola hemorrhagic fever (Ebola HF) is a severe, often-fatal disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees) that has appeared sporadically since its initial recognition in 1976.

The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of the Congo (formerly Zaire) in Africa, where it was first recognized. The virus is one of two members of a family of RNA viruses called the Filoviridae. There are five identified subtypes of Ebola virus. Four of the five have caused disease in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The fifth, Ebola-Reston, has caused disease in nonhuman primates, but not in humans.

Where is Ebola virus found in nature?

The exact origin, locations, and natural habitat (known as the “natural reservoir”) of Ebola virus remain unknown. However, on the basis of available…

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EBOLA HEMORRHAGIC FEVER

What is Ebola hemorrhagic fever?

Electron micrograph of Ebola virus

Ebola hemorrhagic fever (Ebola HF) is a severe, often-fatal disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees) that has appeared sporadically since its initial recognition in 1976.

The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of the Congo (formerly Zaire) in Africa, where it was first recognized. The virus is one of two members of a family of RNA viruses called the Filoviridae. There are five identified subtypes of Ebola virus. Four of the five have caused disease in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo. The fifth, Ebola-Reston, has caused disease in nonhuman primates, but not in humans.

Where is Ebola virus found in nature?

The exact origin, locations, and natural habitat (known as the “natural reservoir”) of Ebola virus remain unknown. However, on the basis of available evidence and the nature of similar viruses, researchers believe that the virus is zoonotic (animal-borne), with 4 of the 5 subtypes occurring in an animal host native to Africa. A similar host, most likely in the Philippines, is probably associated with the Ebola-Reston subtype, which was isolated from infected cynomolgous monkeys that were imported to the United States and Italy from the Philippines. The virus is not known to be native to other continents, such as North America.

Where do cases of Ebola hemorrhagic fever occur?

Confirmed cases of Ebola HF have been reported in the Democratic Republic of the Congo, Gabon, Sudan, the Ivory Coast, Uganda, and the Republic of the Congo. No case of the disease in humans has ever been reported in the United States. Ebola-Reston virus caused severe illness and death in monkeys imported to research facilities in the United States and Italy from the Philippines; during these outbreaks, several research workers became infected with the virus, but did not become ill.

Ebola HF typically appears in sporadic outbreaks, usually spread within a health-care setting (a situation known as amplification). It is likely that sporadic, isolated cases occur as well, but go unrecognized. A table showing a chronological list of known cases and outbreaks is available.

How is Ebola virus spread?

Treating patients with Ebola HF during outbreak of the disease in Kikwit, Democratic Republic of the Congo, in 1995.

Infections with Ebola virus are acute. There is no carrier state. Because the natural reservoir of the virus is unknown, the manner in which the virus first appears in a human at the start of an outbreak has not been determined. However, researchers have hypothesized that the first patient becomes infected through contact with an infected animal.

After the first case-patient in an outbreak setting is infected, the virus can be transmitted in several ways. People can be exposed to Ebola virus from direct contact with the blood and/or secretions of an infected person. Thus, the virus is often spread through families and friends because they come in close contact with such secretions when caring for infected persons. People can also be exposed to Ebola virus through contact with objects, such as needles, that have been contaminated with infected secretions.

Nosocomial transmission refers to the spread of a disease within a health-care setting, such as a clinic or hospital. It occurs frequently during Ebola HF outbreaks. It includes both types of transmission described above. In African health-care facilities, patients are often cared for without the use of a mask, gown, or gloves. Exposure to the virus has occurred when health care workers treated individuals with Ebola HF without wearing these types of protective clothing. In addition, when needles or syringes are used, they may not be of the disposable type, or may not have been sterilized, but only rinsed before reinsertion into multi-use vials of medicine. If needles or syringes become contaminated with virus and are then reused, numerous people can become infected.

What are the symptoms of Ebola hemorrhagic fever?

The incubation period for Ebola HF ranges from 2 to 21 days. The onset of illness is abrupt and is characterized by fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain. A rash, red eyes, hiccups and internal and external bleeding may be seen in some patients.

Researchers do not understand why some people are able to recover from Ebola HF and others are not. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.

How is Ebola hemorrhagic fever clinically diagnosed?

Diagnosing Ebola HF in an individual who has been infected only a few days is difficult because early symptoms, such as red eyes and a skin rash, are nonspecific to the virus and are seen in other patients with diseases that occur much more frequently. However, if a person has the constellation of symptoms described above, and infection with Ebola virus is suspected, isolate the patient and notify local and state health departments and the CDC.

What laboratory tests are used to diagnose Ebola hemorrhagic fever?

Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing, IgM ELISA, polymerase chain reaction (PCR), and virus isolation can be used to diagnose a case of Ebola HF within a few days of the onset of symptoms. Persons tested later in the course of the disease or after recovery can be tested for IgM and IgG antibodies; the disease can also be diagnosed retrospectively in deceased patients by using immunohistochemistry testing, virus isolation, or PCR.

How is Ebola hemorrhagic fever treated?

There is no standard treatment for Ebola HF. Patients receive supportive therapy. This consists of balancing the patient’s fluids and electrolytes, maintaining their oxygen status and blood pressure, and treating them for any complicating infections.

How is Ebola hemorrhagic fever prevented?

Ebola HF prevention poster used in Kikwit outbreak.

The prevention of Ebola HF in Africa presents many challenges. Because the identity and location of the natural reservoir of Ebola virus are unknown, there are few established primary prevention measures.

If cases of the disease do appear, current social and economic conditions often favor the spread of an epidemic within health-care facilities. Therefore, health-care providers must be able to recognize a case of Ebola HF should one appear. They must also have the capability to perform diagnostic tests and be ready to employ practical viral hemorrhagic fever isolation precautions, or barrier nursing techniques. These techniques include the wearing of protective clothing, such as masks, gloves, gowns, and goggles; the use of infection-control measures, including complete equipment sterilization; and the isolation of Ebola HF patients from contact with unprotected persons. The aim of all of these techniques is to avoid any person’s contact with the blood or secretions of any patient. If a patient with Ebola HF dies, it is equally important that direct contact with the body of the deceased patient be prevented.

CDC has developed a set of tools to meet health-care facilities’ needs. In conjunction with the World Health Organization, CDC has developed practical, hospital-based guidelines, entitled Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting. The manual describes how to recognize cases of viral hemorrhagic fever, such as Ebola HF, and prevent further nosocomial transmission by using locally available materials and few financial resources. Similarly, a practical diagnostic test that uses tiny samples from patients’ skin has been developed to retrospectively diagnose Ebola HF in suspected case-patients who have died.

What challenges remain for the control and prevention of Ebola hemorrhagic fever?

Scientists and researchers are faced with the challenges of developing additional diagnostic tools to assist in early diagnosis of Ebola HF and conducting ecological investigations of Ebola virus and its possible reservoir. In addition, one of the research goals is to monitor suspected areas to determine the incidence of the disease. More extensive knowledge of the natural reservoir of Ebola virus and how the virus is spread must be acquired to prevent future outbreaks effectively.