INFERTILITY PART 1 by Dr. Chin

INFERTILITY PART 1

What does infertility mean? In simple terms infertility is defined as inability to make a baby.

Both a man and woman can be infertile. In a third of the cases of infertility , the problem is from the woman, another third is from the man or both may have a problem or the problem may be unknown.

Infertility is very common and it is seen in about 1 in every 7 couples worldwide.

At the moment let us focus on infertility in women:

A woman under 35 years of age would be said to be infertile if she is unable to conceive even though she is having regular unprotected sex for up to 12 months and has no known problem with her reproductive system .
For women older than 35 years, they will be deemed infertile if they are unable to conceive after 6 months of regular unprotected sex rather than 12 months in younger women.
For women over 35 years, time is of essence so after 6 months she needs to be investigated and treatment started if necessary.
A woman can also be described as being sub fertile if she has tried unsuccessfully to have a child after a period less than the prescribed 12 months in under 35 year olds and less than 6 months in older women. This means that she is less fertile than women of her age.

In the UK infertility is defined as a failure to conceive after regular unprotected sexual intercourse for 2 years in the absence of known reproductive pathology. So a woman will not be entitled to free NHS investigation for infertility unless they have been having regular unprotected sexual intercourse for 2 years or more and yet did not conceive.

What does regular sexual intercourse mean?

It means having sexual intercourse at least every 2-3 days.

Irrespective of how infertility is defined, it is usually grouped into 2 categories as follows:

Primary infertility is when a woman has never conceived ( become pregnant) after at least 1 year of unprotected sex (intercourse). while

Secondary infertility refers to when a woman has been pregnant at least once, but never again.

Some important facts about infertility:

* A woman is at the peak of her fertility in her earlier 20s
* At age 35 ( and especially 40), the chances of getting pregnant drops considerably
* Adequate sexual intercourse is necessary for pregnancy to occur
* For a healthy woman under the age of 30 who has sex regularly, the chance of getting pregnant is about 25 - 30% per month.
* A woman can increase her chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation.
* It is especially important to do so 72 hours before ovulation begins.
* Note that ovulation occurs about 2 weeks before the next menstrual cycle (period) starts.
*If a woman sees her period every 28 days, she should have sex at least every 3 days between the 10th and 18th day after the period starts.
* Also note that sperm can survive in the female reproductive tract for up to 72 hours (3 days) after it was deposited
* An egg (ovum) can survive and be fertilized for up to 24 hours after being released from the ovaries ( ovulation).
* 84% of women who are less than 35 years and have regular unprotected intercourse ( every 2-3 days) will become pregnant within 12 months
* 92% of them will get pregnant within 2 years of having regular unprotected sex
* For women older than 35 years 94% will get pregnant after 3 years of regular unprotected sex while those aged 38, only 77% will do so
*For couples who have been trying to conceive for more than three years without success, the likelihood of pregnancy occurring within the next year is 25% or less.

What is required for a woman to get pregnant

* her ovaries must be able to produce eggs or ova (ovulation)
* After the ovulation, the eggs must be able to move to the tube where they get fertilised by sperm
* When the egg is fertilised to form the embryo, the embryo should be able to move into the womb. If not then the pregnancy becomes ectopic one
* when the embryo ( fertilised egg) gets into the womb, it must be able to attach to the lining of the womb (implantation) *
When it implants, it must be able to survive
Failure of any of these stages will lead to inability of the woman to be pregnant or stay pregnant.

LATE JAMES IROHA (AKA GRINGORY) GOES HOME

ABIA POST AND INDEED, THE ENTIRE ABIANS BID FAREWELL TO OUR OWN RENOWNED ACTOR, LATE PA. JAMES IROHA (AKA GRINGORY AKABUOGU), TODAY, THE 5TH DAY OF MAY, 2012 IN HIS HOME TOWN, AMABA, AMOKWE ITEM IN BENDE LOCAL GOVERNMENT, ABIA STATE.

There are no better ways to describe late Pa. James Iroha than what he said and wrote about himself while he was alive. His Autobiography reads thus:

James Akwari Udensi Iroha OON
“I’m one of the several sons of late Mazi Akwari Iroha of Amaba, Amokwe Item in Bende Local Government Area of Abia State. I was born on the 12th day of October, 1942.”
I had my early education in the Northern part of Nigeria, (Bukuru, Plateau State). Secondary Education in the present Cross River of Nigeria and my University Education at the University of Ibadan.
During my lifetime, I spoke fluently in three major Nigerian languages and two International languages (English & French). I had a Bachelor of Science Degree in Mass Communication and a professional Diploma in Theatre Arts.
My working career started with Eastern Nigerian broadcasting service in Enugu.(E.N.B.S) in 1967 as the television producer. Where I rose to the rank of Director of Television cum, Deputy General.
Just after the Biafra war ended, people had no business or reason to smile, let alone laugh. Then, if one hadn’t lost a mother, then it must be the father, or an uncle, or even a twin sister. At that point, i had this emotional burden to put a smile on people’s face again. This was the divine inspiration that gave birth to “THE MASQUERADE” (satirical tv drama) came to me.
First, it started off on stage with live audience, and then moved on to Radio and later TV as a local content programme. And finally, it became a national programme on Nigeria Television Authority (NTA) and across Africa. Ever since then, I have been referred to be one of Nigeria’s most hilarious comedians. A na m anu ihe?!
Did I mention I was the premier director of Imo State Council of Arts and Culture (ISCAC) from 1980 to 1982? Yes, I was.

The funeral was well attended by the likes of Abia State Chief of Staff, Dr. Cosmos Ndukwe,Mr. Chika Okpala, (aka Zebrudaya of "masquerade"), Chris Nkulor,Dr. Okwu I. Okwu, Abia State Commissioner for transport, Jegede's son, Clarius wife, Members of Actors Guild of Nigeria and several other dignitaries.

ABIANS WILL SURELY MISS HIM.

HIV/AIDS PART 2 BY DR. CHIN AKANO

SIGNS AND SYMPTOMS OF HIV INFECTION

Before i discuss this in detail, i will like to state that HIV infected individuals may have only a few or no symptom at all for several years even up to 20 years before they show any. So it is advisable for individuals to run routine HIV tests to ascertain their status.
This is the wise thing to do because the earlier one discovers that they are infected, the sooner they start treatment and better the outcome.
HIV infection goes through three stages in an individual between when they contact the infection to when they develop the full blown late or advanced stage of the infection otherwise referred to as AIDS.

These stages are as follows:

a] Acute infection
b] Latent phase
c] AIDS

* Acute infection phase
This is the phase immediately after exposure to the HIV infection. Often people have no symptoms at all till about 2-4 weeks following the exposure often . This is often referred to as sero-conversion.
Then they may experience symptoms which appear like flu illness or can even be mistaken for malaria or typhoid fever. When these symptoms develop, they may last for several weeks before they disappear and the individual becomes free of them.
The patient is much more infectious during this period and as such it is important that the disease is diagnosed at this stage.
The message is that if any one comes down with the under listed symptoms, it is advisable for them to take an HIV test because this stage is when the person is highly infectious and also for the person to seek correct management

The symptoms are usually as follows:

High temperature (fever)
sore throat (pharyngitis)
Rashes in the body and face
muscle and joint pain
feeling tired and generally unwell
mouth sores
sores in the oesophagus [gullet]
swollen lymph glands (lymphadenopathy)
headache
nausea
vomiting
weight loss
thrush



* LATENCY PHASE or chronic or quiet phase

Following the acute phase, the individual develops a strong immunity against the HIV infection and this leads to the development of this quiet phase where the individual may have only very few or no symptoms at all. This can last anywhere from two weeks to even over 20 years depending on the individual.
This stage is dangerous as the sufferer may not know that he/she is carrying this infection and could transmit it to others.
The common symptom at this stage is lymph glands become persistently swollen. It is so important to identify the HIV infection at this stage because initiation of anti-retroviral treatment significantly improves survival

* Late or advanced stage formerly known as AIDS

AIDS, the final stage of HIV infection when the immunity is almost fully compromised. At this stage the CD4+ T cell numbers decline below a critical level of 200 cells per µL.
At this stage the individual becomes quite ill and comes down with various infections, cancers and other diseases.
Some of the common diseases that the infected individual suffer at this stage are as follows:

unexplained weight loss
recurrent respiratory tract infections like throat infection (pharyngitis) sinus infections, chronic cough, ear infection (otitis media), chest infections
mouth/tongue ulcers
oesophageal ulcers
Skin rashes
thrush [ candidiasis eg vaginal, oral ]
staph aureus, some streptococcal infection
Very serious and fatal pneumonia caused by fungus pneumocystis carinii pneumonia
mycobacterium tuberculosis (TB)
Shingles
Herpes infections
Certain cancers like Kaposi's sarcoma and some lymphomas

Watch out for part 2

THE HISTORY OF ABIRIBA

History
The people who occupy the territory known as Abiriba descended from the Igbo and Efik people of Calabar. They migrated from the upper Cross River area centuries ago led by a Nnachi Oken, from whom the title "Enachioken" ("The Monarch") originates. Initially, they occupied a smaller territory which expanded when the Abiriba people routed the surrounding Nkporo people and took over their lands. The Abiriba people were war-like and quickly established themselves in the area.
The origin of the Abiriba people is not as speculative as the origin of other Igbos of southeastern Nigeria. Historical evidence supports the fact that Abiriba people have common ancestor with the Yakor tribe of Ekoi of cross river basin and the people of Arochukwu. At Ekoi, constant disputes between the seven families under Ukpaghiri prompted the clan to move to Ena and finally to Akpa.

The settlement at Akpa was difficult for many years due to hostilities with neighbors. After the death of Ukpaghiri, Mbiriba and his group moved to Usukpam and stayed there for many years but were never at peace with the neighbors. Mbiriba decided to move to Udara-ebuo whereas Otusi led the other branch of the family down stream and eventually founded Arochukwu. The term Nwadim is often used between Abiriba and Aros because of our common lineage. Mbiriba who had advanced in age, moved his group once more and settled at Udara-ebuo.

Nature was inhospitable to the inhabitants at Udara-ebuo. There was no water and the place was overrun by monkeys. Oral history has it that monkeys used to visit homes to look for food, and the people became sick living on monkey meat only. Mbiriba died at Udara-ebuo and left his son Ifa Mbiriba in charge.
Ifa Mbiriba finally moved to Uruanta and Agboha and settled there. The new settlement was very fertile and had a natural fortress. Thus Abiriba was derived from the name Mbiriba or nickname “Ebiri-Aba”.
Oko Ogo opened Ndi Okogo which is currently where the Chiefs palace is situated. Nwagu Ifa founded Okagwe and later Agboji. Ngwu founded Ihungwu. Chukwu Oke founded Amogudu. The name Amaeke was derived from the market day Eke. The Capital of Abiriba is Ameke and the paramount Chief for the whole Abiriba uses the title Enachi-oken.
Incessant conflicts and border skirmishes between the Item and Amogudu led to the creation of a standing army in form of the age-grade system. Historical artifacts exist to support the consensus that the age-grade system started at Amogudu. Nwagu Ifa, Ngwu, Oko Ogo and Chukwu Oke used the age-grade as a standing army to protect the Abiriba from hostile neighbors.
Geography

The Abiriba people are known to be industrious both in crafts and trading; their arid lands make it tough for agriculture to flourish. These made them popular amongst the Igbo people of Nigeria. As a matter of fact, in the history of the Igbos of Nigeria, Abiriba is reckoned for her pre-historical black smithing and sculpture artifacts. These ancient occupation of the Abiriba people later on metamorphosed into what is today the trademark of the people - Trading (or better merchandise) popularly known among Abiriba People.

Since the people were predominantly merchants, they were widely travelled both within and outside the boundaries of Nigeria, and they are correspondingly cosmopolitan. Being so exposed and prosperous, the people have enough information about vogue and money that made them transform their locality from the normal village setting, as is common with the surrounding villages, to a model sub-urban but purely residential setting with some of the most exotic building in the Igbo land, even in Nigeria as a whole. The Abiriba people take great pride in the serenity and aesthetic value of their landscape, consequently shunning attempts by government or individuals to set up factories in the town, and seeing same as attempts to "pollute" their land. In 1959, the late President of Nigeria, The Rt Honourable Dr Nnamdi Azikiwe was so taken in by the beauty of Abiriba that he called it "Small London" - a name in use today.

Cuisine
Abiriba is known for some of its unique dishes. Among other foods such as rice, yam, beans, and garri (cassava), "Asusu" is a very common dish among the Abiriba people. It is made of corn starch, ground with salt and pepper, wrapped with a local leave call akwukwo-asusu and steamed with water covering all the raps. Asusu is eaten with a popular vegetable soup called Ugboghor. "Oto" (ground water-yam porridge) is also very popular among the Abiriba people.
Government

Abiriba is made up of three main villages: Ameke, Amogudu, Agboji. Abiriba is governed using a monarchichal system. The "Eze" (The King or Monarch) is called Enachioken. The people of Abiriba have experienced little direct impact of the government in their development and governance except in very recent times. In the instances when government has actively involved itself in the life of the town, there is a consensus that the effects have been rather detrimental. Abiriba has a well-developed and active age-grade system, in fact, one of the most effective in Igbo land. Some Age-Grades include:Akahaba, Erinma I, II, Ekpankuma I&II, Onyiba,Egwuena, Ojighiri, Isimini, Okezie etc. which maintain offices in all countries of the world where Abiriba people reside. These age-grades have been the main agents of development in the town, especially those in the diaspora. They also play the traditional role of policing the community and punishing offenders, regardless of age and status. It is often witnessed where a notable and wealthy member of the age grade was whipped publicly due to an offense.The present Enachioken of Abiriba is an enterprising gentleman called HRM Eze Kalu Kalu Ogbu who ascended the throne of his fore fathers after the death of the last occupant Late Eze U.U.Ukiwe. The Ezeship is hereditary and rotates within four royal families that have the birth rights of producing the Enachioken. These are (1) Ndi Okoko, where the palace of the Enachioken is situated; (2) Ndi Ihuezi Ihungwu, (3) Amaelunta-Umueso Ndiagbo and (4) Ndi Agbo-Oha, all in Amaeke. Amogudu and Agboji have their own traditional functions distinct from producing the Enachioken.

Naming traditions
Common Abiriba names include: Kalu, Eleanya, Ndukwo, Nnenna, Akuma, Oyediya, Nwojo, Nwanne, Agwu, Eke, Eme, Ogbonnaya, Agbai, Aluba, Enyindiya, Nnanna, Onwuka, Otisi, Mang, Ukegbu, Ukiwo, Nduka, Igwo, Inyiri, Dike etc. It is a common Abiriba naming tradition for parents to name their first son after the father's father and the first daughter after the father's mother.
Naming traditions are paternal-oriented, Abiriba is a matrilineal society: descent and inheritance are traced through the mother's family.

Achi tree
At the heart of Abiriba—the very center of the town—is a large, ancient tree "Okpu Achi" (Achi tree). The tree is both symbolic and spiritual in nature; and many believe that in the event of its fall, water from Okpu Achi would engulf the entire Abiriba land. Legend also has it that the Ishimokoto River is so mystical that when foreigners tried to leave town with a bottle of water from the river—the bottle broke apart and the water flew miles back to the river.

AROCHUKWU HISTORY

Ibibio Presence

Before Igbo arrival in the Aro territory, a Semi-Bantu group of the Ibibio arrived around 300 AD from the Benue Valley. They mainly inhabited the area now known as Southeastern Nigeria.. Prominent settlements were Ibom and Obong Okon Ita. These hunters and farmers perhaps lived peacefully until foreign settlers invaded.

Igbo Migration and Invasion
The Igbo migration led by Eze Agwu clan among the Ibibio in the Aro territory started around the 17nth century. These were merchants, land hungry people, and laboreres from the Igbo heartland. Tensions escalated between the Eze Agwu group led by Agwu Inobia and Obong Okon Ita kingdom led by Akpan Okon resulting in the Aro-Ibibio Wars. Neither group had a victorious position in the war. Eze Agwu asked Priest Nnachi of the Edda clan near Afikpo for help. The alliance also supported prince Kakpokpo Okon’s coup against his brother Akpan Okon. The war escalated and Nnachi called on Eastern Cross River allies for assistance.

Akpa invasion and the foundation of Arochukwu
Osim and Akuma Nnubi were Akpa merchant princes from the Akamkpa area. They led Akpa forces into the Aro territory to assist their Igbo allies to victory. However, this came at the cost of Osim losing his life at the start of the 18th century. With the Akpas and Igbos being victorious, the Arochukwu kingdom was founded with Akuma as its first king or EzeAro. After Akuma died, the Igbo took over the throne starting with Nnachi's son Oke Nnachi in 1720. Many changes occurred as Arochukwu expanded into 19 city-states due to the increasing population and Aro colonies were forming throughout the area now known as Southern Nigeria.

Aro Confederacy
By the mid-18th century, there were mass migrations of several Aro business families into the Igbo hinterland and adjacent areas. This migration, influence of their god Ibini Ukpabi through priests, and their military power supported by alliances with several related neighboring Igbo and eastern Cross River militarized states (particularly Ohafia, Abam, Abiriba, Afikpo, Ekoi etc.) quickly established the Aro Confederacy as a regional economic power.

Aro activities helped coastal Niger Deltacity-states become important centers for the export of palm oil and slaves. Such city-states included Opobo,Bonny, Brass, Calabar as well as other slave trading city-states controlled by the Ijaw, Efik and Igbo. The Aros formed a strong trading network, colonies, and incorporated hundreds of communities that formed into powerful kingdoms. The Ajalili, Arondizuogu, and Bende Kingdoms were the most powerful Aro states in the Confederacy after Arochukwu. Some were founded and named after Commanders and Chiefs like Izuogu Mgboko and Iheme whom led Aro forces to conquer Ikpa Ora and founded Arondizuogu. Later Aro commanders such as Okoro Idozuka also of Arondizuogu expanded the state's borders through warfare in the start of the 19th century. The Aro Confederacy's power, however, was mostly derived from its economic and religious position. With European colonists on their way at the end of the 19th century, things changed.

British Conquest
British Colonialism in the late 19th century turned Anglo-Aro relations sour. Aro leaders knew that Christianity, colonialism, and end of their monopoly would destroy Aro economic rule. Also the British felt that repeated Aro attacks rendered outright war inescapable. They made plans for war in 1899. The conflict had both religious and economic causes. Aro traders and the Royal Niger Company, had their own issues. An Aro invasion of Obegu in 1901 started the Anglo-Aro War. In 1902, following a direct attack on Arochukwu and months of fighting, the British were victorious. The Aro Confederacy's power was shattered, making it easier for the British to take over the Eastern Nigerian region although resistance in the area was far from over. Although Aro dominance crumbled in March 1902, many Aros took part in later resistances against the British in in the region such as Afikpo (1902–1903), Ezza (1905), and other areas where the Aro had a particularly significant presence.

Nigeria
When Nigeria won independence from Great Britain in 1960, ethnic tensions rose between the regions resulting in the Nigerian Civil War in 1967-1970. After the war, the Aros and the rest of the Igbo People suffered discrimination from other Nigerians. Many Igbo moved out of Nigeria. Aro culture suffered. However, they are currently efforts to unite Aro people and revive their culture.

References
Arochukwu Network Page

ABIA @ 20 PICTURES

HIV & AIDS SERIES (PART 1) BY DR. CHIN AKANO

HIV and AIDS SERIES PART 1

I observed that there is a lot of confusion among the public about this very serious condition and i will attempt to clarify some of these issues .

First i will explain what HIV is, and its relationship with AIDS

WHAT IS HIV?
HIV stands for human immunodeficiency virus. Anyone that contacts this virus is said to be having a HIV infection.

WHAT DOES AIDS MEAN?
AIDS stands for Acquired immuno deficiency syndrome. It is actually the late stage of HIV infection. AIDS on its own is not a disease but a group of diseases hence it is called a syndrome. I like to say at this stage that AIDS is no longer a common term used by medical professionals, it is now described as an advanced or late stage of HIV infection.

Before i go on to discuss the way one can catch this HIV infection, the symptoms, how to prevent it and how to treat it, i will make to discuss the two types of HIV infection one can contact.
They are as follows:

HIV-1
and
HIV- 2

HIV-1 is the type that was first discovered in 1981, more serious, highly infectious and virulent. This type is the cause of most cases of HIV infection globally.

HIV-2
This type is commoner in west africa, less infectious and less virulent.

HOW CAN HIV INFECTION BE TRANSMITTED?

The most common ways of getting HIV are:
• having unprotected sex, including vaginal, oral and anal sex and this constitutes the majority of all HIV infections
• using a contaminated needle or syringe to inject drugs
• from mother to baby during pregnancy, child birth, or by breastfeeding
• Through blood transfusion of blood contaminated by the virus
• Any other procedure where there is contact with infected blood like tattooing, ear piercing etc

So the body fluids that contain enough HIV to infect someone are:

seminal fluid

vaginal fluids, including menstrual fluids

breast milk

blood

the mucous found in the rectum

pre-cum (the fluid that the penis produces for lubrication before ejaculation)

You cannot catch HIV from:
• kissing
• contact with unbroken, healthy skin
• being sneezed on
• sharing baths, towels or cutlery
• using the same toilets and swimming pools
• mouth-to-mouth resuscitation
• contact with animals or insects such as mosquitoes

WHO IS AT GREAT RISK OF CONTRACTING HIV?
• men who have had unprotected sex with men
• women who have had unprotected sex with men who have sex with men
• people who inject illegal drugs
• people who have had unprotected sex with somebody who has injected illegal drugs
• people who have caught another sexually transmitted infection
• people who have received a blood transfusion
• people with genital ulcers
• commercial sex exposure

HOW DOES HIV CAUSE ILLNESS IN INFECTED INDIVIDUALS
When an individual contacts the virus, it gets into the blood stream and attacks the immune system and weakens ones ability to fight infections and disease such as cancer.
If the HIV is left untreated, it will destroy a type of white blood cell called CD4 T-cells, which play an important role in your immune system.
The number of CD4 blood cells that you have is called your CD4 count.
The lower your CD4 count is, the more likely you are to show signs of illness.
However, a low CD4 count is not an illness in itself.
Some people remain well when their CD4 counts get lower, at least for a while.
Other people with HIV may start developing symptoms even before their CD4 count is lowered.
It is when your immune system is reasonably compromised and your CD4 count falls so low that one begins to suffer those diseases that were classified as AIDS, now known as advanced or late HIV infection.
This may take up to 10 years or even more to happen depending on the individual, viral load, and environmental factors

WHAT ABOUT THE SLOW PROGRESSORS OR LONG TERM NON-PROGRESSORS (LTNP):
There are a few infected individuals who take a very long time before progressing to AIDS even without being on treatment. Sometimes it may take up to 20 years from when they are infected to develop AIDS even without treatment.
However if they don't receive treatment they will eventually progress to AIDS very slowly.
This people are said to have a very high immunity.

SOME GENERAL FACTS ABOUT HIV INFECTION

AIDS was first discovered in 1981

WHO reported that AIDS killed more than 1 million people every year from when it was first discovered till in 2006?

HIV infects about 0.6% of the world's population.
Treatment with anti-retrovirals increases the life expectancy of people infected with HIV.
Even after HIV has progressed to diagnosable AIDS, the average survival time with antiretroviral therapy was estimated to be more than 5 years as of 2005.
Without antiretroviral therapy, someone who has AIDS typically dies within a year.
Sub saharan africa remains by far the worst-affected region, with an estimated 22.5 million people currently living with HIV (67% of the global total), 1.3 million deaths (72% of the global total) and 1.8 million new infections (69% of the global total).

Watch out for part 2 where i will be telling you how the symptoms of HIV infection, the phases of the infection, how to prevent it, the treatment and prognosis.

Questions to Dr. Chin can be sent using our comments form below or to abiapost@gmail.com
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