DEPRESSION PART 1 By Dr. Chin Akano

DEPRESSION PART 1

This series shall be looking at the most common psychiatric illness of our time, Depression. This illness is often so serious that a lot of people suffering from it have a lot of physical and psychiatric symptoms. This disease is also so important to talk about because it is the commonest cause of suicide worldwide. About 1 million people commit suicide every year so this disease is an epidemic. Apart from being the most common mental illness, depression is ranked as the fourth among all diseases by WHO.

In this part 1, i shall be explaining what depression is, the causes, the risk factors and the symptoms.

I will begin by asking us who we think can suffer from depression? is it the disease of only women, or the elderly? No, depression can affect men, women and adolescents and occasionally children. However it is commoner in women and those aged between 30 and 40 years followed by those aged between 50 and 60 years.

The next thing is to know what causes depression. Do we know how people become depressed? The answer is that the exact cause of depression is not known, however some experts believe that depression is caused by a combination of biological, psychological, and social factors. Though no one knows the exact cause, there are however some factors and conditions that make some people more liable to developing depression than others. These are known as the RISK FACTORS.

So what are these risk factors for depression?

▪ Loneliness

▪ Lack of social support

▪ Recent stressful life experiences like bereavement, rape, serious accidents,
redundancy etc

▪ Family history of depression

▪ Marital or relationship problems

▪ Financial strain

▪ Early childhood trauma or abuse

▪ Alcohol or drug abuse

▪ Unemployment or underemployment

▪ Health problems or chronic pain

▪ female gender

▪ past history of depression

▪ other mental health problems like dementia



What are the symptoms of depression?

I like to say at this point that feeling down from time to time is a normal part of life and is not classed as depression. This is just temporary blues. Similarly it is normal for one to be sad from time to time that is also not depression.

For someone to be depressed, emptiness and despair must take hold of the person and refuse to go away making it very difficult for them to function and enjoy like they once did.

Hobbies and friends don’t interest them like they used to; they are exhausted all the time; and just getting through the day can be overwhelming and tasking to them.

For one to be diagnosed with depression: there must be at least these 2 cardinal symptoms
* The person must have a low mood for most of the times for at least 2 weeks
* The person must loose interest in things he used to enjoy. This again must be for most of the times for at least 2 weeks.
These symptoms should have been present persistently for at least 2 weeks and must have caused clinically significant distress and impairment for one to be said to be clinically depressed. It is also important to mention that these above symptoms must not be due to physical or organic reasons.
In addition to the above 2 cardinal symptoms, depressed patients may experience some or all of the following symptoms:
* Feeling tired so easily
* Appetite problems usually poor appetite but sometimes over eating
* Loss of concentration
* Loss of libido
* Erectile dysfunction in men
* sleep problems usually disturbed sleep. The classical pattern is early morning wakefulness where the patient wakes up quite early in the morning after struggling to fall asleep and then staying awake till morning. However some depressed patients may also suffer from over sleeping (hypersomnia)

* feeling hopeless
* feeling helpless
* Some may be agitated while others may become so slow and sluggish
* Some are unable to control their negative thoughts, no matter how much they try
*Some are quite irritable, short-tempered or more aggressive than usual
* Some drink more alcohol than normal and often engage in reckless behaviour.
* Some believe that life is not worth living
* Having a lot of physical complaints such as headaches, back pain, aching muscles, and stomach pain.
▪ * Having very strong feelings of worthlessness or guilt criticizing themselves for perceived faults and mistakes.

* Some feel so miserable and sad

*some feel as if even the smallest tasks are sometimes impossible.

▪ *Some don't want to see people or are scared to be left alone. Social activity may feel hard or impossible.

▪ *Some find it difficult to think clearly.

▪ *Some feel that they are a burden to others.

▪ *Some indulge in self harm

▪ * Some take their lives (Completed suicide)


▪ Some signs that can tell you that one is depressed:

* Looking sad

* Unkempt

* dishevelled

* Always blaming themselves

* feeling that they are the worst

* Always lacking confidence

* avoiding eye contacts

* Talks in low tone and frequency

* Slow movements

* drinking a lot of alcohol to feel better

* Not sleeping at night or sleeping a lot

* Always tired

* isolating themselves

Stay tuned for Part 2, coming your way shortly

Thanks

WELCOME TO ISUIKWUATO

After thorough searches online for literatures on Isiukwuato, nothing much was written about them or their culture except this:

"Isuikwuato is a local government area in Abia State in southeastern Nigeria. It has an estimated population of over 50,000 people. Isuikwuato contains many natural resources like Iron ore, Kaolin etc. Oil lines flow throw Isuikwuato and there have been cases of burst pipe which have had severe effects on the local economy and environment. The major cash crops are palm oil and cassava. Isuikwuato is also home to Abia State University Uturu.
Isiukwuato people are predominantly Christians. Catholic, Anglicans, Presbyterians and Methodists dominate other denominations but others such as Assemblies of God has made inroad into the place. The Isuikwuato Christian Organisation (ISUCCO) has helped to evangelise the communities.
Lambert Ndukwe, who was one of the richest men in Nigeria in 1950's, known for stock fish importation from Norway and cotton exportation to Europe is from Isuikwuato"

Abia Post announces it's scheduled first physical meeting with Abia Senior Citizen. With the cooperation of our dear brother, Oforegbu Mike, we've concluded arrangements to interview our first ever Abia Senior Citizen, from Isuikwuato.

Knowing Isuikwuato for what it represents and having birthed notable personalities, we decided to visit the senior citizens themselves who we believe have much cultural information in their archive. It promises to be a worthwhile visit. Note that (ASCI) Abia Senior Citizens Interview, will be conducted across each LGA of Abia State.

We are still collating information on Abia Senior Citizens. Let us know who yours are. Email details to us @ abiapost@gmail.com.

Stay tuned for our first ever ASCI coiming your way soon.

INFERTILITY PART 2 By Dr. Chin Akano

WHAT CAUSES INFERTILITY IN WOMEN


Let us first discuss some basic facts that will help us understand this topic.

For a woman to think of conceiving, first she needs to have normal reproductive anatomy.

What do I mean?

I am trying to say that she needs to be born with the following:

* a vagina ( Note that some women are born without one while some have issues with theirs)

* Womb (uterus)

* Fallopian tubes (tubes) left and right (2)

* Ovary (ovaries) left and right (2)

Even when she is born with all of these organs, they have to be normal and functional.

In a nutshell any problem with vagina, or womb or tubes or ovaries could lead to infertility.

Let me give some examples

* Vagina: absent vagina, or blocked vagina etc would lead to infertility

* Tubes: excessively long or blocked or diseased tubes could lead to infertility

* Ovaries: ovaries riddled with cysts, or not producing eggs or diseased are likely to lead to infertility
* Uterus: abnormally shaped or narrowed womb or one with abnormal linings or muscles or riddled with fibroids, masses or even diseased may lead to infertility.

Let me now go ahead and explain the importance of these reproductive organs


Vagina: This is the organ necessary for sexual intercourse to occur. Following intercourse the man deposits semen into the vagina and it swims through the vagina to the fallopian tube.

What is semen?
This is the fluid deposited by a man following ejaculation or masturbation. It contains spermatozoa (sperm), prostatic fluid, pre-ejaculate, fructose, amino acid , etc. Lesson to take away is that a man may produce semen without sperm in it and his semen will therefore be unable to fertilize the eggs ( ova). That a man ejaculated and produced semen does not mean the semen contains sperm or potent or enough sperm to fertilise the egg(s)
So for a man’s semen to be fertile, it must contact spermatozoa and other necessary components.

After semen is deposited in the vagina, the sperm swims through and gets to the fallopian tube and meet with the eggs waiting there and then fertilization occurs and an embryo is formed. This embryo then undergoes all necessary changes in the womb to become the baby we wish for.

Ovaries:

Every woman should have 2 ovaries, one on the left and another on the right. It is the ovary that produces the eggs (ova) and this happens once every month. This process is known as ovulation.
Both ovaries take their turn to produce eggs every month. So a woman does not need both ovaries to conceive but for obvious reason having both ovaries increase your chance of conceiving.
Ovulation usually takes place on the 14th day of a woman’s cycle if she has a regular cycle of 28 days. For those with cycles longer or irregular, it is difficult to time their ovulation.


Many women know when they ovulate as their cycle is like a clock and therefore easily predictable, however many women have irregular cycles and unpredictable ovulation.

So how can a woman know that she is ovulating?

There are a few features that can help a woman know when she is ovulating. They include the following

* marginal rise in base body temperature

* some vaginal discharge

* sharp one sided abdominal pain

* increased craving to have sex

* abdominal bloating

* breast engorgement among others



Fallopian tubes ( 2 in number)

After ovulation, egg(s) also known as ovum(ova) are released and they find their way to the fallopian tube to be fertilized by a sperm (champion sperm).

After ovulation, the next thing is fertilisation. What is this?

This is the process where a sperm and egg join together to form an embryo.

Where does it take place? In the fallopian tube

So the gist is that after ovulation the eggs move from the ovaries to the fallopian tube while the sperm migrates from the vagina to the tube as well to fuse with the egg to form the baby.

After fertilization in the fallopian tube, the fertilized egg or embryo stays there for a few days and then gradually finds its way into the womb ( uterus). If for any reason the embryo is not able to find its way into the womb, the baby starts developing in the tube. This is known as ectopic pregnancy. As the tube is not suited to accommodate the growing baby, after a while the tube burst causing some of the fatal emergencies associated with ectopic pregnancy.
In essence ectopic pregnancy means a pregnancy developing outside the womb. Please note that it is not only in the fallopian tube that ectopic pregnancy can occur, it can also occur in the ovaries, the cervix and even the abdomen.

Womb (Uterus)

When the fertilized egg (embryo) succeeds to get into the womb, it then gets attached to the lining of the womb. This process is known as implantation.
After implantation the embryo stays in the womb and undergo all necessary changes until the baby is born.

In conclusion for a woman to be fertile, first she has to anatomically normal and all the necessary reproductive organs have to be functional and normal.

Furthermore anything that affects the reproductive cycle ranging from depositing of the semen in the vagina, to the migration of the sperm to the fallopian tube, to ovulation, to migration of eggs to the tube, to fertilization, to movement of the fertilized egg to the womb, to implantation of the fertilized egg to the development of the baby in the womb would lead to infertility in a woman.

RANDOM LOCATIONS IN ABIA

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