Friday, May 25, 2012

HOW TO MANAGE PAIN

Posted  by
the best treatments for pain will depend on the part of your body affected
It’s impossible to go through life without hurting some part of you at some point. But the best treatments for pain will depend on the part of your body affected, the side-effects they cause, other conditions you might have and what you have taken in the past. Fortunately, these days there are lots of options available – so there’s no need to suffer in silence.

‘The pain ladder’

Paracetamol is an effective painkiller for mild pain and can be added to other painkilling medicines to increase their effectiveness. It is often used with drugs from the ‘opioid’ family, which includes codeine and morphine-based drugs.
To keep side-effects to a minimum, the World Health Organization has devised a ‘pain ladder’. If pain is not controlled at one step of the ladder, you move to the next step. The three steps are:
  • Paracetamol/aspirin.
  • Mild opioids (codeine-based tablets).
  • Stronger opioids (morphine-based).

NSAIDs – you may not recognise the name, but you’ve probably taken them!

NSAID stands for ‘non-steroidal anti-inflammatory drug’. They include ibuprofen (brufen or nurofen), diclofenac (voltarol), naproxen and several others. NSAIDs reduce pain and inflammation. They are especially effective for:
They also help with the achiness and fever of bad colds and ‘flu-like’ illnesses. But beware – in the long term, NSAIDs can cause quite a lot of side-effects (see below).

Nerve pain

The medical name for nerve pain is neuralgia. It can happen when a nerve is cut – such as after an amputation, after an infection affecting the nerve endings - such as shingles, in chronic conditions affecting the nerves - like diabetes, or if the nerve gets inflamed for no obvious reasons, as in conditions like trigeminal neuralgia (which affects one side of your face). Nerve pain often doesn’t improve with ‘normal’ painkillers. However, two groups of medicines can be particularly effective for nerve pain:
Amitriptyline - this drug is usually used to treat depression, but can work wonders in nerve pain.
Anti-epilepsy drugs - two drugs in particular (gabapentin and pregabalin) are often tried if amitriptyline isn’t effective. We know they work on the nervous system (which is why they help with epilepsy) but they’re being used more and more for nerve pain.

Risks and benefits

All tablets have side-effects. On the whole, the stronger the medicine, the worse the possible side-effects (think of the side-effects of cancer chemotherapy compared to paracetamol, for instance). Common side-effects of different drug groups include:
  • Aspirin – inflammation of the stomach lining and stomach ulcers, possible bleeding from the stomach.
  • Paracetamol – very few side-effects in recommended doses, although very dangerous for the liver in overdose.
  • Opioid painkillers – constipation, confusion.
  • NSAIDs – inflammation of the stomach lining and stomach ulcers, possible bleeding from the stomach; occasionally they bring on asthma, kidney failure.
  • Amitriptyline and anti-epilepsy drugs – drowsiness.


Wednesday, May 23, 2012

JINSI MALARIA INAVYOONGOZA KWA KUUA TANZANIA


Malaria yaongoza kwa kuua

23rd May 2012
Chapa
Maoni
Wagonjwa wa Malaria
Ugonjwa wa malaria umetajwa kuwa bado ni tishio nchini kutokana na kuongoza kwa kuua watu kati ya 60 hadi 200 kila siku.
Mganga Mfawidhi wa Hospitali ya mkoa wa Mwanza Sekou Toure, Dk. Onesmo Wakyedela, alitoa takwimu hizo jana na kuongeza kwamba takwimu zilizopo katika hospitali ya Sekou Toure zinaonyesha kuwa watoto chini ya miaka mitano ndio wanaofariki zaidi kutokana na malaria.
Kwa mujibu wa Dk. Wakyedela, mwaka 2011 asilimia 39 ya watu waliokufa kutokana na ugonjwa wa malaria  ni watoto, na kwa upande wa watu wazima walikuwa asilimia 25.
Mganga Mkuu wa mkoa wa Mwanza, Dk. Valentino Bhangi, alisema kuwa tiba sahihi na ya mapema ni njia sahihi ya kupambana na malaria na kuwashauri wagonjwa kufika hospitali kila wanapohisi dalili za kuumwa.
Meneja wa Benki ya Stanbic, Joshua Kyelekule, ambaye benki yake ilitoa msaada wa vyandarua 350 kwa hospitali hiyo, alisema  benki yao inatimiza wajibu wa kutoa misaada katika sekta ya afya ikiwa ni sehemu ya makubaliano kati yao na Shirika la Afya Duniani (WHO).


Thursday, May 17, 2012

MALARIA IN PREGNANT

In Africa, 30 million women living in malaria-endemic areas become pregnant each year. For these women, malaria is a threat both to themselves and to their babies, with up to 200 000 newborn deaths each year as a result of malaria in pregnancy.

Photo of pregnant women under mosquito nets
Pregnant women are particularly vulnerable to malaria as pregnancy reduces a woman’s immunity to malaria, making her more susceptible to malaria infection and increasing the risk of illness, severe anaemia and death. For the unborn child, maternal malaria increases the risk of spontaneous abortion, stillbirth, premature delivery and low birth weight - a leading cause of child mortality.
The problem has long been neglected, but new approaches and commitment offer hope for reducing the burden of malaria in pregnancy and improving the health of mothers and newborns.

Protecting pregnant women

Based on available evidence, WHO recommends a three-pronged approach to the prevention and management of malaria during pregnancy:
  • Insecticide-treated nets (ITNs)
  • Intermittent preventive treatment
  • Effective case management of malarial illness.
Sleeping under ITNs remains an important strategy for protecting pregnant women and their newborns from malaria-carrying mosquitoes. In addition, in areas of high and moderate transmission of Plasmodium falciparum malaria (the most prevalent type of malaria in Africa), intermittent treatment with an antimalarial drug is a cost-effective means of preventing malaria in pregnancy. The current recommendation is to give at least two doses of a safe and effective antimalarial (currently, sulphadoxine-pyrimethamine) to all pregnant women living in these areas.
In areas of low or unstable malaria transmission, pregnant women have low immunity to malaria and a two- to threefold higher risk of severe malarial illness than non-pregnant women. In these areas, use of ITNs and prompt case management of pregnant women with fever and malarial illness are the main strategies for malaria prevention and treatment.

Delivering malaria interventions through antenatal care

About two thirds of pregnant women in sub-Saharan Africa attend antenatal clinics at least once during pregnancy, presenting a major opportunity to prevent and treat malaria. The aim is to deliver this package - especially intermittent preventive treatment - to pregnant women as part of their routine antenatal care, using and strengthening the existing antenatal care infrastructure. This strategy is now an integral part of WHO’s “Making Pregnancy Safer” initiative, which aims to strengthen antenatal services and provide preventive measures, treatment, care and counseling to improve all aspects of health in pregnant women and their newborns.

Overcoming challenges

At the first African Summit on Malaria in Abuja, Nigeria, 2000, African heads of state committed to providing effective malaria interventions to at least 60% of pregnant women by 2005. To achieve this goal, several challenges must be overcome:
  • Delivery of malaria interventions through antenatal clinics in Africa needs to be widespread. This approach is currently the exception rather than the rule. However, large-scale programmes are now being developed, and several African countries are reviewing their policies in light of the WHO recommendations. A few have already adopted the strategy as policy.
  • Major issues of concern still have to be addressed. These include drug resistance and the safe and appropriate use of different antimalarial drugs during pregnancy. As resistance to antimalarial drugs increases, the challenges of treatment and prevention of malaria among pregnant women become greater. Research in this area is therefore a high priority. There is also a need for research to develop prevention strategies for women residing in areas of low or unstable transmission, and in areas where the Plasmodium vivax type of malaria is a problem in pregnancy.
  • Pregnant women who do not attend antenatal clinics or who attend only for the first visit or too late during pregnancy need to be reached. New strategies will be required to encourage these women to attend antenatal care early and consistently.
Within the Roll Back Malaria Global Partnership, WHO works with governmental, nongovernmental, bilateral and donor agencies to overcome challenges, meet the Abuja goal and reduce the burden of malaria in pregnancy. The availability of insecticide-treated nets, effective intermittent preventive treatment and a means of delivery through antenatal clinics, provides a unique opportunity that must be taken to protect the millions of African women who become pregnant each year, and their babies.