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Tuesday, July 16, 2019

Sickle Cell and Thalassemia Disease

Sickle cell disease and thalassemia are both genetic disorders that resulted from genetical errors for hemoglobin-a substance that is made up of protein and iron molecule responsible for carrying oxygen in the red blood cells. These orders can lead to fatigue, jaundice and episodes of pain ranging from mild to very severe. Sickle cell and thalassemia can be inherited especially from parents who pass an abnormal gene. When this occurs, both diseases can be severe or fatal.


Related imageSickle Cell Disease was discovered in the 1900s, formerly known as "peculiar, enlongated sickle-shaped erythrocytes (red blood cells)". Advancement in studies indicated that the pain sickle-cell patient go through is caused from a blockage of tiny blood vessels. Furthermore, several studies concluded that sickle cell disease is caused by an abnormality in the hemoglobin, referred to as "hemoglobin S". This is disease among other identified diseases was the first to be understood by scientists at the biochemical level due to the fact that researchers learned that the abnormal hemoglobin is actually changing form (called sickling) because of a single amino acid error in the hemoglobin S.

The underlying molecular cause of the disease has been understoond for over a century. Yet, progress in translating the knowledge to improvde patient care is slow; that is, reflects the challenges of treating the disease. In United States, health research and treated were neglected among the underserved population where they are more prone in developing the disease. In the early 1970s, just after the civil rights movements that it was recognized the fact that patients with sickle cell disease were an example of racial inequality in the healthcare. In addition to this, the Sickle Cell Disease Association of America was founded and eventually helped to establish the Sickle Cell Amemia Control Act of 1972. The government provided grants for screening research and treatment programs.

New treatment for the sickle cell disease were discovered as scientific progress and technology evolved. The Prophylactic Penicilin Study (PROPS) shows that administering penicilin (an antibiotic) to unsick patients could prevent death caused by serious infections in sickle cell disease. Also, the Multicenter Bone Marrow Transplant Study illustrated that 84% of children who were diganosed with the disease could be cured after receiving  a bone marrow transplant from a matched donor or family member. Mid 1990s, the U.S Food and Drug Administration authorized a new therap called Hydroxyurea as a form of treatment to reduce further complications of the disease. "Hydroxyurea works in part by stimulating the body to resume production of fetal hemoglobin (hemoglobin F), a normal hemoglobin in the fetus that prevents sickling".


This is an inherite blood disorder characterized by low hemoglobin and fewer red blood cells in the body compared to normal. In 1925, Thalassemia or Mediterranean Anemia was first described by a Detroit physician who studied Italian children with severe anemia (low levels of red blood cells), poor growth, huge abdominal organs and early childhood death. In 1946, the cause of thalassemia was discovered to be an abnormal structure in the hemoglobin. The body destroys the red blood cells, resulting to Anemia. The body tries to make red blood cells quicker than normal as a means of compensating for the loss; however, this can lead to other thalassemia complications such as bone abnormalities and spleen enlargement.

Related imageIn the year if 1960, doctors started transfusing fresh red blood cells to patients with thalassemia every month to treat the disease. This mitigated most of the symptoms in childhood and had a huge impact in the survival rate of thalassemia patients; this treatment is currently in practiced. Nonetheless, since blood contains a large amount of iron, most patients died during their teenage years from the damaged caused by too much iron. Moreover, researched discovered that surplus iron amount can be removed from the body through by a drug called desferoxamine. The drug has prevented iron-induced heart disease and has improved the life expectancy of patients. Recently, there is availability of two oral drugs that aid in removing iron, which has improved the quality of life of the patient with excess iron from blood transfusion for thalassemia. On the other hand, specialized imaging test can detect iron in the heart and also permit patient to be treated to prevent iron-related heart failure.


Tuesday, July 9, 2019

Violation Of Human Rights in Nigeria: What Is Going On Now!

Infringement of human rightsIn Nigeria, human rights are being violated by the justice system such as the police. These days, the police have broken the code of conduct of human rights that includes unlawful killings, torture and other ill-treatment as well as enforced disappearances. The conflict in Niger Delta poses as a threat to the safety and lives of the Nigerian residents. Human right advocates and journalists are intimidated and harassed for expressing their voice. Women still face the violence, which is widespread across the country, and unfortunately the government has shown no interest so whatever to protect the rights of the children. Furthermore, millions of citizens face eviction in the country.  

Although the government has given its pledges to foresee the challenges in the criminal justice system of Nigeria, there is little or no progress to address the issue. The Nigerian Police Force (NPF) has no regard for human rights; people are subjected to illegal killings by the police either during or before arrest, or along the streets. A majority of the armed forces that perform such crimes are left unjustified by the legal system of Nigeria (the court).  


Saturday, February 2, 2019

Understanding The Aboriginal People

The residential schools were government owned and sponsored by a religious system established to assimilate the aboriginal children in the Euro-Canadian tradition. Despite the fact that the first residential facilities were in the New France, it was usually referred to as a custodial school that was introduced after the
1880s. Originally created by the Christian churches, the Canadian government attempted not just to educate them and convert their culture and adapt them into the Canadian society, but the residential schools also disrupted the lives of the native population and communities; thereby, resulting to a long-term problem among the indigenous persons.  

The institution forcefully separated children from their families for a long period of time and banned them to recognize their Aboriginal heritage and culture or speak their native languages. The children were critically sanctioned if they did not obey the strict rules enforced by the school. The children faced abuse from the staff of the residential school staff such as physical, sexual, emotional, and psychological abuse. They were taught with an inferior curricular structure, which is normally taught up to the 5th grade. These lessons were focused mainly on manual labor in agriculture, light industry (e.g woodworking), domestic work such as laundry and sewing. Furthermore, any studies indicated that a lot of children were beaten and strapped, shackled on their beds and the rest of the children were punished by having needles shoved on their tongues as a consequence of speaking their language. These abuses were also followed with overcrowding, poor sanitation and inadequate food and access to healthcare. The medical inspector PH Bryce reported 24% of death rate among the aboriginal population within the school around the year of 1907.  


Sunday, December 9, 2018

Lymphomas Cancer in Nigeria

Lymphomas are a heterogeneous group of neoplasms of lymphoid tissues, each with distinct clinicopathological features that varies to different response to treatment1 

The finding from the report of Ferlay showed that the cancer rate occurring in Sub-Saharan Africa, Hematolymphoid Malignancies has merged as a major cause of morbidity and mortality with lymphomas and other hemotologic malignancies such as leukemia and multiple myeloma together accounted for 8.7% of incident cancer diagnoses and 9.9% of cancer deaths in 2008. Annual incidence has estimated a rate as low as 30,000 and as high as 278,000 of Non-Hodgkin Lymphoma (NHL) in Sub-Saharan Africa. This has made it one of the most common cancers in the region. Other studies have indicated that in most Nigerian Tertiary Hospitals, Lymphomas, mostly NHL are ranked among the leading cancers2 

Between the year 1960 and 1975 an estimate of 100 patients with Non-Hodgkin's Lymphoma were admitted to the University College Hospital in Ibadan, Nigeria. The related cases were analysed in respective to the clinical findings, histological classification and response to therapy. Majority of the patients (87%) had reticulum cell sarcoma with a high ratio of men than women (2:1). The applied therapy consisted mainly of single-agent chemotherapy, but a few of the patients had either surgical excision combined with chemotherapy or multiple-agent chemotherapy. The derived results were poor as a result of high default rate, late presentation, inadequate supply of drugs and the lack of radiotherapeutic facilities3 

“The contemporary management of these neoplasms requires that they are accurately diagnosed, categorized by sub-typing according to the WHO system of classification”4. These classifications are multiparametric approach requiring clinical, morphological, immunological, cytogenetic and molecular techniques. The impact of this can be reflected in the resource-rich settings where treatment of those malignancies is increasingly related with unprecedented rates of long-term cure and control. Diagnosis of lymphomas cancer remains as a big challenge in Sub-Saharan Africa, because of inadequate facilities5 

Thursday, October 25, 2018

Leukemia in Children-Canada

Leukemia is the most commonly diagnosed cancer in children in Canada.
It can take several years to collect and confirm cancer data, so the number of new cancer cases and deaths from recent years may not be available for some time. The most recent data available are provided.
The most recent incidence and mortality statistics for leukemia in children aged 0 to 14 years are from 2009 to 2013.
  • 1,445 Canadian children were diagnosed with leukemia.
  • 145 Canadian children died from leukemia.
  • 1,130 Canadian children were diagnosed with acute lymphoblastic leukemia and 59 died from it.
  • 180 Canadian children were diagnosed with acute myelogenous leukemia and 57 died from it.

Children with leukemia and their parents may have questions about prognosis and survival. Prognosis and survival depend on many factors. Only a doctor familiar with a child’s medical history, type of cancer, characteristics of the cancer, treatments chosen and response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognosis is the doctor’s best estimate of how cancer will affect the child, and how it will respond to treatment. A prognostic factor is an aspect of the cancer or a characteristic of the child that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together and they both play a part in deciding on a treatment plan and a prognosis.
Prognostic factors can vary depending on whether the child has acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML)

Tuesday, October 23, 2018

Canadian Healthcare Funding

The Canadian healthcare system is predominately public, with 70% of healthcare funding coming from the public-sector and the remaining 30% from the private-sector (Canadian Institute for Health Information, 2016). It is estimated that health spending in Canada will be $228.1 billion in 2016, or approximately 11.1% of GDP, the majority of which goes to hospitals (29.5%), drugs (16%) and physicians (15.3%) (Canadian Institute for Health Information, 2016). Since 2005, physician compensation as a portion of total health spending has increased but since 2014, the share has slowed and is now maintaining levels comparable to those of the late 1980s (Canadian Institute for Health Information, 2016).
Spending on healthcare varies across Canada, but on average provinces spend approximately 38% of their total budgets on healthcare (Canadian Institute for Health Information, 2016). Per capita spending in 2016 for all of Canada is projected to be $6,299, but spending by province ranges from $5,822 in Qu├ębec to a high of $7,256 in Newfoundland and Labrador (Canadian Institute for Health Information, 2016).
Global Budget is the most common healthcare funding in Canada, where a fixed amount of payment is allocated to a provider (such as the health authority or hospital), which covers the operating expenses for a period of time, usually a year. Most Canadian provinces have their healthcare regionalized-the local or regional health authorities are responsible for the delivery of primary health services. In most province, the government allocates funding to health authorities through a global budget and many health authorities, in turn, use global budgets to fund specific groups of services. In Canada, most hospitals, long-term care facilities, publicly-funded rehabilitation facilities and mental and public health programs are funded under global budgets (Sutherland et al., 2013). Funding amounts are typically based on factors such as historical budgets, inflation and politics, and are provided irrespective of the number of patients or levels of demands on resources (Sutherland & Repin, 2012).
Global budget is an effective means of controlling healthcare expenditure growth by the use of spending "caps". It provides financial predictability for administrators and policy makers (Wolfe & Moran, 1993Antioch & Walsh, 2004). Its only weakness is the impetus to meet the budget target. Providers may restrict the access to services or limit the number of hospital admissions. Global budgets covers little incentive for innovation or improve the healthcare efficiency (Sutherland & Crump, 2011), since global budgets do not provide opportunities for increased revenue of patient, healthcare providers have no incentive to shorten patient lengths of stay or to discharge patients to lower cost healthcare settings (Sutherland et al., 2013). Global budgets do not promote coordination across service providers in acute and post-acute settings, creating a fragmented healthcare system that is often associated with inefficiencies and reduced quality of care (Sutherland & Crump, 2011Sutherland & Repin, 2012).

Sunday, October 21, 2018

Child Mortality Rate in Nigeria

About 10% of new born deaths in the world occurred in Nigeria in the year of 2017, a new report of the United Nations Children Fund, according to UNICEF.  

The report states that five countries are accounted for half of all new-born deaths within the year, inclusive with Nigeria as the third country in the list. India had 24%, Pakistan 10%, Nigeria 9%, the Democratic Republic of Congo 4% and Ethiopia 3%. Most new-born deaths occurred in Southern Asia of 39 per cent and Sub-Saharan Africa 38%.  The report indicated that 15000 children died globally at the age of 5 in the year of 2016, with at least 46% of deaths within the first 28 days of life.  

WHO issued a press conference in 2017 stating that there is a new study “Levels and Trends in Child Mortality”, revealing, although the number of children dying before the age of 5 is at a new low-5.6 million in 2016, compare to that of 9.9 million in 200. The proportion of under-five deaths in new-born increased from 41 to 46 per cent during the same period.  

The UNICEF Chief of Health, Stefan Peterson, said “though the lives of 50 million children under-five have been saved since 2000 through increased level of commitment by governments and development partners to tackle preventable child deaths, more still needs to be done to stop babies from dying the day they are born, or days after their birth. “We have the knowledge and technologies that are required – we just need to take them where they are most needed.” 

According to the report released by UNICEF, the World Health Organization, the World Bank and the Population Division of UNDESA, which make up the Inter-agency Group for Child Mortality Estimation (IGME), at current trends, 60 million children will die before their fifth birthday between 2017 and 2030, half of them new-born. 

The Nigerian Minister of Health, Isaac Adewole, had earlier this year described the high mortality rate of under-five in the country as unacceptable. “He said the government has however made significant progress in reducing the rate of new-born deaths in the country as it has declined from 201/1000 live births to 128/1000 live births in 2013”. 
Nigeria loses a total of 2,300 under-five year olds and 145 women of child bearing age per day, making the country the second largest contributor to under-five and maternal mortality rate in the World. Latest reports states that many lives would be save on the circumstances of decrease in global inequalities.  

If all countries achieved the average mortality of high-income countries, 87 per cent of under-five deaths could have been averted and almost 5 million lives could have been saved in 2016. 
Tim Evans, Senior Director of Health Nutrition and Population at the World Bank Group said “it is unconscionable that in 2017, pregnancy and child birth are still life-threatening conditions for women, and that 7,000 new-borns die daily”. 

“The best measure of success for Universal Health Coverage is that every mother should not only be able to access health care easily, but that it should be quality, affordable care that will ensure a healthy and productive life for her children and family". 

“We are committed to scaling up our financing to support country demand in this area, including through innovative mechanisms like the Global Financing Facility (GFF)”, he said. “Pneumonia and diarrhoea top the list of infectious diseases which claim the lives of millions of children under-five globally, accounting for 16 per cent and eight per cent of deaths, respectively”.

Sunday, October 14, 2018

Health Crisis in Syria

Image result for health in syria

According to WHO, attack rate on the health sector in Syria has continued to increase over the past years. There has been 67 verfied attacks on the health facilities, workers and infrastructure within the first two of 2018, and about 50% of verified attacks in the year of 2017.  

Dr. Tedros Adhanm Ghebreyesus General Director of WHO, stated that “this health tragedy must come to an end”. “Every attack shatter communities and ripples through health systems, damaging infrastructure and reducing access to health for vulnerable people. WHO calls on all parties to the conflict in Syria to immediately halt attacks on health workers, their means of transport and equipment, hospitals and other medical facilities.” 

The attacks on the health system occurs in the most needed places for medical attention. An estimate of 2.9 million Syrians is living in the UN-declared hard-to-reach and besieged locations, with the collaboration of the World Health Organization providing health services to the areas that lacks access to healthcare.  

About 400,000 individuals are living under siege for half a decade in East Ghouta, running out of the most basic health supplies in the area, with at least 1000 people in urgent need of medical evacuation. “It is unacceptable that children, women, and men are dying from injuries and illnesses that are easily treatable and preventable,” said Dr Tedros. 

70% of health supplies provided by the WHO aimed to reach East Ghouta were restrained by the authorities and sent back to the warehouse of the World Health Organization. The confiscated items were desperately needed to save the lives of the population, as well as decrease the suffering rate. The medical supplies are also routinely removed from the inter-agency convoys to the hard-to-reach and besieged locations.  

Seven years of conflict has affected the healthcare system in Syria. At least half of the country’s public hospitals and healthcare centres are shot down or in bad conditions to function. More than 11.3 million people are seeking for the immediate health assistance possible, with 3 million injured and disabled people.  

WHO ensures that the people in Syria have access to the essential supplies, life-saving healthcare and has delivered more than 14 million treatments and medications in the country, which includes cross-border and cross-line services.  

“The suffering of the people of Syria must stop. We urge all parties to the conflict to end attacks on health, to provide access to all those in Syria who need health assistance, and, above all, to end this devastating conflict,” said Dr Tedros.