Miscarriages, Stillborn and Rhesus Blood Group Incompatibilty

I am sure we all have learnt about the importance of knowing our Genotypes from the post Genotypes-aa as ac ss-know your compatibility. In this post I will explaining what Rhesus blood group (Rh) means and how it affects mother and her foetus or newborn. I received some questions relating to miscarriages and stillborn and I hope this topic shed some light into why these conditions happens. This topic is kind of complex so what I will do is to define some terms and go straight to the main issue. Kindly ask your questions in the comment box, if you are unclear about anything.

Firstly, in the human system, we have what we call antibodies and antigens. Antibodies are proteins produced by the body that help fight against foreign substances called antigens. Antigens are any substance that stimulates the immune system to produce antibodies. Antigens can be bacteria, viruses, or fungi that cause infection and disease.

Now, when we are asked what our blood group is...our answers are typically "O+ ,O-,A+,A-, B+ or B-, the fact is that these letters (ABO) and symbols (+-) actually represent two different blood group systems in one. Each blood group systems have their different antigens. The (+-) represents the Rhesus(Rh) blood group systems and Rh(D) is the most clinically important antigen. For example, someone who is A+ has the A antigen and the Rh(D) antigen, while someone who is A- lacks the Rh(D) antigen.

The significance of the Rh blood group is related to the fact that the Rh antigens cause very high immune response. This means that a person who does not have the RhD (i.e rhesus negative) will definitely produce an antibody for RhD when in contact with a RhD+ (i.e rhesus positive blood).
How will these bloods come in contact with each other, you would ask... Through blood transfusion and in mothers-to-be.

Now I am landing...Rh incompatibility is a condition that occurs during pregnancy if a woman has Rh-negative blood and her baby has Rh-positive blood. The mother's immune system produces antibodies that react against her baby's blood. The baby's red blood cells break down. The medical word for this process is haemolysis. These antibodies usually don't cause problems during a first pregnancy. This is because the baby is often born before many of the antibodies develop.
However, the antibodies will remain in the body once they have formed. Thus, Rh incompatibility is more likely to cause problems in second or later pregnancies i.e if the baby is Rh-positive. This can lead to serious problems such as brain damage, learning difficulties, deafness, blindness, jaundice and consequently miscarriages or still births.

An Rh-negative woman who conceives a child with an Rh-positive man is at risk for Rh incompatibility. Rh factor is inherited (passed from parents to children through the genes). If you're Rh-negative and the father of your baby is Rh-positive, the baby has a 50 percent or more chance of having Rh-positive blood. Rh incompatibility doesn't cause signs or symptoms in a pregnant woman.

Treatments are available. In mild cases, no treatment may be needed. If treatment is needed, the baby may be given a medicine called erythropoietin and iron supplements.
If the hemolytic anemia is severe, the baby may get a blood transfusion through the umbilical cord. If the hemolytic anemia is severe and the baby is almost full-term, your doctor may induce labor early.

Rhesus disease is uncommon these days because it can usually be prevented using injections of a medication called anti-D immunoglobulin.
All women are offered blood tests as part of their antenatal screening to determine whether their blood is RhD negative or positive. If the mother is RhD negative, she'll be offered injections of anti-D immunoglobulin at certain points in her pregnancy when she may be exposed to the baby's red blood cells.
 So in a nutshell, knowing your Rhesus compatibility status is as important as knowing your Genotype compatibility status to prevent any future complications.

Pharm G B. IDAMKUE

Reference:
1. link accessed on the 26th of July, 2018
2.link  accessed on the 26th of July, 2018

3. link  accessed on the 27th of July, 2018

4. link  accessed on the 28th of July, 2018
5. link  accessed on the 28th of July, 2018

C0DIENE DIET- Nourishing or Detrimental

In Nigeria, the fast rising craze is the “codeine diet”. Most of our youths are now addicted to codeine, they use it to manage their lives problems such as emotional pain and stresses due to the euphoria Codeine produces.

Cødeine is mostly used for the treatment of pain. When taken, Codeine targets pain transmitters but also stimulates the reward center of the brain leaving the user with intense feelings of well being and pleasure. This feeling is what leads to both psychological and physical dependence.

After prolonged use, an individual develops a tolerance for this substance and need to take more and more of the drug in other feel the effects.

Most people go as far as taking Cødeine with other substances such as alcohol etc, to increase the calming and euphoric feeling. Other people may take Codeine with stimulants like cocaine, rohypnol or “meth” in other to reduce the severity of unwanted side effects of the stimulants. This combination of uppers and downers can lead to cardiovascular failures.

Financial problems, domestic problems, loss of productivity at school or work, impaired social relationships, liver and kidney damage, muscle spams, cramps, pains, seizures, major depression, respiratory depression- slowly takes your breath and ultimately coma are the side effects of the use of codeine.

Unfortunately, the economic state of this nation has driven both the “lazy Nigerian youths”,“ the “CEO’s”, “the 8-5’s” and sadly our secondary school students to find solace in the hands of drug abuse. “Like I can’t even share a drink with someone if I’m not sure of its contents. Coke bottle is absolutely a No No for me.”

With most of our artistes singing about these drugs -I believe the government should also ban the promotion of drug abuse in any song,forgetting that they’re models to children and young adults who learn that drug abuse is an acceptable way of coping with problems. I stand with the millions of healthcare providers to tell you that drug abuse has never been and will never be the way out of our lives problems. 

In as much as the government are not helping matters. We now have several private parastatals (e.g Tony Elumelu Foundation) that are aimed to train, provide for and help establish youths that do not want to be in the “lazy Nigerian youth” category. Even churches such as DayStar amongst others have all joined in the struggle to raise better youths.

We ultimately have no excuse to be a lazy Nigerian youth on a Codeine diet.

With the recent ban on the production of Codeine, withdrawal symptoms of addicts might begin to manifest. They include craving of the drug, intense sweating, chills, runny nose, nausea and vomiting, suicidal thoughts, hallucinations. Please kindly contact a healthcare provider when such situation arises.

Kindly help share this post so our affected youths can be enlightened and hopefully slow down on their codeine diet. 

Do have a fulfilled week.

Pharm G B. IDAMKUE

Reference:

1. link Accessed on the 11th of May, 2018

2. link Accessed on the 12th of May, 2018

Symptoms Of The Most Common Types of Vaginal Infections

Bacterial Vaginosis is a condition where there is an overgrowth of a certain bacteria normally present in the vagina. It is due to imbalance of 'good' and 'bad' bacteria in the vagina. Having a new sex partner or multiple sex partners, as well as douching, can upset the balance of bacteria in the vagina -avoiding these can prevent the development of the infection.
 There is no research to show that treating a sex partner affects whether or not a woman gets Bacterial vaginosis. It rarely affects women who have never had sex. You cannot get Bacterial vaginosis from toilet seats, or swimming pools. Male sex partners of women diagnosed with infection generally do not need to be treated, but may be transferred between female sex partners



Yeast is believed to be present in the vagina of 20%-50% of healthy women. Vaginal yeast infections occur when new yeast is introduced into the vaginal area or when there is an overgrowth of the yeast already present in the vagina, for example, when the normal protective bacteria are destroyed by antibiotics taken to treat another infection. Yeast can also overgrow and cause infections in women with suppressed immune function.




Chlamydia is a common sexually transmitted infection that can infect both men and women. Chlamydia is found in infected semen and vaginal fluids. You can get chlamydia by having vaginal, anal, or oral sex with someone who has chlamydia without a condom, or sharing sex toys, or from a pregnant woman to her unborn baby.
Sexually active young people are at a higher risk of getting chlamydia. This is due to behaviors and biological factors common among young people. Gay, bisexual, and other men who have sex with men are also at risk since chlamydia can spread through oral and anal sex.

Trichomoniasis is a Sexually transmitted infection caused by a tiny parasite. You may not experience any symptoms with trichomoniasis, so it’s important to get tested. Trichomoniasis can be treated easily with a short course of antibiotics.

As with most Sexually transmitted infection, these infections puts you at risk of other Sexually transmitted infections, including HIV. A pregnant woman with these infections can pass it on to her unborn baby, which can affect the baby’s eyes and cause pneumonia. Untreated sexually transmitted infections can lead to other health problems like infertility.

If you have any of the symptoms, it is important to contact your health care practitioner. The symptoms of these conditions can also occur in more serious infections and conditions, so a correct diagnosis is important. These conditions can be effectively treated with antibiotics, and an accurate diagnosis ensures the choice of appropriate antibiotic treatment.

Pharm G B. IDAMKUE

Reference:
1.link accessed on 7th July,2018
2.link accessed on 7th July,2018
3.link accessed on 8th July,2018
4.link accessed on 8th July,2018

Stroke - Know The Signs And Act "FAST"

The term "Stroke" is medically defined as a sudden interruption of blood supply of the brain. This might be due to an abrupt blockage of arteries that are linked to the brain -ischemic stroke, or when a blood vessel bursts and bleeds into the brain tissue -hemorrhagic stroke. Stroke occurs rapidly and requires immediate treatment, therefore can also be called a brain attack. When the symptoms of a stroke last only a short time -less than an hour, it is called a transient ischemic attack (TIA) or mini-stroke.

Strokes may cause sudden weakness, loss of sensation, or difficulty with speaking, seeing, or walking. Since different parts of the brain control different areas and functions, it is usually the area immediately surrounding the stroke that is affected. The effects of a stroke depend on which part of the brain is injured, and how severely it is injured. Sometimes people with stroke have a headache, but stroke can also be completely painless. It is very important to recognize the warning signs of stroke and to get immediate medical attention if they occur.The most common sign of stroke is sudden weakness of the face, arm or leg, most often on one side of the body.

Other warning signs can include:

• Sudden numbness of the face, arm, or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

You can prevent stroke by making healthy lifestyle choices.

Healthy Diet: Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet can also lower your blood pressure. High cholesterol and high blood pressure increase your chances of having a stroke.  Be sure to eat plenty of fresh fruits and vegetables.

Healthy Weight: Being overweight or obese increases your risk for stroke. To determine whether your weight is in a healthy range, you can walk into any primary healthcare center or pharmacy to calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI. 

Physical Activity: Physical activity can help you stay at a healthy weight and lower your cholesterol and blood pressure levels. For adults, 2 hours and 30 minutes of physical activity, such as a brisk walk, each week will go a long way.

No Smoking: Cigarette smoking greatly increases your chances of having a stroke. If you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for stroke. kindly signify in the comment section if you need suggestions on ways to help you quit.

Limited Alcohol: Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than two drinks per day, and women only one.

According to W.H.O, Of the 56.9 million deaths worldwide in 2016, more than half (54%) were due to the top 10 causes. Stroke and Ischemic heart disease are the world’s biggest killers, accounting for a combined 15.2 million deaths in 2016. These diseases have remained the leading causes of death globally in the last 15 years.

kindly contact a healthcare provider if you are experiencing any of the above signs.

Happy Sunday!

Pharm G B.IDAMKUE

Reference:
1. link Accessed on the 28th of June,2018
2. link Accessed on the 29th of June,2018
3. link Accessed on the @9th of June,2018

Genotypes - AA,AS,AC,SS. Know Your Compatibility!

Last Tuesday, the 19th of June was the international sickle cell day.
On that day, I took time out to ask random people about their genotype and what they know about sickle cell anaemia. Most people “think” they have a certain genotype, others are not sure of that of their partners.

The term sickle cell disease (SCD) describes a group of inherited red blood cell disorders. People with SCD have abnormal haemoglobin( Haemoglobin is a protein in red blood cells that carries oxygen throughout the body),called hemoglobin S or sickle hemoglobin, in their red blood cells.
“Inherited” means that the disease is passed by genes from parents to their children.
SCD is not contagious. A person cannot catch it, like a cold or infection, from someone else.

People who have SCD inherit two abnormal hemoglobin genes, one from each parent. In all forms of SCD, at least one of the two abnormal genes causes a person’s body to make hemoglobin S. When a person has two hemoglobin S genes, Hemoglobin SS, the disease is called sickle cell anemia. This is the most common and often most severe kind of SCD.


With sickle cell disease, red blood cells contort into a sickle shape. The cells die early, leaving a shortage of healthy red blood cells (sickle cell anaemia) and can block blood flow causing pain (sickle cell crisis).
Infections, pain and fatigue are symptoms of sickle cell disease.





When the hemoglobin S gene is inherited from only one parent and a normal hemoglobin A gene is inherited from the other, a person will have sickle cell trait, AS. People with sickle cell trait are generally healthy.
Only rarely do people with sickle cell trait have complications similar to those seen in people with SCD. But people with sickle cell trait (AS) are carriers of a defective hemoglobin S gene. So, they can pass it on when they have a child.
If the child’s other parent also has sickle cell trait (AS) or another abnormal hemoglobin gene (like thalassemia, hemoglobin C, hemoglobin D, hemoglobin E), that child has a chance of having SCD.


Study this table below carefully:
AA + AA = AA, AA, AA, AA
AA + AS = AA, AS, AA, AS,
AA + SS = AS, AS, AS, AS,
AA + AC = AA, AA, AA, AC,
AS + AS = AA, AS, AS, SS,
AS + SS = AS, SS, SS, SS,
AS + AC = AA, AC, AS,SC,
SS + SS = SS, SS, SS, SS,
AC + SS = AS, AS, SS, SC,
AC + AC = AA, AC, AC, CC,

 Based on the table above, you can see that a person with the genotype AA can marry across. There’s no risk of having a sicklier for a child even when he or she marries an SS.
Someone with the genotype AS should only marry someone with the genotype AA because if AS marries another AS there’s one out of 4 chances (AS, AS, AA and SS) that they will have a child with the sickle-cell disease.
Same applies when AC is combined. AC and AS combine will produce AA, AS, AC, SC, the sickle-cell disease will be SC.
Of course there are many cases where two abnormal was combined that is an AS and AS or AC and AC or AC and AS couples and had up to five or six children without a single sicklier among them. But there is no need to risk it!
SC, SS, or CC are Sickle cell diseases.

 The symptoms of sickle cell-haemoglobin C disease are less severe than the symptoms of sickle cell disease. The main difference between SS and SC is the symptoms caused by each genotype.
Treatments include medication, blood transfusions and rarely a bone-marrow transplant.
People who do not know whether they carry an abnormal hemoglobin gene can ask their doctor to have their blood tested.
Couples who are planning to have children and know that they are at risk of having a child with sickle cell disease (SCD) may want to meet with counsellor.

Do have a wonderful week!

Pharm G B. IDAMKUE


Reference:

1. Hearing impairment in persons with the hemoglobin SC  genotype. Accessed here on 22nd of June, 2018
2.Diffference between SS and SC genotype. Accessed here on 22nd of June, 2018.
3. Sickle Cell Disease. National Heart, Lung and Blood Institute. Accessed here on 23rd of June, 2018.