BODY ODOUR. By Dr Kemi Agbaoye of medik247

I was on a flight to Abuja from Lagos once. I boarded early, found my seat, and got ready to enjoy the one hour flight. There were three seats on my side of the aisle and I had the window seat. I was glad because it looked like I was going to have the entire row to myself, but at the last minute, someone came and took the aisle seat, and with him came this really strong garlic-like odour. It was so strong that I had to reopen the vent I had closed earlier because I was cold. Better to be cold than to choke you know? Yet, I struggled most of the flight. I was shivering AND choking. Oh well. Garlic does have a lot of health benefits, and Asians know it. He was Asian.

 *BODY ODOUR:*

 *Definition:*
Known medically as Bromhidrosis or Osmidrosis is a chronic condition in which excessive odour, usually unpleasant, emanates from the skin.
Truth is everyone has an odour, but when it becomes unpleasantly excessive, and starts to affect the quality of a person's life, then there's a problem.

It is most common in postpubertal people (because the most common type only occurs after puberty) and Asians have been documented to be most dominantly affected, mostly because of their diets and clinical visits on account of resultant depression. A positive family history of Bromhidrosis in them is also a strong predisposing factor.
It is also more common in males than in females.

Pathophysiology*
How does it happen? There are two major types of sweat (human secretory) glands in the body;
 *The Apocrine glands*
These glands are found mostly in the axilla (arm pits), genital skin, and breasts. Some are also found in the periorbital (around the eyes) and periauricular (around the ears) areas. They are found in the reticular dermis and subcutaneous tissue and are controlled by the sympathetic nervous system. They are responsible for Pheromonal odours (basically that unique smell that everyone has that's distinct to them and makes them sexual attractive). They are not responsible for thermoregulation. They are larger. *Apocrine Bromhidrosis* is therefore, more common and it occurs when there is bacterial decomposition (commonest of which is corynebacterium species) of apocrine secretion, which yields Ammonia and Short chain Fatty acids, which have strong odours. The secretions by themselves are odourless. Bacterial action on them give rise to the unpleasant odour.

 *The Eccrine glands* are found all over the skin surface and are found in the dermis. They are responsible for thermoregulation via the production of sweat. *Eccrine Bromhidrosis* occurs when eccrine sweat softens Keratin (in hair follicles) and then bacterial degradation of this keratin yields a foul smell. Ingestion of garlic, onion, curry, alcohol, drugs (like penicillin and bromides) and toxins all predispose to Eccrine Bromhidrosis because they lead to excessive sweating ( *Hyperhydrosis* ). Excessive sweating leads to more softening of keratin, which in turn leads to more bacterial degradation.


*Precipitating Factors*
Are there things that can predispose you to having a body odour? YES! They include;
●Inadequate hygiene
●Medical or   dermatological conditions associated with Hyperhydrosis or over growth of bacteria, which include;
° Obesity
° Diabetes Mellitus
° Intertrigo
° Trichomycosis axillaris
°  Erythrasma
Others include
● Post - Laser treatments
● Foreign body in the nose in children
● Gout
● Scurvy
● Typhoid.

Symptoms and Signs*
The odour is usually mostly axillary (from the arm pits). It's described as pungent, rancid, musty or sour. The other common sites include the genital area and the soles of the feet.
There are usually no significant physical signs to be demonstrated by the physician, except in cases where there are concurrent illnesses, for example, fungal infections like Trichomycosis axillaris in which concretions are seen at the root of the hair follicles in the armpits.

*Investigations*
Not really indicated here; it is a clinical diagnosis. However, in cases of other concurrent illnesses, or where they are suspected, tests are requested for in that line.

*Treatment*
So what do you do when you can't seem to be able to get rid of that smell? (Please note that you should confirm that you actually do stink!!! Ask your loved ones! They say only someone who loves you will tell you that you stink. This is for such cases. Not people who "imagine" that they stink. 😉).
*Health Education*
Very important.
■ Use antibacterial soaps
■ Use antiperspirants
■ If you wear clothes with dried sweat on them, you will stink!
■ Avoid excessive intake of spicy food. Reduce your garlic, curry, e.t.c 🙂
■ Reduce Alcohol!
■ And while you're at it, stop smoking!!!
In other words, reduce the amount of toxins you load your body up with.🙂
■ Oh yeah, wash your armpits! Shave too!

*Medical Treatment*
■ Topical antibiotics can be used when disinfectants fail.
■ Treat underlying skin conditions like Intertrigo, Erythrasma and Trichomycosis axillaris
■ Botulinum toxin: please see your doctor! It basically aims to reduce sweat production by inhibiting the nervous system.

*Surgical Treatment*
Reserved for severe cases, especially those in psychological distress. Common among Asians.
■ Some of the Apocrine sweat glands with cellular and subcutaneous tissue  in the armpits can be removed, leaving behind the skin.
■ Superficial Liposuction Curretage; in which a tube is attached to the armpits and subcutaneous fat is drained out.

*Conclusion*
Body Odour is a medical condition caused by over secretion of apocrine or eccrine glands that becomes malodorous on bacterial breakdown. It can be managed by certain health practises, but when those fail, please seek medical help, because it has been found to be a source of social and psychological distress.

MYTHS ABOUT FEMALE VIRGINITY.

Bleeding doesn't determine a girl is a virgin so I decided to release this article to help educate our young men and women on this issue of girls bleeding during first time sex.

There's a very common myth in South and Central Asia (Pakistan, India, Bangladesh, Afghanistan etc.) and Africa (Nigeria and many other nations ) that you can tell if a woman is a virgin, by whether or not she bleeds the first time she has sex. There is zero truth in this. Not all women bleed the first time they have sex, as I'll explain in this post.
To understand why some women bleed and some don't, it's very important to understand what the hymen is. The hymen is a membrane that tends to cover part of the vaginal opening (it does not always block or cover the entire vagina, as some people mistakenly think). NOT ALL WOMEN HAVE A HYMEN. The hymen also differs from woman to woman - like all women have different heights and weights and features, all women also have different amounts and types of hymen. Some women have thick hymens, some have very thin hymens, and some women have NO hymens at all. Some women have larger hymens, some women naturally have a very little amount of hymen that covers only a small portion of their vaginal opening (and hence does not really get in the way, during first-time sex).
In addition to this, the hymen wears away on its own as you grow up. For most women, the hymen wears away on its own with exercise, bicycling, horseback riding - it can wear off with pretty much any other physical activity, even dancing! - or from using tampons when menstruating. Especially if the hymen is very small or thin, most of it tends to wear away on its own as a girl grows up.
If a woman is born WITHOUT a hymen, she won't bleed the first time she has sex. If a woman has a small or thin hymen, she might not bleed the first time she has sex. If a woman's hymen has worn away on its own (which is very common as girls grow up), she won't bleed the first time she has sex. The result is that the overwhelming majority - at least 63% of women - will NOT bleed the first time they have sex, according to a study published by the British Medical Journal. Women who do bleed include:
- Women with thick hymens (who constitute a small percentage of the population)
- Younger girls. Because the hymen wears away on its own with time, a 16-year old has a higher chance of bleeding than a 25-year old. By the time a girl is of or above the legal age of consent - 18, 20, 24 years of age, for example - most of her hymen is likely to have worn away on its own, meaning it's unlikely that she'll bleed a lot, if at all. However, even a young girl can be physically active, have a thin or small hymen, or have no hymen at all, meaning she might not bleed during first-time sex.
- Most often, women who bleed tend to be women who are dealt with roughly during sex. If the guy forces himself inside the girl, when she isn't ready, relaxed or aroused enough, he is likely to cause injury or bleeding. Because most people think it's normal for women to bleed the first time they have sex, they don't realize that this bleeding is a result of the woman having been hurt, and not of the hymen 'breaking.' Painful first-time sex is generally because the woman is not relaxed or aroused enough, and gets hurt as a result; it is rarely ever because of the hymen breaking.
The bottom line is that there is no way to assess female virginity. Bleeding does not have anything to do with virginity - it has to do with the kind of hymen a girl has, and hymens differ from girl to girl from birth. The result is that only a small percentage of women bleed the first time! (Only 37% bleed during first-time sex, according to the study published in the British Medical Journal.)
Why is this so important to be aware of? Women all over the world get abused, injured and even killed due to the myth of 'virgin bleeding.' Because most people (men AND women) think that bleeding is a sign of virginity, women who don't bleed the first time have been divorced, suffered from suspicion leading to domestic violence and abuse, and even killed for honour. Educating people that a girl does not necessarily have to bleed the first time she has sex - because not all girls have thick hymens, and some are born with no hymen at all - is important because it can literally save lives.
P.S: I understand that not everyone is able to share material like this, even if they want to. However, the only way we can educate people regarding this issue is if it goes into the newsfeeds of as many people as possible, if as many people as possible read it. So please consider sharing.  We need to make content like this visible to increase its reach, to educate people, to have impact.

HYPOTENSION. By Dr M Okenwa of medik247

This is the opposite of hypertension. It is when blood pressure is below 90/60mmHg.
If the BP falls gradually, it does not usually constitute a problem. But if the fall is sudden, there is noticeable symptoms which sometimes might be life threatening.

In practice however, blood pressure is too low only when it presents with noticeable symptoms.

Symptoms;
-dizziness
-thirst
-fatigue
-cold clammy hands and legs
-fast breathing
-blackouts
-lack of concentration
-pale skin
-fainting
-headache
-light headedness
-dark urine
-absence of sweat
-in extreme cases, unconsciousness.

Causes of hypotension:

-dehydration
-low blood sugar
-low blood level
-bleeding(blood loss)
-pregnancy
-thyroid conditions (hypothyroidism)
-excessive loss of fluid (diarrhoea and vomiting)
-adrenal insufficiency
-some heart conditions
-severe allergic reactions (anaphylaxis)
-antihypertensives like diuretics and alpha blockers
-lack of vitamin B12 and folate
-Viagra and other vasodilating drugs


TYPES

Orthostatic( sudden fall in BP as one stands up). Also called postural hypotension

Post prandial hypotension( happens after heavy food)
Vagovagal syncope (inappropriate nerve signal causing sudden fall in BP)

Shydrager syndrome

RISK FACTORS FOR DEVELOPING HYPOTENSION

*medication
*Age
*Some disease conditions

COMPLICATIONS

-Falls
-Inability to perform daily routines and duties.

DIAGNOSIS

See a doctor.
You will be interviewed and examined.
BP check using sphygmomanometer can confirm hypotension.
Tests like blood tests, ECG and others may be done.

TREATMENT

Treatment of the underlying cause
Withdrawal of causative drug
Increased salt intake
Drinking of more water and less alcohol
Volume resuscitation and blood transfusion
Early morning dose of caffeine can help.

LIFESTYLE

More water, less alcohol
Healthy diet.
Get up slowly (in orthostatic hypotension)
Eat small, low carbohydrate meals(in post prandal hypotension)

MONKEY POX OUTBREAK IN BAYELSA STATE, NIGERIA.what you should know.

Monkey pox virus outbreak was announced yesterday in Bayelsa region of Nigeria where over 10 persons including a medical doctor were diagnosed and quarantined. Here is what you should know about the virus

Monkeypox is an infectious disease caused by the monkeypox virus. The disease was first identified in laboratory monkeys, hence its name, but in its natural state it seems to infect rodents more often than primates. The disease is indigenous to Central and West Africa. An outbreak that occurred in the United States in 2003 was traced to a pet store where imported Gambian pouched rats were sold.

Monkeypox virus is a zoonotic viral disease that occurs primarily in remote villages of Central and West Africa in proximity to tropical rainforests where there is more frequent contact with infected animals. Monkeypox is usually transmitted to humans from rodents, pets, and primates through contact with the animal's blood or through a bite. Human monkeypox can be difficult to distinguish clinically from smallpox (to which it is closely related) and chickenpox (to which it is not).

Monkeypox virus which causes the disease in both humans and animals was first identified in 1958 as a pathogen of crab-eating macaque monkeys (Macaca fascicularis) being used as laboratory animals. The crab-eating macaque is often used for neurological experiments. Monkeypox virus is an Orthopoxvirus, a genus of the family Poxviridae that contains other viral species that target mammals.

The virus was first discovered in monkeys (hence the name) in 1958, and in humans in 1970. Between 1970 and 1986, over 400 cases in humans were reported. Small viral outbreaks with a death rate in the range of 10% and a secondary human to human infection rate of about the same amount occur routinely in equatorial Central and West Africa. The primary route of infection is thought to be contact with the infected animals or their bodily fluids. The first reported outbreak in the United States occurred in 2003 in the midwestern states of Illinois, Indiana, and Wisconsin, with one occurrence in New Jersey. The outbreak was traced to a prairie dogs infected from an imported Gambian pouch rat. No deaths occurred.

The virus can spread both from animal to human and from human to human. Infection from animal to human can occur via an animal bite or by direct contact with an infected animal’s bodily fluids. The virus can spread from human to human by both respiratory (airborne) contact and contact with infected person's bodily fluids. Risk factors for transmission include sharing a bed, room, or using the same utensils as an infected patient. Increased transmission risk associated with factors involving introduction of virus to the oral mucosa. Incubation period is 10–14 days. Prodromal symptoms include swelling of lymph nodes, muscle pain, headache, fever, prior to the emergence of the rash.The rash is usually only present on the trunk but has the capacity to spread to the palms and soles of the feet, occurring in a centrifugal distribution. The initial macular lesions exhibit a papular, then vesicular and pustular appearance.

Prevention and treatment
Currently, there is no proven, safe treatment for monkeypox. Smallpox vaccine has been reported to reduce the risk of monkeypox among previously vaccinated persons in Africa. The decrease in immunity to poxviruses in exposed populations is a factor in the prevalence of monkeypox. It is attributed both to waning cross-protective immunity among those vaccinated before 1980 when mass smallpox vaccinations were discontinued, and to the gradually increasing proportion of unvaccinated individuals.

 The United States Centers for Disease Control and Prevention (CDC) recommends that persons investigating monkeypox outbreaks and involved in caring for infected individuals or animals should receive a smallpox vaccination to protect against monkeypox. Persons who have had close or intimate contact with individuals or animals confirmed to have monkeypox should also be vaccinated. The people who have been infected can be vaccinated up to 14 days after exposure. CDC does not recommend preexposure vaccination for unexposed veterinarians, veterinary staff, or animal control officers, unless such persons are involved in field investigations.

Symptoms/Cures
In humans, monkeypox is similar to smallpox, although it is often milder. Vaccination against smallpox is assumed to provide protection against human monkeypox infection considering they are closely related viruses and the vaccine protects animals from experimental lethal monkeypox challenge.
Patients typically experienced prodromal symptoms of fever, headaches, muscle aches, chills, and drenching sweats. Roughly one-third of patients had nonproductive coughs. This prodromal phase followed 1–10 days later by the development of a papular rash that typically progressed through stages of vesiculation, pustulation, umbilication, and crusting. In some patients, early lesion will become ulcerated. Rash distribution and lesions occurred on head, trunk, and extremities; many of the patients had initial and satellite lesions on palms, soles, and extremities. Generalized rashes in some patient are also evidence.

Stay safe.

HOW TUBERCULOSIS HIDE IN YOUR BODY

Tuberculosis bacteria hide in the very cells that normally kills them.
We know more about how they evade recognition.

Tuberculosis affects millions of people worldwide. Treatment for it is often prolonged from six months to two years. Tuberculosis has been around  as long as human existed, says professor Trude Helen- https://www.sciencedaily.com