NEWS AND EVENTS

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17/May/2020

What is dental calculus?

Calculus is a hard deposit that is formed by mineralization of dental plaque on the surface of natural teeth and dental prosthesis, generally covered by layer of unmineralised plaque.

What is dental plaque?

A sticky film that coats teeth and contains bacteria.Dental plaque is a sticky, colorless or pale yellow film that is constantly forming on your teeth. When saliva, food and fluids combine, plaque – which contains bacteria – forms between your teeth and along the gum line.

Calculus cannot be removed with a toothbrush; only a dental professional can remove it during an oral cleaning.

What are the effects of dental plaque and calculus?

  • Bleeding gums/Gingivitis
  • Dental caries/Tooth decay
  • Periodontal disease which may lead to loose/mobile teeth.
  • Halitosis/bad breath.

The best way to prevent these complications is to brush twice a day, to floss once a day, and to visit your dentist regularly for cleanings.

Article By: Dr. Mackatiani
Resident Dental Surgeon,
Imara Mediplus Hospital
Welcome to Imara for Quality Affordable Healthcare!

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13/May/2020

DEFINITIONS

IMMUNIZATION:

Deliberate provocation of an adaptive immune response by introducing antigen into the body.

VACCINATION:

Deliberate induction of an adaptive immune response to a pathogen by injecting a vaccine,a killed or attenuated form of the pathogen.

VACCINE:

A substance used to stimulate the production of antibodies and provide immunity against one or several diseases, prepared from the causative agent of a disease, its products, or a synthetic substitute, treated to act as an antigen without inducing the disease

A. KEPI VACCINE/GOVERNMENT SCHEDULE

Given at birth

1. BCG (Bacillus Calmette-Guerin)

Given as an injection 0.05ml under the skin (intra-dermal) of the left fore arm.

It helps protect the child against Tuberculosis (TB)

2. Polio Vaccine: 2 drops per oral.

It helps protect the child against poliomyelitis (polio) to avert crippling in children.

Given at 6, 10 and 14 weeks of age

1. Polio Vaccine: Dose: 2 drops administered

Children can safely receive the polio booster any time before they are 5 years old.

2. Pentavalent Vaccine: Dose: 0.5mls Intra muscular left outer thigh

Contains a combination of five vaccines hence the name Penta.

It acts against diphtheria, pertussis, tetanus, Hepatitis B and Haemophilus Influenza.

SIDE EFFECTS

  • Fever
  • Pain at injection site
  • Swelling or redness on injection site
  • Irritability

ADVERSE EFFECTS

  • Injection site abscess

3. Pneumococcal Vaccine: Dose: 0.5ml Intra muscular right outer thigh

This vaccine helps to prevent pneumonia. Was added in 2012.

4. Rota Virus vaccine: 1.5mls administered orally

Given at 6 & 10 weeks

Helps prevent rotavirus infection which is the leading cause of diarrheal diseases in children worldwide.

At 6 Months

  1. Measles Rubella Vaccine

In event of a measles rubella outbreak or HIV exposed children

  1. Flu vaccine: Vitamin A 100000iu per Oral

At 9 Months

1st Dose Measles Rubella Vaccine: Dose 0.5ml subcutaneously right upper arm.

At 12 Months

  1. Vitamin A 200000 IU
  2. Deworming with Albendazole 200mg

At 18 Months

2nd Dose Measles Rubella Vaccine: Dose 0.5ml subcutaneous right upper arm

Vitamin A 200000 IU and deworming with Albendazole 200mg

At 9 Months – Only in the selected counties

Yellow Fever Vaccine: Dose 0.5mls Intra Muscular left upper deltoid

N/B: Vitamin A and Deworming is given to the child at 1 year and repeat after every 6 months till the child is 5 Years old.

At 10 Years

HPV – Human Papilloma Virus

Given in two doses 1st Dose then 2nd Dose after 6 months

N/B: For HIV exposed girls receive 3 doses 6 months apart

B. BABY FRIENDLY VACCINES

BIRTH

  • BCG
  • Oral polio
  • Hepatitis B 0.5mls Intra muscular

6, 10 & 14 WEEKS

  1. Hexaxim/infanrix
  2. Rotarix,
  3. Prevenar 13
  4. Oral polio

6 MONTHS

  1. Flu Vaccine
  2. Vitamin A 100000iu

7 MONTHS

Flu Vaccine

9 MONTHS

  1. MMR
  2. Yellow fever vaccine

10 MONTHS

Meningoccal ACY and W conjugate

1 YEAR

  1. Vitamin 200000iu
  2. Hepatitis A
  3. Varicella,
  4. Dewormer 200mg.

15 MONTHS

  1. Meningoccal Vaccine
  2. MMR,

18 MONTHS

  1. Hexaxim/Infanrix Booster
  2. MMR
  3. Vitamin A 200000IU
  4. Dewormer

2 YEARS

  1. Typhoid Vaccine
  2. Flu Vaccine
  3. Dewormer
  4. Vitamin 200,000iu

5 YEARS

Booster

  1. IPV
  2. Typhoid Vaccine
  3. Flu vaccine

9 YEARS

  1. HPV
  2. Flu vaccine

ANNUALLY

Flu vaccine

REVACCINATION

  1. Typhoid Vaccine – every 3 years
  2. Meningococcal Vaccine
  3. Cholera Vaccine
  4. Verorab/Antirabies.

 

Article by: Jilian M’kea
Immunization Nurse
Imara Mediplus Hospital

 

Welcome to Imara for Quality Affordable Healthcare!

 


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28/Apr/2020

1. What is it?

It is also referred to as complete blood count (CBC), full blood count (FBC)

It is a group of tests performed on a sample of blood mainly the three components of the blood; Red Blood Cells, White Blood Cells and Platelets.

2. Why is it done?

By it being a broad screening panel it checks for the presence of a wide range diseases and infections in the body.

3. Which diseases can be detected by this test?

They include but not limited to;

  • Anemia (low hemoglobin)
  • Autoimmune disorders.
  • Bone marrow problems.
  • Cancer.
  • Dehydration.
  • Heart disease.
  • Infection.
  • Inflammation.

4. How do you prepare for the test?

No prior preparation is needed; you can eat and drink normally before the test but if the blood sample will be used for additional tests, you may need to fast for a certain amount of time before the test. Specific instructions are given at the hospital.


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10/Apr/2020

Technically referred to as Respiratory Protective Devices (RPD) The most common masks can be classified as follows:

  1. N-95 masks
  2. Surgical masks
  3. Homemade masks

N-95 RESPIRATORS

CDC does not recommend public use of this masks.

It achieves a very tight fit.

Is very effective in filtration of airborne particles.

Has 95% filtration capacity for particles 0.3 micrometres or bigger.

However, doesn’t 100% eliminate risk of Infection.

Cannot be shared and has limited reuse.

SURGICAL MASKS

Is a loose fitting disposable mask

Offers protection by creating a physical barrier with immediate environment

Protect against large-particle droplets, splashes, sprays, or splatter

Usually has 2-3 layers ie. 2 ply or 3 ply

Has a low filtration capacity and poor protection against particles < 2 micrometres

One cannot share or reuse.

BASIC HOMEMADE MASK

Offers physical barrier for both inward and outward protection

Has a low filtration capacity

Has a low protective factor compared to other masks

Capacity of re-use

MODIFIED HOMEMADE MASKS

Protection of homemade masks can be increased by adding layers to the mask, proper fitting and adding a filter. We propose the use of a sanitary pad as a mask filter.

Filtration Capacity of a Sanitary Pad

Pads consist of 3 main layers

  1. Top- non-woven fabric
  2. Middle adsorbent material
  3. Outer impermeable back sheet with adhesive (Should be removed when using as a mask filter)

The super-fine inner fibers provide filtration capability for micro/nano-size particles

Masks offer protection in two ways:

  • Inward protection

Self-protection against transmission by reducing external exposure to particles

  • Outward protection

Retention of particles inside of masks to reduce spread of infection to others.

Protective Factors:

  1. N-95 Respirators – 99
  2. Surgical Masks – 5.3
  3. Homemade masks – 3.2

Our homemade masks are now available for online purchases. Visit: https://yallo.co.ke/shop/imara-face-masks-set-of-5/

 #StopTheSpread


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03/Apr/2020

Here’s everything you need to know about homemade masks preparation :

  • We recommend using a 3 layer home-made mask
  • Outer layer- Water resistant fabric e.g. Laminated cotton, nylon, polyester, microfiber
  • Inner layer- cotton
  • 3rd layer- Pouch with a disposable microfibre filter

WHAT MATERIAL CAN I USE AS A FILTER?

  1. Hospital microfibre air filter (not readily available, expensive, stocks difficult to find)
  2. Items available at the supermarket i.e. Sanitary pad or diaper (readily available, affordable, stocks are in plenty)

3 layer olson mask, by Unitypoint Health://www.youtube.com/watch?v=ZnVk12sFRkY

HOW TO TAKE OFF THE MASK

Taking off mask wrongly or touching your face may lead to infection. Spend the time to get in-person training or at least watch a video on how to put on (“don”) and take off (“doff”)

PPE sample videos can be found on http://rebelem.com and http://hippoed.com/covid

Wash your hands well before you touch the PPE involving your face.

When taking off your mask, handle the straps behind your ears and never touch the front of the mask.

HOW DO I REUSE THE MASK

After carefully taking off, dispose the filter . Soak reusable mask in 0.5% bleaching solution for at least 30mins.

Follow by washing with clean water & detergent ** You may additionally boil in water for 10-20mins – Addition of 0.3% washing soda enhances boiling**

Always inspect the mask for any tears and damage. Discard if damaged.

Insert new filter and reuse if no damage.

#StaySafe


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19/Mar/2020

These are liquids/ gels that reduce levels of microorganisms by killing them chemically, just like disinfectants kill germs on environmental surfaces.

There are two main types of hand sanitizers: alcohol-based and alcohol-free.

Alcohol-based hand sanitizers contain varying amounts and types of alcohol, often between 60% and 95% and usually isopropyl alcohol, ethanol (ethyl alcohol) or n-propanol. Alcohol is known to be able to kill most germs. It attacks and destroys the envelope protein that surrounds some viruses, including coronaviruses. This protein is vital for a virus’s survival and multiplication. But a hand sanitizer needs to be at least 60% alcohol in order to kill most viruses.

Alcohol-free hand sanitizers contain something called quaternary ammonium compounds (usually benzalkonium chloride) instead of alcohol. These can reduce microbes but are less effective than alcohol. Alternatively, 0.05% hypochlorite may be used as hand sanitizer. This compound is commonly known as jik. When diluted correctly, its stronger than alcohol-based hand sanitizers, as it also destroys fungi which is not destroyed by alcohol sanitizers.

With the recent pandemic of COVID 19 and sanitizers stocks running out, it is necessary for one to know of how to make theirs. However, note that all extemporaneous preparations, should be made by qualified pharmacists only.

 

So what ingredients are needed to make alcohol-based sanitizer

  1. isopropyl alcohol/ ethanol/ surgical spirit
  2. glycerin/ aloe-vera gel
  1. Peroxide
  2. Boiled/ distilled water
  3. Measuring bottle

Ingredients for non-alcohol-based sanitizer

  1. 5% hypochlorite/ jik
  1. Boiled/ distilled water
  2. Measuring bottle

 

SAFETY PRECAUTIONS/ METHOD:

  • Make the hand sanitizer in a clean space. Wipe down counter tops with a diluted bleach solution beforehand.
  • Wash your hands thoroughly before making the hand sanitizer.
  • To mix, use a clean spoon and whisk. Wash these items thoroughly before using them.
  • Make sure the alcohol used for the hand sanitizer is not diluted.
  • Mix all the ingredients thoroughly until they are well blended.
  • Do not touch the mixture with your hands until it is ready for use.
  • Transfer the liquid in appropriate containers.

REMEMBER: Always clean your hands

  • Before touching your face or eyes
  • After touching doors or other surfaces
  • After using the bathroom
  • After handling paper and other public material
  • After greeting or touching others

Contact us for further assistance:

0722353250

We also supply and assist in preparation of hand sanitizer for all our clients and partners.

References:

  1. Pharmaceutical Society of Kenya
  2. WHO STANDARD PRECAUTIONS IN HEALTH
  3. Kenya MHO – KENYA INFECTION CONTROL POLICY
  4. CDC INFECTION CONTROL GUIDELINE

#QualityHealthcare

 

 


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06/Mar/2020

Aspirin has been in use over the years for primary prevention of major adverse cardiovascular events (MACE) a composite of non-fatal stroke, non-fatal myocardial infarction and cardiovascular death.

In a metanalysis on comparison of contemporary versus older studies it was noted aspirin had a significant reduction on MACE and a significant increase in the risk of major hemorrhage and intracranial hemorrhage

It was also noted that aspirin has no mortality benefit when used for primary prevention.

Statins use has however reduced the risk of non-fatal MI when used for primary cardiovascular prevention.

All over the world different guidelines are in use on aspirin for primary prevention of cardiovascular events.

In conclusion more, studies need to be done to come up with one guideline on who and when aspirin should be used for primary prevention of MACE, however as for the metanalysis recommendation made was not to use aspirin for primary prevention.

Reference:

Family Practice, 2019,1_7 doi:10.1093/fampra/cmz080


16/May/2019

WHAT IS CHOLERA? 

  • It is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated even to previously healthy people.

WHAT ARE ITS CAUSES?

  • It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.
  • The bacteria are usually found in food or water contaminated by feces from a person with the infection.

HOW IS IT TRANSMITTED?

  • When a person consumes the contaminated food or water, the bacteria release a toxin in the intestines that produces severe diarrhea.
  • Therefore, it is highly unlikely that you will catch cholera just from casual contact with an infected person.

WHAT ARE THE SYMPTOMS?

  • Symptoms of cholera can begin as soon as a few hours or as long as five days after infection and are as follows;
  1. severe watery diarrhea.
  2. Nausea and vomiting.
  3. Dehydration which may lead to a rapid loss of minerals in your blood (electrolytes) that maintain the balance of fluids in your body. This is called an electrolyte imbalance.

WHAT ARE THE SIGNS OF DEHYDRATION? 

  1. Rapid heart rate
  2. Loss of skin elasticity (the ability to return to original position quickly if pinched)
  3. Dry mucous membranes, including the inside of the mouth, throat, nose, and eyelids
  4. Low blood pressure
  5. Thirst
  6. Muscle cramps

If left untreated, dehydration can lead to shock and death in a matter of hours

HOW IS IT DIAGNOSED?

  • Although the symptoms are unmistakable, it is advisable to perform a cholera Antigen test that is later confirmed by a stool culture test

HOW CAN IT BE PREVENTED?

  • Yes, through vaccination that lasts for up to five years and observance of clean hygienic procedures.

 

HOW IS IT TREATED?

  • Cholera is highly treatable, but because dehydration can happen quickly, it’s important to get cholera treatment right away.
  • Hydration is the mainstay of treatment for cholera. Depending on how severe the diarrhea is, treatment will consist of oral or intravenous solutions to replace lost fluids.
  • Antibiotics, which kill the bacteria, are not part of emergency treatment for mild cases. But they can reduce the duration of diarrhea by half and also reduce the excretion of the bacteria, thus helping to prevent the spread of the disease.

 

Author:

Sal Mukinda, Lab Superintendent, IMH

References:

  1. The incubation period of cholera: a systematic review. https://www.ncbi.nlm.nih.gov/pubmed/23201968 Azman AS, Rudolph KE, Cummings DA, Lessler J. J Infect. 2013;66(5):432-8. doi: 10.1016/j.jinf.2012.11.013. PubMed PMID: 23201968; PubMed Central PMCID: PMC3677557.
  2. Cholera Annual Report 2017 http://www.who.int/wer/2018/wer9338/en/
    Weekly Epidemiological Record 21 September 2018, Vol 93, 38 (pp 489-500).
  3. Debasish S, LaRocque RC. Cholera and Other Vibrios. In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter’s Tropical Medicine and Emerging Infectious Diseases. 9thed. New York: Saunders Elsevier; 2013: 448-453.
  4. David A Sack, Mohammed Ali. Protection from killed oral cholera vaccine continues for 4 years. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30311-5/fulltext

 


06/Oct/2018

Pap smear procedure
  1. WHAT IS PAP SMEAR?

It is a procedure to test for cervical cancer in women that involves collecting cells from the cervix, the lower, narrow end of the uterus.

  1. WHY IS IT IMPORTANT?

It helps in early detection of cervical cancer, hence improving chances of cure.

A Pap smear also detects changes in the cervical cells that suggest cancer may develop in the future. Detecting these abnormal cells early with a Pap smear is the first step in halting the possible development of cervical cancer.

  1. WHY IS IT DONE?

To screen for cervical cancer.

The test is usually done in conjunction with a pelvic exam. In women older than age 30, the Pap test may be combined with a test for human papillomavirus (HPV) — a common sexually transmitted infection that can cause cervical cancer. In some cases, the HPV test may be done instead of a Pap smear.

 

  1. WHO SHOULD DO A PAP SMEAR?

Any female above 21 years.

  1. HOW OFTEN SHOULD IT BE REPEATED?

Once every year. If combined with HPV test, the repeat can take even 5 years. However, depending on certain conditions, it can be repeated severally, of course with the doctor’s advice. These conditions include;

1.A diagnosis of cervical cancer or a Pap smear that showed precancerous cells

2.Exposure to some hormones eg. diethylstilbestrol (DES) before birth

3.HIV infection

4.Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use

5.A history of smoking

6. WHEN SHOULD YOU STOP DOING THE TEST?

  1. After an hysterectomy (complete removal of the uterus and cervix)
  2. Old age i.e. 65 years and above.

AUTHOR:

Sally Gakii, Lab Superintendent, Imara Mediplus Hospital

Date posted: 6/10/18

 

REFERENCES:

  1. Smith RA, et al. Cancer screening in the United States, 2017: A review of current American Cancer Society guidelines and current issues in cancer screening. CA: A Cancer Journal for Clinicians. 2017;67:100.
  2. Curry SJ, et al. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. Journal of the American Medical Association. 2018;320:674.

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