Prostate cancer is one of the most common cause of cancer in men.

It is caused by disordered rapid growth of abnormal cells in the prostate gland found only in men. This gland is located below the bladder and its normal function is the production of fluid that forms part of the semen. This fluid is essential for the nourishment of sperms.

Prostate cancer if detected early has high chances of full treatment. However, if discovered late, it may have spread to surrounding or distant organs. In such a case successful treatment is unlikely.

What are the symptoms?

• Difficulty passing urine
• Blood in urine
• Erectile dysfunction
• Bone pain
• Abdominal discomfort
• Weight loss

Risk factors:

• Age >50yrs
• African Race
• Family history of prostate cancer
• Obesity

Prevention & Detection:

• Maintaining a healthy weight
• Frequent exercise
• Maintaining a healthy diet- more fruits & vegetables, and lower red meat and fats
• Visiting your doctor for annual check-up especially if age >40yrs.

Reference:

1. Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F.. (2021). Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660
2. What is prostate cancer (August 01, 2019). Cancer.org. https://www.cancer.org/cancer/prostate-cancer/about/what-is-prostate-cancer.html
3. Hoffman R. (Jul 01, 2021.) Screening for prostate cancer. Up-to-date. https://www-uptodate-com.ezproxy.is.ed.ac.uk/contents/screening-for-prostate-cancer?search=prostate%20cancer&topicRef=6939&source=see_link#H1507787999

Author:

Dr. Kirengo T. MBChB Msc. Surg, Imara Mediplus Hospital.

World-class Healthcare!

 

 

The world is yet to discover all the myths and misconception ssurrounding breastfeeding. With
over three thousand distinct cultures around the world, it is difficult to know the beliefs each
culture holds about breastfeeding with regards to: how soon should one start breastfeeding after
giving birth? exclusive breastfeeding, how long should a baby breastfeed after introduction of
complementary feeding (Weaning)? and how does breastfeeding affect the mother’s body and
health?
The good news is facts about breastfeeding are constant and cut across all these cultures.
Additionally, components of breastmilk and its benefits do not change with different cultures. Our
task therefore is to demystify some of these facts by answering some of the commonest questions
asked about breastfeeding.

1. How soon should a baby breastfeed after birth?

Breastfeeding should be initiated within the first hour after birth. This has been proven to increase
defense against infection, decrease risk of diarrhoea illnesses and other infections and increase
survival rate in children. (1) Unless a complication arises after delivery preventing breastfeeding, let
the little one feed within an hour after birth.

2. Why should I exclusively breastfeed?

Babies should be exclusively fed on breast milk forthe first 6 months. Other fluids and meals are
discouraged unless they have been medically indicated. Breast Milk is highly beneficial and early
weaning can make your baby prone to illnesses such as pneumonia, asthma, diarrhoea and some
digestive tract infections. Exclusively breastfeeding a baby is not only a lifestyle decision but a great
health investment. (2)

3. Is it okay to use formula alongside breast milk?

Combining breastfeeding and formula can be done out of necessity, as a personal decision or
sometimes for convenience. In many occasions supplementation is recommended in instances
where the baby has a medical condition hindering breastfeeding-(mothers are encouraged to express
breast milk in this case) the baby is not gaining weight steadily or when there is low breast milk
supply. Should any of these arise, consult with your primary health care giver on the best way to
supplement your baby’s feeding for the best outcome. This is a safe practice and the goal of it is to
ensure a healthy baby and happy mother.(4)

4. For how long should my baby breastfeed?

Babies should be exclusively breastfed for 6 months. Breastfeeding should then continue alongside
safe complementary feeding for up to 2 years of age or sometimes longer. The longer the baby
breastfeeds the more they stay protected from illnesses. For every feeding session, let the baby
breastfeed uninterruptedly until they are satisfied (3)

5. How does breastfeeding affect my body and health?

Breastfeeding is less likely to give you saggy breasts; it does not affect the shape or volume of breasts;
the changes that occur during pregnancy are more likely to cause that. Breastfeeding helps you
burn calories and hence lose extra pregnancy weight. The greatest benefit however is the bond that
is formed between you and your baby during breastfeeding; this is out of this world! Other than
that breastfeeding can help reduce the risk of High blood pressure, Diabetes, Cancer of the ovaries
and breast cancer. (2)

As we come to the end of World Breastfeeding Week,we desire to see us all take part in protecting,
promoting and supporting breastfeeding. At Inara Mediplus Hospital, we are open to discuss
Breastfeeding and Nutrition for your baby and family too.

Support Breastfeeding for a Healthier Nation!

“A newborn has only three demands. They are: warmth in the arms of its mother, food from her
breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three.”
Dr. Grantly Dick-Read

Article By: Dan Yego

Nursing Officer

Imara Mediplus Hospital.

References:

1. Abie, B. M., & Goshu, Y. A. (2019). Early initiation of breastfeeding and colostrum feeding among
   mothers of children aged less than 24 months IN DebreTABOR, northwest ETHIOPIA: A cross-sectional
   study. BMC Research Notes, 12(1). https://doi.org/10.1186/s13104-019-4094-6
2. Centers for Disease Control and Prevention. (2021, February 22). Why it matters. Centers for Disease Control
   and Prevention.https://www.cdc.gov/breastfeeding/about-breastfeeding/why-it-matters.html.
3. World Health Organization. (2019, February 11). Exclusive breastfeeding for optimal growth, development
   and health of infants. World Health Organization.
   https://www.who.int/elena/titles/exclusive_breastfeeding/en/
4. Citroner, G. (2020, May 11). Ignore marketing when picking between breastfeeding or using formula.
   Healthline. https://www.healthline.com/health-news/dont-believe-this-marketing-claims-about-formula

Welcome to Imara for Quality Affordable Healthcare!I

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!

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

2. Flu vaccine: Vitamin A 100000iu per Oral

At 9 Months

1^st 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

2^nd 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 1^st Dose then 2^nd 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!

 

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.

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

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

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

 

 

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