Cultivating a healthier West Africa
Dear Esteemed Families,
We are pleased to share our working days and time below.
Monday : 8am – 5pm
Tuesday : 12noon – 4pm
Wednesday : 8am – 5pm
Friday : 8am – 5pm
Contact the Clinic on (+233 56 111 1782 or +233 289 54 3726) to schedule a Telemedicine Consultation or Clinic appointment at any time or day of the week.
Stay safe.
FCA Team.
Dear Esteemed Families,
NOTICE.
Family, Child & Associates officially resumes on Wednesday, 6th January, 2021. Contact us on (+233 56 111 1782 or +233 28 954 3726) to schedule your annual routine medical checkup and immunization.
Happy New Year, we wish you and your loved ones a healthy and prosperous 2021.
Thanks.
FCA Team.
4th January 2021.
NOTICE
The clinic will be closed on Thursday (24th December, 2020).
We will resume on Wednesday 6th January, 2021.
To schedule a Telemedicine Consultation, contact (+233561111782 or +233289543726)
Wish you a happy yuletide and a prosperous new year.
FCA Team.
Dear Families,
Delighted to welcome our new consultant cardiologist, Dr El Sayed Ali Obeid, who is highly acclaimed in his field.
Family, Child & Associates now offers Cardiac and Medical Consultation, Echo Cardiograph (Screening) for pediatric & adult person(s).
تتشرف العياده ان تستقبل د السيد علي عبيد
استشاري القلب والباطنه للعمل معنا ومتوفر بالعياده الان جهاز لتخطيط القلب الكهربائي ( رسم قلب) وكذلك عمل موجات صوتية ( ايكو ) علي القلب( اطفال وبالغين)
استشارات طبيه وقلبيه
وقد سبق للدكتور سيد العمل في المستشفى التعليمي في الكاب كوست وكذلك تاملي
Shingles is an illness caused by a reactivation of the varicella-zoster virus that causes chickenpox. It inflames sensory nerves and can result in severe pain. It causes localized pain, numbness, and itching, followed by the appearance of clustered blisters in a strip pattern on one side of the body. Sometimes the pain can persist for weeks, months, or years after the rash heals (known as post-herpetic neuralgia). The term “shingles” is derived from the Latin word cingulum, meaning girdle — the idea being that the shingles rash often encircles the side of the body.
Shingles is caused by the same virus that causes chickenpox (varicella-zoster virus or VZV), a member of the herpes family of viruses. After a person has chickenpox, the virus can live dormant in the nervous system in nerve fibers for life. Sometimes the virus remains dormant forever, but in other cases, the virus re-emerges or reactivates along a sensory nerve or dermatome.
Each of these factors can weaken the immune system, resulting in varicella-zoster reactivation. However, usually a cause for the reactivation of the virus is never found. If the virus reactivates, it can only cause shingles, and does not cause widespread chickenpox viral infection again in the individual.
The shingles rash appears as painful skin blisters that appear usually on only one side of the face or body along the distribution of nerves in the skin. The skin rash begins as fluid-filled blisters that then form scabs that may leave scars. The rash may occur around the chest, upper back, abdomen, face, the limbs, neck, or lower back. The rash usually appears in one or two adjacent dermatomes, which are parts of the skin that are supplied by a single spinal nerve.
Shingles is most common in people over 60 years of age, although anyone who has ever had chickenpox (varicella) is at risk.
Up to 1,000,000 cases of shingles are estimated to occur each year in the U.S.
The pain of shingles may develop even when there is no rash. The patient may experience tingling, burning pain, or sensitive skin for several days to a week before the rash appears. It may be difficult to determine the cause of the severe pain in the absence of a skin rash.
The rash associated with herpes zoster begins as small blisters in a reddish background. New blisters form for the next few days, usually 3 to 5 days. Blisters emerge in a path of individual nerves in a specific “ray-like” distribution called a dermatomal pattern. Blisters tend to break out in a band-like pattern over an area of skin.
Just like the blisters of chickenpox, the blisters in shingles eventually burst, and the area starts to ooze. The blisters will then crust over and heal. Before the blisters crust over, the VZV virus can be spread to anyone who is not immune to chickenpox through vaccination or previous infection. Herpes zoster spreads when a person who lacks immunity has direct contact with the blisters of someone who has the virus. The scabs eventually fall off, and the rash disappears. Sometimes scarring may result.
An outbreak of shingles can last for 3 to 4 weeks. Sometimes the pain is present but the blisters never appear. This can be a very confusing cause of pain. Some affected people develop post-herpetic neuralgia (PHN), in which the localized pain remains even after the rash is gone. For most people who suffer from post-herpetic neuralgia, the condition is not long-term, but resolves over time.
Postherpetic neuralgia (PHN) is the most common complication of shingles. This is defined as persistence of the nerve pain associated with shingles beyond one month, even after the rash is gone. It occurs from irritation of the sensory nerves by the virus. The pain of PHN can be severe and debilitating. Up to 15% of people with shingles develop PHN. Typically, this occurs in people over 50 years of age. Treatment of shingles with antiviral drugs can reduce the duration and occurrence of postherpetic neuralgia.
Shingles is contagious if you mean that the disease can transmit VZV to other people. Shingles can be spread from an affected person to babies, children, or adults who have not had chickenpox. Instead of developing shingles, these people develop chickenpox. Once they have had chickenpox, people cannot catch shingles (or contract the virus) from someone else. Once infected with VZV, however, people have the potential to develop shingles later in life if their immune system is run down or they experience some other stressor. Consequently, the disease of shingles itself is not contagious, only the VSV it produces is contagious. Thus, some experts say both yes and no to the contagious question.
Shingles is contagious to people who have not previously had chickenpox when there are new blisters forming and old blisters healing. Like with chickenpox, the time prior to healing or crusting of the blisters is the contagious stage of shingles. After all of the blisters are crusted over, the contagious period is over and the virus can no longer be spread.
Usually, shingles heals well and remaining problems are minimal. However, complications may arise from time to time.
On occasion, shingles blisters can become infected with bacteria, resulting in cellulitis. Cellulitis is a bacterial infection of the skin. When cellulitis occurs, the skin area turns reddened, warm, firm, and tender.
A more worrisome complication occurs when shingles affects the face (forehead and nose), which may spread to the eye and lead to loss of vision. Shingles that affects the eyes is called herpes zoster ophthalmicus.
Shingles may also be associated with complications that affect the ears, which can affect hearing or balance. Shingles may weaken muscles on the side of the face. Rarely, shingles may spread to the brain or spinal cord, which can lead to a stroke or meningitis. Shingles may also trigger an immune reaction that affects blood vessels (vasculopathy). People who have shingles have a slightly increased risk of stroke within the first few weeks of the blisters appearing. This increased risk may last for several months.
The clinical appearance of shingles is usually sufficient for a doctor to establish the diagnosis. Diagnostic tests are not usually required. However, particularly in people with impaired immune function, shingles may sometimes not have the characteristic clinical pattern. In this situation, samples from the affected skin may be examined in a laboratory, either by culturing the tissue for growth of the virus or by identifying the genetic material of the varicella virus.
You can take steps to reduce the duration of a shingles outbreak, but in the end, the virus must often simply run its course. There is no cure for shingles. Antiviral medication is effective only if given early, so it is important to visit your doctor soon after an outbreak starts or is suspected Those with facial, nose, or eye symptoms should seek medical care immediately. Early medical attention may also prevent or reduce any scarring.
There are many drugs used to fight shingles and its symptoms. This is an explanation of those drugs and their functions.
Drugs that fight viruses (antiviral drugs), such as acyclovir (Zovirax), valacyclovir (Valtrex), or famciclovir (Famvir), can reduce the severity and duration of the shingles rash if started early (within 72 hours of the appearance of the rash).
In addition to antiviral medications, pain medications may be given. Both nonsteroidal anti-inflammatory medications and narcotic pain-control medications may be used for pain management in shingles. Postherpetic neuralgia (PHN) may require additional medications to control pain.
Topical corticosteroids are sometimes used to decrease inflammation and pain, but these should be used only under the supervision of a health care professional since in some patients, corticosteroids may make the condition worse.
Bathing is generally allowed, and the affected area can be washed with soap and water. Cool compresses and anti-itching lotions such as calamine lotion may also provide relief from symptoms. An aluminum acetate solution (Burow’s or Domeboro solution, available at pharmacies) can be used to help dry up the blisters and oozing. Application of petroleum jelly can also aid in healing. Over-the-counter (OTC) antihistamines, such as diphenhydramine (Benadryl) and pain medicines can also help provide relief.
Wearing loose clothing can help avoid extra pain from clothing rubbing against the rash. Avoid close skin-to-skin contact with others who have not had chickenpox, are ill, or who have a weakened immune system to avoid spread of the virus. People who do not have immunity to the virus may catch varicella by having direct contact with the lesions. In this way zoster is similar to cold sores, which are caused by a virus in the same family as varicella.
In May 2006, the U.S. Food and Drug Administration (FDA) approved the first vaccine for adult shingles. The vaccine is known as Zostavax and is approved for use in adults ages 60 and over who have had chickenpox. The U.S. Centers for Disease Control and Prevention (CDC) recommends the vaccine for people 60 years of age and over who have had chickenpox. It is a onetime injection that contains a booster dose of the chickenpox vaccine that is given to children. An additional shingles vaccine called Shingrix was approved in 2017. It is administered according to a two-dose schedule and is the preferred shingles vaccine for healthy adults age 50 years and older.
Tests showed that the vaccine significantly reduced the incidence of shingles in older adults. The single-dose vaccine was shown to be more than 60% effective in reducing shingles symptoms, and it also reduced the incidence of post-herpetic neuralgia (PHN) by at least two-thirds. Even if you have had shingles, you can still have the vaccine to help prevent future outbreaks. Shingrix is even more effective in preventing shingles and post-herpetic neuralgia. Shingles is largely a vaccine-preventable illness.
Some people should not receive the shingles vaccine, including pregnant women and those with significantly suppressed immune systems.
The shingles vaccine should not be given to pregnant women. It is recommended that a woman wait three months before trying to become pregnant after she has received the shingles vaccine.
People with weakened immune systems due to immune-suppressing medications, HIV disease, cancer treatment, or organ transplants should not receive the shingles vaccine because it contains live, weakened virus particles.
There is not enough information available to determine whether Zostavax may be generally beneficial in people younger than 60 years of age.
The shingles vaccine has not been shown to cause any serious side effects or health consequences. Minor side effects of the vaccine include redness, swelling, soreness, or itching at the site of injection, and headache. It is safe for those who have received the shingles vaccine to be around babies or those with weakened immune systems. It has not been shown that a person can develop chickenpox from getting the shingles vaccine, although some people who receive the vaccine may develop a mild chickenpox-like rash near the injection site. This rash should be kept covered and will disappear on its own.
Pregnant women are susceptible to shingles. Fortunately, shingles in pregnancy is very rare. The antiviral medications described previously are considered safe to use in pregnant women, as are most pain-relieving drugs. Women should not take nonsteroidal anti-inflammatory medications such as ibuprofen (Advil) or naproxen (Aleve) in the later stages of pregnancy, but acetaminophen (Tylenol) is considered safe. Having chickenpox during pregnancy has the potential to cause birth defects, depending upon when in the pregnancy the infection occurs. The risk of birth defects is believed to be lower with shingles than with primary chickenpox infection.
Statement from United Way’s Worldwide Board Chair and CEO on equity and access to justice
United Way believes that every person is entitled to be treated with dignity and respect – this includes equal treatment and access to justice. Recent events involving violence and threats against African Americans expose our society’s underlying racism, prejudice and privilege that prevent too many people from being treated with the humanity and respect they deserve. These incidents are abhorrent and run counter to everything that United Way, its volunteers and professionals value, live and fight for every day.
All people of all backgrounds and identities must call out discrimination and demand its removal from our society; otherwise, we are endorsing the status quo and are complicit in the abuses that follow.
We must all do our part, working United, to make our communities the places that we need them to be – equitable, respectful and opportunity-filled. We, as a society, can and must do better to guarantee that the basic human rights and freedoms of every person in every community are protected.
Dr. Juliette Tuakli (United Way’s worldwide Board Chair) / CEO Family Child & Associates.
High blood pressure is surprisingly common, affecting 60% of African adults.
And it’s a serious threat. High blood pressure increases the risk for heart attack, heart failure, stroke, kidney failure, and several other life-threatening health problems. In fact, high blood pressure causes thousands deaths in the Africa PER DAY. Even more disturbing is that most of these deaths are preventable. High blood pressure is almost always treatable with lifestyle changes and inexpensive medication, yet less than half of people with high blood pressure have it under control.
Lifestyle and High Blood Pressure
Experts suggest that 50%-90% of high blood pressure could be successfully lowered with lifestyle change.
In my practice, if a patient’s blood pressure is mildly elevated and there are no high risk factors (such as diabetes, current smoker or history of heart disease, stroke or multiple cardiac risk factors), I will recommend a 3-month trial of lifestyle change as an initial treatment. I let my patients know that many of these changes can be as effective as any single blood pressure medication.
For many of my patients, the potential to avoid being on medication for the rest of their lives is a strong motivator, and they appreciate the sense of control they have over their health.
Here are the specific areas I recommend my patients focus on in order to lower their blood pressure:
Physical Activity: Even a modest level of physical activity, over time, can make a significant difference in your blood pressure. If you’re not used to exercise, start slow. Five or 10 minutes a day of your favorite activity can be just the start you need to build an exercise habit and allow you to build up to the 2 hours and 30 minutes a week of activity recommended by national guidelines.
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Healthy Diet: I recommend cutting out highly processed food (packaged foods typically high in added sugar and/or refined grains). Watching your salt intake is important if you have high blood pressure, but keep in mind that most of the salt in our diets comes from processed foods and restaurants.
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Weight Loss: Losing even 5% of your starting body weight has been proven to significantly lower blood pressure; and 10% has been shown to dramatically improve other health conditions such as atrial fibrillation. The weight loss strategy I recommend to my patients is the one that works in the long run. Use the lasting power of creating better habits. Restrictive diets might work in the short run, but their results rarely last.
Limited alcohol intake (less than one drink per day): A recent study showed that people who drank 7-13 drinks per week were 53% more likely to have stage I hypertension. Those who drank more than 14 drinks per week had a 69% higher risk of hypertension.
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Not smoking: Smoking cessation can modestly lower blood pressure and dramatically lower the risk for future heart disease.
In addition to these lifestyle changes, avoid regular use of anti-inflammatory medications, like ibuprofen and naproxen, and treat sleep apnea if you have it.
One of the more gratifying events in my practice is when a patient is able to lower, or even eliminate, blood pressure medications because of healthier lifestyle choices. If you have high blood pressure, don’t miss out on this powerful therapy.
Dear Cherished Parent and Patient,
Because of the ongoing uncertainty related to the COVID-19 pandemic, we have introduced virtual consultations either by telephone or by video. This is available from Monday to Saturday and is either covered by your medical insurance company or payment through Mobile Money.
Clinic consultations and any lab tests can still be done on-site on Mondays, Wednesdays or Fridays from 9:00am to 12:00pm subject to availability.
Call us today to find out more
HOW TO BOOK A VISIT:
Please feel comfortable taking advantage of this service.
The “end” of this pandemic is unfortunately not in sight and the risk will continue for months to come. Hopefully by next year we will have an effective vaccine to prevent infection.
Please stay safe and practice social distancing during this unsettling time.
The Team is here for you should you need to talk or address a specific concern.
All the best.
Today is World Malaria day. What you need to know today about Malaria in Ghana. The WHO World Malaria reports that:
The West African sub-region, of which Ghana is a part (Figure 1), is estimated to have more than 300 million people at risk of malaria infection. Thus, the sub-region accounts for about half of the global burden.
The whole of Ghana is at risk of malaria. Malaria in Ghana accounts for 4% of the global burden and 7% of the malaria burden in West Africa.
Malaria was responsible for 19% of all recorded deaths in Ghana in 2015.
Malaria-attributable mortality has declined significantly from 19% (2010) to 4.2% (2016).
The health facility case fatality rate among children under five years of age declined from 14 percent in 2000 to less than half a percent in 2016.
Malaria hospital admissions increased from 280,000 to 340,000 persons between 2000 and 2017.
Gains made towards reducing infection rates have stalled since 2015, increase in the rates of infection
There are at least four known types of malaria and at least one –plasmodium falciparum (which can develop into cerebral malaria)- is fatal if not treated.
Malaria parasites in Ghana are chloroquine resistant. Check with your doctor for appropriate diagnosis and treatment.
Credit : Dr. Judith Castor / MA PhD
Covid-19 in Children of Africa
COVID -19
This pandemic has several facets: a Family, Community, Political, and Medical facet. This is solely about family facets and some pertinent medical facets for families of African origin.
Based on 2135 children studied in China during the initial Wuhan crisis, 9 out of 10 children will have mild symptoms of fever, fatigue, vomiting, nausea and diarrhoea. Pneumonia heralds increasing severity and should be observed closely in children. In Wuhan, only 1 in 20 children had severe symptoms such as pneumonia. It is important to note the symptoms were almost identical to Malaria in children. The blood count was quite different however with evidence of much inflammation ( C-Reactive Protein elevation, high lymphocyte count etc). Total white blood cell counts tended to be normal or low. Chest X-rays demonstrated marked changes in severe cases.
As with adults, children with chronic illness or conditions tend to fare worse should they contract the Covid -19 virus. A major concern in Africa is Sickle Cell Anemia. Africa is home to 80 percent of all Sickle cell Anemia cases and within the continent 59% of all are found in the Democratic Republic du Congo and Nigeria. Other illnesses that can exacerbate Covid 19 illness include: Heart, Liver or Kidney disease: Diabetes, and Obesity (with a BMR above 40): Chronic lung disease and states of Immunocompromise. Symptomatic medical treatment for 2-4 weeks is usually adequate. Many parents however are worried and wanting information on Prevention and Treatment modalities available in Ghana and the rest of Africa.
Prevention in children:
Children should be placed on a hand washing regimen: a minimum number of times per i inversely proportionate to their age.
They should avoid any child or person coughing/sneezing
High touch surfaces should be cleaned and disinfected several times daily. These include the following:
Tables Chairs Door knobs Light switches Remote control switches Handles Desks Toilets Sinks Toys Bicycles Balls etc.
Launder following items frequently:
Plush Toys Day and Night clothing
Quarantine and Lockdown in Children:
Be sensitive to effects of using the following 5 tips.
Onset of severe anxiety or habits such as bedwetting do require a Pediatrician’s assistance.
JM Tuakli, MD MPH April 2020
