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lumbar punctures march-april 2012 lethal or life-saving page 6 the heartbeat of health _health/nutrition/lifestyle from the editor then that i realised there was good cause for this journey we had embarked on -very good cause it is said that the wealth of a nation is its people and the true wealth of any person is his/her health the absence of health makes it difficult to relish the rest of life s pleasures indeed good health is the best and most valuable gift we as humans enjoy it is also important to understand that good health is holistic the world health organization who over half a century ago defined health as a complete state of physical mental and social well-being and not mere the absence of disease or infirmity the health seeking behaviour of most people in many african countries zambia included is the `fire-fighting approach people only seek health care and information when they are ill or have a loved one who is ill they say prevention is better than cure and knowledge is the key to that prevention when individuals are well educated and informed they make better decisions which have a positive impact on their health and life in general this is the intervention that we seek to bring to the general public a complete package of relevant health information that will enable people make informed and wise decisions expect us to discuss and dissect a variety of health matters touching on every aspect of life-from `serious common medical conditionslike hypertension to health issues arising from culture and lifestyle as well as encompassing topics pertaining to diet and exercise however we wish to emphasize that people should not treat themselves or delay treatment based on what they read in this publication the information provided here should instead act as a catalyst helping people become pro-active about their health always verify all health advice provided in the media with your personal physician in this way you get a far better health education once again never attempt to act as your own healthcare provider seek professional medical advice if you have a health problem to borrow the words of riverview wellness centre `health by choice not by chance i look forward to being a continual part of the process leading to a better informed and healthy nation god bless in this issue madly in love pg 2 bad choices or bad genes pg 3 i t took me a while to settle down and write the editorial note for the first ever issue of pulse health it was like i was waiting for some kind of inspiration in deed the stimulus came after listening to my friend dario chongolo a dynamic young inspirational and motivational speaker and writer speak at a youth meeting it was dr sam musariri editor in chief basic dental care pg 3 women s health pg 5 skin care health and beauty pg 4 when children have children pg 5 contributors juanita pretorius dr.fahim abdullah ruth kayira dr.aubrey shanzi ika hindson simba rukayi nyuma mbewe dr.maria akani dr abel mwale wide distribution free copy pulsehealthzambia@gmail.com

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2 madly in love the psychology and science of falling in love by ruth kaira dr sam musariri sam adds this year s valentines came on an especially good notetwo days after winning the afcon cup-talk about a double dose of `feeling ya mbama am certain that right after seeing the chipolopolo boys parade through great east road with that auspicious medal many lovers began finalizing their valentine s plans for some the next day was as simple as passing shy eyed glances and cute notes to their valentines others took the old tried and tested route of chocolate and roses i heard of a lucky few who got their long awaited marriage proposal in grand style and fashion every year when people celebrate valentines it is such a great reminder of the powerful force we call love this love thing has tracked right though human history sparing no man-afflicting both king and peasant alike now the reason i use the word afflicting is because as i began to think about this `ordeal of love which am sure every reader is all too familiar with i could not help but think of how similar it is to a state of madness now before you condemn me consider the major `symptoms of a person in love-especially in the `lust stage as ruth has explained n obsessive thoughts and a constant preoccupation with the subject of their love n ability to spend long hours with their love almost to the point of sleep deprivationespecially in the initial stages n elevated euphoric moods almost bordering on craziness n increased self-image and confidence n the willingness to spend large amounts of money just to please and be with their lovemore especially for the guys n a small sense of losing touch with reality especially when it comes to objectively judging the character of one s lover open any textbook of psychiatry and you get almost the exact same features especially in the form of mental illness called `mania obsessive thought patterns increased energy with hyperactivity and a decreased need for sleep inflated self-image excessive spending and hypersexuality.i have the feeling a lot of us will be going check check and check so perhaps when people comment and say they are madly in love maybe we should believe them perhaps being `lovesick is just that-a sickness i have personally witnessed people do things bordering on and exceeding the boundaries of insanity all in the name of love and it would appear science agrees with me ruth speaks when i got the invitation to write this article first thought was that of reluctance i hadn t experienced falling madly in love in a while and i hadn t experienced the whole butterflies in my stomach i almost gave it up but then i imagined the fun that you get whenever you think and talk about love so what really happens when you fall in love when do you fall in love when do you fall out of love if that time comes i read a facebook post that said it is a mystery to fall in love it s a mystery how it happens and it is a mystery when it comes it is a mystery why some love grows and why some love fails psychologists have come up with different theories trying to explain the whole process of falling in love why we tend to fall in love with certain people and for some reason not with others no matter how hard we try the same everytime some people fall madly in love after hating each other for a while or maybe after arguing with each other some fall in love after been involved in an accident together and yes some after been lifelong friends i would guess you are looking back and thinking of how you fell in love the process of love is said to have three stages lust attraction and attachment according to psychologists every kind of love regardless of how it happens goes through these stages lust is the craving sensation you get for the other person the selfish feeling that makes you feel that you just gotta have this like the feeling and craving you get if you have a sweet tooth and you see a mouth watering black forest cake the i gotta have this feeling that is the usually the first stage however it doesn t last long because it is usually based on what you get from the particular person most of the love that ends here is sexual decision and you decide to care for another individual at this point you have passed the fantasy kind of love and to survive your love has to be strong enough to withstand several circumstances you have to know the other person s flaws and not excuse them but care enough to want to help them become better people it is at this point that i believe that people are truly in love because they have decided in addition to the first stages to nurture what they have according to psychologist zick rubin romantic love is made is made up of three elements attachment caring and intimacy attachment is the need to receive care approval and physical contact caring is valuing the other persons needs and happiness as much as your own and intimacy is sharing thoughts desires and feelings with the other person robert sternberg a renowned psychologist proposed a triangular theory of love what happens at a physiological level when one falls in love are these ongoings in the brain similar in any way to that of a mentally ill patient now the human brain is a very complex thing-i suspect we probably know more about outer space than we do about it thankfully advances in medical science have allowed us to peep into this god s amazing creation it appears that at a biochemical level a person in the process of falling in love or one in the early stages of attraction and romantic passionthe lust stage has elevated activity levels of a chemical called dopamine in the brain dopamine is the pleasure and satisfaction chemical that gives that feeling of bliss it s the same molecule that is raised when one is eating chocolate no wonder the correlation between chocolate and valentines the effects of dopamine on the brain are similar to those of cocaine elation of mood talkativeness and arousal so in a sense love can give the same high you get from drugs the brain also shows increased levels of other neurotransmitters chemicals that facilitate transmission of messages in the brain such as norepinephrine and epinephrine adrenaline which is the chemical that gives us the `butterflies in the tummy feeling-a racing heart sweaty palms and a dry mouth also these cause heightened attention and increase goal oriented behaviour makes you think if love was a course at school we would all score a s so evidence suggests that in the lust stage our brains are bathed in a figurative soup of indigenous produced feel good chemicals this love sickness by nature sets the stage for romantic advances and procreation and in a sense works like nature s booby trap to ensure the continuity of the human species scientist fisher in fact suggests in her study of people in love that couples often show the signs of surging dopamine increased energy less need for sleep or food focused attention and exquisite delight in smallest details of this novel relationship now let s compare this with the brain chemistry of a `mad person in conditions like mania and especially schizophrenia we see a rise in the levels of dopamine norepinephrine and epinephrine activities in the brain schizophrenic patients have increased activity of dopamine-the same chemical responsible for the euphoria of love.in fact the biochemical profile is so similar it has been suggested that it is hard to tell madness and love apart even one of the areas of the brain affected in schizophrenia is the same area that shows increased activity when one is in love-an area called the hippocampus this is the part of the brain that processes emotions especially of love and affection and memories not convinced yet a psychiatrist at the university of pisa ,dr donatella marazziti studied twenty couples who d been madly in love for less than six months she wanted to see if the brain mechanisms that cause you to constantly think about your lover were related to the brain mechanisms of obsessivecompulsive disorder a type of mental illness dr marazziti discovered that serotonin levels of new lovers in the blood samples were equivalent to the low serotonin levels of obsessivecompulsive disorder patients serotonin has a calming effect on the brain and low levels lead to some sort of obsessive behaviour in ocd it s over an object in love it s over someone as earlier mentioned we have increased levels of other neurotransmitters such as norepinephrine and epinephrine especially in mania perhaps the reason we are more tolerant of the `madness of love than other forms of madness is that we all go through it at some point so the next time you see someone abandon all caution to the wind trashing rationale and reason on account of being madly in love try and be understanding-as you would with any other patient in fact the biochemical profile is so similar it has been suggested that it is hard to tell madness and love apart once we meet a person and get talking we start to tick the things on that list when they meet most of the things on the list we go on ahead and date them however this is not the part that we fall in love this is where we give the other a chance to see where it will go meaning we open up a door or a folder in our system and we start to add information to this folder once we date them for a while or we hang out with them for a certain period of time we decide whether we should stop picking up their calls or maybe we can start calling them back the process of falling in love is very mysterious this is because not everyone falls in love the same way and if you have fallen in love quite a number of times you will realise that it s not the next stage is attraction it is at this point that the romantic passion comes into play this is where we say love is blind because we become oblivious to any flaws the subject of our love may have we lose our rational mindset all logical thinking and we just don t care i can imagine you can think of someone who has been at this point before if you are not looking at yourself and saying that s me last year we can day dream about our lovers all day long and no price is too high to be with them to us they are this perfect match for our love and whatever wrong they do they did not mean to do it the third stage is attachment also known as commitment stage this is the mature stage this is where u become rational with your that suggests that there are three components intimacy passion and commitment different combinations of these results in different types of love an example he gives is that a combination of intimacy and commitment gives you compassionate love and then a combination of passion and intimacy results in passionate love he further states that a combination of all three is consummate love which is very rare to obtain love based on two or more elements is more enduring than one that is based on one now if you have been in love like i have you would admit that the lust stage of love as exciting as it may be doesn t last long though my definition of love might be very different we all have the need to belong to be loved and to love march-april 2012

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3 bad choices or bad genes dna illustration by juanita pretorius h but my great grandfather had cancer and my grandfather had cancer even my father had cancer now i have cancer it is not my fault i have bad genes after a lot of research science has come up with a breakthrough in understanding genetic and hereditary disease therefore today we now talk about what we would call epigenetics in the human body we have about 25,000 genes which are perhaps the starting point according to dr randy jirtle geneticist department of radiation oncology at duke university he states lifestyle affects certain carbon-hydrogen chemical tags called methys which grab onto dna and others called histones which grab onto gene proteins and they throw the switch largely determining if the gene will be expressed or not they are called epi-genome epi means above upon or over the epigene is a marker that latches upon the gene now to put all this language that the rest of us can understand research has shown that the way we live can either turn our genes on or off by the things we do or do not do these little epigenomes are like the switches that turn these genes on or off this means that even though it may not be possible to change the genes the choices that individuals make however can help to turn the bad genes off and good genes ones on another study was done by dr dean ornish university of california at san francisco proceedings of the national academy of sciences 2008 how gene expression changed in low level prostate cancer during 3 months of treatment the only things that were used for treatment was some lifestyle changes in 4 different areas namely n plant based diet n moderate exercise n stress management techniques n weekly support group the results were absolutely astounding gene expressions changed in 501 genes 453 cancer promoting genes were turned off and 48 cancer fighting genes were turned on now we truly know that we can make a difference in our own health stress and even the way we think can influence how our bodies react the allan institute for brain science in collaboration with sri international report that some 224 genes in mice showed a changed behavior due to sleep deprivation we tend to take these little things for granted but when it comes to being truly healthy it is very important for us to follow the laws of our being the neglect of even one can be very detrimental to our health below are some of the most prominent laws that we need to look at n nutrition n exercise n water n sunshine n temperance n air n rest n trust in divine power most disease promoting genes do give us a tendency or inclination for sickness but they do not determine the disease itself it is the choices we make that largely determine our future health so remember that health does not come to us by chance but by choice make the right choices today switching good genes on and turning off the bad ones ow many of us have used that line or have heard others use it today science is starting to look into this same question and how it really works inside our bodies science is once more attempting to answer the question whether cancer can be prevented basic dental care what is basic dental care by dr fahim abdullah dental surgeon basic dental care involves brushing and flossing your teeth regularly seeing your dentist or dental hygienist for regular dental checkups and cleanings and eating a healthy diet this means foods high in whole grains vegetables fruits and dairy products why basic dental care is important nnnnnn prevents tooth decay prevents gum disease short time with the dentist and makes the trip more pleasant saves money by preventing tooth decay and gum disease you can reduce the need of fillings helps to prevent bad breath improves overall health health habits and may be a sign of other health problems bad breath can also be made worse by the types of foods you eat and other unhealthy lifestyle habits how does what you eat affect breath basically all the food you eat has to be broken down in your mouth as foods are digested and absorbed into are there ways to avoid dental problems nnnnnn brush your teeth twice a day in the morning and before bed and floss once a day use a toothpaste that contains flouride avoids foods that contains a lot of sugar avoid using tobacco products which can cause oral cancer practice tongue cleaning schedule regular trips to the dentist this causes bad breath when should my child start seeing a dentist by the time your child is 6 months of age your dentist should assess the likelihood of your child having future dental problems your bloodstream they are eventually carried to your lungs and given off in your breath why do poor dental habits cause bad breath if you don t brush and floss your teeth daily food particles can remain in your mouth which promote bacterial growth between teeth around gums and on the tongue what health problems are associated with bad breath nnnnn gum disease plaque dental caries yeast infection of the mouth dry mouth in the next issue we look at the subject of bad breath in detail if you have any questions suggestions or contributions please send them to pulsehealthzambia@gmail com bad breath medically called halitosis,this can results from poor dental pulsehealthzambia@gmail.com

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4 women s health flash that thrush dealing with vaginal candidiasis by dr.shanzi aubrey when it comes to talking about women s health in the land down under very few things bother a wide spectrum of women as much as thrush the more you know about this condition the more you ll be able to do something about it which are placed in the vagina medications to treat vaginal yeast infections are available in either creams or suppositories .it can also be treated by oral drugs if a woman prefers it or when she is menstruating if it recurs four times or more in a year investigations are needed to make sure there are no other serious conditions that are causing the recurrence so what can one do to prevent or control this infection n wearing cotton panties which absorb sweat goes a long way avoid underwear made of silk or nylon because these materials are not very absorbant and restrict air flow this can increase sweating in the genital area which can cause irritation as earlier implied avoiding tight clothing frequent bubble baths and douching can also help douching removes healthy bacteria lining the vagina that protect against infection make sure your genital area is constantly clean and dry avoid using feminine hygiene sprays fragrances or powders in the genital area use pads and not tampons avoid wearing wet bathing suits or exercise clothing for long periods of time and wash them after each use skin care health and beauty ika g.hindson senses at sensorium a ny woman that has ever had thrush will tell you it is quite a nuisance with symptoms as embarrassing as a constant urge to scratch un-public places in public places this ailment can be quite embarrassing even to talk about however without confronting the problem and seeking professional help there s no way that one can find a resolution the more you know about this condition the more you ll be able to do something about it it turns out that this female public enemy number one affects at least 71 of women at some point in their lives so if you are currently battling it be rest assured you are not alone so what is thrush and what causes it thrush a.k.a candidiasis is actually a yeast belonging to the vegetable kingdom that is not only found in many different parts of your body but in the environment as well it is just one of the billions of other friendly organisms that serve a useful purpose in the body-controlling the growth of harmful bacteria the problem comes when the yeast grows out of control itself unfortunately its ambitious quest for expansion occurs at the woman s peril this opportunist thrives where conditions are very favorable especially in the moist and warm areas of the body these include the mouth and the vagina it is most common just before the menstrual cycle as the conditions in the vagina highly favour its growth candidiasis is not a sexually transmitted illness however some men will develop symptoms such as itching and a rash on the penis after having sexual contact with an infected partner in women sexual intercourse which causes bruises and also changes the vaginal environment can trigger an infection other factors that contribute to its overgrowth include a poor immunity as occurs in hiv infection cases of diabetes or in patients on steroids and anti-cancer drugs prolonged use of strong anti-biotics can clear `good bacteria from the genital area and consequently give chance for the fungus to overgrow the genital area being almost perpetually moist and warm makes it a very a favourite site for this fungus in addition the following factors make it easier for this fungus to grow in this area nnnnnnnn wearing tights jeans and other tight clothes wearing non cotton panties vaginal douching bubble baths yes ladiesbubble baths shower gel pregnancy menopause contraceptives nnnnn so what are the symptoms when growth of the fungus is triggered women experience whitish sour milk like discharge with intense itching of the private parts the discharge can also be foul smelling some women also experience pain during sexual intercourse and urination in people with poor immunity the infection can spread into the blood though rarely cause death this infection is on many occasions easily treated with antifungal medications it is important to remember that other infections apart from vaginal candidiasis can also present some of the above symptoms it is hence very crucial not to attempt to treat yourself but to immediately seek medical attention for any questions comments additions or clarifications please do not hesitate to forward them to pulsehealthzambia@gmail.com why do we all want beautiful skin because we care we are all ultimately a tiny bit vain and we would all like to look young and beautiful for as long as possible unfortunately the secret to eternal youth has still not been found today there are products that are advertised that do everything to keep the skin in good condition or so we think as children we are born with soft smooth skin babies have skin pores that are not fully developed and so we should not use the high spf sun protection factor products on their skin because they could clog the pores and even over stimulate the skin however as we get older it is advisable to purposefully take care of the skin during the teenage years to combat acne and later to just have youthful looking skin caring for the skin is a healthy way to keep the skin looking and feeling good one of the most fundamental things we must incorporate into our daily skin care regime from an early age is to be aware of how important cleaning and exfoliating the skin is women tend to read all the beauty magazines where there are articles after articles advising on what to do what to use and how to use it a lot of the time the advice is only to sell a particular product therefore biased to the product it is wise to seek advice from a trained therapist not your girlfriend whose skin is not the same as yours wearing makeup although not bad can harm the skin if the quality of the foundation is incorrect factors for good skin 1 perspiration humidity rain smoke wind and heat can all affect the skin during the course of the day we would have been confronted with the smoke of cigarettes cars and general pollution make sure the skin is cleaned of all makeup and pollution every night by taking a shower/bath before bed time the skin needs to be exfoliated from all this grime dust and pollution we advise clients if their budget allows a facial every four to six weeks this helps keep the skin in good condition this would incorporate an exfoliation cleanse nutrition massage and mask 2 nutrition we tend to forget that whatever we put in our mouth will show on the skin and therefore diet is very important really you put on what you eat drinking a lot of water gives the march-april 2012

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5 skin a healthy glow making sure the diet is full of antioxidants is very important to keep a good tone of skin the effect of a balanced diet i.e enough vegetables and protein and hydration to the body is clearly seen in young children when they are monitored by their parents to eat healthily they usually have great skin energy and vitality 3 exfoliation men are very lucky to shave every day this eliminates the need for exfoliation that women need with shaving the action helps to remove dead cells from the surface of the skin women need to exfoliate or scrub the skin to get the same effect 4 moisturisation applying creams that keep the skin moisturized goes a long way choosing a good moisturizer or night cream is a nightmare there are so many different products on the market all professing to be the best one way to eliminate the entire unknown is to go to your nearest trained therapist to get advice most of the better calibre salon/spa will have at least one or two excellent products they can recommend teenage skins are more susceptible to acne problems this of course is a major irritant to teenagers at senses and sensorium we do treatments to clean and treat these skins we recommend what to use and how often to come in the african environment is another of discussion more specifically the zambian the weather is harsh i.e very dry in winter and humid in the summer this environment is quite hostile to skin to counter this we have imported products that can help with all these problems at senses at sensorium we invite many different experts to speak about skin and what we can do to enhance and care for it another area that is very popular in skin care is `anti-aging we have trained specialists that administer botox and fillers also available are skin treatments of micro-dermabrasion peels and laser and antiwrinkle facials our services allow the skin to be kept in good condition and treat it to prevent wrinkles acne and other ailments in addition to the skin care services we offer our slimming programs can be fun and pain free we have at our disposal machines and methods that help eliminate fat and cellulite we also have a laser machine which eliminates unwanted hair broken capillaries pigmentation and works on unwanted wrinkles by stimulation we are found along addis ababa road in longacres lusaka consultations are part of the experience we explain what we do and we do this simply and professionally please feel free to call or visit to make a booking remember deliberate skin care and attention is vital so that in your later years you have clear and radiant skin in the next issue we discuss the problem of acne what causes it and what you can do to control it when children have children by simba rukayi rampage targeting teenage girls chances that your teenage daughter could become pregnant and drop out of school much earlier than you previously thought possible have become increasingly real with people under 18 years old making up more than half of the population in zambia the danger posed by premature sexual experimentation cannot be estimated sexually active teenagers and children are less likely to use protection more likely to become infected with hiv fall pregnant or both more likely to die in childbirth more likely to have their children die in infancy and should they and their children survive more likely to be trapped in poverty and exploited further many teenagers are not taught about methods of birth control and how to deal with peer pressure and end up in a precarious situation while the re-entry programme is in place to assist the girl child the programme should not be abused by the girls since they are allowed to go back to school young girls should adhere to messages of abstinence religiously without allowing themselves to be swayed by those with weak morals they should remain focused and forum for african of women educationalist of zambia faweza has initiated some programmes meant to sensitize the girl-child on how to be assertive in life and learn to say no to sexual advances which learners should take advantage of more so babies born to teenagers are at risk of neglect and abuse because their young mothers are uncertain about their roles and may be frustrated by the constant demands of caretaking adult parents can help prevent teenage pregnancy through open communication and by providing guidance to their children about sexuality contraception and the risks and responsibilities of intimate relationships and pregnancy some teenage girls drop out of school to have their babies and don t return in this way pregnant teens lose the opportunity to learn skills necessary for employment and self-survival as adults school classes in family life and sexual education as well as clinics providing reproductive information and birth control to young people can also help to prevent an unwanted pregnancy however i have noticed with gravity of disturbance that it is still a taboo in zambian families to talk about sexual issues with teenage children families tend to depend on schools and public media for imparting such knowledge in children evidence can be drawn from the hillside girls high school in chipata where 61 teenage girls got pregnant in 2011 alone from one institution the hillside school saga should not be allowed to rest with the mere revelation that so many girls got pregnant last year there is need to go deeper to the root cause of the problem overall the importance on sexual education cannot be overemphasised the lack of knowledge would be a fact that could be leading to teenage pregnancies this is a problem that cannot be left to parents alone or to the school system it is everyone s responsibility to ensure that we take care of our nation s children children should be allowed to be children and not have the responsibility to be parents i it s always a sorry sight looking into the glowing eyes of a pregnant 13 year old girl whose body can barely support the huge protruded stomach do you remember the day you saw a gorgeous teenage girl struggling with a mature pregnancy and you asked yourself one question who did this at that point you empathized you couldn t stand seeing a child having children when children have children in our community we are disturbed n others may view the creation of a child as an achievement and not recognize the serious responsibilities some may keep a child to please another family member some may want a baby to have someone to love but not recognize the amount of care the baby needs depression is also common among pregnant teens many do not anticipate that their adorable baby can also be demanding and sometimes irritating some become overwhelmed by guilt anxiety and fears about the future depression is also common among pregnant teens happen to know a 15 year old mother whose story and situation left me wondering if there is someone who is on a rampage of telling the teenage girls that it is very normal to get pregnant and if you don t like the pregnancy you can always abort one may perhaps argue that the rise in the cases of pregnant girls can be blamed on the introduction of human rights or child rights which the girls have acquired and been exercising by allowing themselves to be sexually exploited the other reason could be peer pressure emanating from fellow teenagers and other social factors which could be driving them to indulge in unsafe sex or more worrying could be the fact that there are high levels of moral decay that have hit every corner of our society pregnant teens can have many different emotional reactions n some may not want their babies n some may want them for idealized and unrealistic ways nnnnnn chances that your teenage daughter could become pregnant and drop out of school much earlier than you previously thought possible have become increasingly real shockingly the age at which girls are falling pregnant has dropped to as low as 10 it is a new world and the young have become more daring what is more shocking is that even grown men including teachers and male relatives are also on the pulsehealthzambia@gmail.com

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6 lumbar punctures by nyuma mbewe lethal or life-saving c imagine the scene you ve just graduated from 7years of intense medical training and are two months on the job at the university teaching hospital s filter clinic this is another busy day on call with long queues and an overflow of patients resilient you continue offering the patients the best care possible lose your eyes again and imagine with me the wife mother sister or brother of this guy let s call him joe joe has had a headache for several weeks now and it just won t go away he started throwing up on tuesday and last night i think he fitted twice he can t get out of bed anymore he can t even lift his head off the pillow because his neck hurts too much he s got a fever and it s getting worse today he seemed so drowsy his relatives couldn t take it any more so they took him to the clinic and from there they were referred to the university teaching hospital now stop imagining you can open your eyes this picture has come to reality as the two worlds collide joe s family meets the doctor who says those fateful words joe needs a lumbar puncture and mrs joe s heart fills with dread joe s lying there remember he cannot lift his head and the neighbour who escorted mrs joe whispers you know if they do the lumbar puncture he ll be dead and now we face a dilemma as the doctor insists that the lumbar puncture is the next step in joe s care but mrs joe is filled with fear let s be honest now we ve all heard it said a lumbar puncture will kill you or certainly we have heard the horror stories of how uncle so and so was fit as a horse until those doctors attempted a lumbar puncture and the sad thing is that many of us believe this myth without ever considering if it is true this unfounded fear of lumbar punctures that we have as a nation cuts through all walks of life and social classes but what we fail to realize is that this fear is crippling us and inadvertently resulting in more deaths they say the only thing to fear is fear itself well then today ­ the truth shall set you free before any attempt can be made to dispel the myths about lumbar punctures the first thing we need to do is understand what a lumbar puncture is that being said a lumbar puncture i.e an lp is a medical procedure where a sample of fluid is taken from the spinal canal of an individual by accessing it through the lower back this fluid known as cerebral spinal fluid is what bathes the brain and spinal cord it is very important in investigating a patient with suspected infections of their central nervous system the brain and spinal cord in fact there is no other reliable tool with which meningitis a life threatening but treatable condition can be excluded meningitis is an inflammation of the membranes that surround the brain known as meninges joe had the typical symptoms the headache fever stiff painful neck body weakness vomiting trouble staying awake drowsiness and even seizures this infection can be caused by several different viruses bacteria and even fungi accordingly the treatment of meningitis varies depending on the actual cause that is why the lp is so important in establishing the exact cause of the infection one might ask is there no alternative to the lp unfortunately blood tests are often unable to show exactly which bug is causing the infection in the situations when the patient declines an lp the only option would be to treat the patient empirically this is synonymous to shooting in the dark hoping that somehow you will hit your target even when the doctors suspect that the cause of the meningitis might be bacterial there are myriads of bacteria that can cause meningitis worse still some drugs because of their side the myths about lumbar punctures being lethal are really unfounded many times as in joe s case when the patient presents with symptoms of meningitis they present too late the early symptom is just that headache that won t go away many people choose to ignore this until the symptoms get much worse by the time they go to the clinic the disease is already very advanced further delay is made when the patient who is now in a critical condition has to be referred to uth and more so whilst awaiting the final go-ahead from the who s who of the family the condition worsens and the patient slips into an unsalvageable coma condition was it the lethal lp that caused his death absolutely not the bottom line in this situation is that meningitis is a very treatable condition it is a common and ranks amongst the top reasons for hospital admission especially in patients with hiv/aids the lumbar puncture is a vital tool in ensuring our loved ones receive the best clinical care possible several years ago a diagnosis of tb was like a death sentence but now everyone knows that tb is curable and that adherence to treatment is the way to a full recovery likewise turns out our story actually has a happy ending mrs joe listened to the doctor s advice and allowed the lp to be done immediately now joe himself healthy and happy can say that the lumbar puncture helped save his life in the next issue we discuss more in detail on the actual procedure of a lumbar puncture for any questions comments additions or clarifications please do not hesitate to forward them to pulsehealthzambia@gmail com effects cannot be given unless absolutely indicatedand the only way to know is by doing an lp now the usual case scenario is that mrs.joe is very hesitant to aggressively and by the time the lab results come back joe has demised the news spreads quickly-especially at the funeral joe died after the doctors did a lumbar dehydrated by doing the lp according to another doctor dr mputu the common and only reason that patients and their relatives give for declining an lp is that they let s be honest now we ve all heard it said a lumbar puncture will kill you or certainly we have heard the horror stories of how uncle so and so was fit as a horse until those doctors attempted a lumbar puncture consent to have an lp done on her husband so she asks for more time so that she can consult joe s relatives-who also insist that joe s father and `shibukombe hundreds of kilometres away in the village must travel to lusaka judge the situation and then decide unfortunately infections don t wait-minutes wasted can mean death by the time the consultative meetings are done joe s condition is so critical that the relatives are now obliged to consent by then it is too late-the infection has spread puncture scenes like the one above with mrs joe and family declining or hesitating to have the lumbar puncture done are not uncommon a rough estimate made by a dr chomba working in uth filter clinic at the time found that 7 out of 10 patients and their care givers would initially decline to have a lumbar puncture done could it be the awkward positioning of the patient that scares them off or maybe they feel the patient would be have heard that every time an lp is done on someone ­ they die or perhaps the reason has something to do with the name itself-lumbar `puncture let s face it a `puncture in whatever form is not a nice thing to have a tyre puncture means you are immobile stranded and helpless now what more puncturing a human being some people may think you may hear the words `spinal tap being used to refer to the same procedure which is a more `user friendly term i feel march-april 2012

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p. 7

7 suicide part 1 by dr maria akani but if you have experienced suicide of a loved one statistics do not matter the intensity of pain from such a loss does not become less intense or `rare however suicide is on the increase in zambia and world over and is now the thirteenth cause of death worldwide www.who.org suicide refers to the act of deliberately taking one s own life parasuicide refers to deliberate physical harm to oneself that may be serious enough to cause suicide or an attempt to cause suicide for the purposes of this article there is need to clarify that reference is not being made to immolation as a form of sacrifice for religious military or political reasons such as sati sepukku kamikaze suicide bombings altruistic suicide etc parasuicidal people those that make suicide attempts or cause life threatening self harm usually do not intend to kill themselves they usually do it as a protest to send message and so on why most of you are reading this article to understand why people commit suicide some of you it is because you want to understand a suicide loss you have experienced others of you it is because you have been contemplating it and are now wondering whether your reasons are `important enough to stand justified when compared to others broad categories of common reasons why people commit suicide will be stated here n psychiatric conditions which alter thinking and perception cognition such as depression or schizophrenia may lead to suicide this is because a person may have a profound feeling of worthlessness hopelessness and unfounded guilt which may lead to one thinking s/he is better off dead or they may hear voices giving them commands to do dangerous things such as hanging themselves jumping off a tall building or drowning oneself they may also see visions of scary things such as in alcohol or drug intoxication and severe withdrawal that may lead them to run into dangerous situations such as the centre of a busy road and so on acute stress reactions impulsivity sometimes one may experience a crisis situation or sudden chaos which they may never have foreseen or thought through some examples of these include sudden job loss business deal suddenly going bad a broken relationship or marriage etc during this time one may feel at the end of their resources and impulsively make a decision to end it all accidents sometimes those that are involved in self harm slashing wrists overdose scares etc go so far that they actually kill themselves in the process they intended to only send out a message to draw attention in the process but accidentally went overboard accidents also happen to alcohol and drug users that in their quest to receive heightened levels of intoxication and ecstasy accidentally overdose themselves profound suffering or pain or threat of it people who experience excruciating pain from chronic illness or torture in a bid to end their pain may seek to end their lives at that point it is often perceived that their judgement has been obscured/blurred impaired resolve to die some individuals have already decided at which point they will kill themselves such as when they get bankrupt when they get raped when they are diagnosed with a certain condition etc they have thought it through very well and decided which method they will even use and perhaps even a lot of humility and embarrassment but still often they can be resolved if not solvable there is usually a way to manage them somehow that can make life more meaningful than just bearable the move is irreversible if you believe in life after and you decide that you cannot cope with this life where do you get the confidence that the life after will be better moreover one cannot even return from that life if they decide that life on earth is better the emotional trauma caused on the loved ones left behind can be unbearable others that have experienced suicide in their families have ended experiencing emotional break downs so severe that they expressed psychiatric conditions such as depression suicide is hardly a way anyone would like to remember their loved one individuals who lose a loved one to suicide suicide survivors tend n n recently someone mentioned to me how suicide is on the increase in zambia i did not think so within a couple of days after that i heard of four suicide incidences within lusaka suicide in africa let alone zambia is much less common than in industrialised countries to want to hide the cause of death and may have unbearable feelings of guilt wondering if they could have prevented it feeling blamed for the problems that preceded the suicide feeling rejected by their loved one and stigmatized by others suicide survivors also experience complicated grief because they experience anger for the loved one who they view as having brought such complications on them while experience grief from loss of a loved one it increases mortality anything that causes mortality is a concern not only to the health sector but to the nation as a whole it is a concern to humanity in the subsequent article we will tackle questions like `can suicide be prevented how can one cope with suicidal thoughts how can one deal with someone who has survived a suicide attempt how can one cope with suicide of a loved one nnnnnn why suicide is a concern n often the reasons that people kill themselves over are those that can be solved yes maybe not easily solving may involve using a lot more resources ­ financial physical or emotional laughter a good medicine researchers have found that people who have a sense of humor can extend their lives when sick as compared to those who do not for example cancer survival was found to be increased by 70 in those with a sense of humor than those without so kick back relax and have your self a good laugh family planning janet my husband and i have tried so many times but we just haven t been able to conceive bana mulenga you should go and see ba chikondamushi look at me i now have twins janet we did we ve been to see him three times already bana mulenga next time go alone the prisoner in hospital prisoner look here doctor you have already removed my spleen tonsils adenoids and one of my kidneys i only came to see if you could get me out of this place doctor i am bit by bit the dentist during afcon a dentist after completing work on a patient came to him begging dentist could you help me could you give out a few of your loudest most painful screams patient why doctor it wasn t all that bad this time dentist there are so many people in the waiting room right now and i don t want to miss the afcon semis against ghana the doctor after the afcon as the doctor completed the examination of the patient he said i cant find the a cause for your complaint frankly i think its due to drinking in that case said the patient i ll come back when you re sober in the waiting room while i was in the doctors waiting room there was this tiny man only about six inches tall although he was there before me he let me see the doctor first i supposed he just had to be a little patient sex drive yesterday i was in the doctor s waiting room and i heard a ninety-six year old man pleading with the doctor for a lower sex drive surely you re imagining things said the doctor your ninety six years old isn t all the feeling for sex just in your head yes replied the elderly man that s why i want you to lower my sex drive to the place where it might do more good loss of apetite when i asked the doctor to give me something to sharpen my appetite he just gave me a razor blade hillbilly medical terms 1 what is a tablet a small table 2 caesarian section neighborhood in rome 3 definition of benign what you shall be after 8 4 rectum damn near killed him 5 catheterize made her look at me 6 bacteria the back door of the cafeteria 7 dilate to live longer than your kids do 8 labor pains getting hurt at work 9 morbid a higher offer than i bid 10 tumor more than one 11 urine opposite of mine 12 secretion hiding something 13 terminal illness getting sick at the train station 14 post operative a letter carrier 15 pap smear a fatherhood test 16 pelvis elvis s first cousin 17 recovery room a place to do upholstery 18 varicose near by 19 barium what to do with dead folks 20 enema not a friend doctor doctor doctor doctor i feel like a piano then i had better take some notes doctor doctor could you help me my tongue keeps sticking out that s good now if you can just lick these stamps doctor doctor i have just swallowed a whole sheep doctor how do you feel patient quite baaa-d what did the vampire doctor shout out in his waiting room necks please

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p. 8

8 can saliva transmit hiv by dr.abel mwale hiv/aids has left a devastating path in its wake caused by a fast replicating and mutating virus and transmitted via body secretion such as semen vaginal secretions and breast milk aids has permeated all levels of society with no known boundaries close to three decades since the first cases were reported hiv/aids has hastily diffused to the most distant parts of the globe technologies are used in using oral fluids saliva in testing for hiv are worth exploring the answers lie in the techniques employed in correctly administering these tools for example oraquik gets the hiv antibodies these are proteins the body produces after one gets infected with hiv from the rather superficial blood vessels of the buccal cavity the inside of the cheek therefore the tests detect hiv antibodies from superficial buccal vessels and not necessarily in the saliva therefore even if an hiv free individual is from kissing an hiv positive person they will still test negative for hiv using oraquick however hiv is found in and can be transmitted though saliva e.g through kissing this is theoretically possible but practically impossible for a person to get the infective dose during kissing one has to gulp gallons of saliva also the chances of transmission are only highly significant when one has oral ulcerations or sores in the mouth deep french kissing in the presence of sores or gum disease definitely raises the risk in addition the amount of hiv virus contained is much lower as compared to sexual fluids and blood unprotected sexual intercourse remains the sure way of contracting the hiv virus the ever reducing age of sexual debut is a gnawing reality that largely contrib however hiv is found in and can be transmitted though saliva e.g through kissing utes to the standing hiv infection statistics according to statistics the median age at first intercourse is 17 years for women age 20-49 and 18 years for men in the same age groupzambia demographic health survey 2007 an enormous amount of literature has been published on hiv/aids schools have added it to their curricula the internet is flooded with information about it and television and radio are no exceptions and yet the perceived knowledge of the disease is not commensurate with the behavior one wonders if we are dealing with information overload at this stage of the pandemic almost everyone in zambia has heard about hiv/aids however only a little above 70 feel they have enough information about hiv/aids in summary it is important to note that is no risk of transmission through closed-mouth kissing hence the proverbial `kiss of death can only occur in certain circumstances as described above it is also important to realise that despite there being an almost universal knowledge of hiv/aids there is still a need to continue disseminating information not just any information but behaviour changing information for any questions comments additions or clarifications please do not hesitate to forward them to pulsehealthzambia@gmail.com we are looking for people in the following positions to add to our dynamic and vibrant team journalists writers qualified and experienced sales and marketing agents distribution agent please send an email to pulsehealthrecruit gmail.com or medinfozambia@gmail com by the end of 2001 29 million people were living with hiv worldwide and by the close of 2007 33.2 million people were living with hiv worldwide unaids 2007 each region has been affected differently by the pandemic with sub-saharan africa experiencing the most devastating repercussions at the end of 2007 more than two thirds of hiv positive people lived in the region an estimated 1.7 million people were newly infected with hiv in 2007 unaids 2007 the country of zambia nestled in the heart of sub-saharan africa is no exception as a country zambia has not been spared by the ravaging effects of hiv during the last two decades hiv/aids has pervaded all the sub sects of the country s population the virus that causes aids has been said to be transmitted through body fluids such as semen plasma and whole blood many have wondered whether saliva is among the bodily fluids that can serve as a vehicle for the notorious hiv virus this has seemingly been confirmed by the relatively new technology such as oraquik from orasure technologies that has been approved for the screening of hiv 1 and 2 using saliva with a sensitivity and specificity of about 98 the principles under which these new to advertise please call our marketing manager maurice lubasi 0974794460 or email pulsehealthads gmail.com or medinfozambia gmail.com congratulates the chipolopolo boys i this publication is for you and by you we want our stories to come from you because you know best what matters most to you health wise please feel free to suggest health topics make comments and suggestions and send all your questions and queries to pulsehealthzambia@gmail.com.

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