AS-AS Couple: Prenatal Diagnosis Option

WORLD SICKLE CELL DAY JUNE 19 2020

Today we celebrate the 10 year anniversary of the World Sickle Cell Day. It is a day to raise public awareness of sickle cell disease, and shed light on the challenges experienced by patients and their families and caregivers. In this article we briefly discuss the sickle cell disorder and trait

Pre-Natal Diagnosis
With awareness growing about the attendant consequences of having a child with the sickle cell disorder (SS) in this present age, many young people with the AS or AC genotype continue to take precautions regarding the genotypes of their spouses, as parents who have the benefit of hindsight counselling against their sickle cell trait (AS) children getting involved with their type and religious organizations putting in place strict laws including mandatory genotype testing before joining couples.

Many knowledgeable couples who happen to carry the sickle cell trait however still end up together and look forward to having kids without the sickle cell disease and thankfully scientists continue to work tirelessly to add to the present medical options available; Prenatal diagnosis for genotype, In-vitro fertilization and Bone marrow/Stem cell transplant. These options have been proving beneficial to many of such couples and continue to become increasingly available to all.

Prenatal Diagnosis

Prenatal diagnosis is a procedure done in the first trimester of pregnancy to determine the genotype of the foetus in-utero. Couples with the AS trait who are at risk of having a baby with sickle cell disease are offered this service at about 8th weeks of gestation after being screened and counselled.  It is an ultrasound guided procedure and placental samples are taken from the fetus. Complications that can arise from the procedure include pain, bleeding, and rarely miscarriage. 

Sickle Cell for your Information

Sickle cell disease is an autosomal recessive condition. sickle cell disease is a hereditary blood disorder. If both you are your spouse are AS genotype then you are both carriers of the abnormal gene. During each pregnancy you will have a 1 in 4 (25%) chance of having an affected child SS genotype, a 1 in 4 (25%) chance of a normal child AA genotype, and a 1 in 2 chance (50%) of a carrier child AS genotype. 

The availability of direct prenatal testing can provide a definite answer, rather than a statistical estimate, on whether a foetus has sickle cell disease. The information from prenatal testing may be used to consider different reproductive options. You are advised referral to a geneticist or obstetrician that specializes in prenatal diagnosis.

Medic-ALL.Inc 2014

See also World Sickle Cell Day 

Prenatal Diagnosis: This service is available at various centers across the world

Ebola WATCH:.WHAT'S NEW!!!

SATURDAY 02:08:2014

US Ebola victim arrives at Emory University hospital in Atlanta:

One of two two US victims of the West African Ebola outbreak, Dr. Kent Brantly arrived in the country on Saturday and was transferred to an Atlanta hospital with one of the most sophisticated isolation units in the country.

He was flown by specially adapted private jet to Dobbins Air Force Base in Marietta, Georgia, just outside Atlanta. He was said to have contracted the disease while working for a charity in Liberia.

The other victim is to be carried on a latter flight as the plane is equipped to carry one patient at a time.

State of Emergency in Sierra Leone:

A state of emergency has been declared in Sierra Leone and troops have been called in to enforce an Ebola quarantine, joining Liberia in imposing controls to curb the worst ever outbreak of the virus amid fears it could spread beyond West Africa.

Nigeria's 1479 Land Borders raises fears

There are fears that Nigeria's 1479 porous borders poses a threat to the ability of the country to check the spread of the deadly Ebola virus. There are calls being made to ensure the closing of some of the borders by the Federal Government.

A disease out of control?

Doctors beyond borders fear that the deadly Ebola virus disease may be out of control.

Ref : the guardian (U.S)

         Punch (Ngr)

Medic-ALL.Inc

BRAIN DRAIN: The Mass Exodus of Nigerian Doctors

Medic-ALL (02:08:2014) 2:00AM

The Figures

According to the President of the Nigerian Medical Association (NMA), Dr Osahon Enabulele, there are 71,740 medical and dental practitioners listed on the register of the Medical and Dental Health Council of Nigeria, with about 27,000 currently in Nigeria. It is believed that at least 40,000 Nigerian medical doctors practising in the United States! With a recent report stating that 77% of Black Doctors in the U.S are Nigerians!

The implication is that the country has a doctor-population ratio of 1: 6,187, given a population base of 167, 000,000. 

How effectively and efficiently can the healthcare sector cope with such numbers?

The truth of the matter is that things are not getting any better as Nigerian medical doctors at every level of practice, from House-officers to Consultants!, including some Professors are leaving the shores of this country in search of their "Promised land". 

The situation is becoming even more alarming as the doctors, asides from pursuing greener pastures in the usual suspect places such as U.S, U.K ,Canada and Australia have begun leaving for and as I write are immigrating into countries like Saudi Arabia, U.A.E, Trinidad and Tobago, Finland, South Africa and even Gambia to mention but a few!

The massive exit of Nigerians abroad actually started in the 1980s, following the economic crisis caused by the profligacy of a corrupt ruling elite. Faced with poor remuneration, lack of a satisfactory working environment, and the absence of the necessary equipment, doctors and other professionals, including nurses, left the country to the countries in search for better opportunities.

The loser, however, was the country’s health care system.

While many consider this exodus of Nigerian Doctors abroad a "brain drain", a good majority of colleagues now believe that the "Real Brain Drain" is practising in a country where you are relatively not well appreciated and compensated as compared with counterparts abroad coupled with the frustrating limitations posed by certain factors in the healthcare sector of the country.

How then can we prevent the loss of medical professionals to the "more" developed countries? 

I believe Nigeria is without doubt sufficiently endowed to have well-equipped public health facilities manned by well-remunerated and motivated staff as well as research facilities capable of hosting ground-breaking studies towards better healthcare. Equally important is the need to ensure that the  policies in place in the health sector are sane and reasonable enough to keep the doctor focused and happy to work at every given time. 

With this, Not only would we succeed in keeping a good number of the 27,000 - x (! some doctors are leaving right now , remember?) on ground , but we will on the long run find that Nigerian medical doctors, and even nurses and other medical professionals would be wooed back to the country in no time.

Medic-All .Inc

Businessdayonline: Lagos quarantines hospital where Ebola victim died

Businessdayonline (Lagos)

Monday 28/7/2014

The Lagos State Commissioner for Health, Dr Jide Idris on Monday, said the state has shut down and quarantined a hospital where a Liberian man died of Ebola in the first recorded case of the highly infectious disease in the country.

Patrick Sawyer, a consultant for the Liberian finance ministry in his 40s, collapsed on arrival at Lagos airport on July 20 and was put in isolation at the First Consultants Hospital in Obalende. He died on Friday.

“We have shut the hospital to enable us to properly quarantine the environment. Some of the hospital staff who were in close contact with the victim have been isolated,” Idris said.

The hospital will be shut for a week and all staff monitored to ensure the virus has not spread, he added.

Ebola has killed 672 people across Guinea, Liberia and Sierra Leone since it was first diagnosed in February.

It can kill up to 90 percent of those who catch it, although the fatality rate of the current outbreak is around 60 percent. Highly contagious, especially in the late stages, symptoms include vomiting, diarrhoea and internal and external bleeding.

Adding to the risks, Nigerian doctors are on strike over conditions and pay. Chairman of the Nigerian Medical Association Tope Ojo was quoted in local media on Saturday as saying the strike would not be called off despite the Ebola threat.

Nigeria’s airports, seaports and land borders have been on “red alert” since Friday.

Liberia closed most of its border crossings on Sunday and introduced stringent health measures.

The World Health Organization said in a statement that Sawyer’s flight stopped in Lome in Togo on its way to Lagos.

“WHO is sending teams to both Nigeria and Togo to do follow up work in relation to contact tracing, in particular to contacts he may have had on board the flight,” WHO spokesman Paul Garwood said.

The WHO said that in the past week, its regional director for Africa, Luis Sambo, had been on a fact finding mission to Guinea, Liberia and Sierra Leone, which have 1,201 confirmed, suspected and probable cases between them.

“He observed that the outbreak is beyond each national health sector alone and urged the governments of the affected countries to mobilise and involve all sectors, including civil society and communities, in the response,” the WHO statement said.

A relative surge in cases in Guinea after weeks of low viral activity showed that “undetected chains of transmission existed in the community”, the WHO said, calling for containment measures and contact tracing to be stepped up in Guinea.

DIAGNOSIS: A Troubled Health Sector

Day 28,Nationwide Doctors Strike:

It is not uncommon to find that in the midst of several conflicting reports, accusations and counter-accusations, the most salient and important of details are quickly forgotten while "shadow-chasing" very often becomes the order of the day.

Over the last few weeks I have come across several reports in the dailies and on social media as regards the on-going events in the Nigerian health sector. Most of these reports and articles, lopsided on many occasions, have a common denominator, presenting the Nigerian doctor as an enemy of the people and the manner of their submissions is such as to draw undue sympathy from the unsuspecting public and sometimes misinformed public.

It is perhaps apt at such a time as this to look closely at the health sector in Nigeria (which has being recently tagged "one of the least adequate on the continent" by the international media) and the real issues surrounding the nationwide strike action embarked upon by doctors under the umbrella of the Nigerian Medical Association (NMA) which enters it's 5th week from Tuesday the 29th.

I should quickly point out that the deplorable state of our healthcare system is not as a result of the performance of the health workers, but it is a component of an overall failed system called Nigeria which the Government is presently trying to salvage.

It must be recalled that the Nigerian Medical Association did state that it was taking the  "painful decision"  of indefinite withdrawal of services in order to save the healthcare system from imminent collapse. This was after the body had tabled a 23-point demand to the Federal Government about 2 weeks prior to the commencement of the strike action and issuing a 14-day ultimatum for the resolution of the issues.

Two of the key demands of the Nigerian Medical Association include:

1. Issues relating to the appointment of Chief Medical Directors and other federal appointments in the health sector. Clearly "the position of the Chief Medical Director must continue to be occupied by a medical doctor as contained in the Act establishing tertiary hospitals.

BY THE WAY

There are demands from other “Health Professionals” under the auspices of the Joint Health Workers Union (JOHESU) for the chance to occupy such offices as the Chief Medical Director. 

2. An increase in doctors hazard allowance, skipping of grade level 12 (CONMESS 2) for medical and dental practitioners and the reversal of the title of consultants for other professionals in the health care system apart from doctors.

The NMA is largely displeased with certain appointments in the health sector which could distort the chain of command in health institutions and also lead to poor management of patients.

There is no doubt that the average Nigerian doctor is eager to return to work and deliver health care services to an already "short-changed" populace : We presently have less than 30,000 doctors looking after 170 million Nigerians ( a ratio of one doctor to 6000 patients! ). It is however of utmost importance to have a functional working environment, whereby the "over-stretched" Nigerian medical doctor is not hassled by "farcical" policies and defective welfare packages.

Source: Medicall-Inc

WHAT YOU MUST KNOW ABOUT THE EBOLA VIRUS!

EBOLA FACTS

Ebola virus disease (EVD), formerly known as Ebola haemorrhagic fever, is a severe, often fatal illness in humans.

EVD outbreaks have a case fatality rate of up to 90%. The outbreaks occur primarily in remote villages in Central and West Africa, near tropical rainforests.

Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals.

The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission.

In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

Ebola spreads in the community through human-to-human transmission, with the infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids.

Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

It is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.

No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use.

In the absence of effective treatment and a human vaccine, raising awareness of the risk factors for Ebola infection and the protective measures individuals can take is the only way to reduce human infection and death.

SOURCE: World Health Organization Media Centre

NMA Strike to continue despite Ebola threat -Lagos NMA

In spite  of  the imminent threat of the Ebola Virus in Lagos, striking medical doctors under the aegis of Lagos State branch of the Nigerian Medical Association, have said they will not suspend the ongoing strike .

The Chairman of the association, Dr Tope Ojo, said the ongoing strike was not called because of Ebola and could not be called off because of the threat of the viral infection in the state.

He said, “We are not on strike because of Ebola. It was never part of our demands. It wasn’t our fault.”

He, however, said the doctors would continue to partner with the state government to monitor the trend of the disease to check its spread.

Ojo, who spoke at a press briefing organised by the newly elected officials of NMA in the state, said the association regretted that his team had to take over the leadership of the association during the industrial dispute.

He blamed the  ongoing crisis in the health sector on the Federal Government’s  mismanagement of the sector.

He said, ” Why should a government be willing to concede the headship of the medical institutions to the hands of allied health workers?

“Will the same government not concede to a hostess  the right to fly a plane or court bailiff  the post of a judge or the head of a university maintenance unit to be the vice chancellor because of the so-called opportunistic explanation of team work?”

Speaking on the contentious issue of granting the prayers of other health workers to become consultants , Ojo said the decision of the government, if allowed, will only create unending anarchy.

Ojo stated, “The title of ‘ Consultant’ in  medical practice is preserved exclusively for a doctor that has gone through a minimum of six years excruciating full time, postgraduate academic training.

“The patient is traditionally registered under a consultant, who owns the patient and reserves the right of success or failure in the chain of events.  We therefore warn the Nigerian people of the inherent danger of this conspiracy to deceive and confuse them as they attend hospitals for their health needs.

“NMA is not against the normal professional advancement of any allied health professional. Our position is that the situation must not arise where there will be anarchy and disruption of the chain of command that is bound to jeopardise patients’ lives.”

He added that a situation, where doctors are paid N5,000.00 monthly allowance for hazard was not only laughable but unbelievable.

Ojo said,“A doctor’s life can be lost in an instance when exposed to fatal illnesses such as Ebola, Lassa fever or he may be subjected to a life-long suffering from HIV or Hepatitis B infection

Ebola Virus:.Nigerian Government confirm first case in Lagos

ABUJA/GENEVA (Reuters) - A Liberian man who died in Nigeria's commercial capital Lagos on Friday tested positive for the deadly Ebola virus, Health Minister Onyebuchi Chukwu said.

Patrick Sawyer, a consultant for the Liberian finance ministry in his 40s, collapsed on Sunday after flying into Lagos, a city of 21 million people, and was taken from the airport and put in isolation in a local hospital. Nigeria confirmed earlier on Friday that he had died in quarantine.

"His blood sample was taken to the advance laboratory at the Lagos university teaching hospital, which confirmed the diagnosis of the Ebola virus disease in the patient," Chukwu told a press conference on Friday. "This result was corroborated by other laboratories outside Nigeria."