Thursday, 21 December 2017
LEO'S BLOG: THE NEED TO BE GRATEFUL FOR MOST ABORTIONS
LEO'S BLOG: THE NEED TO BE GRATEFUL FOR MOST ABORTIONS: She was the mother of two children, radiant and full of vigor. Her life was normal until she took in the third time. Little did she know th...
THE NEED TO BE GRATEFUL FOR MOST ABORTIONS
She was the mother of two children, radiant and full of vigor.
Her life was normal until she took in the third time. Little did she know that pregnancy would consume her.
She presented to the hospital with history of loss of menstruation, lower abdominal and back pain, weight loss and intractable bleeding per vagina. Before her presentation she had been in a peripheral hospital and had received about 10 units of blood.
The test for pregnancy was positive but the predictive value was alarmingly elevated. Other investigations done supported the diagnosis of a molar pregnancy which had over time transformed into cancer. The chemotherapy wasn't making her condition any better, pain was her constant companion, she bled more than the woman with the issue of blood. She was constantly transfused with blood and all their resources drained. Her husband became frustrated and requested for the uterus (womb) to be removed but no, it was late, the cancer had spread to the bladder, rectum and backbone. Everyone had been exhausted including the health care providers. She could no longer fight to live, her end had come, in tears she gave one last look to her younger sister who had been by her bedside all along and to her weary mother who had been praying and earnestly waiting for a miracle, then to her dear husband, who held tightly to her hands as if in a tug of war game with death. She apposed her eyelids gracefully and passed on with tears rolling down her cheeks.
ABORTION
It stings like a bee, hurts like a sore, painful like labour and agonising like the sorrowful mysteries to have waited for years, spending all the energies in sex, with great expectations for conception which inadvertently ends in abortion. But would you rather prefer it ends like the story above?
Before I proceed it's pertinent that we understand the concept of the term, abortion. It is the termination of pregnancy before the age of viability (when the baby can survive outside the womb). In advanced countries the age of viability is between 20-24 weeks while in less developed countries it's about 28 weeks. Nevertheless, when this termination is initiated by human intervention using any means and not based on medical reason (s) , it's termed 'Criminal Induced Abortion'. On the contrary, when it occurs by itself, it's termed 'Spontaneous Abortion' and this is where my interest lies.
CAUSES OF SPONTANEOUS ABORTION
It is scary to know that pregnancy can transform into cancer. This is usually the product of chromosomal abnormalities following the fertilisation of an empty or normal ovum (egg) by 2 Y chromosomes instead of one.
When the surveillance system fails to terminate this abnormal (molar) pregnancy, it developes into an invasive mole, the cells become immortal and may transform to malignant cancer, Choriocarcinoma. It eventually spreads to near and distant tissues and results in death of the individual.
I'm yet to see a patient that survived this but it's not altogether a hopeless situation.
So see a reason in this and be grateful for your experience(s). Thank you for reading!!!
Her life was normal until she took in the third time. Little did she know that pregnancy would consume her.
She presented to the hospital with history of loss of menstruation, lower abdominal and back pain, weight loss and intractable bleeding per vagina. Before her presentation she had been in a peripheral hospital and had received about 10 units of blood.
The test for pregnancy was positive but the predictive value was alarmingly elevated. Other investigations done supported the diagnosis of a molar pregnancy which had over time transformed into cancer. The chemotherapy wasn't making her condition any better, pain was her constant companion, she bled more than the woman with the issue of blood. She was constantly transfused with blood and all their resources drained. Her husband became frustrated and requested for the uterus (womb) to be removed but no, it was late, the cancer had spread to the bladder, rectum and backbone. Everyone had been exhausted including the health care providers. She could no longer fight to live, her end had come, in tears she gave one last look to her younger sister who had been by her bedside all along and to her weary mother who had been praying and earnestly waiting for a miracle, then to her dear husband, who held tightly to her hands as if in a tug of war game with death. She apposed her eyelids gracefully and passed on with tears rolling down her cheeks.
ABORTION
It stings like a bee, hurts like a sore, painful like labour and agonising like the sorrowful mysteries to have waited for years, spending all the energies in sex, with great expectations for conception which inadvertently ends in abortion. But would you rather prefer it ends like the story above?
Before I proceed it's pertinent that we understand the concept of the term, abortion. It is the termination of pregnancy before the age of viability (when the baby can survive outside the womb). In advanced countries the age of viability is between 20-24 weeks while in less developed countries it's about 28 weeks. Nevertheless, when this termination is initiated by human intervention using any means and not based on medical reason (s) , it's termed 'Criminal Induced Abortion'. On the contrary, when it occurs by itself, it's termed 'Spontaneous Abortion' and this is where my interest lies.
CAUSES OF SPONTANEOUS ABORTION
- Chromosomal/ Genetic abnormalities
- Maternal Disease conditions ; Diabetes, Renal disease.
- Infections
- Genital tract anomalies
- Cigarette smoking
- Alcohol
- Toxins including certain drugs
- Radiation
- Unknown
ESSENCE OF GRATITUDE
There are two main reasons for gratitude to God for some cases of spontaneous abortion.
- Aversion of malformed babies
- Aversion of malignant cancer
Aversion of malformed babies
Incidentally, most causes of spontaneous abortion are responsible for congenital malformation (abnormal structure at birth). The body has a surveillance system that screens, identifies and repairs /eliminates abnormalities at cellular, tissue, organ or systemic levels. This is done to terminate conditions incompatible with life and further prevent complications and preserve an individual. This regulatory mechanisms fail sometime at the initial stage and the child is born with such abnormalities but eventually dies sooner after birth or lives a life without quality. Consider the trauma posed by this situation on both parents as well as relatives.
Aversion of malignant cancer ( Gestational Trophoblastic Neoplasia)
It is scary to know that pregnancy can transform into cancer. This is usually the product of chromosomal abnormalities following the fertilisation of an empty or normal ovum (egg) by 2 Y chromosomes instead of one.
When the surveillance system fails to terminate this abnormal (molar) pregnancy, it developes into an invasive mole, the cells become immortal and may transform to malignant cancer, Choriocarcinoma. It eventually spreads to near and distant tissues and results in death of the individual.
I'm yet to see a patient that survived this but it's not altogether a hopeless situation.
So see a reason in this and be grateful for your experience(s). Thank you for reading!!!
Monday, 4 December 2017
LEO'S BLOG: UNRAVELLING THE PUZZLE OF SYPHILIS IN A THREE YEAR...
LEO'S BLOG: UNRAVELLING THE PUZZLE OF SYPHILIS IN A THREE YEAR...: ... After Dr. Okpokiri announced the result of the VDRL test (test for syphilis) to the disappointment of Mrs. Oruada, neither of them was p...
UNRAVELLING THE PUZZLE OF SYPHILIS IN A THREE YEAR OLD
... After Dr. Okpokiri announced the result of the VDRL test (test for syphilis) to the disappointment of Mrs. Oruada, neither of them was positive, he husband turned and gave her an angry look. The fire in his eyes could raze a sky scraper and she saw hell through his eyes that sent chills down her spine and reawakened her conscience to all her accusations and show of distrust for him. She quickly remembered the occasion where she regretted by words and gestures ever knowing her husband and pushing him down along the stairs when he tried to resolve issues with her. All the ugly incidents and her misbehaviour came back to her like the prodigal son and pierced her soul like the silver arrow in Robin hood, emotionally overwhelmed, tears flowed down her prominent cheeks while she cried like an infant hungry for breast milk. She knelt down, buried her head between her husband's laps while resting her elbows on the later and asking for forgiveness from him. Mr. Oruada was moved with pity that he clasped his arm around her neck and wiping her tears with his brown handkerchief and reassuring her of his forgiveness and endless love.
When this sensational episode was over, Mr. Oruada then asked the doctor, how then their child got syphilis if neither of them was responsible. They were adviced to take their time and tactfully inquire from their child or mount a surveillance since unthinkable things happen these days. That afternoon , the parents called little Daniel into their bedroom, gave him a cup of ice cream, the mother called him several pet names, stroke his hair, all in preparation to dig out the secret in him. When they they felt the time was ripe, she now threw the question at him, Who has been touching you here? While indicating his private part with her index finger. Daniel replied immediately, ' Is it not Ivie'. Shocked at his response she was filled with outrage. what? She asked furiously with an impulse that set her in motion to unleash the dragon on Ivie but her husband signalled with his hand asking her tobe calm. They then further asked him to narrate everything she had done to him.
Ivie was their house help, about 16 years of age. She slept in the same room (children's room) with the kids. At midnight, she would carry Daniel in her laps, stroke his penis and when well erect would introduce it into herself. Daniel got used to it that most times he would lie on Ivie and do certain other absurd things which she thought him. This had gone unnoticed by the parents for 7 months before he fell sick. Ivie outrightly denied all allegations levelled against her. She was taken to the hospital to be tested and behold the result was positive for Syphilis. The other story of what became of Ivie is better imagined than told.
This is a sexual transmitted disease caused by a gram negative organism called treponema palladium. It can also be transmitted through the placenta from mother to developing fetus during pregnancy.
SIGNS AND SYMPTOMS
The disease if untreated will progress through 3 stages, viz:
When this sensational episode was over, Mr. Oruada then asked the doctor, how then their child got syphilis if neither of them was responsible. They were adviced to take their time and tactfully inquire from their child or mount a surveillance since unthinkable things happen these days. That afternoon , the parents called little Daniel into their bedroom, gave him a cup of ice cream, the mother called him several pet names, stroke his hair, all in preparation to dig out the secret in him. When they they felt the time was ripe, she now threw the question at him, Who has been touching you here? While indicating his private part with her index finger. Daniel replied immediately, ' Is it not Ivie'. Shocked at his response she was filled with outrage. what? She asked furiously with an impulse that set her in motion to unleash the dragon on Ivie but her husband signalled with his hand asking her tobe calm. They then further asked him to narrate everything she had done to him.
Ivie was their house help, about 16 years of age. She slept in the same room (children's room) with the kids. At midnight, she would carry Daniel in her laps, stroke his penis and when well erect would introduce it into herself. Daniel got used to it that most times he would lie on Ivie and do certain other absurd things which she thought him. This had gone unnoticed by the parents for 7 months before he fell sick. Ivie outrightly denied all allegations levelled against her. She was taken to the hospital to be tested and behold the result was positive for Syphilis. The other story of what became of Ivie is better imagined than told.
SYPHILIS
This is a sexual transmitted disease caused by a gram negative organism called treponema palladium. It can also be transmitted through the placenta from mother to developing fetus during pregnancy.
SIGNS AND SYMPTOMS
The disease if untreated will progress through 3 stages, viz:
- Primary Syphilis
- Secondary "
- Tertiary "
Primary Syphilis is characterised by:
- A unique painless rash, Chancre on the external genitalia
- Painless solitary lymph node enlargement
Secondary Syphilis is characterised by:
- Bacteremia with associated fever
- Condyloma latum
- Generalised lymphadenopathy
- Systemic symptoms
- Patchy baldness
- Generalised body rash
Tertiary Syphilis is characterised by:
- Gummatous lesions affecting the skin and bones
- Cardiovascular Syphilis with aortitis (inflammation of the aorta), aortic aneurysm (ballooning of the aorta) and myocarditis (inflammation of heart muscles)
- Neurosyphilis with associated General pares is of the insane, visual disturbance, subacute meningitis but may also be asymptomatic (without symptom).
Effects of Syphilis on the Fetus
- Spontaneous Abortion /Miscarriage
- Prematurity
- Intrauterine Fetal demise
- Early infant death
Thank you for reading!
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