Beware of "Ndi Ekpere" a.k.a Intercessors; they almost broke my patient's marriage

It was Saturday, the rain which had blown her whistle and conjured and compelled all on foot to an aerobic exercise had stopped to usher in my index patient. The green empty card lying helplessly on my table introduced the couple before they sought my permission to ingloriously enter the consulting room.

The weak knock on the door suggested a female patient who walked in accompanied by her husband. My prying eyes scanned their countenances while we exchanged pleasantries. The man was semi-mute which made me fix my gaze on him, changing my lens power to a higher magnification to pick up every clue I need to make my diagnosis but no, he would not utter a word. Yet the expression on his bearless dark face was like a thesis waiting to be published. Even though the metal seats on which they sat were juxtaposed, they (couple) presented a concavo-concave position towards each other as though they intend to repel each other.

After extracting the basic information about the couple, I decided to be more friendly, so I asked with a smile, how may I help you? The woman threw out the complain like a hot tea in the mouth, "Dr. we have been trying but it's not entering" I smiled again to give them hope and rephrased her answer to a more palatable parlance and served it to her, cool. You mean you want to conceive? And she concurred both verbally and dramatically.

This couple have been blessed with a child just two years ago which raised my curiosity, so I asked, why do you think you have fertility issues? This singular question came like an invocation of the god, Hermes, the god of speech/language, which visited the husband and like Zacharaih, restored to him the power of speech. He broke his silence, interrupted the wife's perceived misrepresentation and concealment of the truth.

I'm not bothered, he said, his voice becoming deeper and more audible. My wife is the problem as he pointed at her with his index finger while oscillating them like the wave of a troubled sea. These words was like a hammer blow that drove the wife into herself, she tried to slow him down with a signal from her hand but it was like trying to stop the moving train. I want to do a test, he added. Too many assertions and requests, the ball was now in my court. I had to play it in the goal oriented direction, so I asked him directly, Oga! What really is the problem?

The moment of Truth had come when books are opened and everything done in the dark would be laid bare.
My wife went to a prayer house to ask for prayers for the fruit of the womb. The prophetess who laid hands on her, told her authoritatively that I, the husband, is the cause of her infertility because I have a Low Sperm Count.
After that encounter I have not known peace in my house. It is out of frustration that I followed her today to put an end to this madness...

This is a true story... The rest of the gist is mine.
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LAB INDICATES PREGNANCY BUT DR. SAYS OTHERWISE

It was like a game of puzzle. She had the letters P-R-E-G-N, she only needed the letters A,N,T to score 100 points to win her opponent but the gods weren't on her side. It was her last move and all that was left in her tray was N,O,T.

Azuka missed her menses for about two cycles with symptoms suggestive of pregnancy. She obtained a pregnancy test strip from a nearby patent medicine store, rushed into her rest room as though she was in a hurry to catch up with her flight. After struggling with her tight bum short which almost made her irrigate her limbs with hot tempered urine, she got a sample and quickly conducted the test.

While she waited for the result, she made herself a little more comfortable by deflating her gut. The resulting phonics is better imagined. Amidst the performance, she suddenly exclaimed,
Aaaaaaaaah! Obago!! Azuka, you are too much, she said to herself on sighting double lines on the strip. She then sprung up from the toilet seat to do the kerewa dance, out of excitement.

One week later, she visited a clinic on account of blood stain which she observed after cleaning herself up.

After an ultrasound scan investigation, the doctor informed her that there was no evidence of pregnancy.
To her disappointment, she turned round to confirm if she was really in the right place and when she turned to the doctor, her forehead furrowed, her pupils dilated and her voice echoed a masculine tone as she asked the doctor to repeat himself. He tried to calm her down but the more he tried, he met with stiffer resistance. There must be a mix-up somewhere, it's probably someone else's report because am double sure about being pregnant.
With these words, Azuka walked out of the doctor's office angrily to a medical laboratory for a repeat pregnancy test. The result was contrary to the doctor's opinion. Quack doctor, she said, I knew I was pregnant.

She decided to visit another health Care facility to book for Antenatal Care but the same issue reared its ugly head again. She wished the doctor would say something different/positive but he looked at her in the face and unequivocally told her that she wasn't pregnant. This time she was broken, speechless and confused. She bent over the table and sobbed...
Madam are you alright? Asked the doctor. How can I be alright when you people are against my pregnancy? I don't understand you madam, the doctor replied. As though she was recovering from her mishap, she narrated her experience to the doctor and ended her story with this question,
How possible is it that I missed my period and confirmed my pregnancy with a lab test even with a recent one yesterday and you still say am not pregnant? The doctor gave her these explanations. 👇

FALSE-POSITIVE B-HCG

B-HCG stands for beta human chorionic gonadotropins. It's a hormone produced by a placental precursor. It's this chemical that your test strip looks for in pregnancy test. When the strip says it's present (by showing two lines) in a person who actually is not pregnant it's referred to as false positive and can be seen in conditions like:


INTERFERING ANTIBODIES: two persons (antibodies) are needed to indicate the presence of B-HCG in the urine or blood. The capturing antibody catches and holds the B-HCG in place while the signalling antibody binds to the chemical and announces it's presence by showing double lines. In some individuals there's a special antibody called interfering antibody. It gives the signalling antibody the false impression that it has captured the chemical thereafter the signalling antibody announces without confirmation, resulting in false positive result.

EXPIRED TEST KIT: every test kit has expiry date beyond which it's sensitivity and specificity is questionable. Hence an expired test strip would most likely give a false positive result.

CHEMICAL/BIOCHEMICAL: it is possible that she WAS pregnant but lost it before her presentation to the clinic. Sometimes pregnancies occur but for different reasons fail to continue. The HCG resulting from such pregnancies lingers for a while, up to a month, before it is completely removed from the blood. Therefore within this time pregnancy test would be positive.

CANCER: the tissues of pregnancy notably "the trophoblast" may under go abnormal development following chromosomal abberation resulting in Molar pregnancy, a condition referred to as "Gestational Trophoblastic Disease. This is a rich source of B-HCG which can be identified in pregnancy test.

PITUITARY HCG: the pituitary gland is an endocrine gland. It controls the reproductive system and in turn gets feedback regulation from same. When ovarian function declines significantly, feedback is lost and it produces significant amount in B-HCG. This is common above the age of 40 years.
This gland also produces other hormones that have similar structure with B-HCG viz, Follicle Stimulating Hormone,Thyroid Stimulating Hormone and Luteinizing Hormone which can give a false positive result.

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Witch's milk mismanagement in baby ends in hospital admission and surgery

Whatever you lack knowledge about has an edge over you, so they say. Sometimes our actions, inactions or inappropriate actions may become regrettable, especially when it generates ripple effect. So it was in this one month old baby.

It is not uncommon for mothers to find out suspicious appearances on babies during routine bathing.
 On this faithful day Ezinne called out to her mother-in-law to come and see for herself. I hope my eyes aren't deceiving me, she added, these breasts are getting bigger, while pointing at her baby's chest. Bibiana ochoro ikpù añra? ( Is Bibiana growing breast) Chineke! (God)  this one beats my imagination o!

Out of curiosity she compressed the right breast and exclaimed when she saw breastmilk flowing out. This is not normal, how can a new born lactate? Who does she want to breastfeed? They took their turn to empty both breasts and felt a little satisfied after the exercise. The following day, the breasts had become engorged and even bigger. Ezinne spent more of her time trying to decompress the breasts.
In the evening of that same day the right breast had become swollen, reddish and tender (painful to touch), baby developed high grade fever with restlessness. With these developments, mother wrapped up her baby and zoomed off to a drug dispenser who told her that her child has a "hormonal imbalance". Six injections were given to the baby instantly and some take home drugs.
After two days of nightmare, she then brought the child to the clinic. By then, the child had developed "Right Breast Mastitis and Abscess" which therefore prompted surgical incision and drainage.

Witch's milk/ Neonatal milk

During pregnancy certain hormones become elevated in the woman, including Prolactin and Growth hormone. These are transferred to the baby during breastfeeding. When significant, they stimulates transient breast development and lactation in both sexes.
Thyroid hormones which also peaks in babies after delivery (to help in temperature regulation) also contribute to this phenomenon referred to as Witch's milk.
The production of breastmilk may last up to two months before it resolves.
N:b it's a normal occurrence seen in some children.
It does not require any TEST or TREATMENT.
DO NOT COMPRESS THE BREAST OF AFFECTED CHILDREN.
The term "witch's milk"does not imply that the baby is a witch but from history it was thought that the breastmilk was a source of nourishment for witches.

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28 years old lady battles with her life after inserting drug into her vagina

Despite different Heath education on the dangers of self medication people still pay deaf ears to warnings from health experts.

In the wake of yesterday, a young lady name withheld, in the beautiful city of Owerri, Nigeria was rushed to a private clinic in an unconscious state.

Infirmation at our disposal has it that she opened an Ampiclox capsule and poured the powder into her vagina.
She did this following itching which she had two days proir to the incident.

After the drug application she felt an intense burning sensation and dizziness before she passed out.
She has been revived in the clinic thanks to the medical team on call.

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LEO'S BLOG: BREASFEEDING MALPRACTICE: Baby doesn't get filled ...

LEO'S BLOG: BREASFEEDING MALPRACTICE: Baby doesn't get filled ...: With zero enthusiasm and just to fulfill an unholy righteousness she sat down on the hard metal chair to listen to the day's talk. As ...

BREASFEEDING MALPRACTICE: Baby doesn't get filled or add significant weight

With zero enthusiasm and just to fulfill an unholy righteousness she sat down on the hard metal chair to listen to the day's talk. As the instructor introduced herself, Caris, distracted herself with assessing her instructor's physic and outfit. Cheap shoes, she whispered to herself...
She had heard so much about the benefits of exclusive breastfeeding but the fourth point as outlined dropped on her rich soil like the parable of the sower . It was  the fact that breastmilk improves the intelligent quotient ( IQ)  of children. She adjusted herself and focused on the instructor, like one hypnotized by a psychologist ,with her eyes dilated with curiosity. The weighty words sank deep into her subconcious and turned on her centre for creative imagination. She saw her child with awards for excellent academic performance and just when he was about receiving  the best graduating medical student award, she received a tap on her shoulder which disconnected her from her day dreaming.
It was her loquacious friend, Omasiridiya, who came to seek for her company home, since the antenatal class was over. Seeing she was lost in thoughts, Omasiridiya  lowered herself and in sympathy asked her friend, Caris, if all is well with her. But when she wasn't yielding for fear of being engaged in a never ending gossip, Omasiridiya prompted Caris, asking "I hope its not about your husband again this time? But she gave her a smile, shook her head in response, picked up her bag to go home.

 On their way home,  Omasiridiya persistently poked her friend with words until she eventually engaged her in a conversation. They chewed and digested the antenatal topic. Caris smartly raised the topic before Omasiridiya would choose her victim from her archive for gossip. For Omasiridiya, the fact that exclusive breastfeeding keeps her baby away from frequent hospitalization, saves her some money, reduces the risk of breast cancer, serves as contraception, reduces the incidence of diabetes in her child and increases the bond between her and the baby, was enough to convince her. As usual Omasirudiya did most of the talking while Caris listenl to save herself some energy but they both agreed on exclusive breastfeeding.

Caris had put to bed and waited anxiously for the breastmilk to begin flowing so she can transform her child's brain to that of a genius. It came, in answer to her prayer, first like a drizzling rain and later like a fountain. Out of curiosity and enthusiasm she began quizzing her five days old baby...

Breastfeeding soon became frustrating for her following increasing demands from her baby. The intermittent cries, sleeplessness and occasional dizzy spells squeezed the life out of her and like a fragile egg, she cracked and in a jiffy threw all her memories and dreams away like ashes. Her mother-in-law recommended water to complement the breastfeeding. A suggestion she grabbed with both hands and with thanksgiving.
One week later, the baby was rushed to the hospital on account of high grade fever and stooling.

WHY BABY MAY NEVER GET FILLED OR HAVE SIGNIFICANT WEIGHT GAIN DURING BREASTFEEDING

The concept of foremilk & hindmilk

The MATURED BREASTMILK (breastmilk produced after colostrum) as it flows varies in it's component. The initial milk is watery with more sugar (lactose) than fat. This is referred to as the foremilk. The foremilk quenches the baby's thirst, provides energy and simulates brain development but doesn't fill-up the child.
The milk that flows later in the course of breastfeeding is creamy and contains high fat, higher calorie, vitamin A&E. This is referred to as hindmilk and stimulates baby's growth and therefore promote weight gain.
Both types of breastmilk are equally important and each round of breastfeeding should be such that adequate amounts of both types be obtained- balanced diet.
Improper breastfeeding practices like abnormal posture and frequent switch between breasts results in imbalance. Excess foremilk causes gassing, abdominal pain, irritability,passage of loose greenish colored stool with possible blood stain. This is due to excess sugar in the foremilk.

WHAT TO DO

• Increase the frequency of breastfeeding to less than three hourly.
• Eat good food rich in protein and fat.
• Ensure by inspection that a child gets the hindmilk during each breastfeeding session.
• If observed that the foremilk is in excess, it may be expressed.

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REPRODUCTIVE LIFE BEYOND 35 YEARS OF AGE

Every woman has her prime time, when she blossoms like a rose flower and glows like the olympic torch. At this time all hormones are working together for her glory.
Emelda was like an emerald. She had the perfect figure that would make a man forget his meals. She was young, attractive and industrous. Every door she knocked at opened without hesitation.
One expected that she begin a family life pretty earlier following the mad rush by suitors but,no, not yet. She likes adventure, freedom and knowledge and would rather fullfil these before the perceived entrappement/enslavement called marriage.
Now she is forty years of age, one year into her marriage, still retaining her gorgeous looks but unfulfilled. This is the first time in all her life of adventure that she had searched so hard for a treasure that has eluded her. The story of her friends/mates whose children are either concluding basic education or half way into college added a blow to the nail of anguish in her fragile heart.
Her menses like a clown made gest of her. It became unpredictable, irregularly irregular and when it came, it flowed torrential like one from a slained Eldir Malud ram or like a provoked storm demonstrating its destructive potentials. At a time in the history of her menstrual cycle, she could swear she was pregnant after missing two cycles but boom it came to renew her hopelessness.
After several fertility treatments she conceived and just when all was calm, a drop of blood came forth like the angel Gabriel to announce an inevitable miscarriage. She is back to the first station of the cross.

Reproductive Life Beyond 35years of Age

Subfertility/ Infertility
The probabilty that each mentrual cycle would result in pregnancy (fecundity) declines from age 22years. It declines further after age 35years making conception more difficult.

Congenital Anomalies
These are deviations from the normal in terms of form and function. The eggs in the ovary are present before birth. They sit like employees or footballers on reserve bench waiting to be recruited into the field. The longer they stay, the more vulnerable they are to accidents. Any accidented egg recruited for fertiliztion will either predispose to abnormal baby eg Downs Syndrome or Miscarriage.

Miscarriage
Research has shown that above the age of 35years, the incidence of miscarriage increases.

Medical Conditions in Pregnancy
Most first time pregnancies above this age experience hypertension in pregnancy with associated presence of protein in urine and progressive leg swelling, a condition termed Pre-eclampsia. This can contribute to Preterm delivery.

Postpartum Hemorrhage
This leading cause of maternal death in which a woman loses blood in excess of 500mls after delivery via the birth canal or in excess of 1L after Caeserean delivery.
Poor contraction and/or rupture of the uterus accounts for major causes,as well as, genital traumas.

Menstrual Abnormalities and Cancer

Above this age, there is an increased risk of increase in the thickness of the endometrium (uterine inner lining). This is so because of anovulation (no ovulation) leading to lower progesterone levels and therefore no counteraction to the stimulating effect of estrogen which makes the endometrium grow thick (Endometrial hyperplasia). It makes menses irregular and may predispose to Endometrial Cancer. Therefore if you miss your period for more than two circles, it may indicate potential danger. Do not hesitate to see your doctor

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LACTATION AND ITS CHALLENGES

Inconsolable burning tears rolled down her eyes like a child chased down the street with a cane. In her tears were blue prints of the inexpressible agony she was feeling. Her eyes, like the red moon marking the feast of martyrs. She cried louder than her baby. Her joy had been stolen away by her favorite part and replaced with pain, her laughter disappeared like a ship in the Bermuda triangle . Her very natural asset which was well formed at her tender age and which she flaunts ridiculously to the attraction and admiration of the opposite sex both young and old and to the envy of her pearls , her breast, had now become a torn in her flesh.

The breast development orchestrated by the pregnancy hormones added color to the picture. Her breast had become full, more prominent, succulent and desirable. She wished this state would last forever, so like a virgin land ready to grow any crop, she quickly took to the ill-advice of her friends who told her that breastfeeding facilitates breast sagging. She decided to go on complementary feed for her new baby.

One week after her delivery, hell was let loose, nature had mobilised her armoury against her breasts for civil disobedience and denying her baby HIS BIRTHRIGHT. The war was so fierce that she wished her breasts off. The breasts had become very painful and unbearable with fever and chills which made her shake like men dancing the 'Ohafia war dance'. She was adviced again by same friends to take antimalaria, but, to no avail.
Her right reasoning returned from exile and like the prodigal son she decided to visit the clinic for expert management.

Breast Engorgement with mastitis

This is the diagnosis of the story above and therefore does not require any more emphasis.
The following should be done to prevent or alleviate the pain for breast engorgement.

• Place an ice park or warm water in a satchet/towel on the breast(s). This will take care of the pain.
• Express the breast and ensure the baby suckles to prevent reocurrance.
• Wear tight fitted bra. 
• Simple pain relief medications like NSAIDs can suffice.

Mastitis and Sour breastmilk

Mastitis is the inflammation of the breast tissue with or without infection(i.e Acute Inflammatory Mastitis and Infective Mastitis respectively).
When the infection/inflammation occurs within the duct system (Epidemic Adenitis), it produces pus which is expressed together with breastmilk. Babies generally avoid the affected breast and mothers interpret it as soured breastmilk but in reality there is no such thing as soured breastmilk.
This case should be managed by a physician.

Stopping lactation

 If you are desirous to stop the breast from further production of milk;

• Stop breastfeeding or expression and all forms of nipple stimulation.
• Wear tight fitted bra.

When this fails, consult your physician for expert management.

Nipple crack
This usually occurs due to inexperience in breastfeeding especially wrong positioning. Abnormal nipples,flat or inverted also contribute. A crack permits germs into the breast tissue with resultant mastitis and breast abscess. It's therefore adviced that it be managed by a qualified health personnel.

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COMPLICATIONS OF BIG BABY.

Her confidence was unparalled. Such faith when compared to the potential size of the biblical mustard seed would not only move mountains but the heavens.

Every medical advice from her physician was like pouring water on stone. She was more stubborn than a mule. She responded repeatedly that her previous pregnancies were Big Babies and if she could deliver them then, why not now? She drifted with her defence into spirituality and adopting herself as a HEBREW WOMAN, a Zionite... 

Few days later, her labor set in, she visited the clinic by 8am and clinical examination was assuring as the first stage of labor was said to be progressive.

Then came the tempter of Job, the accuser of brethren at the eleventh hour. It was a cascade of troubles. She had series of urge to bear down but all her efforts could not hold any water, the harder she tried the weaker she became, the baby could no longer decend. Few minutes later came trickles of frank blood through her vagina, her genital tract had been lacerated. To facilitate the labour, her membrane was ruptured and a thick greenish liquor gushed out like unchained furious mob (indicating fetal distress).
She was adviced by the midwife to opt for Ceaserean delivery but like one under a spell, kept reiterating the words of the scripture, "I can do all things, through Christ who strengthens me" amidst her obstructed labour,  bleeding, dying weakness and fetal distress.
Perceiving the imminent danger of loosing both wife and baby one of the midwives sneaked out of the labour room and whispered softly these piercing words into the ears of her husband, itching for a good news, "Oga, you may loose both your wife and daughter if you don't consent to C/S". This sent a very strong impulse to his spine and necessitated the surgery but one cannot undue the damage already done. What a provocative scenario, what foolishness (MY PEOPLE PERISH FOR LACK OF KNOWLEDGE), what a waste, what a loss. She was revived but lost the baby she had been praying for, a male child, for her previous four pregnancies were all females.

Complications of Big Baby

 Some of the complications have been highlited in the story above. There are both maternal and fetal complications . Those worth discussing will be given attention.

Maternal complications of Big Baby

Prolapse: this is the alteration in the anatomical position of organs with decent. It is due to damage of nerves supplying the supporting structures of the pelvic organs by the passage of the big baby. It may affect the uterus, vagina, bladder or rectum with resultant urinary embarrassment and affect sexual activity. Most women think themselves as strong when they deliver babies as big as 5kg but most pay the price later in life. It usually occurs later in life.

Diabetic retinopathy: uncontrolled sugar causing damage to the retina and resulting in blindness.

Fetal complications of Big Baby
This also includes

• Congenital anomalies
• Unexplained fetal or infant death
• Respiratory distress syndrome
• Metabolic syndrome; including hypoglycemia, hyperbilirubinemia, hypocalcemia
• Birth trauma;  including clavicular and limb fractures and Brachial plexus nerve injury. 

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BIG BABY AND DIETARY ROLE

It was her very first pregnancy and she had tried so hard to adapt to the lifestyle challenges posed by it on her but the more she tried, new doors introducing new challenges opened up.

Her first trimester was graced with nausea (urge to vomit), excessive salivating like a dog chained, on fast, and presented with the aroma of a sumptuous meal. She threw up even the best appetizing meal like an angry volcanoe and could only tolerate soft drinks which she soon became used to.

Later in her second trimester, the above episodes gave way, her appetite improved and she decided to recover the weeks the locust attacked. The more she ate the hungrier she became.
After her routine antenatal visit at 36 weeks, tears filled her eyes, as she kept staring at her protruding tommy. She had been counselled on ceaserean delivery of the 'big baby'.

BIG BABY
Known in medical parlance as Fetal Macrosomia is considered by some as weight of 4kg and above while another school of thought designates it as weight of 4.5kg and above.

BIG BABY AND DIETARY ROLE

Big baby may have a genetic predisposition but like most genetic conditions environmental factors, in this case, diet, plays a very important role.
Carbohydrates is a very important nutritional requirement in 1st and 2nd trimesters because it supplies the fetus energy for growth and development. In the third trimester, there is a switch in the nutritional need of a pregnant woman to favor more protein intake than carbohydrates .

Hormones, Diet and Big baby

The hormones of pregnancy notably Progesterone, Human Chorionic somammotropin and Pregnancy associated Plasma Proteins are 'anti-insulin' and increase in quantities as pregnancy advances. By 3rd trimester, they effectively stop insulin from driving sugar into maternal cells thereby increasing maternal blood sugar levels. More sugar therefore flows to the baby and results in Big baby.

Therefore the 3rd trimester is very crucial to dietary control especially carbohydrates in other to avoid having Big babies and it's complications to be discussed in the next article.

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LEO'S BLOG: APA-AFO

LEO'S BLOG: APA-AFO: Mark of torture-Apa afo In came this middle aged woman with a child of about two years old with the limbs dangling like a lifeless sou...

APA-AFO

Mark of torture-Apa afo

In came this middle aged woman with a child of about two years old with the limbs dangling like a lifeless soul. The furrows on her forehead were begging for hope and her tears like a leaking roof.

Her child had been sick for two weeks  with high grade fever, abdominal distention, prostration (can't stand without support)  and anuria (no urine formation; indicating Kidney failure) .

She discontinued his herbal medication as her son's health worsened. She boldly informed me that her first daughter had a similar health challenge and was taken to an Apa-afo centre where she was cured so she had to give it a second try.

I was so disappointed seeing the countless scarification marks on the child's abdomen and was even shocked when she confirmed holding the child in her arms while this brutality was meted out on the child. The child was paper-white and bloated all over like a Christmas balloon.
This only son (yet) after two days of admission in the hospital threw in the towel and bowed in submission to the cold hands of death. It's a pity that his last days were so agonizing.

APA-AFO : AN ASSENT TO CHILD TORTURE

I'm but limited by ethnic know how as to alternative names and practices of the subject matter and so I'm using Abia State, Nigeria, in this discuss. If you understand the subject you can give the name in your dialect and the practice.
APA-AFO in Igbo literally means WOUND /INJURY IN THE ABDOMEN. Those who coined the word at least have an idea that the health challenge of the patient is in the abdomen but lacks specificity as to the diseased organ. They often make this diagnosis when patients (Child) present with FEVER & BLOATED ABDOMEN and waste no time in TORTURING the child. The treatment modalities include ; DIPPING A BUNCH OF NEEDLES INTO NATIVE CONCOCTION AND PIERCING THE ABDOMINAL SKIN WITH THEM; SOME HOWEVER HEAT UP LEAVES AND METALS IN FIRE AND BURN THE ABDOMINAL SKIN WITH WITH THEM, SOME OTHERS ARE SPECIALIZED IN INCISION & PREFER RAZOR CUTS...  THIS IS BARBARIC and it pains me to hear that parents submit their children to such AGONIZING & INHUMAN TREATMENT.
The SPLEEN, is an organ in the abdomen that can be likened to IMMIGRATION AND CUSTOMS OFFICERS, since it is responsible for removing foreign invaders ( BOKO HARAM) in our system. It also removes old red blood cells and can produce blood cells in certain disease conditions. When it has so much work to do, it enlarges (SPLENOMEGALY)  and causes the abdomen to be bloated. So in INFECTION LIKE SEVERE MALARIA, IN LIVER DISEASES LIKE HEPATITIS, IN CANCERS LIKE LYMPHOMA & LEUKAEMIA, IN TRAUMA, AFTER SOME MEDICATIONS, IN CYSTIC FORMATIONS AND IN SEQUESTRATION CRISIS OF SICKLE CELL PATIENTS etc the spleen enlarges and it will be NICKNAMED APA-AFO. Other organs in the abdomen can be diseased and cause bloating (swelling)  of the abdomen e.g INTESTINAL OBSTRUCTION.

COMPLICATIONS ASSOCIATED WITH APA-AFO TREATMENT

Sepsis: the skin is a primary protective organ but when it is broken, infectious organisms find their way into the blood stream and cause more harm. When it becomes overwhelming it compromises the vital organs.

Renal Failure: both infections and toxins from herbal concoction damage the kidney.

Viral Infection: HIV and Hepatitis B & C can be spread from poorly sterilized sharps used on positive persons.

 Death: all above complications may  result in death in addition to late presentation has caused death of so many children.

Cosmetic Embarrassment: the indelible mark/scar due to treatment raises suspicion and embarrassing looks. To some it could degenerate to low self esteem, relationship and social issues.

REJECT EVERY ADVICE TO TREAT YOUR CHILD FOR APA-AFO, ITS KILLING OUR CHILDREN. Please take them to the hospital for expert management. THIS PENNY WISE, POUND FOOLISH AND LIFE OF PRIMITIVITY IS NOT THE BEST. A STUBBORN FLY WILL END UP IN THE GRAVE. IF YOU LOVE YOUR CHILD, GIVEN HIM/HER THE BEST NOT TORTURE.
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