INFERTILITY?DON'T SPARE THE MAN

As an African, having children immediately after marriage is the reward of every successful marriage. A delay of signs and symptoms of pregnancy in the wife after 4 to 6months of tieing the knot will definitely result in eye brow raising from both families, each directly/indirectly pointing accusing fingers at the female, even if there are tell tale signs saying otherwise.

To avoid this, there has been a shift in marriage technique in this recent generation, the saying goes "I wan preg am before I marry am".

I run my gynae clinic once a week, seeing a minimum of 15 fresh infertility cases per clinic, 60 fresh cases per month, am just one of about 6 doctors running the clinic, we share the cases equally to increase work rate and productivity, this makes the total of fresh infertility cases to about 360 per month!.

For the sake of this awareness, I spoke with my colleagues to find out the commonest cause of infertility in couples, using my hospital as a case study, surprisingly, the male factor contributes up to 50% of infertility in this environment, the remaining shared by other factors which could be female alone or both male and female combined or unknown factors.

While in school I was thought infertility affects about 30% of males, during my housemanship I learnt infertility affect both male and female equally, few years into my practice, this is what I found, infertility in males is fast increasing by the day, infact it's getting so alarming right now.

The commonest cause of infertility in males is low sperm count, a condition called OLIGOSPERMIA. A condition diagnosed when the total number of spermatozoa in the male ejaculate is less than 20 million per one Mil.
There are various parameters to analyse in the sperm
The volume
The count
The motility
The morphology
The activity
The inactivity
Infections .

This article is not based on analysing the parameters one by one, rather it's based on general discussion on male infertility, for questions on these parameters pls drop a comment on d blog or follow us on Twitter for dms @dr90ng.

Various factors are implicated as causes of male infertility but using my direct environment as a focus, the following factors are highly implicated
Infections
Stress
Hormonal imbalance
Varicocoele
Malnutrition
Weight loss
Stock fish consumption
Smoking
Environmental factors eg ozone layer depletion.

Infection is the commonest of all patients seen,by culturing the sperm the Organisms implicated mostly are staphylococcus aureus, chlamydia and e. Coli.
Low testosterone hormone, high prolactin are the common hormonal problems seen

Recent studies shows consumption of stock fish to be a cause of male infertility in Nigeria, this poses a big problem because stock fish is of significant "stomach infrastructure" in the igbo culture.

Recent studies also point accusing fingers on the harsh environmental conditions in the Niger delta, raising the heavy metals and fossils level in the blood. A fertility expert, joint pioneer of test tube baby /In vitro Fertilisation (IVF) in Nigeria. Professor Oladapo Ashiru told the Guardian

"We have seen people who work in the
Niger Delta region. The ozone layer in that place is bad and
there is a lot of pollution. One of my students did a Ph.D
and saw that those extracts of crude oil have severe effect
on fertility of both male and female, they compromise them
severely. No oil industry will encourage that level of pollution.
"Recently too we found out that people who work in that
area if they carry out some tests they see they have some
heavy metals and oil fossils in them and those things have
the capacity to depress gametogenesis because gametes
forming is dependent on some mitochondria activities that
require oxygen, that require the best form of enzymes".

Varicocele occurs when the network of veins that leave the testis
(pampiniform plexus) become elongated and enlarged. The valves
within the pampiniform plexus when they work properly only allow
the blood to flow away from the testicle - if there is something
wrong with them, blood builds up.
Approximately 15% of men have a varicocele. A varicocele develops
over time.
It is common for the patient to experience no signs or symptoms at
all. In some cases there may be pain.
Varicocoele is commonly described as bag of worms in the testes, a condition that's is treatable by the urologist.

Most cases of male infertility are treatable depending on severity and point of diagnosis, male infertility is a broad topic, and we can only cover few at a presentation.

The use of antibiotics to treat infection, hormonal replacement for hormonal disorders, multivitamins, relief of stress,tested and researched herbal drugs, weight gain, surgery and life style modifications are the common methods used in my center to treat male infertility.

A method am researching and applying recently on my patients in male infertility treatment has to do with nutrition, most important of this nutrition is the increment in TOMATOES consumption, yes you heard me right, tomatoes!!.

It has been found that tomatoes is highly rich in the substance LYCOPENE. A bowl of tomato soup every day can help boost fertility among men, scientists claimed.

They have discovered that lycopene, which gives tomatoes their bright red colouring, can turn sperm into super-sperm.

Researchers at the University of Portsmouth studied the effect of lycopene in the diet on a random group of six healthy men, with an average age of 42. The men were asked to consume a 400g tin of Heinz cream of tomato soup every day for two weeks.

Are u a doctor? Do u have any recent findings on male infertility, do you know anyone with male infertility issue, drop your comments below, follow us on Twitter @dr90ng, like our page on Facebook https://m.facebook.com /Dr90ng. Let's talk about it.

FAKE HYMEN

This artificial hymen pill has been designed to fake
virginity by creating a real fake hymen. This fake hymen is
designed to simulate the loss of blood that occurs when
losing your virginity.
This artificial hymen pill has been used by Chinese women
for very long but is still not very well known in occident.
If you are afraid that the regular artificial hymen will not
work, or you do not feel at ease by using it, the artificial
hymen pill is the solution you need!
How it works?
Placed into the vagina, between 45 to 60 minutes before
intercourse, this artificial hymen pill will dissolve by itself,
under the influence of body heat and vaginal moisture,
and create a membrane that fakes the hymen and tighten
the vagina.
During sexual intercourse the fake membrane created by
the artificial hymen pill will break and a red liquid that
looks like blood, will spread and stain the sheets, not too
much but just the right amount, thus simulating the
breakdown of the hymen.
How it compares?
The main differences with the regular artificial hymen are:
The color of the fake blood is even more realistic.
You have to insert it between 45 to 60 minutes before
intercourse, instead of 15 to 20 minutes for the regular
artificial hymen.
It feels a lot more realistic for your partner.
How to use?
45 to 60 minutes before sexual intercourse:
1. Clean hands and vagina before using.
2. Slowly insert the pill 7cm (2.75 inches) into your vagina.
3. The pill will dissolve between 45 to 60 minutes.
4. Have sexual intercourse.
The artificial hymen pill is made of pure Chinese herbs
extract, with no side effects.
The artificial hymen pill is by far the most advanced
technology and safest existing product to fake virginity
today.
Researchers on duty.

TOBACCO AND EBOLA

A genetically Modified Organism is an Organism whose genetic material has been altered using genetic engineering  techniques. Organisms that have been modified in the past include:bacteria, yeast, insects, plants, fish and mammals.

The process started far back as 12000BC,but it's commercialization started around 1976,with companies producing and selling genetically Modified food and medicine.

The latest of this technique is modification of tobacco!. Scientists are now genetically modifying tobacco to make proteins needed to build our skin, tendons and connective tissues. This protein is called COLLAGEN. Surprisingly this protein can also be used to develop vaccines for the deadly disease like ebola.

Researchers at Mapp Biopharmaceutical created Zmapp,
an experimental drug that received positive— if still
tentative —results for helping victims of the ongoing
West African Ebola outbreak, by inserting Ebola
proteins into a plant virus. The scientists then infected
tobacco plants with the virus, triggering an immune
response. The plants began to pump out antibodies,
proteins that grab and neutralize harmful bacteria and
viruses, which the researchers collected to treat
patients suffering from Ebola. While Zmapp’s efficacy
still needs more testing, the drug provides proof of
concept that genetically modified tobacco plants can
provide huge medical benefits.
Using a similar infect-and-collect method, scientists
have engineered tobacco plants to make treatments for
other devastating diseases , vaccines for rabies and
hepatitis, as well as human collagen , which could be
used in wound care to rebuild tattered flesh.

Do you know other Organism or food that has been modified?have you consumed any modified food or product?drop a comment let us hear from you

RHESUS INCOMPATIBILITY

Discussing this topic brings mixed feelings,not because of its importance but for its complexity,it's a topic that has created arguments among medical professionals too.

Sometime last week one of my nurses sent me blood samples of her children to run in the lab of a friend. She wanted blood group and genotype test on them. The result came out with one of them having a rhesus negative group O(O-).

There are various blood grouping systems,but the common ones are the ABO system and the Rhesus groups.

In this case,both parents are rhesus positive and test result revealed one of the offspring to be negative! This puts the scientist that performed the test on a hot seat,calling a friend will be an option if he can.
The nurse got angry about the result and hell was almost let loose,if not for her maturity I probably won't be here to discuss this.

The question remains,is it possible for 2 rhesus positive parents to have a rhesus negative child?

Keep your money for paternity test in your pockets,the answer is YES!.

In this system the positive are dominant over the negative. If your
genetic type is ++ or +-, your blood type will be Rh positive. Only if
your genetic type is — will you be Rh negative. This means that if
both parents have Rh+ blood with the +- genes, they could have
children who are ++, +-, or –. In other words, their children could be
either Rh positive or Rh negative. Children who are Rh negative can
have parents who are either Rh positive or Rh negative.

Two parents who have O positive blood could easily have a child
who is O negative. In fact, most children who are O negative have
parents who are positive since the +- combination is so much more
common than the — combination.

Confused? I would be too,if I wasn't a nerdy doctor,just take away this, parents who are rhesus positive can have a rhesus negative baby. Get it?yes you do.

This last point is very important,if you are a rhesus negative lady and your husband is rhesus positive(most people are rhesus positive)once u are pregnant you will need to take an injection called RhoGam at second trimester and immediately after birth,some school of thought says only after birth is necessary.

The reason for this is that,in the first pregnancy,the blood of the rhesus positive baby you are carrying may cross to the mothers blood stream through the placenta bed and sensitize the immune system to produce antibodies that will fight the rhesus positive baby.

The first pregnancy might be issue free,resulting in a healthy baby. Subsequently,any rhesus positive baby you carry in the womb will be sensed as a foreign body by the immune system. The body fights it accordingly,causing miscarriages or habitual abortions.

The implication of this are,if you are rhesus negative any pregnancy you have/miscarriages /abortion or D&C,must be followed by intramuscular RhoGam injection or anti D,otherwise you stand a chance of frequent miscarriages and habitual abortion.

For quick reference,the following points should be noted:

• Couples who are both rhesus positive can have rhesus negative offspring

• Every rhesus negative woman MUST take RhoGam injection after delivery

• Every rhesus negative woman MUST take RhoGam injection after abortion or D&C

• Any woman with history of habitual abortion or frequent miscarriage should check are rhesus group

• A rhesus negative woman married to rhesus negative man does not need RhoGam injection.

Spread the word,have seen a lot of this in my gynae clinic,together we can change a lot.

Hypertension in pregnancy

Majority of my discussions here will be based on my real life experiences in medical field,with the challenges faced in tackling them. 
In most cases I will spare medical jargons as much as I can,while I use some for clarity and follow up in episodes to come. 
Cases of elevated blood pressures are becoming very common,in my practise, anytime am on call I see at least 2per day! Which is a lot,although my hospital is a referral center for most smaller centers around. 
Most women book with blood pressure of about 90/60 mmhg, some can have booking blood pressure of 120/80mmhg,depending on a lot of factors. 
Normal BP is measured as (systolic/diastolic) eg90/60,if the systolic goes up to 30 from the initial reading, and the diastolic up to 15 from the initial measurement,we diagnose high BP in pregnancy. 
Note that any form of  sudden elevated blood pressure from above 20weeks is very significant and your doctor must take this serious, the presence of this and protein in your urine is know as PRE-ECLAMPSIA. 
In Nigeria surprisingly majority of our learned citizens still book for antenatal with the so called traditional birth attendants,this causes a sharp increase in the morbidity and mortality rate of pregnant women, despite the efforts of lagos state gorverment in Nigeria to provide the maternal and child complex in various local government areas. 
A case I will never forget is one I saw sometimes last year, when a very beautiful lady was rushed down to our center at 36weeks gestational age,with unrelenting seizures and restlessness,with spoons and all sorts in her mouth. She was brought by her learned husband and a traditional birth attendant with the husband's mother. 
So I asked the husband where was she booked for antenatal, I was told with a nurse that has a hospital(TBA). 
Probing further I asked the TBA what happened,to my greatest suprise she said "doctor the patient was fine oh,until 2wks ago she started complaining of headache,and i gave her chloroquine injection and paracetamol,she was fine, all for them to rush her to me tonight that she has convulsions". 
I gently asked her what was the blood pressure few weeks ago?her reply! "the BP was very fine, it was just 150/110?.i shouted jesus! 
In other words,the woman has advance form of pre-eclampsia called ECLAMPSIA.She was treated accordingly and the baby delivered via cesarean section, mother and baby discharged home after 3wks of special treatment. 
The lesson learnt from here is, all pregnant women should:

--register at a good center
--ask about your booking blood pressure,and keep tabs afterwards 
--ask about your urinalysis result for protein or others
--every headache is not malaria,tell your doctor about it
--pre-eclampsia is very common in pregnancy and nobody can predict who will have it or not
--don't let anyone coherse you into making decisions on your pregnancy, you and your spouse should make informed decision(from d above example,d mother in law did) 
--bringing out the baby by the fastest route is the best treatment once eclampsia sets in,no matter the age of the pregnancy.

--endeavour to keep tab on your normal blood pressure, even before pregnancy
--some anti hypertensives are useful in treating pre eclampsia,don't reject it when your doctors give you
--no matter where you book for antenatal,always ask questions,it's your right to know,not a favour.