The Nation Newspaper

Category: Family Health

  • Malaria: The human host with G6P DD

    Glucose 6 phosphate dehydrogenase deficiency (G6P DD) is a condition that is most commonly found in malarial regions of the world – parts of Africa, Asia, the Mediterranean, and the Middle East. It is found in about 400 million people, and especially in males. In the USA, it is known to affect 1 in 10 African American males.  G6P DD is most common in black males in general. Black women may carry the gene for the deficiency but may not have the deficiency and transmit the gene to their children, who, if male, will definitely have the deficiency.

    G6P DD results from mutations in the G6PD gene. The gene provides instructions for making the enzyme and a mutated gene makes a variant enzyme or less enzyme.

    G6P DD is inherited through a recessive gene located on the X chromosome.  Males have one X chromosome and one Y chromosome.  Females have two X chromosomes.  In males, a single mutated gene on the X chromosome produces the deficiency.  In females, it takes a mutated gene on both X chromosomes to produce the deficiency. Hence males are more likely to manifest the deficiency.  Fathers cannot pass X-linked traits to their male offspring.

    In Africa, one form of G6PD deficiency (G6PD A-) is common.  G6P DD is also known as “favism” because people with this condition are allergic to fava beans.

    G6PD is an important enzyme in red blood cells (erythrocytes) and helps the cells to function normally. Like many other enzymes, G6P is involved in the generation of energy through the processing of carbohydrates. In addition, it protects the red blood cells from formed harmful by-products (oxidants) triggered by infections, medications or other factors. Reactive oxygen species (ROS) are byproducts of normal metabolism and GP6D is involved in production of chemical species that mop up ROS, preventing toxic levels of ROS in red blood cells.

    Scholars believe that a lack of G6P or a reduced amount of this enzyme function prevents the plasmodium from invading red blood cells.  It is thought that G6PD deficiency is associated with increased oxidative stress in red blood cells in G6P DD people compared to people without this deficiency. The parasite needs to invade the red blood cells to continue its life cycle.  The elevated oxidative stress is harmful to the parasite. The parasite may avoid cells that appear to have some oxidative stress.

    G6PD deficiency can lead to disruption of red blood cells by severe oxidative stress.  If new red blood cells are not produced at the rate of cell loss, hemolytic anemia results.            In neonates, prolonged jaundice may lead to neurological complications.

    Symptoms of G6P DD anemia include weak or rapid pulse; heavy, fast breathing; tea colored urine; enlarged spleen, sudden rise of body temperature; yellowish skin and mucous membrane; fatigue, paleness; and physical degeneration. Symptoms of the anemia are reversed by stopping the trigger, e.g. a drug.  A child with severe anemia may be hospitalized to get oxygen and fluids or in extreme cases, to get a transfusion of healthy blood cells. Severe cases of G6P DD anemia can lead to kidney failure or death.

    GP6 DD is identified in newborns through screening and children can be properly managed. Older persons can also be screened by measurement of G6PD enzyme levels in the blood, a complete blood count, serum hemoglobin test, and a reticulocyte count.

    People with G6P DD live a healthy life if they avoid triggers and have a safe diet. Hence, many African may not even know they carry such a trait while being strong against malaria.

    Some of the known triggers to avoid if one has G6P DD are camphor (moth balls), fava and some other beans, some types of red wine, tonic water because it contains quinine, and some soya products.  Diet that is rich in antioxidants is helpful.  Foods that should be included include fresh fruits and vegetables.  They contain antioxidant vitamins.

    Many Africans actually live healthy lives, in spite of G6P DD and are able to thrive in an environment where they are constantly exposed to malaria.

    Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis.  For any comments or questions on this column, please email bolajohnwritings@yahoo.com or call 08160944635

  • About Malaria: The mosquito

    The word mosquito means “little fly” in Spanish.  This insect has adapted to living in various parts of the world, where there are humans.  There are about 3500 species or types of mosquitoes adapted to live in diverse environments, some on mountains and others in valleys. The Culiseta species, for example, may be adapted to cold regions and the Anopheles species may be adapted to hot regions.   In Africa, some of the species found are Anopheles gambiae, Anopheles arabiensis, Anopheles funestus, Culex pipiens, Culex quinquefasciatus, and Aedes aegypti.

    Mosquitoes are important to humans because they transmit microbes that cause various diseases: malaria, yellow fever, dengue fever, West Nile virus, chikungunya, filariasis, tularemia, encephalitis, and various forest and river fevers.

    The presence of the mosquito around humans is stubborn because the female mosquito that feeds on human blood does so to nourish its eggs. They are apparently attracted to humans by the exhaled carbon dioxide and heat trail.

    The life cycle of a mosquito consists of four stages: egg, pupa, larva, and adult.  The complete metamorphosis takes about one month.

    The female mosquito may lay up to 300 eggs a day, and thousands of eggs in its lifetime.  The eggs of Culex and Culiseta species may attach together forming a floating raft. Anopheles and Aedes lay eggs singly and do not form rafts.

    The mosquito eggs are laid on fresh water surfaces – particularly on stagnant pools.  This can be on water trapped in litter, trash, potholes, tree holes, gutters, sewers, irrigation water, open water tanks, and unkempt environments.  One of the chief methods of malaria control is environmental management.

    The eggs hatch within 2 days into larvae (wrigglers) that move around and feed on minute aquatic plants and other microorganisms. The larvae of some species hang from the water surface because they need to breathe air from the water surface and one of the methods of controlling malaria or preventing malaria epidemics is by spraying water surfaces to create an oily film through which the larvae cannot breathe.  Larvae may protect themselves when disturbed by wriggling down into the water.

    The mosquito larvae pass through molting stages, shedding their outer parts or exoskeleton four times, growing to about 5 mm in length, and eventually become pupae. The stages between molts are called instars and can be a few days to two weeks long depending on the species, the water temperature, and availability of microbes for food.  The pupae undergo development within themselves for about 4 days, without feeding, until an adult fly emerges. Pupae breathe air at the water surface and are sensitive to light and disturbances. Pupae tend to tumble down into the water when disturbed, hence they are nicknamed tumblers.  Water bodies used for landscaping can be prevented from becoming mosquito breeding ground if landscapers introduce tiny aquatic animal species that feed on mosquito eggs, wrigglers, and tumblers.

    The eggs, larvae, or pupae of some mosquito species may lay dormant through unfavorable weather or bad conditions and rejuvenate when conditions are conducive.

    During emergence from pupae, males come out faster and stay nearby to quickly mate with females.

    About 30% males die on emergence and the rest of the males live for about one week, feeding on plant juices.  Females can live much longer, even up to five months, and travel far, even up to 40 km, in their life time. They feed on plant juices as well as human blood which they need to nourish their eggs.  Depending on the species, they may lay eggs once or several times in their life.

    Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis.  For any comments or questions on this column, please email bolajohnwritings@yahoo.com or call 08160944635

  • About Malaria: The parasite

    For a long time, European explorers had known the West African Coast as the White Man’s grave.  This is because of the terrible fever they contracted from this region of the world.  They called it “bad air” or “mal aria” as they thought it was from the air.

    However, malaria disease appears to have been known by the Greeks and Romans more than 2,000 years ago who described patterns of fever that we now recognize as malaria fever.  The parasite that causes malaria, plasmodium, was discovered by Charles Louis Alphonse Laveran in 1880.  Mosquitoes became recognized as the vectors of the parasite for malaria in birds by British army surgeon Ronald Ross in 1897 who was given the 1902 Nobel Prize in Physiology or Medicine.

    The Italian physician and zoologist, Giovanni Battista Grassi, was a pioneer in the science of parasitology, especially malariology.  “He was the first to describe and establish the life cycle of the human malarial parasite, Plasmodium falciparum, and discovered that only female anopheline mosquitoes are capable of transmitting the disease” (https://en.wikipedia.org/wiki/Giovanni_Battista_Grassi).  Since then scientists have gained encyclopedic knowledge about the single cell (protozoan) malaria parasite, plasmodium, and its vector, the mosquito.

    There are several well studied types of Plasmodium which cause human malaria: Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax, and Plasmodium malariae.  Plasmodium falciparum and Plasmodium vivax cause the most severe malaria and they are found IN Africa, Asia and South America.  In Nigeria and many parts of West Africa, malaria is mainly caused by Plasmodium falciparum but Plasmodium malariae and Plasmodium ovale are also endemic.

    Plasmodium vivax is more prevalent in the Indian subcontinent and Central America.  Plasmodium malariae is found in sub-Saharan Africa, in much of southeast Asia and on the western Pacific Islands.  Plasmodium malariae and Plasmodium brasilianum which infects monkeys are found in some parts of the Amazon Basin of South America. P. knowlesi which infects animals can rarely cause disease in humans.

    Some of the mosquito species, Anopheles gambiae, carry the plasmodium parasites and transmit them to humans without getting the disease.  In humans, depending on the degree and duration of infection, the parasites cause fever, liver and kidney failure, convulsions, coma, and death.  This is because the parasites lodge in different tissues of the human body. Plasmodium falciparum is the most dangerous and can kill rapidly, even within a few days, and may be responsible for infant deaths in sub-Saharan Africa and Oceania.

    The female Anopheles mosquitoes which takes blood meals from humans ingests the parasite with the blood of infected people.  The female needs this blood meal to get nutrients for its eggs. The parasites taken with the blood live and reproduce within the mosquito. The infected mosquito then introduces the parasites into the next human beings that it bites.  This is done through its saliva that it injects first to facilitate blood sucking.

    Plasmodium may infect red blood cells in mammals, birds, and reptiles.  Apart from mosquitoes, some other biting insects such as mites may transmit plasmodia.  It is generally good to avoid biting insects in endemic areas.

    They life cycle of plasmodium is completed between the mosquito and human hosts.  The asexual reproductive process is within the human and the sexual process occurs in the mosquito. In human hosts, the plasmodium parasite can be found in various stages or forms: the blood parasites and the tissue parasites.  There is also the vector stage that lives in the mosquito.

    The Mosquito injects sporozoites into the human victim. Different forms of the plasmodium then emerge, passing through the liver (exoerythrocytic stages) and into the blood (erythrocytic stages ): tissue hypnozoites, blood and tissue schizonts, blood trophozoites, blood and liver merozoites, and gametocytes.  Gametocytes ingested by mosquitoes during a blood meal transform within the mosquito into, zygotes, ookinetes, oocyts and sporozoites.

    The size, shape and appearance of the forms are characteristic. For example, the microgametocytes presents a large nucleus that is ready for gamete production, the macrogametocytes present a cytoplasm with numerous ribosomes for protein synthesis.  Within humans, the plasmodium may become a hypnozoite, a long-lived dormant stage, that persists in tissues even when a person appears recovered from the disease.  Schizonts are vegetative forms which rupture to release daughter cells called merozoites that infect  red blood cells (erythrocytes).

    Merozoites can adapt to lodge in liver cells and can remain in the liver for more than one year. They later emerge from liver cells and enter into the blood as blood forms.  The malaria parasite is thus a serious health threat because it has developed ways of staying in the human body both as an active pathogen that can cause disease and alert the immune system and also as a dormant potential hazard that does not seem to readily alert the immune system.  Moreover, the different forms have different susceptibility to different types of drugs such that each drug in use can affect some forms and not other forms of the parasite within the body.  The more commonly used drugs such as artesunate destroy schizonts.

    Presently efforts are being made to produce effective malaria vaccines that can prevent malaria by inducing personal immunity. A malaria vaccine approved in 2015 is RTS,S, (trade name Mosquirix). However, it requires four injections, and its efficacy is low.

    Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis.  For any comments or questions on this column, please email bolajohnwritings@yahoo.com or call 08160944635

  • Malaria

    If I am ever asked to list ten things that I do not like, mosquitoes will be on the list. I don’t even know if they are beautiful insects. Even though a lover of nature and life, I have never tried to admire these particular creatures.  Nobody poisoned my mind about them.  I have experienced their habits. They invade my environment and they bite painfully and leave a bump on my skin. They are so persistent in following their target that they can make a person paranoid.  They suck blood and they cause malaria.  It is because of the latter that most people do not like mosquitoes.

    The World Health Organization tells us about malaria: “Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable”.  The WHO estimates of 2017 tell us of 219 million cases of malaria in 87 countries that year with 435 000 malaria deaths.  Africa was “home to 92% of malaria cases and 93% of malaria deaths” (https://www.who.int/news-room/fact-sheets/detail/malaria).

    Malaria is caused by parasites called plasmodia (singular: plasmodium). Plasmodium falciparum and Plasmodium vivax are recognized as the most dangerous of plasmodia, to humans: P. vivax in the Americas and P. falciparum in the rest of the tropical world, particularly in Africa.  The mosquito is the vector that carries the parasites from person to person.  Mosquitoes have killed many more Africans than snakes or lions.

    It is raining season in Nigeria, a time when the incidence of malaria may sky rocket if people are careless about their environment and the parasite is easily transmitted. The WHO summarizes that: ‘The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment.”  All four factors are important for us to take care of for good health and we shall discuss each of them.

    During the raining season, we can save our communities from an outbreak of malaria by vector control.  WHO recommends two forms of vector control – insecticide-treated mosquito nets and indoor residual spraying.  These are the basics.  There are other measures we can take.  We shall discuss them.

    One of the challenges humans face in tackling or even in eradicating malaria is the problem of resistance.  The malaria parasite involved may be resistant to known drugs.  The mosquito vector may be resistant to known insecticides.

    The plasmodium parasite that causes malaria is one of the most perfectly adapted parasites know, with characteristics that enable it to conquer its host and also to assure its own propagation.  We shall discuss this parasite.

    Wikepedia tells us that: “Over 200 species of Plasmodium have been described” (https://en.wikipedia.org/wiki/Plasmodium). Microorganisms often undergo genetic mutations and give rise to changed offshoots.  Some of the changed offspring have characteristics that make them survive drugs and other factors.  They survive and then proliferate and form new generations or new lines of parasites that are resistant to used drugs.

    WHO tells us that “There are more than 400 different species of Anopheles mosquito; around 30 are malaria vectors of major importance”.  It is possible that new mosquito species keep evolving and some may have characteristics that help them survive human weapons.  WHO tells us that “According to the latest World malaria report, 68 countries reported mosquito resistance to at least 1 of the 5 commonly-used insecticide classes in the period 2010-2017; among these countries, 57 reported resistance to 2 or more insecticide classes.”

    Some scientists have come up with a malaria vaccine.  This is a good prospect for children especially.  Young children, unlike many adults, do not yet have partial immunity to malaria.

    Other scientists may finish the story.  They have come up with genetic modification of mosquitoes that could eliminate them from the surface of the earth (at least those that are vectors, the others do not bother humans).  This is a hot topic.  A Smithsonian article deliberates on the question: “New gene-editing technology gives scientists the ability to wipe out the carriers of malaria and the Zika virus. But should they use it?” (https://www.smithsonianmag.com/innovation/kill-all-mosquitos-180959069/).  Every time I see a mosquito now, I might as well study it and admire the skinny legs that land on our skins, the dangerous proboscis that pricks us, the expert antenna  that finds us, the slender body that balloons up when filled with blood, the hunch back that pretends humility, and pointed bottom that lays 300 eggs at a time –  because very soon indeed, we may never see them again.

    Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis.  For any comments or questions on this column, please email bolajohnwritings@yahoo.com or call 08160944635

  • Nurturing your relationship (1)

    Dear reader, I welcome you to this wonderful month. It is my prayer that all that the month holds will be delivered to you speedily. In this teaching series for the month, I shall be exploring the topic: Nurturing Your Relationship.

    God instituted marriage so that man can enjoy the power of relationship. God saw that the first man – Adam, was in need of companionship. And the LORD God said, It is not good that the man should be alone; I will make him an help meet for him (Genesis 2:18). God wanted it to be for man “as it is in heaven” (Matthew 6:10). So, He gave man the gift of relationship. This means that God believes in relationships and they are important to Him.

    Relationship means “to connect with someone else or to be in touch with someone.” But it is important for you to understand that although God initiated the idea of relationships, it is our duty to develop and sustain it. We sustain our relationship by nurturing it with all the right nutrients necessary for it to grow.

    To nurture means to care for, to look after and to take care of somebody or something. You nurture your relationship with your spouse, just as you nurture your baby to adulthood. You should learn to feed and care for your relationship, if it must be a success. Food here does not mean what we eat physically, but there are physical, spiritually and emotional nutrients you must give your marital relationship so that it can grow and be well-nourished.

    How to nurture and grow your relationship

    I will be sharing with you on certain factors that can help you nurture and grow your relationship with your husband, wife and family members.

    Commitment

    Any man or woman who is genuinely committed to God is bound to be committed to the success of his/her home, because he/she will endeavour to obey God. Someone once said that what the spinal cord is to the body is what relationship is to your marriage.

    The level of your commitment to your relationship with your husband, wife or family members will ultimately determine how heavenly your home will be. For you to be committed to your husband, wife and family members, first and foremost, you must be committed to God if commitment to your spouse will yield a positive result.For every house is builded by some man; but he that built all things is God(Hebrews 3:4).

    That means all your efforts to build a heavenly home will amount to nothing without the help of God.

    The Bible says, I am the vine, ye are the branches: He that abideth in me, and I in him, the same bringeth forth much fruit: for without me ye can do nothing (John 15:5).

    Let me say this to singles, before you marry any man or woman; ensure that he is genuinely committed to God, because if he or she is not, it will affect the success of the home.

    I remember my husband (then my fiancé) writing a paper titled “Sailing Under Sealed Orders.” One thing that struck me most in that vow of commitment to God was the phrase, “Christ is either Lord of all or not Lord at all…” I rejoiced when I read and even had to sign that I will allow him to serve God completely and unreservedly. That is why I am not surprised at his commitment to our home, because his commitment to God is unquestionable.

    However, commitment to God must find expression in your commitment to your spouse and family members. Commitment to God and to your spouse is like a bicycle. Each wheel represents these two levels of commitments.

    Commitment is what drives a man to love his wife despite how he feels or what she has done or failed to do; and it is also a driving force in a woman that is submissive to her husband. Any man you see who finds it difficult to love his wife or makes excuses for not loving her is not committed to making that marriage work.

    If you are a stubborn and naughty wife who refuses to submit to her husband, your problem is simply lack of commitment! If you are committed to the success of your marriage, you will not need anyone to advise you, you will willingly and excitedly submit to your husband, and your husband will express his love for you.

    A lady once wrote me and said, “I started reading your article in one of the daily newspapers after I got born-again in November 1998. I gained a lot from most of what you discussed in the articles. I am married with four children and used to do many things that were not right to my husband. But as soon as I read your articles, I made a change. Whenever I want to fight my husband, I remember your article on how to be patient with our husbands, and I stop. You have taught me a lot about marriage, so I don’t miss that newspaper.” It is time to get committed if you desire a heavenly home.

    You need Jesus Christ to be committed and maintain commitment in marriage. If, peradventure, you are not born again and you want to accept Jesus as your Lord and personal Saviour, then say this prayer in faith: Dear Lord Jesus Christ, I come to You today. I am a sinner. Forgive me my sins and cleanse me with Your Blood. I accept You as my Lord and personal Saviour. Make me a child of God today. Thank You for delivering me from sin and satan to serve the living God and thank You for accepting me into Your Kingdom.

    Congratulations! If you prayed this simple prayer of faith with me, you are now born again and a child of God. He loves you and will never leave you. Read your Bible daily, obey God’s Word and seek Christian fellowship (John 14:21).

    With this, you are guaranteed all-round rest and peace in Jesus’ Name! Call or write to share your testimonies with me through contact@faithoyedepo.org, 07026385437 OR 08141320204.

    For more insight, these books authored by me are available at the Dominion Bookstores in all Living Faith Churches and other leading Christian bookstores: Marriage Covenant, Making Marriage Work, Building A Successful Home and Success in Marriage (Co-Authored)

  • Stop inserting hard objects in the mouth of convulsing patients-Expert warns

    A medical expert, Dr Shola Aina of Lifecare Hospital, Ilorin has warned against inserting hard objects into the mouths of convulsing patients.

    Aina told the News Agency of Nigeria (NAN)  in Ilorin that the insertion of hard objects in the mouth of a convulsing person to stop teeth clenching does more harm than good.

    He said it could dislodge the dentures (teeth), cause aspirations or even death, as against the perceived dangers of clenching of teeth, which never kills.

    NAN reports that convulsion is a medical condition where body muscles contract and relax rapidly and repeatedly, resulting in an uncontrolled actions of the body.

    READ ALSO: How to save convulsing children – Expert

    The physician, therefore, advised that ” the first thing to do once seizure is noticed, is to ensure that the environment is safe, and not try to restrain the victim as it can cause fracture.

    ”Lay the person down on a flat surface and remove all tight clothings around the head or neck, like ties or necklace, and check if the victim is still breathing.

    ”Make sure the victim is in a relaxed position and move to the hospital as soon as possible for proper evaluation,” he advised.

    He idehtified high fever as one of major causes of convulsion in children within the ages of 6 months to 5 years.
    ”High fever, birth trauma, or low blood sugar are among the causes of convulsion.

    ”But to ascertain the cause in a particular victim, it is necessary to visit the hospital even after the convulsion has stopped, to ascertain the underlying cause.

    ”Ascertaining the cause will make the parent or caregiver know the symptoms to watch out for, and things to avoid, so as not to trigger it again,” Aina said.

    (NAN)

  • NGO donates 40 machines to Jigawa Govt. to improve family health

    An NGO, Marie Stopes, has donated 40 autoclave machines to the Jigawa Government to enhance reproductive family health in the state.

    Mrs Hadiza Abdulwahab, the organisation’s Advocacy and Partnership Coordinator in the the state, made this known to the News Agency of Nigeria (NAN) in Dutse on Wednesday.

    Abdulwahab, a fomer  Commissioner for Women Affairs in the state, said the gesture was part of the organisation’s contributions to improve family planning and child spacing in the state.

    She explained that the machines were expected to be used at the Women’s Integrated Sexual Health (WISH) facilities in the state.

    “WISH is a DFID supported programme which is addressing reproductive issues of women, including family planning.

    Read Also: Ebola: Death toll in DR Congo rises to 1,540, says WHO

    “It is a three-year programme which is targeted at demand creation, improved service delivery, increased supply of commodities, improved financing and policy environment.

    “It is working in partnership with four Consortium – Marie Stopes, Option, Ipass and IPPF – in 13 Nigerian states,” Abdulwahab said.

    The organisation’s advocacy and partnership coordinator said the 13 states were those in the North-west, excluding Kaduna, all states in the North-east as well as Benue in the North-centra.

    When contacted, the Executive Secretary, Jigawa State Primary Health Development Agency (JSPHCDA), Dr Kabir Ibrahim, confirmed the receipt of the machines.

    Ibrahim, who thanked the NGO for the gesture, added that the machines would be put to proper use.

    (NAN)

  • Methods for improvement of scars and tribal marks

    Scars that are formed from wounds that go deep enough to destroy the inner layers of the skin are not reversible because of the permanent damage and too much replacement of normal tissue with scar tissue.

    Many superficial scars fade over a period of time but the skin cannot return to its original form.  For a newly formed scar, one may give it a chance to fade, even if it takes a year or more. It may be safer than tampering with it and developing a worst condition.

    If a scar is a sure, prominent nuisance and one wants to have it removed or reduced, there are a number of medical options for treatment.

    We get wounded regularly in small measures.  A woman cooking might get a cut from a sharp knife or a burn from hot oil splattering from a frying pan. Kids playing often get a scrape on the knee or elbow or other parts of the body. Teenagers irresistibly pick their pimples leaving dark spots and dents. Some persons may experience a great wound at some point in life. Serious accidents happen, leaving physical scars that can change ones social behaviour and relationships.

    For minor injuries we should respond with a first aid.  The wound should be cleaned so that bacteria or other microbes do not have a chance to attack it and then petroleum jelly (Vaseline) may be applied as a protective cover.  Presence of bacteria could stimulate the body’s defensive cellular mechanisms  that can enhance scaring.  Petroleum jelly keeps the would moist and prevents formation of a dry scab and minimizes scaring. In the kitchen, when fast action is needed, any oil may be put on a burn or wound before better care is received.

    Certain topical products can be kept in the first aid box for treating minor wounds.  Cocoa butter cream is an example.  Some products contain vitamin E which helps scars to heal well. For large wounds and burns, special products for protecting the wound are made of silicone gel or hydrogel sheets or non-adhesive gauze pad.  Simple bandage may suffice.  Such covering should be changed regularly to keep the wound sanitized.  After the wound is healed, regular application of sunscreen with a high SPF can help reduce the hyperpigmentation that accompanies scar formation.

    When a scar is well established such as in the case of tribal marks, some forms of surgery may be used to improve the appearance or to partially erase the scaring.

    Ablative and non-ablative laser treatments are used.  Ablasive treatment involves removal of surface skin cells.  Non-ablative lasers do not affect surface cells but target skin tissue below the surface using heat to stimulate collagen production.  Carbon dioxide abrasive laser and laser skin resurfacing can be used to improve different forms of scars. Abrasive laser can be used to remove tattoos and for extreme cosmetic makeovers.  Abrasive lasers are generally used for atrophic scars.  Fraxel laser treatment can be used for acne scars. Acne scars can also be improved with microneedling.  This involves the use of tiny needles to prick the skin and stimulate collagen production in acne dents. It can be used to improve facial looks with a smoother and toned skin. Apart from acne scars, microneedling may improve wrinkles and large pores. Non-abrasive lasers are used for hypertrophic scars and keloids. Laser treatments are done by board-certified cosmetic surgeons or dermatologists. They assist the patient in the recovery process.

    Steroid injections can be used to flatten raised or protruding scars such as some forms of raised tribal marks, keloids, and hypertrophic scars.  Steroid injections into scar tissue may help to flatten it. Combination therapy with the use of fractionated carbon dioxide plus topical steroidal drug triamcinolone is being used for scar treatment with some measure of success.

    Chemical peeling is a controlled destruction of surface cells of the skin using a chemical rather than laser. Dermabrasion or microdermabrasion is used to try to regularize the surface of the skin.  For severe scars, a surgical skin graft or an excision may be performed. Scar revision means cutting the scar tissue out and guiding the healing.

    Cryotherapy is the use of liquid nitrogen to freeze and destroy cells and this can be applied to keloids or raised scars. On the contrary, filler injections using collagen as filler are used to raise atrophic or deep scars to the level of the normal skin.  The procedure is repeated regularly.

    Whatever the condition of the scars one bears, one should try to live above them or beyond them and not allow them to limits one’s life.  There will be busybodies who like to pay attention to other people’s flaws, but such people can be ignored.

    Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis.  For any comments or questions on this column, please email bolajohnwritings@yahoo.com or call 08160944635

  • Why some scars cannot be removed

    The National Cancer Institute Dictionary of Cancer Terms describes scare tissue in the following manner. “Fibrous tissue that forms when normal tissue is destroyed by disease, injury, or surgery. For example, scar tissue forms when a wound heals after a cut, sore, burn, or other skin condition, or when an incision (cut) is made into the skin during surgery. It may also form inside the body when certain conditions, such as cirrhosis, cause normal tissue to become fibrous tissue.”

    Scars form during the healing process on the skin but can also form inside the body.  For example in the heart after a heart attack and may subsequently affect the function of the heart in contracting and pumping blood.  Most parts of the body can scar easily.  The lining of the womb, the endometrium, is an exception.  Bones too may heal without scaring,

    Certain cells called fibroblasts proliferate (increase rapidly) in wounds to create scar tissue.  The scar tissue is different from normal tissue in the amount of the protein collagen and in the structural arrangement of collagen.  Scar tissue contains much more collagen and less elastic fibres and the composition and structural arrangement makes scar tissue less elastic than normal tissue. Some structures of normal skin such as sweat gland, and hair follicles do not form in scar tissue. Yoruba people with tribal marks on the cheeks cannot grow a uniform beard.

    Scar tissue is usually darker than the surrounding tissue because of post inflammatory hyperpigmentation.

    We also talk of emotional scars which are changes in a person’s emotions, passions, feelings, dispositions, understanding, or mentality caused by hurts and painful experiences.  Just as tissue or skin scars are often permanent, emotional scars are also often permanent and may permanently affect a person’s functioning and life style.

    Scars are described by their appearance.  Hypertrophic scars are raised above the surrounding skin because of tissue proliferation during healing and are limited to the site of wounding. Keloids are scars that are raised above normal skin and spread beyond the original site of wounding into the surrounding skin. Keloids may become tumorous (large masses) but not cancerous (uncontrolled growth and spreading to other parts of the body). Most of the swelling is due to collagen deposition.  Keloids are more easily formed in black people. Contracture scars are mainly formed by burns.  The skin is tightened and flattened or sunken. Atrophic scars are also flattened in appearance. A  pit is formed if some supporting muscle or fat has been lost under the superficial layer of the skin. Acne scars and chicken pox scars are atrophic scars.

    Some facial tribal marks are made by burns and create flattened scars (contracture scars).  Other tribal marks are made with blade cuts and may heal as raised scars (hypertrophic scars).

    Amongst other factors, the degree of wounding mainly determines the degree of scaring. Deep wounds affecting various structures of the skin such as fat and muscle layers will create deep scars.  Wounds that are not protected by first aid measures during healing will develop well-formed scars.

    Tribal marks were traditionally used to identify.  They were meant to be permanent.  They are still used but some people are opposed to them even though it is their own tradition.  Today’s science and technology may have some solutions for some people who want to erase or reduce their marks.

    Physical scars are ugly in their looks.   Emotional scars are ugly in their effects.  Typically, neither can be erased easily, quickly or painlessly, if they can be erased at all. Neither should be encouraged or engendered.

     

    Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis.  For any comments or questions on this column, please email bolajohnwritings@yahoo.com or call 08160944635

     

  • Tribal marks, stretch marks, blemishes and scars on the skin

    As I was writing this series on skin care, a reader kept calling me to ask about how to remove tribal marks.  I did not have an answer but he kept pestering for help for his brother.  Finally, I gathered that the tribal marks were disturbing his brother’s life.  He was being taunted everywhere even in Church.  He wanted to go and study abroad but the scaring was a hindrance to his every move.  He was at a standstill in life and had to get the marks removed.

    Tribal marks and tattoos can be done as a matter of choice and pride.  My father, who wanted us his children, to be identified with the Oyo Royal Family, brought home a traditional medicine man who was  an expert in doing tribal marks.  We rebelled and the man left with his blade and powder.  As an adult living in California, I submitted myself for a tattoo which I like very much.  Tattoos can be beautiful artwork done for cosmetic or sentimental reasons.  Many people get tattoos but they may face a situation where they need to remove the tattoo.  Some work environments forbid tattoos, therefore if one wants to get a job in such an environment one may opt to get any visible tattoo removed.  Many people who now wear tribal marks actually had no say in it when the scarification was being done.  The choice was made in their childhood by some adults, usually parents or Ifa priests.  For some, tribal  marks are beautifully done and become an identity stamp worn with pride.  For others, tribal marks are other than beauty or pride.  My reader who called for help actually claimed that the tribal marks he wants to get removed were done out of malice to make sure the person will not make progress in life.  That is some curse was sealed in those marks and the curse will be broken if the marks are removed.  Some tattoos are done out of fetish beliefs or to identify with occult groups.  Therefore tribal marks and tattoos are done, it seems, for every reason under the sun.

    Marks, scars, and blemishes can make one stand out.  One can become as insecure as a person of interest that is always surrounded by unwanted attention or curiosity.  One can be discriminated against, excluded, persecuted, and even continuously be inadvertently punished by ignorant persons and busybodies. One might continually curse his or her parents or whoever did the scaring.

    Scars can be formed on the skin from accidents or diseases.  Such scars on the face or on visible parts of the body may be embarrassing and one may wish to have them removed.   Another reader has called me asking about stretch marks.  Some women are left with stretch marks after pregnancy or scars after a cesarean session. People are left with stretch marks after a weight loss session.  Many people are bothered about ugly stretch marks.  Perhaps, only one’s spouse gets to see them but still this can be embarrassing and a source of insecurity.  Some refrain from going to swim in public places or doing sports because they do not want to expose their stretch marks.  Many are looking for ways to get stretch marks removed.

    Facial scars are especially bothersome as people may be paying attention to the scars rather than listening to the bearer.  Oily skin sometimes develops pimples and over time, the skin becomes scarred from pimples. Some drugs may cause this side effect.  Many young people wanting to date or marry are troubled by such skin problems.  Everyone wants to have good facial looks and be attractive.  Some have sunken into depression or other psychotic states because of skin problems and insecurity with their looks.

    We shall discuss scars and the possibility of reversing certain types of scars.  Some blemishes, marks, or scars may be easily reversed or improved.  Others may be impossible to remove altogether without damaging effects.  We can try home remedies or buy scientifically tested products or even go for surgery, depending on what we can afford and the type of skin problem we want to erase. To be continued.

    Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis.  For any comments or questions on this column, please email bolajohnwritings@yahoo.com or call 08160944635