Category: Family Health

Alopecia is the medical name for hair loss. Androgenetic alopecia (AGA) or male pattern baldness is a common, genetically determined hair loss in men.   It involves the male hormone dihydrotestosterone (DHT).  In 50% of males above the age of fifty, the hair loss from the temples presents as a receding hairline and from the crown of the head as a thinning of the hair or as a bald patch.  The hair pattern may become an M shape or hair loss may even result in total baldness.

In about 25% females, female pattern hair loss typically presents as a thinning of the hair all over the head and the cause is unclear.

Alopecia areata or spot baldness is an autoimmune disease in which one’s own immune system attacks one’s own hair follicles causing hair to fall off in small patches.  It can be caused by drugs that affect the immune system.  It requires clinical attention. Alopecia totalis is complete loss of hair from the scalp.

Many people are not concerned with hair loss and wear their new look proudly.  Others keep the baldness with resignation. Others wear a wig or camouflage their baldness with hair spray.  However a sizable portion of the affected population wants a solution to arrest or reverse the condition.

Scientists have been working hard to study the biology of hair loss and have been coming up with promising new solutions, some of which are revolutionary.  We here take a look at both current treatment and new inventions.

Many Nigerian men would possibly not spend their hard economy earnings on baldness.  Perhaps they don’t even notice they are getting bald while worrying about electricity supply, traffic jams, school fees, and rich men playing with their wives.  In the USA, Finasteride (Propecia, also Proscar) and a similar drug dutasteride (Avodart) are approved by the United States Food and Drug Administration (FDA) for the treatment of hair loss in men. These tablets are taken orally once a day. Some doctors may try them for female pattern baldness, though this is not the approved usage.

Minoxidil (Rogaine) is approved by the FDA for the treatment of male and female pattern baldness.  It is made in a liquid or foam preparation which are available over the counter for application on the scalp twice daily. It is not to be taken during pregnancy to avoid the risk of birth defects. Results of thicker hair are obvious by 6-12 months but hair growth may also appear on the cheeks or other unwanted areas. Side effects during the first year may include headaches, hot flashes, and a decreased sex drive.

A chemical messenger, FGF5, down regulates the hair growth cycle, causing hair thinning. Evolis is a product that blocks FGF5T and its use is supposed to help reverse hair loss.

Platelet-rich plasma is a product that has high levels of growth factors and when injected into balding patches of the scalp may rejuvenate hair growth. Platelets are collected from the patient’s own blood and then injected into the patients scalp to stimulate hair growth.

Spironolactone (Aldactone), a diuretic drug that also blocks male hormone androgen production may help regrow hair in women with androgen dependent alopecia. Because it is hormonal and acts on different parts of the body apart from the scalp, it has many side effects such as electrolyte imbalances, fatigue, blood spotting between periods, irregular menstruation, and tender breasts. Use of it requires blood pressure and electrolytes monitoring.  It should be avoided in pregnancy and women planning to get pregnant as it may cause birth defects.

Dietary supplements that may help to promote hair thickening are iron, biotin, folic acid, omega-3 fatty acids, omega-6 fatty acids, and antioxidants.

Various procedures in use are hair transplant, laser combs and helmets which all FDA approved. In hair transplant, hair is removed from one part of the scalp and implanted into a bald area. Low-level laser therapy (LLLT) uses light and heat to activate epidermal stem cells in the hair follicle.  This returns the follicle into the growth phase. The process is used for both men and women.

Sufficient studies exist to qualify some herbs and herbal products as reliable treatment for hair growth and for increasing hair thickness. Amongst these are coconut oil, sweet almond oil, walnut oil, olive oil, mineral oil, jojoba oil, wheat germ oil, Chinese hibiscus, and the Ayuverdic medicines: jatamansi, coat buttons, and brahmi. Some herbal ointments made with petroleum jelly or cocoa butter and water contain herbs such as holy basil, aloe vera, gooseberry and gotu kola and are sold for hair health.  Herbal creams containing the Ayuverdic medicine giant dodder may be effective against hormone induced hair loss.  Herbal gels containing fenugreek, medications with nanoparticles containing oriental arborvitae and Mexican espinosilla are thought to stimulate hair growth.  In Nigeria, the Asian herbal formula “Gentle Care Hair Growth Treatment Serum” has been used by many men with apparent results within 4 weeks. Two bottles cost about N15,000.00 which is about half minimal wage. Local herbal medicines are not yet developed in this line. Next we shall discuss new inventions.

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

The hair is rooted in hair follicles which can become infected by bacteria, fungi, or viruses, or can become inflamed by chemical or other assaults, including new growth hair after shaving that turns towards the skin. Some forms of oil can clog hair follicles and create problems.  All these factors cause damage of the follicles or folliculitis.

Razor bumps from shaving beard, moustache, and side boards (side burns), hot tub rash, barber’s itch, groin itch from bikini waxes, boils, and carbuncles are forms of folliculitis. Folliculitis may become severe with complete destruction of follicles, permanent hair loss, and dark spots or scaring.  Use of sterilized utensils and skin antiseptics at barbers and hair salons may prevent spread of folliculitis. Personal care may be with non-prescription folliculitis face or skin cream, lotion, or gel.  Folliculitis may be treated by prescription antimicrobial and anti-inflammatory products but formed scaring is not reversible.  Extreme options are to stop shaving and keep hair and follicles undisturbed or on the contrary to go for laser hair removal that permanently destroys hair follicles.

Lice are tiny insects that live in the hair, suck blood, and lay their eggs at the base of the hair shafts.  They do not have wings to fly from head to head.  They can be transmitted by sharing combs, brushes, hair styling utensils, scarves, hats, pillows, seats, etc. Products used to treat lice infestation contain drugs such as ivermectin, permethrin, pyrethrin, or spinosad.  Ask your pharmacists for creams, lotions, or sprays containing such drugs.

So-called ringworm is not a worm.  It is a fungal rash that appears as round reddish patches with hair loss. It is contagious and is spread by sharing toiletry items. Orally administered antifungal drugs are prescribed for it.

Psoriasis is a skin diseases that can occur on the scalp. It is caused by rapid growth of cells and thickening in a portion of the skin.  It may be painful or itchy and requires a dermatologist’s attention and prescription medication.

Hair loss may be reversible or irreversible.  Temporary causes such as stress generally lead to reversible hair loss and hair regains its fullness with time.  Progressive hair loss such as happens with aging can be slowed down with treatment.

The hair styles we carry crown our looks with beauty and may even give us a signature appearance.  Style, from the prim and neat to the wild and bold, makes a person memorable. It also raises our mental status because of the confidence or satisfaction it gives us. Do not be lazy with your hair style, even if your style is simply “skinhead”, let it look good and shine, possibly include a touch of cologne or scalp tonic.

Wash your hair every day or every few days or as convenient depending on your life style and exposures.  Scalp massage while washing helps remove dead skin, stimulate circulation, and alter the feeling of stress as there are many nerve endings on the scalp.

However, avoid dry scalp from excessive use of soap or use of harsh soaps.  The natural oil produced by your skin is a needed protection.  Dry, scally scalp can predispose to itching, scratching, and disease. Dandruff from a scaly scalp falls on one’s shoulders when the hair is brushed or combed and makes one look unkempt even when one is hygienic. .  Use helpful products such as hair conditioner, petroleum jelly, hair oil, or hair gel to revitalize the scalp and hair. On the contrary, avoid build-up (of grease or dirt) on the scalp by long periods in between washings as this can also predispose to itching, scratching and disease. Some types of bacteria and fungus take advantage of scally scalp and scalp with build-up.

Rashes, itch, bumps, and skin eruptions, should be given clinical attention quickly because, if allowed to persist they can cause deterioration and disfigurement of the scalp. Hair problems too may develop causing such things as hair thinning and hair loss.

Ladies who like to hold a hair style, keep it fresh with non-alcoholic perfumed hair mist or scented oil but use such products mildly as scent can be off putting to some people.

Because hair is important to many people and people suffer because of hair loss, we shall next consider the various methods and products available for reversing or slowing hair loss, some of which are current scientific breakthroughs.

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

Many of us in the course of each day come near other persons’ hair: in a crowded bus or train, at a desk discussing some matters, having a tête-à-tête with a relation or associate, cuddled-up watching television, etc.  Love-making sometimes begins with the hair: a sniff, a kiss, a stroke, etc.

We can see if a person’s hair is well cared for by the look.  We can smell unkempt hair.

The scalp is generally hidden in people with hair but there is evidence of a scalp problem when a person scratches the scalp frequently, perhaps also rigorously or suddenly, indicating a bite of an insect was felt. Slapping the scalp, as some people do, calls attention to lice infestation.

For people who are bald, scalp health and the look of the scalp may be more interesting because the scalp is clearly visible.

We all have different types of hair and wear our hair in different conditions such as permed, braided, or with weaved-on attachments, or wigs.  Made is China attachments and wigs have done wonders for black women all over Africa and the Americas and for the Chinese economy.  Black beauty with artistic hair styles made possible by such artificial products can be stunning.  However, taking care of the cleanliness, freshness, and neatness of these styles can be tasking and time consuming, and also expensive. The ability to keep a hair style in a good condition depends on one’s daily exposure to factors such as: kitchen fumes and sweat, exercise sweat, and street or outdoor pollution and sweat. Frequent exposure to such factors requires that the hair be washed and treated often, with or without keeping the style.

The head lies on a pillow several hours a night. Pillows should be clean and freshened frequently.  Modern manufactured pillows can actually be washed, disinfected, and dried quickly, especially with a home washing machine or at a laundromat.  Hair that has been all night in contact with an unclean pillow may become whiffy if not washed in the morning. For women who keep hair styles for several days without washing, keeping the pillow clean and fresh is important.  Clean pillows are also important for bald people.  Pillows with dirt and mite can cause scalp infections and infestation, even when a pillow is covered with a clean pillow case as is done in some hotels.

Barbers, hair dressers, and hair salons should generally operate under licence and should have oversight of regulatory agents as they can help to spread scalp and other diseases. However in a developing country where many people live on petty businesses and provide affordable services to the masses, such oversight might be a fuss.  Individuals who patronize hair dressers should demand for standards of care and reject questionable or substandard habits of their hairdressers. Soap, hot water, methylated spirit, disinfectant, or bleach can be used to control contamination in these services.

Some hair and scalp problems that we can avoid are dandruff, folliculitis, lice, ringworm, and psoriasis. Over-the-counter remedies may be obtained from your local drug store with your pharmacist’s advice. Some hair and scalp conditions may not be avoidable. An example is genetic hair loss in men (male pattern baldness) or women (female pattern baldness – genetically determined hormonal changes associated with pregnancy or menopause may affect hair pattern), and hair loss associated with aging.  Certain experiences such as malnutrition (e.g., lack of iron and proteins), stressors, life challenges, weight loss, smoking, and chemical hair treatments may affect individuals’ hair growth and lead to hair loss with resultant balding, thinning of hair, or receding of hair line. Alopecia areata is areas of baldness on the scalp caused by an immune system mediated destruction of hair producing cells. Such bald spots can be reversed with professional treatment. Other causes of hair loss that your physician may need to investigate are thyroid problems and effects of long term medications already in use.

The scalp produces natural oils and if this is removed by washing, use of hair oils and pomades can revitalize the scalp.  Dandruff is from flakes of dead skin shed by dry scaly scalp.  Microbial infection, possibly fungal, may cause scaly skin. Some skin disease of the oil glands can also produce a type of dandruff with oily scales. Ask your pharmacist for dandruff shampoos and creams. The active ingredients are antifungal agents such as ketoconazole, ciclopirox, selenium sulfide and zinc pyrithione; or salicylic acid or coal tar. Severe dandruff requires clinical attention. 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

It is typical of young people to be ambitious, energetic, driven, insatiable, audacious, time-conscious to the point of desperation, etc.  The young want many good things and want them fast.  Time matters to them more than other factors.

It is typical of old people to take their time, to take it easy, to be cautious, to avoid trouble, and perhaps to be cynical, critical, or even fatalistic. Old people are watching their bodies more than any other factor.  Sometimes they are watching their minds and spirits too.

What matters changes as time goes on and on coming to a new year, the experience of the last year helps to determine what matters in the new year.

The objectivity and subjectivity of what matters is a long story and we shall not begin to tell it here.  It suffices for each person to examine his or her own experiences and determine what matters for good health, wellness, and fitness.

Everyone has a stage in life, a place in society, roles, duties, possibilities, opportunities, etc., through which he or she is destined for fulfilment and happiness. To become our best and to achieve our best in all our activities, we do need good health of body, mind, and spirit; we do need wellness; and we do need fitness.

Good health has been defined variously. In 1948, The World Health Organization’s Constitution defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Perfect health may actually be non-existent as most of us, if not all of us, are born with some minor or major health challenge which may be physical, mental, or spiritual.  The perfect genome is simply original and historical.

Good health means the body, mind, and spirit are in good form and functioning well.  Factors such as balanced nutrition, adequate regular exercise, and effective rest contribute to good health of the body.

Good mental health is the correctness of one’s emotions, passions, and psyche and its reference is one’s personality. What is expected of a child is different from what is expected of an adult.  What is expected of a man is different from what is expected of a woman. What is expected of the young is different from what is expected of the old.  What is expected of a worker is different from what is expected of a retiree.  What is expected of a professor is different from what is expected of a clown. What is expected of an older generation is different from what is expected of a newer generation. What makes an introvert breaks an extrovert.   It can be damaging to refer to mental health without reference to personality.

Good spiritual health is proper connectivity with one’s spiritual source and ruler.

Wellness is the ability to live fully and enjoy life fully.  Wellness includes a proper perspective of oneself, relationships, environment, and society.  Wellness includes an ability to gain from the past and present and ensure a good future. Wellness is physical potency, emotional potency, intellectual potency, and spiritual potency.

Factors that prepare us for wellness are learning, education, training, experience, and exposure.  Factors that contribute towards wellness are family and relationships, income, finances, property, resources, status, comfort, prospects, opportunities, freedom, safety, security, and privacy.  Factors that ensure wellness are faith, hope, and love.

Wellness is reflected in results such as hygiene, order, sanity, sanctity, functionality, and fruitfulness.

Spiritual wellness is living in good conscience, good vision – hindsight, insight, and foresight, and peace.

Fitness is the dynamic maintenance of balance against constitutive (from within oneself) and exogenous (from outside of oneself) influences. Life is full of stressors, dangers, assaults, challenges, and difficulties that may affect us bodily, mentally, or spiritually. Being fit makes us less vulnerable. Without fitness, we would not live long, we would not be continually functional, and we would not truly enjoy life.  In fact, human babies are born healthy but not fit and remain vulnerable for long compared to babies of many other species. We develop fitness, bodily, mentally, and spiritually as we become adults.  Fitness is induced and stimulated by living and experience of life. Fitness conditions us to other humans and adapts us to environments, times, and events.

Fitness gives us stamina, immunity, emotional response, and ability to cope.  Fitness provides us with strategy, makes us resilient, makes us recover, and gives us bodily, mental, and spiritual endurance.

Mysteriously, bodily and mental fitness wane with age when life is supposedly fulfilled and the elderly become respectively more and more vulnerable physically and mentally while generally their spiritual fitness waxes towards death.

Good health, wellness, and fitness are needed for enjoying a full life and as we enter a new year, it is opportune time to reconsider for ourselves – what really matters.

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

The human being is not totally healthy if any part of him or her is not healthy. We generally try to care for our bodies, and sometimes for our minds, but possibly not as much for our spiritual component.

As the world celebrates Christmas and indeed the coming of a New Year for which all pray for good things, we here consider our spiritual health. A writer can however leave readers things to think about rather than actually effect any change in spiritual health.

I look around at people and I here begin with askology.  Is a psychiatrist 100% sane 100% of the time? Is a doctor 100% healthy 100% of the time? Is a professor 100% knowledgeable 100% of the time? Is a lawyer 100% lawful 100% of the time?  Is a pastor 100% holy 100% of the time?

Now, Jeremiah is not my favourite book of the Bible but recently this prophet gave me something to think about as I read: “Cursed is the man who trusts in human beings, who makes flesh his strength, whose heart turns away from the LORD.” (Jeremiah 17: 5, NAB).

Surely we must trust a psychiatrist, a doctor, a professor, a lawyer, a pastor, etc. but this counsel puts us in the perspective of the universal limitation and imperfection of humanity. Even a person who is presumably a perfect professional cannot be presumed a perfect human being or a perfect spiritual being. Seemingly we all have good and evil or are influenced by good and evil.

The world of religion is an obvious battle ground of good and evil using human and other agencies. Humans are apparently at the centre of this battle. Only God knows where we are heading and if each man or woman is on the side of good or on the side of evil.

Religion has a great propensity to benefit all.  How people give their time, energy, efforts, money, resources, knowledge, etc., for the good of others because of their faith in God. The religions we practice themselves have been passed down to us through the love, sacrifices, and dedication of people before us.  Much of the world’s development and human progress has come from religion.  Religion led by the spirit of God is a channel of God’s goodness towards humanity. It is humans reaching out to God and being used by God.

Religion also has a great propensity to cause trouble.  How we can be stiff and strong in falsehood, error, and fabrications.  How we can be stiff and strong in wrong doing, injustice, and hurts to others.  How we can be stiff and strong in missions of evil consequence.  Religion played out by human nature may be just an expression of what lies in the dark side of humanity: egotism, rivalry, greed, selfishness, avarice, envy, jealousy, stupidity, malice, injustice, prejudice, bias, ignorance, anger, fanaticism, falsehood, etc.

What are we calling religion? What are we practicing as religion? What are we doing with religion? What is the result of our religion?

Zeal has to be examined.  Holy zeal is a carriage of the human spirit by God’s spirit to enable one to accomplish holy tasks.  It is not a mental state (such as excitement, obsession, addiction, fanaticism, craze, anxiety, or paranoia) which we sometimes encounter in religion.

Religious leadership has to be examined.  People can be damaged in body, mind, or spirit to a point of no return because of improper religious leadership.  Religions are establishments and enterprises and always have something at stake: money, property, memberships, doctrines, traditions, causes, etc.  They also always have things to propagate, to conquer, to live for, to fight for, to kill for, and to die for.  Thus leaderships in religion can be pressured into unhealthy mental or unhealthy spiritual states.

Religions stand for God rightly or wrongly.  This is a source of audacity, license, perceived prerogatives, and blindness that can result in blatant disrespect, hurt, persecution, and injustice towards people who don’t tally. Frankly, our works of hatred, our works of envy, our works of ignorance, our works of arrogance, our works of enmity, our works of stupidity – that we sometimes call God’s work are works of human weaknesses.

What has religion turned us into?  Is our religion a true encounter with God? Is our religion an agent of sanity and sanctity? Is our religion an agent of physical well-being and fitness for our presence, place, and role in society?  Does religion need to change?  Our spiritual health can improve with a dose of grace and mercy.  Humanity is always in need of mercy and grace otherwise life would just be a long, long night with no light at the end of it. Hopefully for many, religion is a source of joy, peace, and glory this Christmas and in everyday life.

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

Muscles are important for movement. Muscles are made up of bundles of muscle fibres that contract and relax in the process of movement. Muscle tone is the strength of contraction of the muscle at rest.  It helps to maintain posture, bodily balance, and readiness for movement. In sports and body building, muscle tone is often used to refer to both muscle size and strength, and firm bodies.

The immediate micro-environment around the muscle fibres in our bodies requires a liquid composition that supports the chemical and electrical requirements for normal muscle contraction and relaxation.  The metallic ions such as sodium, calcium, magnesium, and potassium, and the non-metallic ions such as chloride, bicarbonate, and phosphate all have electric charge and, within body fluids, they maintain the necessary minute electric currents that maintain automatic biologic processes of life.

In particular, electrolytes are vital for nerve and muscle function and continually move in and out of nerve and muscle cells and between the cells.  Electrolytes keep the body with normal water balance (good hydration), regulate acid-base balance or pH of body fluids and pH inside the cells, contribute to normal blood pressure, and are also important for cellular nutrition, expulsion of cellular waste products and reversal of tissue damage.  Other charged ions that contribute to body functions are iron, zinc, copper, and iodide.

Biological activities, including nerve-muscle functions, always produce their waste products and there are channels of removal of such products which includes their conversion to harmless forms that can be excreted by the kidneys or other organs. Occasionally, waste molecules accumulate within or around cells such as muscle cells, disturbing their function.

Another important process that may affect nerve-muscle function is molecular stress. Oxidative stress of the cells is a process whereby certain reactive atoms or molecules called free radicals (not normal oxygen) spontaneously form and attack normal molecules and damage them. Free radicals are continually formed as by-products in the body and they are continually mopped up by antioxidant enzyme processes such that no harm is caused.  However when overwhelming amounts of free radicals are formed, body tissues such as muscles are affected.

Sometimes muscles are unable to contract or relax.  This is call paralysis.  Flaccid paralysis is when muscles cannot contract, lack tone and they feel soft.  Spastic paralysis is when muscles cannot relax, have increased tone and they feel rigid.

Paralysis can be a symptom of disease or an actual disease state.  However, occasionally normal, healthy people experience a form of brief or transient paralysis such as leg stiffness and leg cramps.

If you have been driving in Lagos traffic for long and you come out of your car, you may find yourself waddling like a duck, body leaning forward because the legs are not easy to move. Sitting for long in a cramped vehicle can give one leg stiffness. The difficulty in movement soon subsides when one continues to move.  Improved circulation helps to improve mobility as it helps to bring more oxygen and nutrients to the muscles and also helps to clear waste products.

Leg muscles can get cramps or spasms during which one cannot move and one feels pain. Exercise-induced cramps are well known.  The cramped muscle feels hard because it is in a state of excessive contraction. Some people stretch or massage their muscles and this may be helpful in recovery from the effects of cramps.

In a class of their own are own are hypnic leg stiffness and hypnic leg cramps. Adults in midlife may experience such difficulties when they wake up from sleep.  While any of the factors mentioned above: water imbalance, electrolyte imbalance, accumulation of metabolic waste, and oxidative stress may contribute, adults in midlife have added predispositions.  Posture and body weight are important. By midlife many adults have spinal curvatures (hump, lordosis, scoliosis, etc.) that may affect nerve-muscle relationships.  Long periods of standing or walking by such adults with midlife weight and spinal curvature may result is leg muscle trouble.  Also, as people become elderly, their metabolic waste clearance power, liver and kidney function, and antioxidant function also wane and during sleep the processes of recovery may not take place fast enough if the day’s activities had been overwhelming. Many older people also have high blood pressure. Pressure inside blood vessels can force some fluid into the spaces surrounding cells changing the extracellular fluid water and electrolyte balance around muscles which can result in stiffness or cramps.  Midlife people who need blood pressure medications should keep to their medication as directed by their doctor and should monitor their blood pressure before sleeping and when waking. Finally, midlife people are often on long-term medications for various ailments and they should crosscheck with their health care provider if leg cramps or leg stiffness can be caused by their medicines.

If you have frequent leg stiffness or muscle cramps, see your doctor for a thorough medical examination.  Various diagnostic tests are produced for testing issues related to body fluid balance, e.g., Anion Gap Blood Test, Carbon Dioxide (CO2) in Blood, Chloride Test, Electrolytes Test, Osmolality Test, and Sodium Blood Test F.

Drink enough fluids especially in hot weather.  Limit junk food that can deposit waste into your body. Eat clean fresh fruits and vegetables because they supply the body with electrolytes and antioxidants. Antioxidant carotenoids such as beta-carotene, vitamin E, lycopene, flavonoids, proanthocyanidins are found in fresh plant foods. Astaxanthin (a carotenoid) and Spirulina are powerful antioxidants that are helpful for midlife people and the various ailments common in this age group. Freshly cooked sea food such as red pigmented shrimps, crabs, and fish such as salmon contain astaxanthin.  Chicken is a source of food added astaxanthin. Spirulina is a nutritious food supplement from cultivated blue-green algae. With a healthy diet, lifestyle-induced leg stiffness and cramps can be minimized or cured.

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

Now, only Father Christmas is allowed to walk around in the middle of our homes at night and he is usually wide awake when he does it and knows what he is doing. Occasionally, someone else may be walking in the middle of the night but does not know what he or she is doing.

Sleepwalking or somnambulism is an odd hypnic behaviour.  A person gets up and walks or does some activity while sleeping and may not remember ever doing such things.

It usually occurs early in the night within the first few hours of falling asleep when a person is in deep sleep, usually lasts 5-15 minutes, and occurs once a night.  Strangely, the somnambulist is in the period of slow wave (N3) of non-rapid eye movement sleep, a state of low consciousness but is able to perform some tasks that normally require the high consciousness of wakefulness. Twenty per cent of children are likely to sleepwalk at least once and those who sleepwalk more might continue it into adulthood.  After sleepwalking, a person returns to bed and sleeps normally.  Such as established sleep disorder is medically classified as a parasomnia.

A somnambulist may simply sit up in bed with eyes open, usually with a dazed glassy eyed expression, may sleeptalk nonsense, may get up and walk or do something, may not communicate if talked to or may answer with confused sound, and is usually difficult to wake up during an episode. In severe cases, a person may do routine activities – from dressing, cooking, eating, cleaning or sexual activity, to going outdoors and driving a car or may do unusual activities such as urinating in the wrong place, jumping out of a window, or may have an accident.  The sleepwalker is in deep sleep and waking the sleepwalker may precipitate confusion or violent behaviour.  However if he or she is not awakened he or she might end up having an accident. If your child could sleep walk, you should tell any baby sitter or person in charge about it, if the child is sleeping in a new environment  such as when visiting another family.

Sleepwalking is often harmless but there are cases that have had severe consequences such as injury to self or to another person, destruction of property, assault, homicide, etc.  Sleepwalk catastrophes can create legal battles as the culprit can claim lack of volition and refute criminal liability.  The Law may struggle with claims of non-insane automatism (involuntary conduct) and insane automatism in deciding if the person is not guilty, guilty, should be remanded, put on death roll, etc. From legal experience, we know that a person killing his spouse, his date or a prostitute, or killing his mother-in-law can try to get away with murder on the basis of sleepwalking.

The biologic mechanism behind the behaviour of somnambulism is unknown but associated factors and triggers include genetic disposition, disturbed sleep, illness or stress, medications such as sedatives, alcohol and recreational drugs, change in sleep environment, waking up suddenly from deep sleep because of bladder pressure or noise or touch disturbance, etc. People who have sleep disorders such as obstructive sleep apnoea and restless legs syndrome that cause them to wake suddenly from deep sleep can also end up sleepwalking.

If someone is sleepwalking, guide the person gently back to bed. If the sleepwalking is frequent, seek a doctor’s advice. Somnambulism that starts in adulthood should be medically examined.

To reduce a disposition to sleepwalking, a person should avoid sleep deprivation and irregular sleep, avoid stress, make the sleep environment conducive for good sleep, have a relaxing routine before bedtime, avoid drinking a lot before bedtime, and empty the bladder before going to sleep. For a child or adult with regular sleepwalking at same time at night, the guardian may try anticipatory waking.  Cognitive behavioural therapy (CBT) or hypnotherapy may help correct sleep disorders in some persons.

Drugs are not remedies of first choice for somnambulism. Rarely, a doctor may prescribe a sedative-hypnotic benzodiazepine (clonazepam, diazepam, flurazepam, or triazolam), barbiturate sodium amytal  or antidepressant imipramine or paroxetine to help improve sleep if a person’s sleepwalking poses severe threat. Other drugs that have been used to alter brain patterns in somnambulism are the anticholinergic biperiden, antiepileptics carbamazepine and valproate, and antipsychotic quetiapine. Sleep promoting melatonin has also been tried as so have herbal medicines.

Generally, rather than seeking the use of these prescription drugs whose effectiveness are not certain, for a known somnambulist one should: avoid using a bunkbed; the bedroom and surroundings should not have weapons such as a loaded gun, a knife, razor blade, or rope; breakable objects should not be around; obstructive objects that can be tripped over should not be around; the windows and doors should be locked or have alarms attached; the staircase should be barred, etc. When being allocated a room in a hotel, hostel, etc., or an apartment in a block, indicate preference for situation on the ground floor. With such measures, somnambulists can be well taken care of by family members.

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

Now, only Father Christmas is allowed to walk around in the middle of our homes at night and he is usually wide awake when he does it and knows what he is doing. Occasionally, someone else may be walking in the middle of the night but does not know what he or she is doing.

Sleepwalking or somnambulism is an odd hypnic behaviour.  A person gets up and walks or does some activity while sleeping and may not remember ever doing such things.

It usually occurs early in the night within the first few hours of falling asleep when a person is in deep sleep, usually lasts 5-15 minutes, and occurs once a night.  Strangely, the somnambulist is in the period of slow wave (N3) of non-rapid eye movement sleep, a state of low consciousness but is able to perform some tasks that normally require the high consciousness of wakefulness. Twenty per cent of children are likely to sleepwalk at least once and those who sleepwalk more might continue it into adulthood.  After sleepwalking, a person returns to bed and sleeps normally.  Such as established sleep disorder is medically classified as a parasomnia.

A somnambulist may simply sit up in bed with eyes open, usually with a dazed glassy eyed expression, may sleeptalk nonsense, may get up and walk or do something, may not communicate if talked to or may answer with confused sound, and is usually difficult to wake up during an episode. In severe cases, a person may do routine activities – from dressing, cooking, eating, cleaning or sexual activity, to going outdoors and driving a car or may do unusual activities such as urinating in the wrong place, jumping out of a window, or may have an accident.  The sleepwalker is in deep sleep and waking the sleepwalker may precipitate confusion or violent behaviour.  However if he or she is not awakened he or she might end up having an accident. If your child could sleep walk, you should tell any baby sitter or person in charge about it, if the child is sleeping in a new environment  such as when visiting another family.

Sleepwalking is often harmless but there are cases that have had severe consequences such as injury to self or to another person, destruction of property, assault, homicide, etc.  Sleepwalk catastrophes can create legal battles as the culprit can claim lack of volition and refute criminal liability.  The Law may struggle with claims of non-insane automatism (involuntary conduct) and insane automatism in deciding if the person is not guilty, guilty, should be remanded, put on death roll, etc. From legal experience, we know that a person killing his spouse, his date or a prostitute, or killing his mother-in-law can try to get away with murder on the basis of sleepwalking.

The biologic mechanism behind the behaviour of somnambulism is unknown but associated factors and triggers include genetic disposition, disturbed sleep, illness or stress, medications such as sedatives, alcohol and recreational drugs, change in sleep environment, waking up suddenly from deep sleep because of bladder pressure or noise or touch disturbance, etc. People who have sleep disorders such as obstructive sleep apnoea and restless legs syndrome that cause them to wake suddenly from deep sleep can also end up sleepwalking.

If someone is sleepwalking, guide the person gently back to bed. If the sleepwalking is frequent, seek a doctor’s advice. Somnambulism that starts in adulthood should be medically examined.

To reduce a disposition to sleepwalking, a person should avoid sleep deprivation and irregular sleep, avoid stress, make the sleep environment conducive for good sleep, have a relaxing routine before bedtime, avoid drinking a lot before bedtime, and empty the bladder before going to sleep. For a child or adult with regular sleepwalking at same time at night, the guardian may try anticipatory waking.  Cognitive behavioural therapy (CBT) or hypnotherapy may help correct sleep disorders in some persons.

Drugs are not remedies of first choice for somnambulism. Rarely, a doctor may prescribe a sedative-hypnotic benzodiazepine (clonazepam, diazepam, flurazepam, or triazolam), barbiturate sodium amytal  or antidepressant imipramine or paroxetine to help improve sleep if a person’s sleepwalking poses severe threat. Other drugs that have been used to alter brain patterns in somnambulism are the anticholinergic biperiden, antiepileptics carbamazepine and valproate, and antipsychotic quetiapine. Sleep promoting melatonin has also been tried as so have herbal medicines.

Generally, rather than seeking the use of these prescription drugs whose effectiveness are not certain, for a known somnambulist one should: avoid using a bunkbed; the bedroom and surroundings should not have weapons such as a loaded gun, a knife, razor blade, or rope; breakable objects should not be around; obstructive objects that can be tripped over should not be around; the windows and doors should be locked or have alarms attached; the staircase should be barred, etc. When being allocated a room in a hotel, hostel, etc., or an apartment in a block, indicate preference for situation on the ground floor. With such measures, somnambulists can be well taken care of by family members.

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

Bruxism is the act of teeth grinding or gnashing during sleep at night.  Teeth grinding can be voluntary or involuntary. Dogs can do it.  Humans can do it.  In some cultures (possibly more in past civilizations), it may be routinely used to manifest anger.  This means it could also be a learned behaviour and cultural expression. In the Middle East, it might have been routinely used to show anger or distress.  The famous words of Jesus about the damned: “…there will be weeping and grinding of teeth” indicates that people of those days were familiar with the act of grinding of teeth and the act connoted a feeling of anger or distress. It possibly would take extreme emotion such as when damned for any human being to grind teeth, physical or spiritual teeth (God forbid bad ting, as Nigerians say).  However some people more readily grind their teeth physically with life’s common stressors. The reasons for this could be genetic, biological, mental, or spiritual.  It is not well understood scientifically or in any other specialty. However some believe that teeth grinding is a primitive reflex.  How the reflex is triggered is unknown, especially the night time occurrences. Bruxism as a hypnic behaviour may be manifested involuntarily during sleep when one is saint or when one is sinner.  Some recreational drugs such as stimulant ecstasy, cocaine, methamphetamine and heroine all increase bruxism.  Severe bruxism can be caused as a side effect by selective serotonin reuptake inhibitors used clinically as antidepressants.  Broxomania refers to daytime teeth grinding expressed during intense emotion.

Nowadays, teeth clenching is perhaps the more common expression of anger, hostility, frustration, distress, hatred, etc. in healthy persons.

Wikipedia tells us that “In the beginning of the twentieth century, Moritz Karolyi, a Viennese dentist, described bruxism as “traumatic neuralgia” and stated “it was the cause of a periodontal condition called pyorrhea (periodontitis).””  Bruxism and bruxomania wear off the hard enamel cover of the teeth, make the teeth sensitive and decay fast because the inner dentine and nerves become exposed and also cause jaw  joint or neuromuscular pain (temporomadibular joint (TMJ) discomfort).

A feature of bruxism is unconscious repetitive contraction of the masseter muscle. Botulinum toxin (Botox) injected into the masseter muscle weakens the muscle spasms but does not prevent normal utilization of the muscle.  Botox has been successfully used to relieve the symptoms of bruxism.

Magnesium deficiency is thought to contribute to muscle spasms of bruxism.  Calcium disorders are also suspect.  Magnesium and calcium are both important for proper nerve and muscle functions.

Examples of devices that can been worn on the teeth during sleep at night are the generic  bite guard or teeth grinding night guard, they limit the erosion of the teeth when a person in bruxing.  To get a comfortable one, one needs to visit the dentist to mold a custom fitted guard. 

For severe cases a pharmacist may give a sufferer a supplement such as Magnesium and Rhodiola.  A dentist may provide a biofeedback device which includes having an electronic device near one’s face while sleeping. Migraine Relief|NTI-tss Plus™ by Keller Laboratories helps reduces muscle contractions and prevents migraines and has been found to also reduce bruxism. Physiological dentists specialize in various treatments involving facial muscle and orthodontics that may eventually stop a patient bruxing. 

A psychologist, religious counsellor, career or professional counsellor, social counsellor, certified hypnotist and other behaviour modulators can help one reduce one’s emotional stress or change one’s experience of stressors.  Acupuncture techniques have also been used for bruxism and TMJ discomfort.

A person on social drugs such as ecstacy and amphetamine should do what is necessary to cease the habit.  Exercise is important for relieving stress as it can be a mental distractor from stressful thoughts, it stimulates the circulatory and immune systems and bodily fitness. Cognitive behavioural techniques, relaxation techniques, daily meditation, quiet focussed prayer at the end of each day or beginning of each day or both, relaxing shower or bath at bedtime  –  all help to normalize our emotions and our processing of stress and may help prevent bruxism.

One suffering TMJ discomfort and cannot get clinical assistance may try such remedies as applying ice or a towel heated in hot water to the sore jaw muscles, avoid eating hard foods or chewing gum, massage facial, neck, and shoulder muscles.  Massage helps to increase circulation of blood in the area which brings nourishment as well as removes both metabolic waste product s and inflammatory mediators.

Doctors prescribe inhibiting drugs such as hypnotic-sedatives such as benzodiazepines, anticonvulsants that reduce neuromotor function, muscle relaxants, beta-blockers, dopamine agents, and serotonin agents such as buspirone.  Some of these drugs are addictive and cannot be given long term. They alter the emotions, brain firing, autonomic transmission, and other nerve functions. Examples of drugs prescribed by doctors are gabapentin, pergolide, clonazepam, tiagabine propranolol and clonidine.  Herbs and essential oils that reduce anxiety and promote deep sleep are also used for bruxism.  Examples are hops, valerian, skullcap, chamomile and the oils of lavender and chamomile.

Teeth grinding is only a health problem if it is severe enough to erode the teeth and cause decay or if it precipitates painful jaw problems.  For most people experiencing it is an inconsequential natural phenomenon.

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