STROKE/CEROBVASCULAR ACCIDENT (CVA)

STROKE/CEREBROVASCULAR ACCIDENT (CVA)

A stroke occurs when a blood vessel in the brain ruptures and bleeds, or when there’s a blockage in the blood supply to the brain. The rupture or blockage prevents blood and oxygen from reaching the brain’s tissues. Without oxygen, brain cells, tissue become damaged and begin to die within minutes.

According to the Centers for Disease Control and Prevention (CDC), stroke is the 5th leading trusted Source cause of death in the United States. Every year, more than 795,000 people diagnosed with stroke. In  U.S also the prevalence of stroke is roughly 3% of the adult population, which translates to approximately 7 million individuals. Approximately 800,000 primary (first-time) or secondary (recurrent) with the majority being primary strokes (roughly 600,000).

In Nigeria, the most populous black nation in the world, stands to risk the further straining of its resources as a result of the increasing prevalence of stroke and other cardiovascular diseases due to epidemiological transition, the current prevalence of stroke in Nigeria is 1.14 per 1000. Management of the disease is largely conservative while there is little or no funding for high-quality research. Primary prevention is the key to reducing the burden of the disease in a country with such poor resources. However, stroke is more common in women than men do to biological compositions.

DEFINITION

STROKE: can be defined as disease commonly occur as a result of damage or blockage to the arteries supplying the brain's tissues with oxygen and nutrients. Also called CEREBROVASCULAR ACCIDENT (CVA) or BRAIN ATTACK, classified as EMERGENCY.

Stroke occur when the blood supply to the part of the brain is interrupted or reduced, preventing brain tissue from getting enough oxygen and nutrients. Brain cells begin to die in minutes. 

CAUSES

•Bleeding

•Thrombosis (blood clot)

•Narrowing of the blood vessels' lumen

•Aneurysm (bulging of blood vessels)

•Higher blood pressure 

•Blood vessels malformation

RISK FACTORS

According to the National heart, lung and blood institution below are some of the risk factors

•Diet e.g higher salt intake, saturated fat intake and cholesterol

•Lack of exercise

•Alcohol consumption

•Smoking

•Genetic/hereditary

•Age more common in elderly

•Sex more common in men

•Race & ethnicity

•Previous health history e.g diabetic, heart disease, sickle cell disease

•Chronic kidney disease

TYPES OF STROKE

1. Hemorrhagic stroke: occur as a result of blood loss

2. Ischaemic stroke: occur as a result of blockage or narrowing in the arteries supplying the brain

3. Embolic stroke: occur when the blood clot form in the other part of the body and move through the blood and block the blood vessels.

4. Transient ischaemic attack (TIA): occur when there's temporary blockage in the blood flow to the brain.

SIGN & SYMPTOMS OF STROKE

WARNING SIGNS

•Facial paralysis

•Paralysis of one part of the body (limbs)

•Severe headache

GENERAL SIGNS

•Paralysis

•Numbness or weakness in the arm, face, and leg, especially on one side of the body

•Trouble speaking or understanding speech

•Confusion

•Altered level of consciousness

•Slurring speech

•Vision problems, such as trouble seeing in one or both eyes with vision blackened or blurred, or double vision

•Trouble walking

•Loss of balance or coordination

•Dizziness

•Severe, sudden headache with an unknown cause

•Eating difficult

SYMPTOMS IN WOMEN

•Nausea or vomiting

•Hallucination

•Pain

•General weakness

•Shortness of breath or trouble breathing

•Fainting or losing consciousness

•Seizures

•Confusion, disorientation, or lack of responsiveness

•Sudden behavioral changes, especially increased agitation

SYMPTOMS IN MEN

•Drooping on one side of the face or an uneven smile

•Slurred speech, difficulty speaking, and trouble understanding other speech

•Arm weakness or muscle weakness on one side of the body

The symptoms differs by sex

DIAGNOSTIC TESTS OF STROKE

•History taking and neurological examination

•Magnetic resonance imaging (MRI)

•Electrocardiogram

•Blood test e.g full blood count, thrombin time 

•Computed tomography scan (CT scan)

•Carotic ultrasound (CU)

•Cerebral angiography

•Echocardiogram

TREATMENT

The treatment is multidisciplinary approach, include the followings:

1. Anticoagulant drugs

2. Anti platelet drugs

3. Antihypertensive drugs

4. Clot breaking drugs

5. Mechanical thrombectomy

6. Stents

7. Surgery

8. Coiling

9. Clamping

10. Statins

11. Speech therapy

12. Cognitive therapy

13. Relearning sensory skills

14. Physical therapy 

15. Rehabilitation

COMPLICATIONS

•Brain damage

•Long term disabilities

•Paralysis

•Impaired memory functions

•Death

PREVENTIONS OF STROKE

•Early detection and prompt treatment

•Awareness

•Avoid self medication

•Blood monitoring (frequently)

•Dietary modifications

•Exercise

•Avoid smoking

•Avoid alcohol consumption 

•Regular check of people with heart disease

•Special Care for old people

•Effective management of people with related diseases e.g diabetic

•Avoid food contain higher salt and fat

•Regular blood pressure checking

PROGNOSIS/OUTCOME

Stroke is a leading cause of long-term disabilities; more than three quarters of people who suffer stroke survive for a year and over half survive for more than five years. The patient prognosis after an ischaemic stroke is much more positive than after a hemorrhagic stroke thus, stroke lead irreversible disabilities.

SUMMARY

A stroke occurs when blood flow to part of the brain is interrupted, as a result of blockage, clot formation, bleeding, dietary consumption among others which leads to oxygen deprivation to brain tissue. The ability to recover from a stroke depends on the severity of the stroke and how quickly you get medical attention. A massive stroke can be fatal, as it affects large portions of the brain. But for many people experiencing a stroke, recovery is long.

REFERENCES.

American Heart Association/American Stroke Association. TIA (Transient Ischaemic Attack)external icon. Accessed October 6, 2016.

Center for disease control and prevention.

Mozzafarian D, Benjamin EJ, Go AS, Arnett DK,    Blaha MJ, Cushman M, et al., on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation 2016;133(4):e38–360.

National heart, lung and blood institution

Thank you.

Yours sincerely,

Nurse Abdullahi Musa,

Sokoto State Nigeria.

WORLD HYPERTENSION DAY 2021 By Dr. Anas Chika

WORLD HYPERTENSION DAY 2021.

May 17th, 2021

‘Measure Your Blood Pressure Accurately, Control It, Live Longer’

What is hypertension?

When the systolic blood pressure is 140 mm Hg or more and diastolic BP is 90 mm Hg or more, that stage is known as hypertension. When systolic blood pressure is between 120 to 139 mm Hg and diastolic blood pressure is between 80 to 89 mm Hg, it is known as the prehypertension stage.

It is important to take appropriate measures to control the disease in the prehypertension stage. Currently, more than 30 percent of the world’s adult population is suffering due to hypertension which amounts to 1 billion people.

Risks of high blood pressure can originate from many factors including age, race, family history, being overweight or obese or not being physically active, smoking, too much salt in your diet, too much alcohol, and stress.

Hypertension is generally a silent condition. Many people won’t experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.

Symptoms of severe hypertension can include: headaches, shortness of breath, nosebleeds, flushing, dizziness, chest pain, visual changes

blood in the urine. These symptoms require immediate medical attention. They don’t occur in everyone with hypertension, but waiting for a symptom of this condition to appear could be fatal.

Hypertension is a major cause of a range of health problems such as strokes, heart attacks and kidney disease, blindness, and can also contribute to dementia. Many people who suffer from hypertension are not aware that they have it as there can be no symptoms, often people only find out after suffering a heart attack or stroke.

How to lower hypertension?

Maintain an active lifestyle: To keep the disease at bay, it is important to be active. Dedicate at least 30 minutes or 1 hour to yourself. Exercise or take a walk. 

Maintain a healthy diet: Add more fruits, vegetables, nuts, and low-fat dairy products to your diet. It is important to lower your salt intake. Avoid oily foods. 

Stop smoking and drinking: Both of these activities lead to high blood pressure in addition to various other diseases like cancer.

Take medication regularly: If a doctor has prescribed you medication to keep the blood pressure in control, it is of utmost importance that you do it without fail. Don’t stop taking medicines without the advice of your doctor

So join this year's world Hypertension day, test your blood pressure, learn about hypertension and stay healthy.

Dr. Anas Chika (MBBS 2020)

May 17th, 2021

GOLDEN RULES OF EMERGENCY NURSING.

Golden rules of emergency nursing

1- An emergency is an emergency. It is only not an emergency in retrospect!

2- There is no such thing as a ‘minor’ injury. Behind any so-called ‘minor’ presentation there may be a ‘major’ one masquerading.

3- Remember that what looks trivial to you may have significant ramifications for the patient.

4- Don’t forget the fundamentals—communication and observation.

5- Monitors are an adjunct—nurse the patient not the monitor.

6- If you don’t like the patient spend twice as long with them’—that way you will minimize mistakes.

7- There is no such thing as a poor historian’—it is probably your inability to elicit the history.

8- A fall is only a fall after a collapse has been ruled out.

9- It may be a common injury or illness to you—remember it may be a first for the patient and carers.

10- Have a plan for the worst possible scenario—anything less is a bonus!

11- Expect the unexpected.

12- If the patient says they feel like they are going to die, believe them and do something about it!

13- Common things are common but they can still kill you—you can bleed to death from your nose or a large scalp laceration!

14- The patient is not drunk until they have experienced the hangover—do not be misled by the smell of alcohol.

15- In a woman of child-bearing age with abdominal pain—actively rule out ectopic pregnancy.

16- In all unwell patients—Don’t Ever Forget Glucose (DEFG).

17- When caring for children, toys and distraction are essential tools.

18- Do not attribute hyperventilation to hysteria until underlying pathology has been ruled out.

19- Do not dismiss or trivialize the frequent attender. They may have an underlying illness.

20- Ensure patients re-presenting with the same complaint are seen by someone senior.

Crouch, et al. (2009)

LUNCH OF DRUG ABUSE PREVENTION CAMPAIGN; YALI, MWFAAN, YALI RLC

YOUTH DRUG ABUSE PREVENTION IN NORTHERN NIGERIA:

SOKOTO STATE CAMPAIGN

In its efforts to invest in the next generation of African leaders through trainings, mentorship, coaching and guidances Yali Network Sokoto is Collaboration with MWFAAN, YALI RLC ALUMNI, YALI sponsored by US mission Nigeria to conduct a drugs free campaign across five northern states with the aim to help tackle the menace.

The project which targets secondary school students to sensitize and train them on the effects of drugs abuse and how best to shun them, a special session for drugs abusers and addicts to help overcome through support in form of assisted rehabilitation and counselling. 

Drugs free clubs will be established in these institutions to help implement the year long project, teachers will be trained and engaged as coaches for the clubs. 

Sultan Bello Secondary school Sokoto and Government Girls Secondary school Sokoto are the pilot schools selected for the exercise. Activities are to start tomorrow 10/2/2021 by 10 am at GGC Sokoto and to run till 11/2/2021 for the first phase of the campaign.

Signed:

Salahuddeen Bello Bala

State coordinator 

Yali Network Sokoto

9/02/2021

DRUG ABUSE AND IT'S EFFECTS ON HUMAN LIFE

DRUG ABUSE AND ITS EFFECTS ON HUMAN LIFE.

INTRODUCTION

Drug abuse: became public health challenge, also called Substance abuse, is use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well. In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction. 

According to the report, about 14.3 million abuse drugs by using them without prescription, and there are close to 3 Million Nigerians living with some level of drug dependence.

The level of drug abuse in Nigeria, about 1 in 10 persons abused drugs in the past year, is more than twice the world’s average.

Cannabis was the most abused drug in Nigeria and that corresponds to global findings as well. Other drugs that were found to be abused in the country includes opioids such as tramadol, cough syrups and other street drugs.

RATE OF DRUG ABUSE

Following a report by the United Nations Office on Drugs and Crime (UNODC), in collaboration with the National Bureau of Statistics (NBS) and Centre for Research and Information on Substance Abuse (CRISA), funded by the European Union that about 14.3million people in Nigeria use drugs outside prescription, drug control experts have urged the authorities to improve on drug control policies in the country.

The report of the National Drug Survey Use released in Abuja showed that the number of drug users in Nigeria is higher than the entire population of some European countries; they're between 15 and 64 years of age. One in every four of them is also a woman.

The survey showed that the rate of drug use in Nigeria in 2018 is more than twice the global average of 5.3 percent.

Moreover, according to the report, close to three million of the drug users are drug dependent and cannot access help due to lack of health facilities.

Therefore, the extremely limited availability of drug counseling and treatment services has intensified the health crisis in the country. Women drug users often do not get specialised attention in the country because most of the limited facilities are targeted at male drug users.

WHAT'S DRUG ABUSE?

Drug abuse: Drug abuse is the use of illegal drugs or the use of prescription or over-the-counter medications in ways other than recommended or intended. 

OR

Excessive use of psychoactive drugs, such as pain medications or illegal drugs. It can lead to physical, social or emotional harm.

OR

is a condition characterized by a self-destructive pattern of using a substance that leads to significant problems and distress, which may include tolerance to or withdrawal from the substance.

OR

 is when you use legal or illegal substances in ways you shouldn’t. 

OR

Is the use of drugs out of medical order.

RISK FACTORS OF DRUG ABUSE

_Peer pressure

_Stress and inability to cope

_Availability of drug

_Anxiety disorders or depression

_Attention-deficit hyperactivity disorder

_Accessibility of drug

_Bipolar disorder

_Poor drug supplying policy

_Early drug use

_Low self esteem

_Lack of parental supervision

_Male gender

_Parental substance abuse

_Grief/ bereavement

_Personality disorders, such as antisocial behavioral disorder or borderline personality disorder

_Academic pressure

_Physical or sexual abuse

_Poor parent_child communication or bonding

_Failure in love matters

_Unemployment

_Bad company

_Maternal deprivation

_Urge of affluence

_Illiteracy

SOME COMMON DRUGS OF ABUSE

The drugs commonly abuse are basically categorized in to two:

1. Psychoactive drugs: Are those that affect mind and metal process (brain), examples:

_Tobaccos/Nicotine such cigarette, marijuana, shisha etc

_Alcohol

_Stimulant e.g cocaine, caffeine

_Opioid drugs e.g Pentazocine, morphine, heroin 

_Moderate opioid e.g trydal (Tramadol)

_Expectorants e.g emzolyn, exiplon, coflin, codine etc

_Anxiolytic drugs sedatives e.g Diazepam, bromazepam, carbamazepine

_Antipsychotic drugs e.g chlorpromazine, fluphenazine, trifluoperazine

_Antiparkinson drugs e.g Benzhexol (artane)

_Inhalants e.g gasoline

_Anaesthetic agent e.g ketamine, propofol, ametocaine, halothane

2. Non psychoactive drugs: are those drugs with no effect on the mind and mental process but affect the body directly or indirect when abuse; examples:

_Analgesic (Pain killer) e.g paracetamol, acetaminophen, aspirin 

_Non steroidal anti inflammatory drugs e.g Ebumol, diclofenac, piroxicam

_Steroidal anti inflammatory drugs e.g predinisilone, dexamethasone, butamethasone

_Antibiotics e.g amphiclox, amoxyl, tetracycline

COMMON SYMPTOMS OF DRUG ABUSE

_Craving the drug despite difficulties obtaining it or wanting to quit

_Deterioration of relationships

_Deterioration of school or work performance

_Difficulty holding a job

_Disengagement from non–drug-related activities

_Financial problems

_High-risk sexual behavior

_Increasing time spent thinking about, obtaining, using, and recovering from the drug

_Leaving responsibilities unfulfilled

_Legal problems

_Needing higher doses to get the same effect (tolerance)

_Using a drug to avoid its withdrawal symptoms

_Using drugs before or during activities where safety is a concern

COMMON SYMPTOMS OF DRUG INTOXICATION 

_Drug use can lead to symptoms of intoxication including:

_Balance problems, difficulty walking, and falls

_Change in mental status

_Changes in mood, personality or behavior

_Diminished reflexes

_Drowsiness or excessive energy

_Impaired balance and coordination

_Impaired judgment and memory

_Impaired vision

_Nausea with or without vomiting

_Pupil size changes

_Slurred speech; excessive talking

TREATMENT

The treatment of drug abuse is often an extended process done in the psychiatric hospital or specialized institution for drug abusers involving multidisciplinary approach including:

_Cognitive behavioral therapy to work on thought patterns and behavior

_Family therapy to help the family understand the problem and to avoid enabling drug use

_Identification and treatment of coexisting conditions e.g memory loss, brain damage, cancer etc.

_Occupational therapy

_Medications to decrease cravings, block withdrawal symptoms, counteract drug effects, or to cause unpleasant side effects if a drug is used

_Motivational incentives to reinforce abstinence

_Motivational interviewing to utilize a person’s readiness to change behaviors

_Rehabilitation to assist those with severe addiction or coexisting mental illness through the initial stages of quitting

_Supervised withdrawal (detoxification) to prevent, recognize and treat physical symptoms of withdrawal

_Support groups

EFFECTS OF DRUG ABUSE TO HUMAN LIFE

_Brain damage, memory loss, attention difficulties, and impaired judgment

_Cancer

_Cardiovascular disease e.g cardiac arrest, stroke, hypertension

_Hepatitis

_HIV and AIDS, and other infectious diseases

_Legal, academic and social problems

_Liver disease e.g liver cirrhosis

_Domestic violence and other violence

_Lung e.g lung cancer

_Marital problems e.g divorce

_Kidney disease e.g renal failure

_Loss of job

_Malnutrition

_Mental problems/Psychological changes, including aggression, paranoia, depression, stupor and hallucinations

_Respiratory arrest

_Stupor or coma

_Withdrawal symptoms

_Decrease productivity

_Suicidal behavior

_Trauma such as bone deformities, burns, laceration

_Change of skin colour 

_Broken home

_Child delinquency

_Child abuse etc

WAYS TO PREVENT DRUG ABUSE

_Awareness/health education/public enlightenment

_Youth empowerment

_Manufacture control

_Strengthen the agencies that control criminal use of drugs e.g National Drug Law Enforcement Agency (NDLEA), National Agency for Food and Drug Administration and Control (NAFDAC)

_Avoid peer group that are expose to such act

_Ensure effective control of dangerous drugs

_Seek medical advice when ever you're fall sick

_Avoid self medication

_Job opportunities/Occupation

_Ensure effective control of dangerous drugs supply

_Avoid prolong use of addictive drugs e.g pentazocine

_Monitor children closely especially during adolescence stage

_Establishment of centre for rehabilitation of victims

_Guidance and counselling

_Avoid selling of drugs without medical prescription

_Establishment of skills acquisition centre

_Deal with life pressure

_Keep a well balanced life

_Avoid the use of drugs at early age

_Avoid social exposure

_Avoid use of abusive substance in the presence of young children e.g cigarette

_Provide regular time for family

_Involve kids in family projects

_Cut the electronics down the notch 

_Talk to children on drugs and educate them

_Community involvement

_Avoid keeping unused pharmaceuticals within the children easy reach

_Extra curricular activities 

_Establish policies against substance abuse and consequences to whom violate the rules

_Avoid doping

SUMMARY AND CONCLUSION

Drug abuse also called substance abuse which involves the illegal use of drug or taking of drug without medical order or prescription, including self medication that's taking drug by yourself without medical consultation from health practitioner and with no health related knowledge either psychoactive or non psychoactive drugs. It's commonly among both gender and all ages but more common at early age and goes on till old age. The most dangerous drugs of abuse are mainly psychoactive that has the ability to alter psychological stage of an individual including physical, physiological and social well-being as well, thus, injuring the body's systems and result in to so many damage enclose kidney damage, liver damage, heart diseases, marital problems, loss of job, violence, mental illnesses among other. 

However, prolong drug abuse may result in to drug dependency (is a state when the drug a person became physically dependent to a certain drug/substance) and drug addiction (is a disease when the drug is rooted in to the person's brain).

Conclusively, the major ways to overcome drug abuse are avoidance of self medication, seeking medical advice when ill and awareness is the best way to address such public challenge.

REFERENCES

_American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing.

_Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 national survey on drug use and health. HHS Publication No. SMA 15-4927, NSDUH Series H-50.

_National Institute on Drug Abuse. (2016). Commonly abused drugs charts.

_National Institute on Drug Abuse. (2014). Drug abuse and addiction.

_National Institute on Drug Abuse. (2014).  Principles of adolescent substance use disorder treatment: A research-based guide

#SAY_NO_TO_DRUG_ABUSE_SAY_YES_TO_FREE_DRUG_ABUSE_LIFE.

#SAY_NO_TO_DRUG_ABUSE_SAY_YES_TO_BETTER_LIFE.

#DRUG_ABUSE_IS_DANGEROUS_TO_THE_HUMAN_LIFE.

#STOP_DRUG_ABUSE.

#DRUG_ABUSE_CAN_END_LIFE.

Thank you.

Nurse Abdullahi Musa,

An advocator,

Drug abuse awareness campaigner,

From Sokoto-Nigeria.

Gmail:abdurrahmanmct08@gmail

08/02/2021.