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Severe chest pain, indicator to sudden death

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Sudden cardiac deaths (SCD), also known as sudden heart death, is rising in the country with many unrecorded cases, as well, worsening the nation’s health indices. Most of these deaths, grouped as heart related are, however, preventable through healthy diet and lifestyle. APPOLONIA ADEYEMI reports

A story of apparently healthy persons who suddenly collapses and dies is now a common feature in the news. Such was the story of the late Mr. Olayinka Sonaike, the chairman, Estate Surveyors and Valuers Registration Board of Nigeria. He died while delivering his speech at an event at the headquarters of the Independent Corrupt Practices and Other Related Offences Commission (ICPC) in Abuja on Tuesday, December 11, 2017.
The deceased who was 74 years old, was one of the resource persons invited by the ICPC to speak at a one-day colloquium of business management organisations. He was about to make his presentation when he slumped and efforts to revive him failed.
Similarly, the Clerk of the House Committee on Agricultural Production and Services, Mohammed Shuaibu slumped while walking down the National Assembly staircase at about 12:00 noon on Monday, March 13, 2017. He was rushed to the National Assembly clinic where he died, according to reports.
The late Shuaibu had arrived Abuja from Zaria for a committee meeting, but died some minutes before the meeting commenced. The death of another prominent lawyer Barrister Solomon Uzoigwe in Onitsha also occurred in the same manner.
According to reports, the shocking incident occurred on Wednesday, January 24, when the deceased slumped and died in the premises of Onitsha High Court in Umuchu town, Aguata Local Government Area of Anambra State where the late Uzoigwe had gone to defend a land matter. The most recent of such deaths which has left many Nigerians wondering what could be amiss, was that of the late Deji Tinubu in January, 2018.
According to the Lagos State Commissioner for Information, Kehinde Bamigbetan, the late Tinubu, the former chairman of Lagos State Sports Commission, slumped while playing five-a-side match with fellow participants at the ongoing retreat of members of the state executive council and permanent secretaries at the Jubilee Chalets, Epe in January 25. He was 52 years old.
There is no doubt that these reported sudden deaths would be a tip of the iceberg. If the deaths reported in the media are those of prominent Nigerians, the number of unreported sudden deaths involving the poor and less privileged in rural far-to-reach areas can best be imagined. What this means is that many more of such deaths would have gone unreported, prompting the question: ‘’What is making some Nigerians that were not sick to die suddenly?”
A Cardiovascular Heart Health Physician, Dr. Kingsley Kola Akinroye with expertise, in the prevention of heart disease, classified most deaths that happened in this manner as sudden heart death.
According to him, a sudden heart death occurs within one hour in an individual that is apparently healthy.
The World Health Organisation (WHO) estimates that globally, almost three million people die every year from sudden heart death. A lot of the studies in the United States (US) shows that more than 300,000 people die annually from sudden heart death but in terms of percentage, “we have less than that happening in the Asian region and very low happen in Africa,” he said.
Presently, data on sudden heart death in Africa is very scanty; Akinroye said most of these deaths were related to blood flow to the heart, which is called ischemic heart disease.
“The other causes of sudden deaths are non-ischemic, which are not related to the blood vessels of the heart, the common ones being problems with the muscles of the heart, which is called cardiomyopathy.
“In the African region, available documents in literature on sudden heart deaths involve athletes including footballers.”
Also, among those whose sudden heart deaths are recorded include people living with hypertension and those with heart muscle problems. Electrical activities of the heart have also been known to cause sudden heart death in some Nigerians, but documentation on this were still very rare, Akinroye added.
The cardiovascular heart health physician said heart muscle disease is more of the problem in Africa, while the blood vessel disease is common in the western world including America and Europe. Nevertheless, he noted that blood vessel disease is now coming up in the African region.
Six per cent of Africa’s adult population with blood vessel disease (coronary heart disease) five years ago, has risen to 11 per cent presently because of western diet and unhealthy lifestyle in terms of poor physical activity, uncontrolled blood pressure, and blood sugar, sedentary lifestyle, all of which contribute to rising diseases of the blood vessels and the heart muscles.
Akinroye said, ‘’You must recognise that in Nigeria, hypertension, which is the rise in blood pressure is our heart disease.
‘’With regard to heart rhythm problem, when the heart vessel disease occurs they can also affect the rhythm of the heart as well. So, the rhythm of the heart can also be the cause of sudden death in the population.’’
Hence, he listed some of the causes sudden heart death as heart muscle disease, coronary disease (blood vessel) and heart rhythm problems.
On his part, a Consultant Cardiologist, Dr. Chinedu Eluogu attributed rising sudden deaths in the society to several factors of which them is the increase in the prevalence of some conditions that cause sudden death.
He attributed the common causes of sudden death to cardiac causes. Medical conditions that increase the risk of Nigerians to sudden heart deaths include hypertension, diabetes, smoking, alcoholism, dietary indiscretion, obesity, among others.
Eluogu said, “These conditions have increased among Nigerians presently and that, in turn has increased the prevalence of sudden cardiac death.”

Also, the consultant cardiologist said poor detection of these medical conditions has contributed to why sudden cardiac death is prevalent.
He said, “These problems are not detected on time,” adding, “If there is primary detection of these conditions, some sudden cardiac deaths can be prevented.”
While admitting that the case of everyone that slums and died suddenly was not necessarily a sudden cardiac death, Eluogu asserted that most of them were heart related.

Signals
Eluogu said, “Sometimes there were pointers; but a lot of time, there were no pointers.”
Eluogu listed some of the symptoms as a fainting attack, a severe chest pain, an excruciating headache, among others.
In people that suffer stroke, a blood vessel burst in the head, sometimes could be a symptom. A severe headache could be as of sudden heart death as a result of a blood vessel that had expanded and busted, Eluogu explained.

Prevention
Eluogu said it was important for people to screen themselves and find out if they had some background health conditions like high blood pressure (HBP) that can predispose them to sudden death. A test in the clinic will tell someone whether his blood pressure is high or not.
If one has a relation – father, mother, siblings, among others that has hypertension, the person should not just monitor blood his blood pressure, the fellow should check his blood sugar, body mass index (BMI) and adopt healthy lifestyle modifications that can even help to control these conditions.
A healthy diet is rich in fruits and vegetables.
“A lot of people also don’t sleep well and this is one of the things that predispose one to sudden cardiac death,” he added.
Similarly, he urged people to reduce alcohol consumption, especially binge drinking, which is the consumption a large quantity of alcohol in one sitting. “That is also dangerous,” Eluogu noted.
He urged the three tiers of government to teach people how to do cardio pulmonary resuscitation (CPR), which saves lives. “It has been found that when people around anyone that faints knows how to do CPR, it increases the person’s chances of recovery.”
According to the American Heart Association (AHA), CPR performed in the first few minutes of a sudden cardiac arrest, can double or even triple a person’s chance of survival.
Sudden Cardiac Arrest, or SCA is an electrical malfunction in the heart that causes an irregular heartbeat. It can disrupt the blood flow to the brain, lungs and other organs. The AHA said 90 per cent of people who suffer out-of-hospital SCA die. However, teaching Nigerians how to do CPR would save lives, Eluogu affirmed.
Other necessary risk factors include checking level of cholesterol, the body’s electrolyte, kidney and liver functions, body mass index (BMI) to ensure that they are within normal limit.
He recommended echcardiography and ultra-sound as part of key screening to determine the state of one’s heart health.
Echo cardiograph, a necessary heart check costs between N25,000 to N45,000 and ultrasound scan. “When you consider that when some people die several millions of Naira is spent to bury them, bringing out funds to carry out these routine tests is not too much,” he reasoned.
Eluogu said although, our health insurance may not cover most of these heart tests including ultrasound scan, but individuals can walk into clinics and check their blood pressure, blood sugar, be mindful of what they eat to prevent obesity, and the consumption of excessive alcohol and salt.
Furthermore, he causiioned against the current trend of taking illicit drugs. “A lot of people that experienced these sudden deaths had been found to be taking illicit drugs such as cocaine, amphetamines, tramadol, etc. Eluogu added, “Everyday clubs spring up in our environment and a lot of people are going into taking drugs and cigarettes including shisha, but the public needs to be aware of the health risks these could pose.”

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Health

National hospital receives 2nd cancer treatment machine

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The National Hospital, has taken delivery of the second Radiotherapy machine for Cancer treatment,  in Abuja on Monday. The Elekta machine for Linear Accelerator (LINAC) is made up of several components to be coupled and installed soon.

Speaking in a brief interview at the hospital, the Chief Medical Director (CMD), National Hospital, Dr. Jeff Momoh, said the Abuja Radiotherapy centre would be the only centre in West Africa running two Linear accelerators at the same time. This, the CMD explained, was to avoid running down the 1st machine which has currently treated over 200 patients.

Describing the arrival of the 2nd machine as a major breakthrough for the country, the CMD said its installation would further check medical tourism as patients who travelled abroad for cancer treatment would return home to receive treatment at the centre.

In his words, “A cancer patient has returned from India for treatment at the centre and we will soon see patients from other sub-regions receiving cancer treatment in the hospital because with the state of the art equipment available, it will be the best Cancer treatment centre in West Africa”

Commending the Minister of Health, Professor Isaac Adewole, for seeing to the delivery of the machine, Dr. Momoh informed that the procurement of the second machine was made possible by the unflinching commitment of the minister who had earlier made a pledge to the hospital in that regards.

According to Momoh, similar machines would soon be installed in each of the six geopolitical zones in the country.

On the maintenance and optimum functionality of the Cancer machine, the CMD said the Hospital has fully trained the First set of Nigerians on the maintenance and supervision of the Linear Accelerator under the supervision of Engr. Ikede John, a Deputy Director in the National Hospital, Abuja, to ensure its proper use.

To ensure safe delivery of the machine was, the representative of its manufacturer, JNC International Ltd, Engr. Wale Akinola.

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UNICEF says world is failing newborn babies

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Global deaths of newborn babies remain alarmingly high, particularly among the world’s poorest countries, UNICEF said today in a new report on newborn mortality.

Every year, 2.6 million newborns around the world do not survive their first month of life. One million of them die the day they are born.

Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report said. In high-income countries, that rate is three deaths per 1,000.

“While we have more than halved the number of deaths among children under the age of five in the last quarter century, we have not made similar progress in ending deaths among children less than one month old,” said Henrietta H. Fore, UNICEF’s Executive Director.

“Given that the majority of these deaths are preventable, clearly, we are failing the world’s poorest babies.”

The report notes that eight of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. With the newborn mortality rate of 29 deaths per 1,000 births, the global estimates rank Nigeria as the 11th highest on newborn deaths.

In the recent Multiple Indicator Cluster Survey (MICS) conducted by the Government of Nigeria in 2016/17, the rate of newborn deaths per 1000 births is 37. This national average hides the differences between the 36 states and the slow progress in some of them.

“A fair chance in life begins with a strong, healthy start. Unfortunately, many children in Nigeria are still deprived of this,” said Mohamed M Fall, UNICEF Nigeria’s Representative. “MICS data tells us that the trend is improving but urgent action needs to be taken for Nigeria to reach the Sustainable Development Goals (SDGs). It cannot afford to fail its newborns today.”

More than 80 per cent of newborn deaths are due to prematurity, asphyxia, complications during birth or infections such as pneumonia and sepsis.

These deaths can be prevented with access to well-trained midwives during antenatal and postnatal visits as well as delivery at a health facility, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact, proper cord care, and good nutrition.

 However, a shortage of well-trained health workers and midwives means that thousands don’t receive the life-saving support they need to survive.

This month, UNICEF is launching Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns. Through the campaign, UNICEF is issuing an urgent appeal to governments, health care providers, donors, the private sector, families and businesses to keep every child alive by:

Recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care;

Guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;

Making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and

Empowering adolescent girls, mothers and families to demand and receive quality care.

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Health

New blood test shows promise for early autism detection

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Scientists yesterday said a new blood and urine test that could detect autism early in children’s urine and blood, was underway.

 

The researchers from the University of Warwick, United Kingdom (UK), said their test could lead to earlier diagnosis of autism spectrum disorders (ASD), a major factor that was key in the management of children living with the condition.

 

A new study, which unveiled this development, was published in the Molecular Autism journal. Autism, or ASD, refers to a range of conditions characterised by challenges with social skills, repetitive behaviours, speech and non-verbal communication, as well as by unique strengths and differences.

 

Diagnosing autism over the years, especially in developing countries including Nigeria, has been a difficult task and this, in addition to poor awareness about the condition, poverty and stigma, had contributed to make many cases go undiagnosed until very late when affected children had become adults.

 

However, scientific evidence showed that early detection of autism and medical intervention, often resulted in good treatment outcomes, enabling many autistic children achieve independent living. Currently, there were no biological tests that can spot autism, which was often diagnosed through behavioural assessments by clinicians.

 

Often the personnel and equipment for conducting these tests were available in mainly health facilities located mostly in urban centres, leaving thousands of autistic kids from poor background in rural farto- reach communities, unable to access the therapy. In the new study, researchers tested children with and without autism and found higher levels of protein damage in those with the disorder.

 

They looked for chemical differences in the blood and urine of 38 autistic children and 31 children without the condition, all aged between five and 12. In those with autism they found higher levels of protein damage, particularly in the blood plasma, which they said were associated with illhealth.

 

Dr. Naila Rabbani from the University of Warwick, who led the study, said the tests could ultimately be used by doctors to diagnose autism earlier in childhood by detecting these markers. Rabbani added that she hoped the tests could also eventually reveal some of the factors that cause autism and improve its diagnosis.

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