₦airaland Forum

nelszx:
That guy don jam quack. Even from his comment you'd know he has entered. Working with mobile and studied microbacteria .

Only God can answer his prayer if he doesn't use the right route to his problem.

Hmm my dear, I pray his case doesn't get complicated by the activities of quacks... if you don't have the right information then you become an endangered species... God will help him.
cheers!!

Solomyn:
"the lab man is qualified lab scientist who work with mobile in there lab. He study me he was trained and cerifty in micro bacterial study"......................... "I have been taking some prescribed antibiotic which i still feel pain".

Thanks Op for your response. Sincerely I don't understand what you mean by the lab man working with mobile in there lab and him being trained in microbacterial study. You complained of pain in your scrotum, he went about running some tests including typhoid? I'm just wondering the connection between the two.

Of all the simpler things to do he subjected you to seminal fluid analysis,....... which Scientist does that for God's sake. How was it collected, where was it collected and after how long was it analysed. This is important because the place and mode of collection as well as time of analysis will impact the result greatly. You can introduce pus cells and bacteria yourself if you collect it wrongly, the motility can be affected if it was analysed late. Was there a culture and sensitivity test as well?

Who prescribed the antibiotics for you? The same lab man

My advise is for you to go and see a doctor in a good hospital and stop wasting your money with one lab man working with mobile in their lab and who also studied microbacteria.
Cheers!!

Kayus4real:
About 10% of pregnancies need to be induced in order to expedite
vaginal delivery. This happens when the benefits of delivering the
baby outweighs the risks of continuing the pregnancy or awaiting
spontaneous labour.
*What are the indications for induction of labour?
-Placental insufficiency : when the placenta is diseased and no longer
capable of supporting the foetus
-Prolonged pregnancy : beyond 41 weeks of gestation
-Intrauterine growth restriction (IUGR) : when the foetus fails to gain
weight, or loses weight due to constitutional, maternal or placental
disease
- Premature rupture of membranes : when the "bag of water" breaks
without any sign of labour after 24 hours (to avoid infection to the
baby)
- Intrauterine fetal death - to prevent the risk of toxicity or infection
to the mother
- Intrauterine infection (Chorioamnionitis)
- Unexplained antepartum hemorrhage
- Potential or presumed fetal macrosomia : increasing growth beyond
4kg, especially in diabetic mothers
- Medical diseases in the mother : such as severe hypertension,
uncontrolled diabetes, cardiac or renal diseases, cancers, etc.
*What are the methods for inducing labour?
Before induction of labour, it is important to assess the cervix to
determine its "ripeness", ie. to predict whether induction is likely to
succeed or fail. Predictors of a successful induction includes advanced
gestational age (above 37weeks) and multiparity (having delivered by
vagina in the past).
The cervix can be ripened through medical and non-medical methods.
There is limited evidence to support the efficacy of non-medical
methods (eg. Sexual intercourse, nipple stimulation, herbal mixtures,
dates, castor oil, etc.)
The medical methods of ripening are :
1. Mechanical methods - this includes using the finger to "stretch and
sweep" the cervix and/or insertion of a catheter into the cervical
canal.
2. Pharmacological methods - use of chemical agents (prostaglandins
and oxytocin)
**********
Certain parameters are used by the midwives/physicians to "score" the
ripeness of the cervix. After satisfactory ripening, induction of labour
proper begins. This can be done in one of two ways -
~Artificial rupture of membranes - Deliberately breaking the "bag of
water", which stimulates the process of active labour through the
release of prostaglandins.
~Induction/Augmentation of labour using oxytocin infusion - Oxytocin
is released normally by the brain at the time of labour. This process
can be augmented by infusion of controlled amount of oxytocin
(Syntocinon®) through dedicated intravenous infusion pumps.
*Note that induction of labour MUST be done in a hospital where
adequate feto-maternal monitoring and standard obstetric care are
available. This will ensure that any complication in the course of
induction can be identified promptly and treated appropriately.
It is also better to have standby facilities for Caeserean section in
case of complications during, or failure of induction of labour.
Wishing all expectant mothers safe delivery!

Op thanks for this information. I want to differ on some of the points you raised.

In writing about the indications for induction of labour, you mentioned macrosomia and antepartum haemorrhage. Foetal macrosomia means BIG baby. It is not an indication for induction of labour. The reason is because your aim of induction is for the woman to deliver vaginally and when BIG babies are coming of through the vagina, the labour is prone to be prolonged and tedious, the baby is prone to birth injuries (including features) and death, and even when they survive may have long term complications including poor performance in school, and various forms of brain injury including CEREBRAL PALSY.

Therefore, it is very risky to go inducing a pregnant woman with suspected or confirmed foetal macrosomia.

Antepartum haemorrhage is bleeding through the birth canal before birth. This is a serious emergency and no obstetrician or any other doctor will go about inducing a bleeding woman, that is medical malpractice. More so when the cause of the bleeding is not confirmed, it is dangerous. It could be placenta praevia (low placenta) or abruptio placentae(partially or completely detached placenta).

Please it is bad obstetrics practice to induce a a pregnant woman with APH. Thanks.
Cheers!!

Solomyn:
I don't knw how to begin, but i will go straight. Is about my reproductive system. I was feeling pain on my right scrotum and each time i have the i couldn't do anything, it will come like 10mins and relief me so i did not take it serious until 2014 where i went for fertility test, the result show i was fertile but have procells i was giving antibiotic. I again went for same test in 2015, my fertility test drop a bit with same puscells which is numerous and i was told is same infection called orchitis, i was giving drug yet i still have those pain it come and go... Until 2017, i went for test my fertility test drop further which my lab guy advice i marry before any risk cos my sperm cell is reducing due to the puscells and the infection. Pls it has been 5yrs now still having the pain but not much cos i do take herbs. I need your help i want permanent cure and relieve my fertility

Which one is fertility test? Who sent you for the test or you just went on your own? What type of test did they run for or on you? What was their finding that made them advise you to go and marry? What is the professional status of the person(s) that gave you that advise?

The above questions are just for more clarifications so as to know how to help you.
Cheers!!

The National Association of Resident Doctors has commenced a total and indefinite strike starting from Monday 4th September 2017.

This followed the emergency ENEC which was concluded about less than an hour ago after intervention by the Honourable Ministers of Labour and Employment and that of Health a few days back.

NARD has not officially suspended their srike

MademoiselleMiel:
Cc ebookmathswaec
drpompay
Alice07
ChelseaDr.

Thanks a million Times for the well articulated response. Honestly, you guys 'schooled' me. It's not like I haven't registered for ante-natal have. But you know all these our nurses with their 'frustration-laden' way of attending to patients. But with all that I've read here, I fully understand and will do the needful asap. Once again, I sincerely appreciate everyone's contribution on this. This is how an e-family should be. ..

You're welcome.
Cheers!!

Kennie21:
but the drug is still beneficial when the woman has a miscarriage? After which she can have children normally right?

If someone has been sensitized the drug has no added benefit whether it is after miscarriage (post sensitization) or after normal delivery. Rhesus incompatibility is not a very common cause of miscarriage as drpompay pointed out.
Cheers!!

Ebookmathswaec:
God bless you Doctor for your wonderful contributions!

We give God all the glory my brother. Cheers!!

Ebookmathswaec:
God bless you Doctor for your wonderful contributions!

We give God all the glory my brother. Cheers!!

Kennie21:
but she said the woman is O negative, had a miscarriage didn't get the injection, lost another one, got the injection and is able to have other children

Yes, that someone is sensitized does not mean that she cannot carry pregnancies to viability and even to term. It all depends on the quantity of antibodies present.

If the antibodies present are not too much then all the pregnancy needs is monitoring with intervention only when things change, otherwise it should be allowed to continue till nine months (or 34-38 weeks) and delivered.

Yes if someone is sensitized then rhogam has no benefit any longer.
Cheers!!

MademoiselleMiel:
The amount of knowledge I've gained on this thread is unauantifiable.


Please I'd have a few questions to ask the doctors in the house;

I'm O- while my husband is O+. I lost my first pregnancy with him under some not too palatable circumstance. Now, I'm carrying another baby which is around 30 weeks old. My questions are;

1- How do I ascertain if the antibody has also been secreted in me as a result of my first pregnancy loss?

2- Let's say it has been secreted, what do I do to be sure that this baby I'm carrying wouldn't be hurt. Although she's very fine at the moment. Scan has


revealed that it's gonna be a girl and that she's in a perfect state.


3- Let's assume my body didn't secret the antibody that time, will there still be any need for the injection?

PS: Do not blame me for asking too many questions, ever since I read all these I've not been able to swallow ordinary water very well.


Cc
ChelseaDr.
Scholar212
Maasoap
Alice07
Other Docs in the house.

Don't worry after this contribution you should be able to swallow not just water but full blown "eba" (on a lighter note).
N/B: You should have had Rhogam injection after the miscarriage if you had visited the hospital with doctors that understand the implications of rhesus negative prenancy.
Now to your questions.....

Q1:
To ascertain if the antibody had been secreted you should have registered for antenatal in a health facility with doctors who have knowledge about rhesus negative pregnancy. They will conduct a simple blood test called indirect coombs test. If the test is positive then, they will conduct other tests to confirm.

At 30 weeks it is still not late to do although scan has shown that the baby is OK, but you can still go start antenatal for further care if you have not started but if you have remind the doctors about the test.

Q2:
If the antibody had been secreted, then all you need is surveillance for the baby which scanning is a component, go for antenatal if you've not started.

Q3:
YES! If your body did not secrete the antibody, and you are rhesus negative, you will definitely need the injection after your baby is born, unless if her blood group is also rhesus negative.

ENJOY YOUR "EBA" JARE!!!
cheers!!

[quote author=korday post=59880977][/quote]It's not yet uhuru, don't relax yet, the indirect coombs test will have to be repeated monthly because there is still chance of her getting sensitized. There may be need for rhogam at 28 weeks and after birth, so get ready because the drug is expensive.
Cheers!!

Alice07:
If a Rh– woman commits an abortion for a Rh+ man and the antibodies are activated in her system, the woman might end up childless throughout her life except if she later marries another man with with the same Rh–. The possibility of a Rh– woman finding a Rh– man is slim as about 85% of human beings are Rh+. [b]This is a warning to our young girls who commits abortions all in the name of boyfriend-girlfriend relationships.

Op, pls get your facts right on this topic and don't cause people to panic. If you have been sensitized and you didn't know and the antibodies activated in your blood, once you get pregnant again, you will most likely lose the child but after the loss, Rhogam-D can be taken to deactivate them and you can have a healthy baby later with repeated doses of the injection at 28wks of pregnancy and within 72hrs after delivery. Ewo ni ti "end up childless for the rest of your life" �

I think we should get this fact right... Rhogam has no role or benefit in a woman who has been sensitized already.

Rhogam is an antibody given to the rhesus negative woman during pregnancy or after birth or outside pregnancy after being transfused with rhesus positive blood (rarely anyway) in order to mop up the rhesus factor circulating within the woman's blood before they are being recognized as foreign and antibodies produced against them.

If a woman is sensitized, then it means her body has already formed antibodies waiting for the incoming rhesus positive baby to attack, hence rhogam (which is an antibody) cannot fight the already formed antibody because they are similar and cannot antagonize each other. Rhogam only attacks antigens (rhesus factors).

Therefore if she is sensitized, then she does not need rhogam.
Cheers!!

Onorie:
Please ChelseaDr. what if the woman Rh+ and the man is Rh-, does it also lead to the aforementioned?

No no not at all, it only applies to women who are negative getting pregnant for men who are positive not the other way round.
Cheers!!

Aquariann:
In addition, as a Rh- girl, please never think of an abortion if you happen to get pregnant out of wedlock. You'll never have a child again. (Caveat: Unless you find a Rh- man to marry).

And if and when you do keep the pregnancy (this include Rh- married women), a CS is the best (or rather only) option if you intend to have other kids in the future.

Mehn, I love Biochemistry

With due respect Sir, this is not correct.

Ebookmathswaec:
Thanks so for the clarification Sir. The OP is not a Doctor.

One love my brother. Cheers!

korday:
hi op.
God bless you for the write up. my wife is rh-. she once had miscarriage before now. we were advised to go for indirect coombs test.bwhich came out negative and you know Nigerian hospital and their time wasting tactics. I want to understand the negative outcome. does it means she hasn't develop antibodies or she has already. or does it mean the child is rh-. according to tour right up of a father is rh-+ then the child have to be rH+. please enlighten me a bit more. the doctor in charge of her case have refused to pick call since last week.
thank you in advance

I hope your wife received Rhogam after the miscarriage. Indirect Coombs test being negative means there is no antibodies detected and even when it is positive it does not mean the woman is sensitized already because there are a lot of things that could make indirect coombs test positive including sensitization.

For more info, check out this:
https://www.nairaland.com/2429829/rhesus-negative-blood-group-pregnancy

Thanks Op for this educative piece.
Let me however make this clarification. A child born to a rhesus negative mother and whose father is rhesus positive must not be rhesus positive as the op pointed out. The child may either be rhesus positive (like the father) or rhesus negative (like the mother).

Again, a rhesus negative woman can actually receive blood from a rhesus positive donor without the compatibility issues that will lead to maternal death as the Op posited. The only thing is to weigh the risk between saving the woman's life or allow her become sensitized. So the fear is for the future pregnancies not on the woman.

However, even in a setting of sensitization, the foetus can be monitored closely and many have been salvaged without dire consequences.
https://www.nairaland.com/2429829/rhesus-negative-blood-group-pregnancy

cheers!

Who prescribed the abortificient for you, how many months was the pregnancy? What drug(s) did you use? (you don't need to answer this here).

The answers to the above are important because even lay men suggest all manner of things to abort a pregnancy. Also note that the type of/use of drugs depends on how many months the pregnancy is.

For the pregnancy test to still be positive and pregnancy symptoms still present means the pregnancy is still there, although it may not be viable, and this could be a time bomb!!!

It could be a pregnancy outside the womb, an abnormal pregnancy called molar pregnancy (with potential to turn to cancer), or it could lead to a severe infection later whose end is death.

But do not be afraid, you still have time to correct it.

I guess you did not consult a doctor before embarking on such journey. Therefore, I suggest you quickly go and see a doctor for proper check to ascertain the type and location of the pregnancy.
Cheers!

futuremoma34:
best advice so far,and Pls some local herbs do cure fibroid..but I was operated to remove my fibroid .but am still TTC. so my own advice is to do anoda more scan before u tk a decision. Dnt rely on one scan.my regads to ur Dear wife,pka tell her everything will be ook..i was once in her shoe.

I wish you all the best, never lose hope.
Cheers!

mrhubby:
Thank you so much for taking your time to provide such detailed explanation. I wouldnt say we were impatient enough to listen to the doctor's explanation but you may not be far from the truth anyways. The word, surgery, is scary enough to induce concentration lose. I will put everything you said in mind and we will wait to weigh our option. Once again, thanks and God bless.

You're welcome, anyday.
Cheers!!

From the scan, there are two very small fibroids in her womb.. 2.9cm and 1.9cm. These are obviously very small, located within the substance of the womb and at the mouth of the womb (cervix).

From your narrative, this was an incidental finding meaning that your wife had no symptoms relating to fibroid like heavy menstrual flow, painful period, chronic waist pains, etc.

It may also interest you to know that there are reasons to undergo surgical operation for uterine fibroid, meaning most fibroids must be operated while some are left alone irrespective of their sizes.

If a woman has real disturbing symptoms, no matter the size of the fibroid, or if she has been having recurrent pregnancy losses, or if she has been finding it difficult to conceive for some years and scan showed she has fibroid (not as tiny as the one your wife's scan shows anyway), then such a woman will be offered surgery for the fibroid.

If she has no symptoms and fibroid was found incidentally during a test for some other things, irrespective of the size, then she doesn't need any surgery unless, she feels she should get it removed, especially the huge ones in which her tummy is obviously swollen.

There are two major types of surgical operations done for fibroid, the first is to remove the fibroid alone and leave the womb while the second is to remove both the fibroid and the womb together.

While the first operation is done for the younger age group, who have not finished giving birth or still looking for the fruit of the womb, the latter is for those who have no business with childbirth again.

Note that after the former surgery, the fibroid may reoccur after some years, and may require another surgery, the latter is a permanent cure for fibroid, because fibroid requires the womb to grow.

Note also that there are drugs to reduce the size of fibroid (for huge ones) in preparation for operation but their side effects are not palatable and once they are stopped, the fibroid may grow bigger.

There is no native medicine to cure fibroid, no food supplements, no natural roots and herbs, so don't let anyone deceive you.

Note also that fibroid does not cause infertility neither does infertility cause fibroid, that causal relationship between the two has not been established.

Based on the foregoing, I don't think your wife needs surgery for those fibroid nodules, for now. It's possible you were not patient enough to listen to your doctor's explanation, you were carried away when you heard operation but was not ready to hear the explanations he was to give later.

Just relax, your wife will get pregnant in no distant time. mrhubby

Cheers!!

MzEddytan:
ok then...am not fully into it yet because am still a fresh graduate/a Corp member so after then I will major more on family planning.

Thanks to both of you for enlightening me more on this.

You are most welcome. yomi007k I see you.
cheers!

MzEddytan:
Oral contraceptive














Pills

Pills after 15 days? No it won't work.

There is what we call emergency contraception which details I will not say here for reasons you and I know.

They should do pregnancy test, if negative then thank God but if positive, then the Opposite is in for what he bargained for

sainty2k3:
Thanks for the additions especially the role of quantitative analysis

For people who want to read this from other sources
https://www.google.com.ng/amp/www.graphic.com.gh/news/health/aa-and-as-partners-produce-ss-baby-is-that-possible.amp.html

Again well done for your attempt at educating people, but I think you should rephrase the topic as someone suggested earlier and remove every form of ambiguity, thanks for your effort.
Cheers!!

AlphaT1:
Oh ok, I got your point. Regards.

Thanks again.
I also think people that are made moderators of a particular section should be individuals who have a good grasp of the subject of discourse, because if this was the case the Mod should have advised the Op to rephrase his topic and possibly remove all forms of ambiguity.

I hope Seun will act appropriately.

seun

AlphaT1:
Oh ok, I got your point. Regards.

Thanks again.
I also people that are made moderators of a particular section should be individuals who have a good grasp of the subject of discourse, because if this was the case the Mod should have advised the Op to rephrase his topic and possibly remove all forms of ambiguity.

I hope Seun will act appropriately.

seun

innosaint27:



Your analysis is comprehendable to even a tomatoes seller with no education.
But the OP has muddled up everything, creating unnecessary confusion for many.

He is only seeking to bring to the awareness of people, what alpha & Beta thalassamia are as types of SCD. Dragging sickle cell anaemia (SCA) into it wrongly made it all clumsy.

Thanks a million. I also think the Op should change his topic
Cheers!!

Protein0:
How's the quality of a thalassemic hemoglobin sir if Sbeta thalassemia is a result of the quantity of HB present?

Assuming I understood your question Sir, here is the clarification:
Haemoglobin (Hb) is a type of protein composed, structurally, of several amino acids arranged serially to form a chain of amino acids. There are two chains that make up normal adult haemoglobin, called the α-chain and the β-chain.

In the β-chain, glutamic acid is naturally located at position 6 in the chain of amino acids, to form a normal haemoglobin called HbA. If this glutamic acid is replaced by another amino acid
called valine, then Haemoglobin S is formed. If both HbS genes are inherited, then sickle cell anaemia (HbSS) results.

If HbA and HbS are inherited a carrier state HbAS results, which is not a form of sickle cell disease.

If the same glutamic acid is replaced by lysine, another amino acid, HbC results, and if HbA and HbC are inherited together then HbAC results, if S and C then HbSC results.

HbS and HbC are abnormal haemoglobins, therefore Sickle Cell disease results if an individual inherits an abnormal haemoglobin in the presence of an HbS, e.g. HbSS, HbSC etc.

All the above are due to defect in the structure (quality) of haemoglobin not problem of number of amino acids but it has to do with problem of arrangement of those amino acids. Hence, Hb electrophoresis used to determine genotype analyses the structure of these amino acids which makes them possess different speeds as they pass through an electrical field, due to their weight (in a layman's language).

Thalasaemias are also forms of abnormal haemoglobin due to lack of production of the appropriate number of chains or lack of production at all.

For instance, if there is defect in the production or complete lack of production of the α-chain or β-chain (as the case may be), then α- or β-thalaseamia results. This is as a result of the quantity present or absent.

Therefore Hb electrophoresis does not detect Thalasaemias, it can only be detected through procedures that analyse the quantity and type of chains affected (quantitative analysis)

Sβ-thalasaemia is a form of sickle cell disease due to the presence of both an S haemoglobin and another haemoglobin in which there is shortage in the number of the β-chain.

I hope I have been able to make some sense to you.

Cheers!

Protein0:
How's the quality of a thalassemic hemoglobin sir if Sbeta thalassemia is a result of the quantity of HB present?

Assuming I understood your question Sir, here is the clarification:
Haemoglobin (Hb) is a type of protein composed, structurally, of several amino acids arranged serially to form a chain of amino acids. There are two chains that make up Hb, called the α-chain and the β-chain.

In the β-chain, glutamic acid is naturally located at position 6 in the chain of amino acids, to form a normal haemoglobin called HbA. If this glutamic acid is replaced by another amino acid
called valine, then Haemoglobin S is formed. If both HbS genes are inherited, then sickle cell anaemia (HbSS) results.

If HbA and HbS are inherited a carrier state HbAS results.

If the same glutamic acid is replaced by lysine, another amino acid, HbC results, and if HbA and HbC are inherited together then HbAC results, if S and C then HbSC results.

HbS and HbC are abnormal haemoglobins, therefore Sickle Cell disease results if an individual inherits an abnormal haemoglobin in the presence of an HbS, e.g. HbSS, HbSC etc.

All the above are due to defect in the structure (quality) of haemoglobin not problem of number of amino acids but it has to do with problem od arrangement of those amino acids. Hence, Hb electrophoresis used to determine genotype analyses the structure of these amino acids which makes them possess different speeds as they pass through an electrical field, due to their weight (in a layman's language).

Thalasaemias are also forms of abnormal haemoglobin due to lack of production of the appropriate number of chains or lack of production at all.

For instance, if there is defect in the production or complete lack of production of the α-chain or β-chain (as the case may be), then α- or β-thalaseamia results. This is as a result of the quantity present or absent.

Therefore Hb electrophoresis does not detect Thalasaemias, it can only be detected through procedures that analyse the quantity and type of chains affected (quantitative analysis)

I hope I have been able to make some sense to you.

Cheers!

barcaboi:
this is just trying to play on our intelligence using medical jargon. That is how u mislead people into going into marriages based on mathematical jargon and ignoring medical advice and thereby giving more SS kids that deserves better......

Sorry I was actually talking to the Op
Thanks
Cheers!!