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When is the right time to visit a doctor? Which symtpoms should never be ignored?
Disclaimer: This article is majorly for public Education. As a medical practitioner reading this, you are obligated to know more than these basics.
Consider your nerves as fine electrical fibres that conduct impulses to various muscles and organs leading to coordinated muscle and organ functions.
Now consider your Brain as the control centre of all these wires consisting of complex circuits and connections.
A Seizure is an abrupt non synchronised electrical disturbances and conductions.
Before we go FAR, we want to make it Clear that not everyone who has suffered a Seizure has EPILEPSY.
EPILEPSY is defined as a chronic neurologic disorder with predisposition of epileptic seizures.
So careful: People having EPILEPSY as a diagnosis will always have recurrent seizures at points of their lives.
BUT NOT Everyone who has a Seizure has EPILEPSY. Confusing as it is; not all seizures =Epilepsy. (Read it again carefully)
Classification of Seizures.
1.General Seizures: Electrical disturbances in the whole brain.
2.Partial Seizures: Disturbances in one part of the brain.
CAVE: partial seizures can transit to general Seizures.
General Seizures:
Under this Category we have.
a) Tonic-Clonic Seizures: with muscle stiffness and Jerking.
b) Absence Seizures: No jerking involved, just a transient loss of awareness: Affected just stare absent mindedly.
c) Atonic seizures: loss of muscle strength.
d) Myoclonic: Rhythmic muscle jerking without stiffness.
Partial Seizures:
a) complex partial: Loss of consciousness and awareness.
b) Simple partial seizure: No loss of Awareness.
Causes of Symptomatic Seizures:
There are stimuli that also trigger seizures these may include:(These can be observed on people with or without epilepsy)
Again, be reminded: Not all seizures mean the affected have Epilepsy:
MANAGEMENT OF SEIZURES:
Disclaimer: As a clinician reading this, you will need much more knowledge than this.
Why is this important?
In as much as most seizures last for 2-3 mins on average,
epileptic Seizures past 5 mins are known as status epilepticus and might cause irreversible brain damage if not intervened and broken, it could also lead to death.
This is how to conduct yourself when a victim suddenly develops a seizure in your presence:
Easier said than done:(not necessarily in this order, but have a structure)
1.Stay calm, observe the nature of the seizure. Note the beginning of the seizure and immediately alert the paramedics, since it’s not predictable how long a seizure lasts.
2.Do not try to physically stop a seizure.
3.Secure the Surroundings to ensure no further injuries occur.
4.Loosen tight clothes such as Ties and belts.
5.If it’s a person with known history of seizures (a family member for instance) check their emergency kit, if there is an acute seizure pill/spray/ injection.
6.When the Seizure ends and the patients are still in the post seizure sleep, secure the airway using the stable Side recovery position, In case of a foaming mouth, this manoeuvre should be done as soon as possible.
Diet for epilepsy
The most well-established dietary therapy for epilepsy is the ketogenic diet (high fat, adequate protein, low carbohydrate). Other diets with great potential for managing epilepsy are the Atkins diet (high fat, high protein, low carbohydrate), a diet enriched in polyunsaturated fatty acids, and a diet with overall restriction of calorie intake.
The modality of work of the ketogenic diet is through the anticonvulsant effect of fasting/ starvation as protein digestion becomes the primary source of energy and not the carbohydrates thus tricking the brain that it is starved. In the ketogenic diet, the body produces ketones through the process of ketosis. The ketones then inhibit the release of glutamate which is an excitatory neurotransmitter and produce GABA which is an inhibitory neurotransmitter. The ketones also prevent degradation of GABA and thus lead to better seizure control through the combined effect of GABA and inhibition of release of glutamate. It is effective in all people, but more effective in toddlers and school going ages. It helps in all convulsions, but more specific about 50% of patients treated with the ketogenic diet exhibit 50% or more reduction in seizure frequency.
Examples of foods that make the ketogenic diet are: dairy (cheese, plain Greek yoghurt, cottage cheese), unsweetened plant based milk, seafood (fish and shellfish), green leafy vegetables (salad greens, cooking greens and herbs), peppers (small hot peppers, jalapenos, bell peppers and poblanos), summer squash, avocadoes, cauliflower, turnips, poultry, meat (preferably grass-fed due to higher content of omega 3 fatty acid and conjugated linoleic acid), nuts and seeds, berries (especially raspberries and strawberries), dark chocolate and cocoa powder, olive oil, butter and ghee, unsweetened tea and coffee and unsweetened sparkling water etc.
Keto diets can be restrictive at first and can have some side effects: dizziness, digestive changes, increased cholesterol etc. Of essence is to ensure a variety of foods are eaten so as to meet the daily requirements. At the beginning, it also important to keenly monitor carb intake and discontinue the diet if side effects are severe.
Some vegetables should be avoided while on the ketogenic diet, the main reason being that their carb amounts are high. These are: potatoes (Irish and sweet potatoes), onions (especially in large amounts), certain winter squashes (such as acorn squash and butternut squash), corn and beets.
The Atkins diet is also a low carb diet with high protein and fat intake. In essence, the Atkins diet is quite like the ketogenic diet. The difference is that with the Atkins diet, you gradually increase your carb intake while with the ketogenic diet, the carb intake remains very low.
NB: Before starting any diet it’s important to seek medical advice just to be sure that the diet you plan undertaking won’t further affect your health.
We sure shall do another Article on Seizures and Epilepsy. It’s a broad topic.
According to WHO data in 2020 Deaths caused by liver diseases in Kenya were about 13,400 or 5.09% of the total deaths. With an age rate of 57.44 deaths per 100,000 of the population, ranking Kenya at number 6 in the world.
Leading causes of death in Kenya as per worldlifeexpectancy.com sept/2020
Liver cirrhosis is a condition where the liver becomes scarred and damaged over time, which can prevent it from performing its important functions. Let’s break down these functions in a simpler way:
In liver cirrhosis, the liver’s ability to perform these functions is compromised due to the scarring and damage it has undergone.
Liver cirrhosis can have various causes. Here are some common ones:
Liver cirrhosis can be classified as either:
The signs and symptoms of liver cirrhosis can vary, but here are some common ones:
It’s important to note that liver cirrhosis is a serious condition that requires medical attention and treatment.
The treatment and interventions for liver cirrhosis include:
Diet for cirrhosis
Therapeutic role of nutrition in liver cirrhosis has been known for many years and as such, nutritional status was one of the criteria observed in the initial prognostic tests for liver disease.
Being malnourished is also very common in people with cirrhosis with about 20% of people with compensated cirrhosis being malnourished and more than 50% of people with decompensated cirrhosis. When dealing with liver cirrhosis, being malnourished is a risk factor for succumbing to the disease. So, to enable better coping, reversal of malnutrition to a state of good nutrition is key.
In general, a diet that ameliorates or prevents the symptoms of liver cirrhosis as described above is a good diet for management. This is for example a diet that prevents high pressure in veins, a diet rich in albumin etc.
Some of the diet recommendations are:
It’s important to consult with a healthcare professional for an accurate diagnosis, appropriate treatment options, and ongoing management of liver cirrhosis.
And as always keep yourself informed at Doki’s Advice
In Sub-Sahara Africa, about 9.5% of children and adolescents
are reported to have a psychiatric disorder such as (depression, post-traumatic stress disorder, anxiety)
As the Kenyan population has grown research showed that the estimated ratio of one psychiatrist is to a population of about half a million people, with most psychiatrists practising in the capital, Nairobi.
The World Health Organisation reports that mental health problems affect 10 – 20 % of children and adolescents worldwide. In addition to that half of all mental illness begins by age 14.
Common childhood conditions include:
Autism or autism spectrum disorder is an umbrella or various disorders:
Condition characterised by:
Intervention:
Tips for Parents:
General therapy:
E.g.:
Prior: The teacher says “It’s time to clean up your toys” at the end of the day.
Behaviour: The student yells “no!”
Consequence: The teacher removes the toys and says “Okay, toys are all done.”
How could ABA help a child learn a more appropriate behaviour in this situation?
Prior: The teacher says “time to clean up” at the end of the day.
Behaviour: The student is reminded to ask, “Can I have 5 more minutes?”
Consequence: The teacher says, “Of course you can have 5 more minutes!”
With continued practice a child will be able to replace an inappropriate behavior with one that’s more appropriate.
This is characterised by: impaired attention, hyperactivity, impulsivity or a combination of these symptoms.
Diagnosis criteria:
Impaired attention
often:
Hyperactivity and impulsivity:
Often:
It’s associated with low rates of high school education and poor peer relationships,
Children who are disruptive and hyperactive are more likely to be identified and diagnosed as opposed to ADHD-children without these behaviours.
ADHD frequently presents with other conditions such as: learning and language disorders, oppositional behaviour, conduct disturbance, anxiety, depression and coordination disorders.
Tips for Parents:
– In CBT your thoughts, feelings, physical sensations and actions are deemed connected, and that negative thoughts and feelings can trap you in a never-ending cycle.
-The aim of CBT is to help break down all the overwhelming issues into small parts that one can deal with easily
Intervention:
Behavioural therapy: this enhances motivation using rewards and other consequences and providing models and opportunities for social learning.
-Parental training in behavioural management teaches parents to shape their child’s behaviours with the use of simple behaviour modification and social learning theory like teaching parents how to communicate about their emotions, promoting positive parent-child interaction skills.
ODD is a diagnosis appropriate only when the below behaviours occur to such a degree that they interfere with academic success, peer relationships, familial relationships, or other major areas of life
Risk factors that can lead to development of ODD:
Children who:
Symptoms: over a period of at least 6 months and the cause of these behaviours should not be caused by other factors like trauma or abuse:
Intervention/ tips for parents:
-praising good and positive behaviour rather than strict punishments for unwanted behaviours
Behavioural and emotional disorder characterised by disruptive and breaking societal rules.
Symptoms: behaviour present with 12 months
Risk factors:
-High comorbidity with ADHD or ODD
Tips for parents:
*These tips may seem like easy and basic but when dealing with opposition/conduct disorder they don’t come that easy. That means they require routine, practise, and a lot of patience while still showing consistent, unconditional love and acceptance towards your child.
Mental disorder after exposure to traumatic events.
Either:
Symptoms:
Tips for Parents:
Disclaimer: Always seek medical attention before beginning any new medications for your child or as soon as you notice any symptoms within the span of 6 months.
For more keep it Doki’s Advice….
Interactive Series between Doki and Students. enjoy the session with a cup of coffee
Dokis Seminars take Place every month. Our aim is to help you learn about the ECG basics, diagnosing acute myocardial infarction, atrial fibrillation and other various diseases which can be detected easily by an ECG device.Lets get to work!
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