TALE OF A MED STUDENT

It's a new week, I'm grateful, optimistic and full of expectations. This last two weeks has been quite stressful and emotionally draining with little or nothing to remember with a smile except the fact that I have great friends and we had a great time together yesterday.
They're beautiful, smart, intelligent, fun to be with, caring, loving adventurous and crazy. Wonderful combination like a sweet soup with alluring aroma made by my mother. I feel so hungry all of a sudden. Lol
We had an exam two weeks ago, precisely 19th June, which lift me empty and tense through out that week end. I came out of the exam feeling dejected apparently just existing, I felt suffocated by everyone present and by the air itself. All I wanted to do was disappear but just then I remembered "my lord" once told me that "there's someone feeling worse than you do no matter how bad you're feeling at the end of an exam". On that note, I walked straight to the car, got in, turned on the ignition and started leaving. It took the shout and waving of two hefty colleagues to pull me back to reality as I was apparently lost in my thoughts. We were home in less than 40 minutes.
The rest of the weekend and the Monday that followed was uneventful but the Tuesday got hearts and legs racing. The result was out, most people passed on borderline and suddenly, guys just realized how easily one can fall below the borderline. Well, the rest of the week saw us standing for long hours in the clinics of UNTH with pleasure, there was hardly anyone who complained.
Last Saturday morning was a beautiful one, a day I could lay in my bed till noon after all, it was environmental sanitation but I just couldn't this time around. The series of the "rat race" have began. I have to answer to ophthalmology in 7days so my bed just wasn't the place for me. 10:30 am saw me in class and soon I found myself in the hostel.
To be continued....

HIV Paradox

HIV Paradox

New clue shows how some fight infection without drugs 

By SUE McGREEVEY

June 11, 2015

An HIV-infected H9 T cell. Image: NIAID

Investigators from Harvard Medical School, Massachusetts General Hospital, and the Ragon Institute of MGH, MIT and Harvard have added another piece to the puzzle of how a small group of individuals known as elite controllers are able to control HIV infection without drug treatment. 

In their paper published in the journal PLOS Pathogens, the research team reports finding that dendritic cells of elite controllers are better able to detect the presence of HIV—paradoxically through a greater susceptibility to HIV infection—which enables them to stimulate the generation of T cells specifically targeting the virus. 

“It’s been recognized for a while that these individuals have stronger T-cell immune responses against HIV than other patients, but the reason for that has been unknown,” saidXu Yu, HMS associate professor of medicine at Mass General and corresponding author of the paper. “We have shown that dendritic cells, which play a critical role in generating virus-specific T cells, have an improved ability to recognize HIV and build effective immune responses in elite controllers.”

Part of the innate immune system that is the body’s first line defense against infection, dendritic cells sense the presence of pathogens in the blood or other tissues, ingest infecting organisms and then display fragments of the invaders on their surface, which alerts and activates both killer and helper T cells (CD4 and CD8 cells), essentially teaching them to target the specific pathogen. 

Because of this critical role of dendritic cells, the investigators explored the hypothesis that dendritic cells of elite controllers were better able to sense HIV and, as a result, better able to generate virus-specific T-cell responses.

When HIV infects a cell, it first injects its genetic material—RNA in this case—into the cell along with the reverse transcriptase enzyme that transcribes the single-strand RNA molecule into a double-stranded DNA molecule. After HIV DNA enters the nucleus of an infected cell, it becomes integrated into the cellular DNA, turning it into an HIV factory that generates more virus particles. 

In experiments using dendritic cells from elite controllers, from patients with progressing HIV infection, and cells from uninfected individuals, the investigators found a surprising difference. In most people, HIV infection of dendritic cells appears to be blocked at an early stage, resulting in a lack of HIV DNA and limited viral replication within those cells. While this may seem beneficial, it actually works more to the benefit of the virus than the infected individual by allowing HIV to escape recognition by dendritic cells. 

The dendritic cells of elite controllers, however, were found to contain higher levels of HIV DNA, probably because of limited expression of a protein called SAMDH1 that usually blocks reverse transcription in several types of immune cells. The dendritic cells of elite controllers also appear to produce higher levels of a DNA-sensing protein called cGAS that recognizes the presence of HIV and induces rapid expression of type 1 interferons. This contributes to the generation of the more powerful T-cell responses against HIV that are typically observed in elite controllers.

“We are now focusing on fully understanding all the components required to trigger appropriate activation of dendritic cells in HIV infection, which may help to induce an elite-controller-like, drug-free remission of HIV in a broader patient population,” Yu explained. 

Support for the study includes National Institutes of Health grants AI078799, AI089339, L121890, AI098484, HL126554, AI116228, AI087452, AI098487 and AI106468.

Adapted from a Mass General news release.

THE VALLEY BETWEEN THE TWO MOUNTAINS- BREAST CANCER

Three years ago I was in my hostel (my girlfriend, vee's room to be precise) at the University of Nigeria, Enugu campus.  It was a long dull hectic day. We just returned from class and everybody was hungry. I got cooking, I prepared spaghetti and as we were eating, we decided to discuss the topic of the day "The Anatomy of the Female Breast".
    As young medical students, we were more interested in the different shapes and sizes he (the lecturer) talked about.   So we started comparing the shapes and sizes of our Breast and soon we were all doing self breast examination. It was at this point one of us mentioned that she had had a lump on her breast for a while now and the father is against surgery so seeing the doctor is out of the question. And we were like wah, wah?! Timeout. I for one I snapped, because I just couldn't wrap my head around it
    Well, to cut the long story short, we convinced her after a "fight" to see the doctor which she did. She had the surgery done among others and she's been fine.
      Now, this kind of thing happens a lot. We see them virtually everyday. A situation whereby a patient or patient's relative refuse help because they've been misinformed or lack the right information.
      Breast cancer is so real that I have lost two relatives to it in a space of 3 years. Young vibrant ladies full of life and vitality silenced just like that.  It is the most common cancer in Nigeria. No single person can fight cancer alone so please, do not ignore the plea. Every single person should be involved because we all have mothers, wives, sisters and daughters.
       Spread the words mouth to mouth, person to person use what ever media you have to encourage self breast examination and regular medical check up.
         Let me use this media to say this. It is SAFER to visit the medical doctor first when ever you do not feel fine. I do not see any sense in camping in baba's house or a pastor's place for 3 months, then you start running to the hospital when they can't help you. Don't get me wrong, I pray, I believe in angels and miracles but it's disheartening to see people presenting to the doctors at "heaven's gate" and dying from conditions which would have been effectively managed if only they presented a bit earlier. A study carried out in UNTH by Ezeome ER revealed that 17.5% of subjects present to alternative medicine before seeing the doctor.
                             SELF BREAST EXAMINATION
Once a month
                     Adult women of all ages are encouraged to perform breast self-exams at least once a month.  Johns Hopkins Medical center states,

“Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.”

While mammograms can help you to detect cancer before you can feel a lump, breast self-exams help you to be familiar with how your breasts look and feel so you can alert your healthcare professional if there are any changes
 In the shower

Using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening, or hardened knot. Notice any changes and get lumps evaluated by your healthcare provider.

2) IN FRONT OF A MIRROR 

Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead.

Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match—few women's breasts do, so look for any dimpling, puckering, or changes, particularly on one side.

3) LYING DOWN

When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit.

Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.

                                           SYMPTOMS 
      Please quickly report to your doctor if you notice any of these.

• A pain in the armpits or breast that does not seem to be related to the woman's menstrual period
• Pitting or redness of the skin of the breast; like the skin of an orange
• A rash around (or on) one of the nipples
• A swelling (lump) in one of the armpits
• An area of thickened tissue in a breast
• One of the nipples has a discharge; sometimes it may contain wblood
• The nipple changes in appearance; it may become sunken or inverted
• The size or the shape of the breast changes
• The nipple-skin or breast-skin may have started to peel, scale or flake.

                                                 CAUSES
Experts are not sure what causes breast cancer. It is hard to say  why one person develops the disease while another does not. Thought, there are strong indication of genetic origin, environmental factors can not be over looked. Hence, there are risk factors which could increase or decrease a person's chance of developing breast cancer
                                  RISK FACTORS 
1 Sex: occurs more in female than male
2 Age: most of the life time risk is accumulated in advanced age
3 Family history: history of breast cancer or other cancers in the                            family.
4 Reproductive factors: increased age at first pregnancy, lack of lactation, use of combine oral contraceptives, hormone replacement therapy etc.
5. Radiation: undergoing X-rays and CT scans may raise a woman's risk of developing breast cancer slightly. Scientists at the Memorial Sloan-Kettering Cancer Center found that women who had been treated with radiation to the chest for a childhood cancer have a higher risk of developing breast cancer .
6 Diet and life style: alcohol consumption, reduced vegetables, increased fat intake and lack of exercise.
7 Certain occupations : like those which bring the body into close contact with carcinogens. Examples include bar/gambling, automotive plastics manufacturing, metal-working, food canning and agriculture. They reported their findings in the 
November 2012 issue of Environmental Health.
Management? See your doctor and thanks for dropping by.

National Cancer Week Kicks-off Today

AS the National Cancer Week commences today, Nigerians have been urged to join in the effort to reverse the current cancer trend in the country.

The weeklong event would be rounded-off on June 14, while Tuesday, June 9, has been dedicated to advocacy and fund raising by media and communication practitioners.

According to a statement on the programme, one out of every three persons will be diagnosed with cancer in their lifetime, adding that 70 per cent of cancer deaths take place in poor countries, due to lack of infrastructure to deal with the problem.   “Over 100,000 new cases of cancer are diagnosed yearly in Nigeria, out of which 80,000 die.

This means that cancer kills 10 Nigerians every hour. Breast cancer now kills Nigerian women daily, while prostrate cancer kills 26 Nigerian men daily,” it said.

It stressed that most of the cancer deaths are preventable given early detection.   “Media and Integrated Marketing Communication/Advertising Practitioners across the nation are supporting the efforts of the Committee Encouraging Corporate Philanthropy (CECP-Nigeria) to acquire Mobile Cancer Centres to enable them take cancer screening and treatment to the grassroots.”

The Guardian 

Today's Reality

*Big House ... Small Family
*More Degrees ... Less Common Sense
*d more u work for people.... D more dey nruka u
*Advanced Medicine ... Poor Health
*Touched the Moon ... Neighbors Unknown
*High Income ... Less Peace of Mind
*High IQ ... Less Emotions
*Good Knowledge ... Less Wisdom
*Number of Affairs ... No true Love
*Lots of Friends on Facebook ... No Best Friends
*More Alcohol ... Less Water
*Lots of Humans ... Less Humanity
*Watches and Clocks Everywhere ... But no Time
..... Where are we really headed? .....

The Three Reasons So Many People are Getting Cancer (Op-Ed) Dr. Bhavesh Balar, CentraState Medical Center in Freehold, NJ Date: 04 June 2015 Time: 08:42 PM ET

Dr. Bhavesh Balar is a board-certified hematologist and oncologist on staff at CentraState Medical Center in Freehold, NJ, where he serves as chairman of the hospital’s Cancer Committee. He is also a medical director at Regional Cancer Care Associates in New Jersey. He contributed this article to Live Science's Expert Voices: Op-Ed & Insights.

As an oncologist, I'm frequently asked why so many people these days are being diagnosed with cancer. Considering the significant inroads we've made over the past 50 years in terms of cancer research, prevention, diagnosis and treatment, it doesn't seem to make sense.

The good news is that each of us is more likely to survive a cancer diagnosis and go on to enjoy a high quality of life than at any other time in history. There are estimated to be nearly 14.5 million cancer survivors in the United States. 

While there are several factors contributing to the increase in cancer diagnoses, there are three main reasons which account for most of the cancer cases in the U.S.

1. Older people get cancer most often, and we're getting older

Like heart disease, cancer largely affects the senior population. About 77 percent of all cancers are diagnosed in people over age 55, a segment of the U.S. population that is expected to double by 2060. Therefore, more seniors means more cases of cancer. Keep in mind, seniors are also living decades longer than just a century ago, when you were not expected to live beyond your mid-50s. According to the National Cancer Institute, seniors have an average life expectancy of about 79 years, on average, while 73 is the median age of cancer death.

2. Obesity opens the door to several types of cancer

A second key factor in our rising cancer rates is our country's battle with obesity and the continued lack of proper diet, exercise and weight control for many Americans. In 2014, the American Society of Clinical Oncology (ASCO) issued a report warning that obesity will soon overtake tobacco as the No. 1 risk factor for cancer. Obesity is associated with increased risk of the following cancer types: breast (after menopause), colon and rectal, esophageal, endometrial, pancreatic, kidney, thyroid and gallbladder. 

3. Certain cancer types are on the rise

Despite increased awareness, there are some cancer types that continue to gain ground and contribute to the cancer increase:

HPV. Human papillomavirus (HPV) is the most common sexually transmitted disease, and consists of 40 different mutations, according to the U.S. Centers for Disease Control (CDC), which also reports that 79 million Americans are infected, most of whom have no outward symptoms. U.S. Food and Drug Administration (FDA)-approved vaccines can protect against some of the most common types. Head and neck cancers are increasingly attributed to HPV, including cancers in the back of the throat, most commonly in the base of the tongue and tonsils. In addition, high-risk types can cause cancer of the cervix, vagina, vulva, anus and penis. [Protect Your Teen from HPV, Prevent Deadly Cancers (Op-Ed)]

The virus can cause normal cells in infected skin to become abnormal. In most cases, the body fights off the HPV infection naturally and infected cells then go back to normal. But in cases when the body does not fight off the virus, HPV can cause cellular changes that may eventually turn into cancer years after the initial infection.

Gastrointestinal cancers. These cancers affect the digestive system — the stomach, gallbladder, liver, pancreas and bowel (small intestine, large intestine or colon , and rectum). ESPN anchor Stuart Scott lost his long battle with appendiceal (appendix) cancer in early 2015, which has recently brought more attention to these lesser-known cancer types. 

If you're a topical expert — researcher, business leader, author or innovator — and would like to contribute an op-ed piece, email us here.

Gastroesophageal adenocarcinomas (stomach cancer) as well as pancreatic, liver and kidney cancers have increased recently. Again, obesity may play a role here. About half of liver cancers in the United States are among people with chronic hepatitis C infections, and the increase in incidence is consistent with the aging of the hepatitis C-infected population. Cancers in that region of the body can be particularly difficult to diagnose, as symptoms often present similarly to less-threatening conditions, such as irritable bowel syndrome or acid reflux. This allows the cancer to spread, undiagnosed and untreated. [Want to Cut Your Cancer Risk? Lose That Weight (Op-Ed )]

Skin cancer. One of the most preventable cancers continues its reign as the most common. Despite efforts to address skin cancer risk factors, such as inadequate sun protection and intentional tanning behaviors, skin cancer rates — including rates of melanoma — have increased in the United States every year since 2001, according to the CDC. Many Americans tan intentionally for cosmetic reasons, and by doing so increase their risk. The U.S. Surgeon General reported that 33 percent of Americans experienced a sunburn, a key skin cancer risk factor, in 2014. The two most common skin cancer types are basal cell and squamous cell, which usually form on the head, face, neck, hands and arms. Melanoma accounts for less than two percent of skin cancer cases — but results in the most deaths. A bright spot is that non-melanoma cancers are being diagnosed and treated earlier and with more success.

Earlier diagnosis leads to more successful outcomes

Keep in mind, more people are diagnosed with cancer because of the plethora of cancer-specific screenings that are available today. Like many life-threatening medical conditions, early diagnosis can increase your likelihood of beating the disease and going on to live a long life.

Thankfully, in this day and age, receiving a cancer diagnosis is no longer a death sentence.

Follow all of the Expert Voices issues and debates — and become part of the discussion — on Facebook, Twitter and Google+. The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on Live Science.