Should we throw away our medicines after the ‘Best Before’ or Expiry date?

Postpartum depression (PPD) is characterized by a major depressive episode that begins within four to six weeks following delivery, as per international diagnostic criteria. Recurrence rates for PPD are high, with 40% of affected women experiencing depression again in their lifetime and nearly 50% facing another episode in subsequent pregnancies. Symptoms of PPD encompass fatigue, irritability, anxiety, lack of pleasure, feelings of helplessness, sleep and appetite disturbances, indifference towards life events, low self-esteem, and feelings of incompetence as a parent, among others. PPD is considered a multifactorial condition influenced by both environmental and genetic risk factors for depression.

Risk factors for PPD  include:

• Previous depression.
• Adverse life events.
• Lack of social support.
• Socioeconomic position.
• Personal and family psychiatry history.
• Stressful experiences (such as trauma).
• Specific pregnancy-related factors.
• Intimate partner violence (IPV) occurring close to or during pregnancy also elevates the risk of postpartum depression.

The impacts of PPD are significant and extend beyond the affected individual. They include poor attachment between the mother and newborn, potential stunted growth and low weight in the child, disrupted breastfeeding, and adverse effects on the infant’s cognitive, emotional, and social development. There is also an increased risk for psychiatric disorders in the child during infancy, childhood, adolescence, and adulthood. Women of color and those with lower incomes are more likely to suffer from postpartum depression and may face barriers to accessing treatment (Gopalan et al., 202).

The four-stage process to regain control

Women experiencing PPD often undergo a four-stage process in an attempt to regain control:

1. In the initial stage, mothers grapple with intense worries, persistent obsessive thoughts, and difficulties focusing.
2. In the second stage, women feel a sense of loss of their “regular selves,” describing a robotic feeling while caring for their infants. Withdrawal may occur, and thoughts of self-harm or suicide may surface.
3. The third stage involves women planning strategies to overcome PPD, such as seeking help from healthcare providers, engaging in prayer, or finding comfort in support groups.
4. In the final stage, women regain control of their thoughts and feelings as despair lifts.

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The prostate is a small, walnut-sized, shaped organ below the bladder and in front of the rectum. The main functions are to create fluids for semen and force semen through the urethra during ejaculation. It is usual for the prostate to get larger as one age.  Because of the location just below the bladder and in front of the rectum, also wrapping around the upper part of the urethra, the tube that carries urine from the bladder out of the body, it means abnormal prostate conditions can affect urination and sexual function. The prostate is prone to three main conditions, which are Prostatitis, an infection or inflammation of the prostate gland; Benign prostatic hyperplasia (BPH), an aging-related enlargement of the prostate gland; Prostate cancer, the growth of cancerous cells inside the prostate, which may break out of the gland and affect other parts of the body.

Prostatitis

This is the inflammation (swelling) of the prostate gland, and common causes include infection (usually bacteria), injury, or an immune system disorder. The symptoms may include the inability to urinate, Painful or difficult urination, and painful ejaculation, accompanied by fever, Blood in the urine (hematuria), and Severe discomfort or pain in the pelvic area or genitals.

The Risk factors for prostatitis include:

Previous prostatitis, Infection of the urinary or reproductive system, HIV infection or AIDS, Use of a tube inserted into the urethra to drain the bladder (urinary catheter), and Diagnostic sampling of prostate tissue (biopsy).

Laboratory tests for Prostatitis include Urinalysis, urine microscopy/culture/sensitivity, HIV, measurement of Prostatic specific antigen levels in the blood, Scan, etc.

Benign prostatic hyperplasia (BPH)

The prostate will almost certainly get larger increasing age. A small amount of prostate enlargement is present in many men over age 40 years of age.  More than 90% of men over age 80 have the condition. It’s not clear why it happens, but it may be linked to the decline in the male sex hormone testosterone with aging. This enlargement is a condition called benign prostatic hyperplasia (BPH).  The key word is benign.  BPH has nothing to do with cancer and doesn’t increase the risk of prostate cancer. It can make urination and ejaculation difficult because as the prostate grows, it presses on the urethra. That interferes with the flow of urine and the release of ejaculate during orgasm. In less than half of all men with BPH, symptoms may include dribbling at the end of urinating, Inability to urinate (urinary retention), Incomplete emptying of the bladder, Incontinence, needing to urinate two or more times per night, Pain with urination or bloody urine (these may indicate infection). Slowed or delayed the start of the urinary stream, straining to urinate, Strong and sudden urge to urinate, and Weak urine stream.

The Link between BPH and Sexual Problems

Scientists aren’t sure why, but they agree that the worse the BPH symptoms are, the more likely an individual is to have sexual issues such as reduced sex drive, trouble keeping an erection, and less sexual satisfaction. It may have something to do with genetics or age. It’s also possible that the sleeplessness or anxiety that can come from an enlarged prostate makes sexual problems worse.

Laboratory Test for BPH.

A digital rectal exam is usually done to feel the prostate gland. Urine flow rate is monitored, Urinalysis to check for blood or infection, Urine culture to check for infection, Prostate-specific antigen (PSA) blood test to screen for prostate cancer, Cystoscopy, Blood urea nitrogen (BUN) and creatinine tests to check for reduced kidney function.

Risk Factors for BPH include;

• Age – symptoms start manifesting by age 50 to 60 in 60% of men.
• Unhealthy diet- daily consumption of a diet high in red or processed meat, saturated fats, and dairy products can increase your risk for prostate problems. Sodium (salt), Alcoholic and caffeinated beverages like coffee, tea, and soda can also increase your risk due to being diuretics that increase urine production.
• Type 2 diabetes, poorly managed Hypertension, and other heart diseases, Smoking, obesity, and a Sedentary lifestyle are common risk factors.
• Prostatitis
• Family history/genetics
• Frequent Urinary Tract infection (UTI)

Prostate Cancer

Cancer is a disease in which abnormal cells divide uncontrollably and destroy body tissue, in the case of prostate, abnormal prostate cells continue to grow until it has destroyed normal body tissues around and beyond the prostate.  Prostate cancer usually develops slowly, so there may be no signs for many years. Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra). When this happens, one may notice things like increased need to pee, straining while peeing, a feeling that the bladder has not fully emptied. Causes of prostate cancer are largely unknown. However, certain things can increase the risk of developing the condition.

Risk factors for Prostate cancer include;

• Age: The chances of developing prostate cancer increase as one gets older. Most cases develop in men aged 50 or older. Prostate cancer risk begins to rise sharply after age 55 years and peaks at age 70–74, after which it starts to decline. For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
• Men whose fathers or brothers were affected by prostate cancer are at slightly increased risk themselves.
•  Other risk factors include Obesity, Smoking (increases steroid hormone production such as DHT, and estrogen), High levels of pesticides, excessive consumption of dairy products (milk, yogurt, cheese, lactose-free milk, and fortified soy milk and yogurt), excessive red meat consumption, Saturated fat, and Sedentary lifestyle.

Beneficial Foods to Eat

A diet rich in fruits, vegetables, and healthy fats, such as the Mediterranean diet, may benefit health. Salmon, rich in healthy fats that contain omega-3 fatty acids, helps prevent and reduce inflammation within the body, and other cold-water fish, such as sardines and trout, are also rich in these fats.

Tomatoes: Tomatoes are packed with lycopene, an antioxidant that may benefit prostate gland cells. Cooking tomatoes, such as in tomato sauce or soup, helps to release the lycopene and make it more readily available to the body. Berries: Strawberries, blueberries, raspberries, and blackberries are excellent sources of antioxidants, which help to remove free radicals from the body. Free radicals are the byproducts of reactions that occur within the body and can cause damage and disease such as concern over time.

Broccoli: Broccoli and other cruciferous vegetables, including bok choy, cauliflower, Brussels sprouts, and cabbage, contain a chemical known as sulforaphane. This is thought to target cancer cells and promote a healthy prostate.

Nuts: Nuts are rich in zinc, a trace mineral. Zinc is found in high concentrations in the prostate and is thought to help balance testosterone and DHT. Besides nuts, shellfish and legumes are also high in zinc.

Citrus: Oranges, lemons, limes, and grapefruits are all high in vitamin C, which may help to protect the prostate gland.

All these are vital in addition to exercises to strengthen the pelvic floor muscles, such as brisk walking, Kegel exercise, and moderate strength training.

(Written by Ebenezer Dic-Ijiewere PhD.)

Inadequate exercise or physical activity can contribute to the prevalence of non-communicable diseases. Given that non-communicable diseases account for over 80% of deaths in some nations, they are regarded as “the number one killer” globally. Physical exercise is any movement that requires energy, like housework, manual labor, walking, or manual labor. Exercise, on the other hand, is a regimen of physical activity that is organized and planned to enhance physical fitness.

Evidenced-based benefits.

1. Physical Health: Research reported that 150 min of moderate-intensity or 75 min of vigorous-intensity physical activity led to a 14% risk reduction in all-cause mortality in patients with cardiovascular disease. In healthy adults, the risk decreased by 7%. Regular exercise has been shown in numerous studies to be beneficial in lowering the risk of cardiovascular disease as well as improving the health of patients with a variety of other conditions, such as certain cancers. stroke, type 2 diabetes, age-related sarcopenia, obesity, and multiple sclerosis.
2. Mental Health: Research findings indicate that youth with mild to moderate mental health issues can benefit from organized sports and exercise programs. In one study, participants highlighted the significance of intensity choice for their enjoyment and commitment to the program, and it was shown that a self-selected intensity sport and exercise intervention was beneficial for depression. Research findings indicate that youth with mild to moderate mental health issues can benefit from organized sports and exercise programs. In one study, participants highlighted the significance of intensity choice for their enjoyment and commitment to the program, and it was shown that a self-selected intensity sport and exercise intervention was beneficial for depression. Also, engaging in physical exercise for 14 weeks can considerably improve mental symptoms, reduce anxiety and somatization, lessen obsessive-compulsive symptoms, and lift depressed moods.
3. Quality Sleep: Study indicated that quality of sleep was positively impacted by exercise. Additionally, insomnia was somewhat alleviated following the exercise intervention. For instance, studies reveal that first-year students who exercise more get better sleep than those who exercise less during the night.

Evidenced-based research recommended the following:

1. Adults should aim for more than 300 minutes of moderate-intensity aerobic physical activity, 150 minutes of vigorous-intensity aerobic physical activity spread out over the week, or an equivalent mix of moderate-intensity and vigorous-intensity aerobic physical activity.
2. Engage in moderate-to-intense muscle-strengthening activities that target all major muscle groups two or more days a week.
3. Adults 65 and older engage in multicomponent physical activity that involves functional balance and strength training at a moderate or higher intensity for at least three days a week in addition to aerobic exercises.

Developing new, healthier habits could shield you against life-threatening conditions like diabetes and obesity. Creating new routines that include regular exercise and a healthy diet may also help you lose weight and feel more energized. Here are six strategies to maintain good physical and mental well-being.

1. Make regular exercise a part of your daily routine.: Regular exercise depends on maintaining a healthy weight, building stronger bones and muscles, and enhancing cardiovascular health. On most days of the week, try to get at least 30 minutes of moderate-intensity exercise. Look for things to do that you enjoy, like biking, swimming, dancing, walking, and running.
2. Seek routine medical examinations: See your doctor regularly to ensure preventive care and early detection of potential health issues. Make regular check-up appointments with your physician and abide by their recommendation regarding tests and screenings.
3. Make getting enough sleep a priority: Your body needs rest to rejuvenate and heal. Aim for 7 to 8 hours of sound sleep every night. Make a soothing bedtime ritual, stick to a regular sleep schedule, and abstain from caffeine and screen time right before bed.
4. Manage stress effectively: Your physical and mental health may suffer if you experience persistent stress. Try healthy stress-reduction strategies, like working out, practicing relaxation, or going outside. Consider getting professional assistance if you’re struggling to manage your stress alone.
5. Establish a Support Network: Tell your loved ones, a support group, or friends about your health objectives. Support networks can offer accountability, inspiration, and encouragement. Look for a friend or workout partner who shares your health objectives to foster connections and increase the enjoyment of activities.
6. Prioritize a wholesome diet: Achieve this by managing a healthy weight, enhancing your immune system, and relying on a well-balanced, nutrient-rich diet to supply your body with the essential nutrients needed for optimal functioning.

Limit processed foods, sugar-filled beverages, and high amounts of unhealthy and saturated fats. Instead, concentrate on eating abundant fruits, vegetables, and whole grains.

The rising cost of living has become a significant public health concern, particularly for low-income individuals who are struggling daily to survive. Addressing the social determinants of health among this population remains an urgent issue, as many face ongoing challenges accessing essential needs such as food, housing, transportation, and healthcare. During my assessment of some of the low-income individuals, I found that several individuals eat only once a day to save money for rent. Many reported choosing to go hungry rather than risk homelessness. Some have been living in their cars for nearly a year, while others rely on the homes of friends to shower and change clothes. It is heartbreaking to witness the difficult situations people endure every day to stay alive.

The rising cost of living has multiple impacts on health and well-being. According to Grewal et al. (2024), increasing housing costs—one of the key components of living expenses—can have both direct and indirect health consequences. Their study indicates that:

• Financial strain from high housing and living expenses contributes to increased stress, anxiety, and depression, particularly among renters and low-income individuals.
• Food insecurity often results when households must prioritize rent or transportation over nutrition, leading to poor dietary intake and higher risks of chronic diseases.
• Limited access to healthcare arises when individuals cannot afford medical visits, medications, or preventive care due to competing financial demands.
• Housing instability or homelessness can expose individuals to unsafe environments, lack of sanitation, and interrupted social support networks, which worsen both physical and mental health outcomes.

Overall, Grewal et al. (2024) emphasize that the effects of rising housing and living costs are unequally distributed, disproportionately affecting low-income individuals who already face multiple barriers to health. This highlights the need for comprehensive policy approaches that integrate housing affordability, income support, and healthcare access as essential strategies to promote health equity.

Source: https://doi.org/10.1186/s12889-024-18360-w

As we know, obesity stands as a significant health concern affecting the lives of African Americans. It is imperative to grasp the barriers that contribute to the rising rates of obesity within this population.

Obesity is characterized by excessive body fat accumulation influenced by environmental and genetic factors and poses various health risks, including specific cancers, type 2 diabetes, hypertension, osteoarthritis, hyperlipidemia, and cardiovascular disease. Omondi & Freysteinson (2023) estimated annual medical expenses related to obesity issues in the United States to be around $147 billion. Research reveals that obesity prevalence is notably high among African Americans, with rates around 49.6%, surpassing non-Hispanic Whites at 42.2%. Mainly, obesity rates are higher among African American women, reaching 56.9%, compared to 41.1% among African American men (Lofton et al., 2023).

Access to nutritious foods is limited for African Americans, who often consume less nutritious diets with high levels of added sugars and fried foods. Multiple obstacles hinder healthy eating habits, including limited knowledge, the cost of nutritious foods, time constraints for meal preparation, reliance on transportation to access stores, and communication barriers with healthcare providers regarding dietary habits.

Similarly, opportunities for physical activity are restricted, exacerbating the obesity issue. Reduced physical activity levels and increased sedentary behaviors like gaming or screen time have been associated with higher body mass index (BMI). African Americans facing obesity encounter various challenges in engaging in physical activity, including a lack of awareness regarding effective exercise methods, limited access to affordable exercise programs, inadequate facilities, transportation limitations, and health concerns.

References

Omondi, H., & Freysteinson, W. M. (2023). Understanding Obesity in African American Women Using Leininger’s Theory. Nursing Science Quarterly, 37(1), 71–75. https://doi.org/10.1177/08943184231207383

Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023). Obesity among African American people in the United States: A review. Obesity, 31(2), 306–315. https://doi.org/10.1002/oby.23640

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