The Struggle to Survive: Living Through the Rising Cost

Sleep is essential for the health and well-being of children, adolescents, and adults. Quality sleep supports emotional well-being, metabolic health, cognitive function, mental health, and cardiovascular and cerebrovascular health. Additionally, getting sufficient, high-quality sleep helps reduce the risk of fatigue-related accidents and injuries, such as motor vehicle accidents and workplace incidents.

Recommended Sleep Duration

The American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS) recommend that adults aim for at least 7 hours of sleep each night to promote optimal health. Similarly, the National Sleep Foundation (NSF) advises adults to get 7 to 9 hours of sleep per night, with older adults requiring 7 to 8 hours.

Prevalence of Sleep Disorders and Mental Health Impacts

About one-third of the population experiences insomnia symptoms, such as difficulty falling or staying asleep. Additionally, 4% to 26% of individuals report excessive sleepiness, and 2% to 4% have obstructive sleep apnea. Insomnia is associated with a significantly increased likelihood of mental health issues; individuals with insomnia are 10 times more likely to experience clinically significant depression and 17 times more likely to experience anxiety compared to those without insomnia. Poor sleep is also linked to post-traumatic stress, eating disorders, and psychosis spectrum experiences, such as delusions and hallucinations.

Improving sleep Quality

Improving sleep quality benefits mental health, and research reports that sleep plays a causal role in mental health challenges. Better sleep positively affects future mental health, even those without clinical symptoms.

Strategies for Improving Sleep Quality

• Creating a relaxing sleep environment
• Limiting daytime naps
• Managing stress and worries
• Being mindful of food and drink choices
• Sticking to a consistent sleep schedule
• Incorporating physical activity into daily routines.

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.)

Overview of Stress: Stress significantly affects health, contributing to disease development and burdening healthcare systems considerably. It is a significant factor in various ongoing health issues, particularly cardiovascular diseases, which are often impaired by everyday psychosocial pressures, such as work-related stress.

The following are the roles of stress in disease development.

Gender Differences in Stress Responses: Gender plays a vital role in how individuals experience and manage stress. Research reports that women are more likely to develop mood disorders and autoimmune. At the same time, men tend to have higher rates of early substance abuse, infectious disease, mortality, and antisocial behavior. Unsuccessful stress management can lead to severe physical and mental health consequences for both individuals and communities.

Physiological Responses to Stress: The study reports that stressful events can trigger emotional responses such as anxiety and worry, impacting the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic-adrenal-medullary (SAM) system, which may lead to unhealthy lifestyle choices, comprising poor sleep, alcohol consumption, decreased physical activity and increased smoking thereby increase the risk of diseases.

Chronic Stress in Specific Environments: Chronic stress in educational settings and workplaces impacts mental and physical health noticeably. Also, it indicates that occupational stress significantly affects mental well-being.

Traumatic Events as a Stress Source: Traumatic events are a prevalent source of stress that affects a large portion of the population. The study reports that In North America, about 60% to 75% of individuals will experience a traumatic event in their lifetime, including serious accidents, exposure to war, sexual assault, chronic childhood abuse, or neglect.

Postpartum depression (PPD) presents a significant public health concern, affecting not only the physical and mental well-being of mothers but also that of their infants. Research suggests that approximately 13 million women worldwide are diagnosed with PPD annually (Xu et al., 2023). Mild depressive symptoms are experienced by around 50% to 75% of mothers, with 10% to 15% developing postpartum depression within the first week after childbirth (Xu et al., 2023).

Understanding preventive measures to reduce its prevalence is very crucial.

 1. Exercise intervention has proven effective in preventing PPD disorders. In a 12-week exercise intervention study, aerobic exercise was found to relieve postpartum depression symptoms in PPD patients. Engaging in suitable aerobic exercise during pregnancy has been reported to promote pelvic mobility and improve birth canal space to relieve maternal labor pain. However, it also aids in preventing pregnancy complications. Studies suggest that PPD symptoms may manifest during pregnancy, with a similar 12% occurrence rate of depression reported, which indicates that preventive measures during pregnancy may have a significant impact on reducing PPD (Xu et al., 2023).

Moreover, research indicates that the antidepressant effects of exercise can persist beyond the cessation of physical activity. Therefore, research suggested that incorporating aerobic exercise into prenatal care may substantially prevent PPD more than exercise as a postpartum treatment strategy.

Engaging in moderate exercise during pregnancy can reduce the likelihood of developing postpartum depression (PPD) among expectant mothers. Partaking in at least 150 minutes of moderate-intensity aerobic exercise per week significantly enhances the efficacy of physical activity in preventing and treating PPD (Xu et al., 2023). Moderate aerobic exercise prompts the release of endorphins, which uplift mood and alleviate symptoms of anxiety and depression. Additionally, it helps regulate hormone levels, improve sleep quality, and enhance self-awareness and self-esteem, thereby positively influencing the mitigation of postpartum depression (Xu et al., 2023).

Also, social support plays a vital role in maintaining the mental well-being of pregnant and postpartum women, with supervised exercise and team-based exercise serving as effective avenues for providing such support. For instance,

• Team exercise fosters a positive environment for maternal emotional communication, and sharing maternal emotions enhances mothers’ childbirth knowledge and skills, reduces fear of labor pains, alleviates negative emotions, improves interpersonal communication, and enhances self-efficacy (Xu et al., 2023).

• Supervised exercise, which involves physical activities piloted and supervised by healthcare professionals or fitness trainers, ensuring that exercises are safe and suitable for individual pregnant and postpartum women. Participating in supervised exercise classes or programs also offers opportunities for social interaction, which is critical for mental well-being and can lighten feelings of isolation by connecting with other new mothers and professionals in a supportive setting (Xu et al., 2023).

2. Music therapy, when used as an adjunct to conventional psychotherapies, has been shown to improve physiological symptoms and effectively reduce negative emotions without any adverse side effects. It can positively impact and alleviate symptoms of PPD, offering a safe and affordable substitute to standard treatments. Music therapy is considered to reduce the need for pharmacological interventions during PPD treatment. Research has indicated that music therapy interventions such as music listening, improvisation, songwriting, singing, relaxation and meditation, and lyric analysis effectively reduce the risk of prolonged PPD and it can encourage strengths, empower individuals, and foster connections with themselves and others (Patch & Short, 2022).

References

Xu, H., Liu, R., Wang, X., & Yang, J. (2023). Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis. PLOS ONE, 18(11), e0287650–e0287650. https://doi.org/10.1371/journal.pone.0287650

Patch, M. C., & Short, A. E. (2022). Addressing the “Baby Blues”: Developing a Music Therapy Model for Prevention and Treatment of Postpartum Depression. Australian Journal of Music Therapy, 33(2), 82–90. https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=10&sid=e5bc3ad9-8160-4ed8-bb4f-752141ecd9c5%40redis

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Introduction

One of man’s best inventions is drugs, especially disease-specific ones. Drugs are substances other than food, which can prevent, relieve the symptoms, or cure an abnormality or disease. Globally, the cost of drugs has soared over the years, resulting in a situation whereby low-income earners are unable to buy branded medications. In underdeveloped and developing countries where food and drug agencies have poor capacity to perform their regulatory functions optimally, we tend to see the proliferation of substandard or fake drugs. So many times, this ugly trend is energized by not just greed but by the market demands for affordable medications.

Why Medication exceeds expiry date

 To mitigate the challenge of not being able to buy drugs, when necessary, people from resource-limited settings stack up some essential medications in their homes, which eventually exceed the best before or expiry dates on them. Sometimes, doctors could change a patient’s prescription because of reactions, allergies, or inability to purchase the drug, which could result in leftover drugs that eventually exceed the expiration date. Also, big pharmacies and patent-drug stores cannot sell all their stock, leading to the expiration of some drugs. This situation has raised many questions about the safety of these drugs after their expiration or beyond the “best before” date. Because of the importance of drugs and the health risks involved when taken wrongly, people have always consciously discarded unused drugs when it’s past the expiration date, even one day.

How Safe is a drug after the expiry date?

The debate about drugs being safe after their expiration date has persisted over the years, as many people still hold the opinion that pharmaceutical companies deliberately label their drugs with short shelf lives to guarantee steady patronage. Eventually, most of these unused drugs are discarded. The context that drugs can still be safe for a long time after expiration has gained several affirmations. In a recent study by Benjamin Davido and others titled ‘Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages’ published in MDPI Journal “Antibiotics”, it was reported that when appropriately stored in line with the expected conditions, no expired antibiotics tested failed to be potent after one year of expiration. In another study by Sushil Sharma and others, titled ‘A study to investigate the chemical potency, physical stability, and efficacy of analgesic agents over a period of two years post their expiry date’ published in the “Medical Journal Armed Forces India”, it was seen that drugs such as Diclofenac, Piroxicam, and Ibuprofen retained their stability, analgesic efficacy, chemical active ingredients and by implication their potency up to a duration of two years after expiration.

Important factors to consider

However, the issues of proper storage and handling can play a big role, especially in the tropical climate of West Africa and other geographical regions. Hence, people in the tropics may have to rely on their capacity to store their drugs in the required condition in deciding whether to use a drug past the expiration date or not.

Conclusion

This article doesn’t advocate for the use of expired medication but to reduce anxiety about accidental use. It is essential to understand factors that impact drug stability.

(Written by Ebenezer Dic-Ijiewere PhD.)

NB: Always consult your healthcare professionals regarding expired medications to ensure medication safety and effectiveness.

High cholesterol (hypercholesterolemia) refers to elevated levels of cholesterol in the blood, especially low-density lipoprotein cholesterol (LDL-C)—which is widely regarded as a key modifiable risk factor for atherosclerosis and cardiovascular disease (CVD). LDL-C can deposit in arterial walls, forming plaques that narrow arteries and increase the risk of heart attack and stroke. Meanwhile, high-density lipoprotein (HDL-C) is considered “good” cholesterol because it helps transport cholesterol away from the arteries to the liver for excretion. Several factors can increase the level of cholesterol in the blood, as indicated below

Factors That Contribute to Elevated Cholesterol

• Poor diet
• Lack of Physical Exercise
• Excess body weight
• Smoking increases cholesterol profile, and excessive alcohol increases triglycerides
• Genetic traits
• Chronic stress and poor sleep
• Diet low fiber

To decrease high cholesterol in the blood, it is important to make positive changes to health behaviors by following the strategies below:

Strategies to Decrease High Cholesterol Levels

• Reduce intake of saturated and trans fats, and substitute with MUFA and PUFA-rich foods such as fatty fish(Salmon and Mackerel), olive oil/canola oil, Avocado/nuts

A study by Okobi et al. (2023) found that an avocado-rich diet can lower total cholesterol (TC) and low-density lipoprotein (LDL) levels.

• Increase consumption of food high in soluble fiber, such as oats, fruits, apples, and legumes.
• Regular aerobic exercise for 150 minutes/week lowers LDL and triglycerides and improves HDL.
• Losing excessive weight will improve LDL profiles.
• Quitting smoking will improve cardiovascular health and HDL levels