Wednesday, September 21, 2016

You Can Now Insert A Microchip Into A Penis To Catch A Man Cheating


Image result for microchips
If he has sex with someone OTHER than you, it sends alerts to your phone (!!!)

Worried your man might be cheating? Then have we got the set of microchips for his penis and your vagina!

Commit-Tech (a most likely fake company) has announced a November launch for a product designed to stop cheaters in their semen-covered tracks.

Just get your guy to slip this chip into the tip of his penis (here is where I started laugh-crying and never stopped). Then, put a similar chip in your vulva, download the Commit-Tech app to your smartphone and presto, sexo, you've got constant access to his doodle and all of its activities.


The device claims that if the penis with said chip in it has sex with a hole that does not have the corresponding chip inside of it, it will send an alert to your phone.

Can you imagine being at work, leaning in hard and leading a meeting about last month's numbers and your phone vibrates. You glance down, adjusting your sensible Meroni suit jacket and see "TREVOR IS PORKING SOME STRANGER" flashing on your screen.

Then you're like "Again with this, Trevor?" And you get distracted and botch the meeting and now you'll never be CFO all because of Trevor, his penis, and high tech phone science.

This story smells totally fake, but it's not outside the realm of what's possible. Until popular science comes up with a way of making penile microchip insertion pleasant and totally not suspicious, those worried that their partners are stepping out on them can do what all paranoid girlfriends have done since the advent of smartphones: Track his ass using a GPS.


There is another alternative measure you can take if you suspect that your dude is cheating. You could be like "Hey, we need to talk, I'm feeling like there is some cheating happening." What's great about doing this is that every single man on planet earth when confronted this way will respond with: "WHAT? ME? CHEAT? NO? YOU'RE CRAZY!"

The good news is that because men are as transparent as sheets of the finest rice paper, you'll be able to glean from his own rendition of this response whether or not it is true and proceed from there.

If you think your dude is cheating, the truth is almost inconsequential.

The fact that you're feeling insecure in the relationship is what matters. It's a sign there's shit that needs to be addressed. I'm sorry to say there is no penile microchip that can miraculous heal your own trust issues.


Very funny post

Fake doctor, nurse apprehended for aborting six-month-old pregnancy

A certain Mr. Taiwo Ogunlana, claiming to be a medical doctor and his assistant nurse, Kafayat Oyekola, have today been arraigned before an Ebute Metta Magistrates’ Court, Lagos State, for allegedly carrying out an illegal abortion on one Miss Kemi Awoniyi.

The self-acclaimed medical doctor claimed to have graduated from the Lagos State University Teaching Hospital School of Nursing in 1983 and have worked as a doctor with the National Orthopedic Hospital, Igbobi, Lagos.

According to reports, he said he was sponsored by the hospital authorities for a Post-Basic Theatre course in 1987 and is presently the proprietor of Amu Medical Clinic registered by the Lagos State Private Hospital Authority, located at 4, Church Street, Dalemo.

“Miss Kemi was brought to me on Monday evening, July 6th to be precise,” Mr. Taiwo said. “It was my nurse, Kafayat who brought her to me,” he noted.

“She has worked with me for about 6 months on internship and all the while, she brings patients to me for abortion which I did successfully, and for every patient she brings, she gets a commission,” he added.

“She told me Kemi had taken some drugs which she said gave her sleepless nights as she had severe abdominal pain for three days.”

“When I examined her, her vagina had a very bad odour due to the protrusion of the foetus which was already dead,” Taiwo added.

“After I treated and cleaned her up, I told her to rest for a while and pay N25, 000 for the treatment before leaving but she said she would have to contact her boyfriend whom I have not met before.”

“She however called her boyfriend while I was there,” he said, “and he asked me to kindly forward my account details to him which I did right away.”

“Sadly, I never got any alert to that effect,” the ‘doctor’ stated. “I treated Kemi before asking her to pay because she was in a very bad state.”

He added that Kemi said she wanted to go home because she was afraid that her father would find out.

“As she stood up, she said she was feeling dizzy and I had to ask her to stay in the hospital. Few minutes later, I realized she was pale so I immediately ordered the nurse to give her two pints of blood and it was in this process we were invaded and summoned for questioning,” he said.

It was gathered that the victim was 6 months pregnant before the abortion was carried out.

Speaking to the court, the nurse said the 31-year-old victim came to her and told her that she was having body pains because of some tablets she used.

“I asked her to come back on Monday which she did and on that day, I realized she smelled awfully.”

“I took her to a doctor in Sango Ota who checked her and discovered that the tablet she took had affected her pregnancy,” the nurse said.

As the story goes, they were both charged to court and charges were leveled against them.

The charge against them reads:

“That you, Taiwo Ogunlana and Kafayat Oyekola, on the 6th day of July 2015 at Oke-odo area of Lagos State, in the Lagos Magisterial District, did unlawfully carry out abortion on one Oluwakemi Awoniyi, aged 31 years and thereby committed an offence punishable under Section 145 of the criminal laws of Lagos State of Nigeria 2011.”

They both pleaded not guilty to the charges.

The magistrate, Mr. L.A Layeni, granted the defendants bail in the sum of N100, 000 with two sureties each in like sum.

The case was however adjourned till 31st August, 2015 while further investigations will be carried out to confirm if they are both certified medical practitioners.

Source : http://dailypost.ng/2015/07/30/fake-doctor-nurse-apprehended-for-aborting-six-month-old-pregnancy/

Lassa fever: Another patient dies in Federal Medical Center Asaba

Another patient suffering from the dreaded Lassa fever disease has died at emergency ward of the Federal Medical Centre (FMC), Asaba, the Delta State capital.

Last week, a certain female patient smuggled the disease into Asaba from neighbouring Anambra State. She was the first death recorded in Delta State following the recent outbreak of the disease across the country.

Commissioner for Information, Mr. Patrick Ukah had in the wake of the first incident said other samples taking to the laboratory at Irrua Specialist Hospital in Edo State tested negative to Lassa fever.

Ukah said 22 persons who were suspected to have had contact with the late woman from Anambra State, were placed under close surveillance.

But it could not be ascertained if the latest death was one of the 22 persons earlier quarantined.

The latest incident caused panic among other patients at the facility as they reportedly took to their heels.

Medical personnel who had hectic time restoring normalcy and educating the fleeing patients about the disease, later shared medical face mask to the patients and relatives apparently to ensure their safety.

The health personnel who wore protective clothing later removed the corpse from the ward to the mortuary.

A top management staff of the hospital who pleaded not to be named in print confirmed the death but declined further comments particularly on the identity of the latest victim.

Lassa fever is caused by a virus found in the urine and faeces of a specie of rat when they contaminate food or water or come in contact with broken skin of humans.

Infected persons spread the disease when their body fluids such as blood, faeces, urine, sperm and vomit come in contact with others.

According to experts, some signs and symptoms of Lassa fever infection include cold and fever, sore throat, headache, pains in different parts of the body, nausea, cough, diarrhea and general sense of being unwell.

Severe stage of the infection comes with swellings on the face and hand, bleeding in different parts of the body such as ears, mouth, nose, anus and vagina.

Source : http://sunnewsonline.com/new/lassa-fever-another-patient-dies-in-asaba/

Why are we scared of 'down there'?Nurse explains the silence around GYN cancers

When it comes to our v.aginas and reproductive system, too many of us find it difficult to talk about for a lot of reasons

British reticence is famous. Anything deemed embarrassing or personal is shied away from - and heaven forbid we should ever overshare.



Much of this reluctance is evident in how we speak, and the way we word things - especially when it comes to our reproductive organs, aka 'down there' .

There are times, however, when an unwillingness to talk about what's going on with our genitals can prove deadly - and perpetuates the belief they're something to be ashamed of.

From the symptoms to the treatment needed, gynaecological cancers (ovarian, cervical, uterine, vaginal and vulval) are not spoken about with the same readiness other cancers are.

One thing is for sure though, as we live longer, they are on the increase.

Do we just not want to hear about the fact they affect a woman's genitals, reproductive system and fertility? Or is it a case of the symptoms being so hard to detect, we're not as 'exposed' to a large amount of knowledge about them?

Visibility

"Gynaecological cancers aren't discussed enough. It is easier to talk about breast cancer. Perhaps because it is above the navel.

"Breasts aren't seen as embarrassing in the same way. You only have to open a newspaper to see them. We're far more silent about our private parts."


Angelina Jolie has said she has had her ovaries and fallopian tubes removed to avoid the risk of ovarian cancer

Shame


"There is most definitely a reluctance and a sense of shame women feel in coming forward.

"To give an example, in clinical practice, womb cancer is the most common of all the gynae cancers, and predominantly in post-menopausal women.

"The symptoms are post-menopausal bleeding, and so many women do not come in when they experience this.

"We're so used to bleeding that even if we have gone through the menopause, we shrug it off and put it to the back of our minds.

"Unfortunately, the longer women sit on this knowledge, the more time the cancer has to grow.


More than half of women are embarrassed to ask for help with intimate concerns

"A woman needs to feel comfortable bringing it up to someone - her daughter, her husband - and they need to be able to say 'I think you should get that checked out.'

"If more women came in after their first bleed, it would make such a difference."

School


"We should bring up women's cancers at the same we're having sex education and learning about our reproductive systems.

"We're learning about periods and bleeding and it ties in with what to look out for.

"The thing is, often bleeding is probably NOT a sign something is amiss.


The younger we're brought up to speed on gynaecological cancers, the better

"But it's important for girls to know, for example, that post-coital bleeding could be a sign of cervical cancer.

"Information which is important later on is if a woman is NOT expecting a bleed and has one, they should go the GP. It is so much better to get it checked, yet so many women don't."

Hidden signs


"These cancers often happen at a time when a woman's body is changing, and the symptoms can be subtle, they tie in with these changes.

"With ovarian specifically, the signs can be difficult to pick up on. A woman's body shape is in flux and she may be getting thicker around the waist. We accept this and think this is normal.


A cervical cancer smear test

"But we should watch out for bloating which is consistent and and does NOT go away - this is not normal, and any woman affected should go the GP.

"Other signs are a change of bowel habits - again, so subtle - a slow change in the frequency with which we urinate and feeling full very quickly.

"We accommodate these changes because they're happening at a time of change."

Getting help


"If caught early, all gynaecological cancers can potentially be treated successfully.

"However, it does remain that ovarian cancer has the lowest positive outcome, mainly because women are presented with a bleed a lot later."

The unease women have talking about their reproductive health and subsequent stigma around it is a vicious cycle.

Getting women to open up to others is a big step - there are not a lot of places for them to go.

Source : http://www.mirror.co.uk/lifestyle/health/scared-down-there-nurse-explains-7306548

Pregnant and Unaware? Midwife explains how it's possible

Ever wondered how some women have no idea they're pregnant until they go into labour? Like Sonia Jackson, for example. Well a midwifery expert has now explained how that is actually very possible. As crazy as it sounds…

Helen Cheyne is professor of midwifery research at the University of Sterling. She says that 'cryptic pregnancies' are more common than we think, and that the signs of being pregnant, like missing your period and weight-gain can easily be dismissed as being a side affect of something else.

Writing for The Conversation, Helen says that 'cryptic pregnancy' can occur in around one in 2,5000 cases, and adds that there are around 320 cases in the UK every year.

One of the first ways women suspect they're pregnant is that they miss their period. But a lack of period can be down to a number of other things.

Helen says: "There are many reasons why a woman may not menstruate regularly, including some medical disorders and factors such as poor diet or stress. Women approaching the menopause are likely to have disrupted menstruation and some women stop having periods altogether when taking the contraceptive pill. Conversely, 'menstrual–like' bleeding during pregnancy (any pregnant woman who experiences any vaginal bleeding should seek medical attention) is reported, although not explained, in around 1% of women."

Surely a woman would notice she was putting on weight, or getting a bit of a baby bump? Well, that can easily be put down to something else too.

"The 'average' pregnant women would be expected to gain around 12.5kg but this is widely variable and subject to cultural and ethnic difference.

"But many women anticipate gaining weight and an increased waist circumference around the menopause – and, at any age, weight gain is easily explained: for example, as the result of comfort eating in times of stress. Women who have a restricted diet (intentionally or unintentionally) throughout pregnancy may gain very little weight, while the baby's birth weight may still be within the normal range."

And morning sickness – that's a tell-tale sign surely…

"Morning sickness is experienced by around 70% of pregnant women but varies widely in severity and duration and may again be attributed to numerous other causes."

Source : Cosmopolitan

10 List Of STD's And Symptoms We May Or May Not Know

List of STDs and Their Symptoms

The most common types of STDs in the world includes

chlamydia,

genital warts,

genital herpes,

gonorrhoea,

hepatitis B&C,

Syphilis

HIV.


Then there are also various other STD infections of the urinary tract and the genitals which can cause annoying symptoms but are easy to cure. The sooner your infection is diagnosed, the better are your chances of
getting it treated and cured.

1. Chlamydia

Chlamydia is the most common STD in the world It is also easily curable - chlamydia treatment usually consists of a single dose antibiotic. About 50% of men and 70% of women don’t have any symptoms for years (if at all). When symptoms appear, people often suffer from abnormal vaginal discharge and vaginal bleeding, discharge from the tip of the joystick and pain when peeing or during sex.
When left untreated, chlamydia can lead to infertility in women and men. When you’re infected with chlamydia, other STDs may also be present.

2. Gonorrhoea

Gonorrhoea is often caught alongside chlamydia. About 1 in 3 women infected with gonorrhoea also has chlamydia. The bacteria that cause gonorrhoea need to be inside the human body to survive. For this reason, you can only catch it through sexual activity (and not through contact with objects/swimming etc).
The symptoms of gonorrhoea include the same irregular discharge as the one caused by chlamydia (from the vagina or joystick). As with chlamydia,
many infected patients won’t develop any symptoms even though the infection can cause damage to women’s reproductive system in the long run. Men, however, sometimes suffer from infections of the urinary tract and associated symptoms when infected with chlamydia: painful urination and discharge from the joystick. If untreated, the bacteria can spread to the
rest of the body, often infecting the skin or muscle joints. Gonorrhea treatment normally involves a course of the antibiotic cefixime.

3. Genital Herpes

Over 80% of people who are infected with genital herpes, don’t know they have the virus. Most of them will never find out - it’s quite common for patients to live a lifetime without knowing about their infection or suffering from any symptoms. However, they can pass the virus to another partner who can then develop symptoms. Asymptomatic patients tend not to use protection (condoms) every time they have sex, unlike patients who know they have herpes. Genital herpes is caused by the herpes simplex virus. The symptoms are
soreness of the infected area and/or painful blisters around the genitals. Most people are able to recognise recurrent episodes due to the itching and tingling sensation in the genitals that they feel a few hours
before the blisters appear. This is the best time to start an antiviral treatment , right before the virus starts producing genital herpes blisters. In general, the first herpes outbreak is the most severe one and lasts much longer than any episode that follows – up to 2-3 weeks. Over time, outbreaks of genital herpes tend to get milder.

4. Genital Warts

Genital warts (also known as anogenital warts) are located in or around the anus and genital area. They’re caused by the human papilloma virus (HPV) which often doesn’t cause any symptoms at all, and sometimes shows only years after infection. Genital warts appear as little bumps that sometime form clusters with a
cauliflower shape. Since they come in different sizes treatment ranges from antiviral creams (e.g. Warticon ) to surgery (e.g. laser, cryosurgery). While they are not dangerous, they are easily transmitted and require
immediate treatment. As far as symptoms go, genital warts are sometimes itchy and in rare cases they can be painful. Women can suffer from irregular vaginal bleeding or discharge.


5. Syphilis

Syphilis is one of the oldest infections on this list of STDs. While, nowadays, syphilis is fairly easy to treat with antibiotics, if left untreated the infection can cause severe symptoms (e.g. contagious ulcers on the genitals, anus and mouth; then infection of the brain, eyes or ears) and is potentially life-threatening. In the early stages, like many types of STDs, the symptoms of syphilis are hard to recognise and it can take several months before they appear. However, as soon as the bacteria enter your body, the illness progresses – in three stages – with the symptoms getting worse at each stage..


6. Hepatitis B

As for hepatitis B, it is a virus that attacks the liver (like hepatitis C) and is passed through sexual contact and blood (e.g. via needles). The symptoms of hepatitis B start with a short acute infection to which everyone responds differently: a few will develop chronic hepatitis B and others will develop liver severe dysfunction. The majority of people actually develop their own antibodies against the virus and are protected from further infections. Yet, 5 in 100 people who are infected will suffer from serious consequences from the virus.
Note that hepatitis A and C can also be passed on through sexual activity but it remains quite rare, so we won’t include them in this list of STDs. If you have had unprotected sex you may need to go to a GUM clinic and get tested for hepatitis.


7. HIV – Human Immunodeficiency Virus

Finally, HIV is the last item on this list of the different STD infections. It is caused by a virus that attacks your immune system. Basically you don’t die from HIV, but from any benign infection that your body can’t cope with. This is the final stage where HIV results in your body to suffer from AIDS – the Acquired Immunodeficiency Symptom (i.e. your immune system is down). Like Hepatitis B, HIV can be transmitted through blood exchange (for example sharing needles) or sex. It can also be transmitted to the new- born by a pregnant woman. And like Hepatitis B and other types of STDs, the first symptoms are difficult to recognise as they can feel like the flu (with muscle pain, sore throat), sometimes in combination with vomiting and diarrhoea.
This fever tends to develop within 2-4 weeks after the virus has entered the body, but it can sometimes take several months. Most patients will only suffer from AIDS about 10 years later as they start losing weight and suffer from uncommon infections and cancers. There is no cure or vaccine for HIV at the moment, but early treatment considerably slows down the spread of the virus in infected patients. There are over 8,000 HIV-positive people in the UK, and an estimated 30% of them are not aware of their condition.

8. Crabs

Pubic lice (crabs) is another example, which is neither an infection nor a disease but just tiny bugs (lice) that settle in your pubic hair to lay their eggs and reproduce. They are transmitted during intimate contact between two pubic areas. Many people don’t have any symptoms, but some do suffer from itchy genitals and inflammation. You can only get rid of them with special treatment for lice (shampoos, lotions & creams).


9. Trichomoniasis (Trich)

Trichomonas is a germ causing a benign infection known as trichomoniasis. It’s a treatable infection which is cured with a simple course of antibiotics. The symptoms it causes are common STD symptoms, namely an abnormal discharge from the genitals and pain when urinating or when having sex.
Not Strictly STDs…
There is also a whole range of infections that are sometimes considered to be STDs, but they are not strictly speaking STDs. Although they are sometimes transmitted during sex they may be genital infections that are aggravated by sexual activity.


10. These STD infections are easily curable and include:
Bacterial vaginosis (smelly discharge) in women;
Water warts caused by a virus which leads to liquid-filled warts around the genitals. These warts are relatively contagious and can be transmitted by skin contact and exchanging towels and clothes; Chancroid, caused by a bacteria and results in bump-like warts that
turn into painful ulcers. The symptoms are very similar to genital warts. The advantage of broad spectrum antibiotics such as azithromycin is that while they’re specifically prescribed for certain types of STDs (e.g.
chlamydia), they can also be used to treat other STD-related infections (e.g. chancroid). By getting tested and treated, you can sometimes cure many types of STDs at the same time.

source https://www.dred.com/uk/list-of-stds.html

Five health checks for every woman

Women and matters that concern the female gender are on the front burner of most discussions this week. Why? There have been week-long activities lined up by stakeholders, international organisations and the corporate world to celebrate women who have excelled in life.

However, as the celebration goes on, women must ask themselves one crucial question: do they value themselves especially their health? For instance, only a few women above the age of 40 reading this article have done a mammogram.

Studies have shown that women generally spend more money on cosmetics, shoes and clothes than they do on their health.

Given a choice, it is no exaggeration to say that many Nigerian women would rather spend N30,000 on ‘aso-ebi’ (party cloth) than pay the same amount for a cervical cancer vaccine.

Experts, however, warn that women are at a greater risk of dying of quite a number of diseases compared to men. Examples abound that more women die of breast cancer compared to the number of men that die of prostate cancer.

Statistics show that 26 Nigerian women die daily of cervical cancer; yet the disease is preventable and curable.

Doctors note that detecting these diseases at an early stage makes them easy to cure. Therefore, every woman must take responsibility and ensure her own safety and wellbeing.



Here are the lists of screenings doctors recommend every woman must undergo.

Self-breast examination

Oncologists (cancer care specialists), note that the diagnosis of breast cancer starts with the woman, who is observant and takes action when necessary.

Professor of Oncology and Radiation at the College of Medicine, University Of Nigeria, Nsukka, Enugu State, Ifeoma Okoye, notes that a major reason why women who had breast cancer in the past died in spite of access to treatment is late presentation at the hospital with the disease.

The oncologist recommends that women of all ages should examine their breasts every month and report unusual changes to a doctor for medical examination.

She states, “It is important for every woman to perform self-breast examination every month. If you notice anything that is odd, especially a lump that hurts you while you are doing it, you need to see the doctor.

“If it is painless, you should also see the doctor. There are painless lumps that are also cancerous. Early detection starts in your youth.

“Breast cancer is no longer a disease of the old. There are young women with breast cancer and this explains why every mother should teach their female children how to carry out the examination.”

Pap smear test
The Pap smear test checks the cervix and the vagina of a woman for any abnormal cells that could develop into cancerous cells. Ideally, the test should be conducted as soon as a woman turns 21 and should be repeated every three years. Once she turns 30, she can wait five years between tests unless she senses any abnormal changes in her body.

Mammograms

Doctors recommend that every woman should undergo a mammogram screening after the age of 40. Mammograms are a low-dose X-ray that screens your breast and other surrounding tissues for cancerous lumps that may be too small to feel during a regular breast exam. Always remember that early detection of breast cancer can lead to a cure.

Osteoporosis X-ray

Many women face weakened bones after menopause. This puts them at a greater risk of osteoporosis where weakened bones begin to deteriorate. The osteoporosis X-ray is recommended for women after the age of 65. The screening includes a dual energy X-ray absorptiometry that measures the bone marrow density and determines the risk for osteoporosis before the fracture occurs.

Ovarian cancer screening

Ovarian cancer affects women between the ages of 50 and 75. It kills approximately 15,000 women each year. Therefore, women should do this exercise regularly. During the exercise, the doctor performs a pelvic examination to check for ovarian cancer in the exposed vulva and then proceeds inwards to check the uterus and ovaries for the same.

Heart disease screening

Heart disease is the number one killer of women. A future president, mother, wife, scientist, sister, and boss dies roughly every minute from it. More disheartening still: most, if not all of these deaths are preventable, trailing a wake of modern preventative care, drugs and surgery.

Heart disease rates among men have been steadily declining, while women’s rate of decline has been slower. A very important factor?Women’s heart disease symptoms can look starkly different from men’s. Contrary to the pervasive myth that you have to go down on a shag rug clutching your chest and wailing in pain to be having a heart attack, women frequently experience subtle and often dismissible symptoms they’re trained to ignore, like problems breathing, fatigue, stomach aches, and a vague sense of uneasiness. Many women think they have the flu, acid reflux, or are just plain exhausted.

Statistically, women are significantly more likely than men to have their heart disease symptoms ignored by a health care provider or hospital. They are also twice as likely to die in the first year after a heart attack.

Heart disease kills more women than men each year. Therefore, it becomes important that women above the age of 50 along with women who have a family history of the disease should undergo yearly Electrocardiography screening to monitor their heart for any abnormalities.

Source: Punch Newspaper

States where midwives practice independently have lower rates of cesarean delive

WASHINGTON, DC (March 8, 2016) -- States that allow autonomous practice by certified nurse-midwives (CNMs) have a higher proportion of CNM-attended births as well as lower rates of cesarean sections, preterm births, and low birthweight infants, according to a study published today in Women's Health Issues. Women's Health Issues is the official journal of the Jacobs Institute of Women's Health, which is based at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.

Authors Tony Yang of George Mason University and Laura Attanasio and Katy Kozhimannil of the University of Minnesota School of Public Health analyzed data on 12 million births from 2009 through 2011 reported by 50 states and the District of Columbia to the Centers for Disease Control and Prevention. They classified each state as either being subject to collaborative agreement, meaning CNMs must have physician supervision or contractual practice agreements in order to practice (28 states), or as having autonomous practice, in which no such agreements are required (22 states and the District of Columbia). The authors found that women giving birth in the states allowing independent midwifery practice had a 60 percent greater chance of having a certified nurse midwife as a birth attendant.

Past research has found that midwives are less likely than obstetricians to use interventions like labor induction and cesarean delivery that may have higher risks for women and infants when performed without definitive medical need. The authors of this study also found that women giving birth in the group of states allowing autonomous midwifery practice had 13 percent lower odds of cesarean delivery, 13 percent lower odds of preterm birth, and 11 percent lower odds of delivering low-birthweight babies when compared to women giving birth in the states with stricter requirements for CNM practice.

"Future policy efforts to enhance access to midwifery services may be beneficial to pregnancy outcomes and infant health," the authors conclude, adding that more midwife-assisted births could lead to better birth outcomes and lower costs. They note that cesarean deliveries not only come along with health risks but are approximately 50 percent more costly than vaginal deliveries.

The study, "State Scope of Practice Laws, Nurse-Midwifery Workforce, and Childbirth Procedures and Outcomes," has been published online ahead of print and will appear in the May/June issue of Women's Health Issues.

Source : Eurekalert

USA : Changing minds about midwives

Angela Love is a midwife in Vero Beach. In most countries she would be considered a valued medical professional.

But in the U.S., midwifery still carries somewhat of a stigma as an old-fashioned way of doing things. Love would like to change that perception.

Her practice, Midwife Love, operates from an office on 43rd Avenue. And business is booming.

She has attended 180 births since she opened her own practice in 2010 – and more than 700 in her career. She offers free pregnancy tests, and works with well-mother support groups such as La Leche League, an international breastfeeding information and support organization.

Her birth success rates are high and patients are borderline devotional.

The inclusion of midwives in the business of pregnancy is part of a cultural debate about whether childbirth is a natural, physiological occurrence that women are innately equipped to handle, or a surgical and medical procedure requiring teams of physicians and operating rooms.

But today's midwives are medical professionals trying to bridge that gap.

Love is a licensed advanced registered nurse practitioner with a specialty as a certified nurse midwife, and has OB/GYN clinical and hospital experience.

Her approach is dedicated to assisting mothers from first pre-natal visit through natural, home birth and post-partum care.

Teaching

During Love's hour-long pre-natal appointments, she forms a personal bond with her patients. Their conversations include such topics as breathing, exercises and newborn care.

"There's a lot of teaching in the visits," Love says.

In 2014, Vada Mossavat was new to Vero Beach and without a regular physician. She went to Love for general gynecological services and was so impressed that she thought, "If I ever have a child I want this woman to deliver my baby." And she did.

"Angie helps you become a mother, not just give birth," says Mossavat.

Love arrives for a home birth fully equipped, bringing oxygen, medications, IV supplies and resuscitation equipment.

Another way

She also assists with "vaginal births after C-section" – known as VBAC.

The most feared potential complication for mothers who have previously undergone C-sections are uterine scar ruptures, a serious medical event that endangers mother and baby. But Love believes that the appropriate candidate can do well with VBAC, as opposed to automatic repeat C-sections.

Indian River Medical Center does not do VBAC. The Newsweekly contacted IRMC staff OB/GYN Dr. James Presley about this article, but his office chose not to comment.

Ashley Kosack, 25, came to Love during her second pregnancy, after a 2011 C-section at St. Lucie Medical Center made her determined to have a natural birth the next time.

Recovery from a C-section had been traumatic for her. She spent four days in the hospital after surgery and couldn't fully participate in the early days of her daughter's care. A friend recommended Love and their first meeting sealed the deal.

Kosack had found the doctor's office experience stiff and impersonal, and thought a midwife was perfect for her.

During pre-natal visits she'd share her progress. "Angela was just as excited as I was," she says.

Through months of pre-natal training with Love, Kosack prepared for her first experience with natural childbirth. After a long, exhausting night, Colby was born weighing nine and a half pounds. There were no problems with her cesarean scar throughout pregnancy or during the birth.

High rates

The National Institute of Health found that nearly 90 percent of mothers who have C-sections have them again.

Nevertheless, the study concludes that, "Our findings do not support the widely held belief that neonatal mortality risk is significantly lower compared to VBAC delivery."

And according to the Mayo Clinic's website, between 60 and 80 percent of women have successful vaginal births after a cesarean.

Nationally, the cesarean rate is approximately 32.8 percent according to the Center for Disease Control.

The World Health Organization recommends rates between 10 and 15 percent.

Florida has one of the highest C-section rates in the country. In 2013 it was 38.94 percent, according to cesarianrates.com, which compiles state health department and hospital association data.

The rate at Indian River Medical Center is nearly 33 percent.

South Miami Hospital and Kendal Regional Medical in Miami have 61 and 63 percent C-section rates, respectively.

Discouraging

It was those high numbers in Miami that inspired Love to embrace her life's work.

She always knew she wanted to be a nurse. As a gifted high school student who excelled in math, she was offered a full tuition scholarship to Messiah College, a private Christian College in Mechanicsburg, Pa.

After receiving her nursing degree she chose obstetrics, because, "it was happy," she says. "Smiling moms, beautiful new babies."

She moved to Miami, "to be in a multi-cultural environment."

But as an RN in labor and delivery units at Miami hospitals she was surprised and even distressed by disturbing break room conversations.

Doctors cited hot dates or tee-times as reasons to induce labor or persuade a patient that a C-section was necessary.

Love hadn't previously considered becoming a midwife or doing home-births, but after five disillusioning years, she "couldn't be a party to it anymore," and made a change.

During graduate school she had spent summers at a birth center.

"At first it was like a social science study," she says. But she discovered a whole new experience. "Women (in labor) were walking around, they were eating and drinking, and in and out of tubs, which makes for an easy transition for the baby."

Love had found her calling. And she has had to send only ll percent of her patients to a hospital for delivery, where 8 percent have had a C-section.

Avoiding problems

Her wholistic approach focuses on teaching women ways to avoid issues that require medical attention. For instance, she teaches massage techniques and pushing methods to help avoid tearing. She has never had a patient go through an episiotomy, an incision to enlarge the birth canal.

Financial considerations, as well as inconvenience, can also dictate C-sections, according to Love. Doctors and hospitals receive higher fees for C-sections than for natural births. A study by Truven Health Analytics cites natural birth costs at around $16,000 and cesareans are approximately $26,000.

At Midwife Love the total cost is $5,000, which includes all lab work, pre-natal visits, the birth, and six weeks of postpartum care for mother and baby. They accept insurance and Medicaid.

More natural

Love points out another distinction between natural home birth and hospital delivery. At hospitals, women are "leashed to a machine for continuous monitoring. Love has found, "Intermittent is better.".

The American College of Obstetricians and Gynecologists agrees. Their website states that there is no benefit in continuous monitoring for low-risk women, and that it restricts mobility and limits comfort positions.

"Continuous monitoring," according to the ACOG, "has also been associated with an increase in other interventions, such as forceps, vacuum extractors, and cesarean section, without evidence of benefit to the baby."

For natural birth, Love uses no pain relief medications. At hospitals, mothers in labor routinely receive narcotics including Demerol (a form of morphine), which can cause side effects such as nausea.

For babies, potential problems are more serious. Narcotics cross the placenta during labor and may cause central nervous system and respiratory depression, as well as altered neurological behavior and many other adverse effects, according to the American Pregnancy Association.

Mossavat experienced a painful labor.

"You want the pain to stop," she says. "If I'd been at a hospital, I would have asked for something for the pain. It's like a Snickers – if it's there you'll eat it, even though you probably shouldn't."

Other solutions

Love has delivered both of Jennifer Smith's children: 15-month-old Milan and newborn Taleia.

Smith wanted to give birth at home, even though friends tried to talk her out of it. "What if something goes wrong?" was the repeated question.

But Smith says, "As soon as I met Angie I felt connected."

Her son Milan came with long labor. "We tried everything, the pool, doing lunges, I was exhausted."

Finally a "rebozo" technique worked. This Mexican midwife tradition uses a scarf around the belly to gently vibrate the abdomen, relaxing tight ligaments and adjusting the baby's position.

It seems to have been just what Milan needed. Shortly after the second rebozo maneuver, "Milan descended and Jenny immediately started feeling more pressure," Love said.

When he came out, his hand was against his cheek, and Love speculates his elbow may have caught on the walls of the uterus, stopping him from entering the birth canal sooner.

His birth was a true family affair. Smith's husband Tomas, mother-in-law, sister, mother, a doula (a birth coach) and Love were all in attendance, taking pictures while Smith gave birth squatting on her knees.

Midwife Love is doing so well that Love (who chose that name and changed it legally) is considering adding another midwife to her practice.

She organizes an annual Babies, Bellies & Brunch reunion at South County Park. It's a well-attended event for current and former patients, their families and babies, lots of babies.

"She's created a whole community," says Mossavat. "She's a catalyst for good, healthy things. I can't say enough good things about her and about what she's doing."

Angela Love will continue helping women committed to the alternative of having their babies at home naturally, and possibly change some opinions about midwives in the local medical community – one baby at a time.

"Child birth," Love says, "is the last frontier of feminism."

MDCN Introduces course against Female Genital Mutilation in Medical Curriculum

The ugly experiences associated with the age-long practice of female genital mutilation in some states in the country have led to the introduction of the subject as part of the curriculum for nurses and doctors by the Nursing Council of Nigerian (NCN) and the Medical and Dental Council of Nigeria (MDCN).

At a two-day Media Dialogue on female genital mutilation/cutting in Nigeria, organised by the Advocacy Unit, Child Rights Information Bureau (CRIB) of the Federal Ministry of Information, in collaboration with the United Children’s Fund (UNICEF), to mark the World Zero Tolerance to Female Genital Mutilation/Cutting in Osogbo, Osun State, the National President of Inter-Africa Committee on Harmful/Violent Practices against Women and Children (FGM), Professor Modupe Onadeko, observed that there was no single benefit in the practice of female genital mutilation and cutting.

According to her, it has now become a punishable offence for any medical practitioner, be he or she a nurse or doctor to be involved in the practice of female genital mutilation/cutting, hence the Harmful/Violent Practices against Women and Children was introduced into the curriculum of medical professionals.

In her presentation on: “The Practice and Experience of FGM/C in Nigeria” she said the practice of FGM/C is widely common in parts of the South-west, South-south, South-east and areas located around Chad and Niger Republic extending to some areas in North-east like Kano, Abuja, Nassarawa among others, where certain cultural practices have infiltrated.

She said though the prevalence of cutting is more in the South-west and South-south, some tribes are however practicing the unclassified types including one which is often referred to as medical circumcision. “Here a medical practitioner helps to carry out the procedure in a facility to eliminate infections.
“Whichever form or method of mutilation or injury done on the female child, this is unacceptable and it is a harmful practice that must be stopped forthwith,” said Onadeko.

She continued, “It is estimated that between 100 million to 140 million girls and women alive today have experienced FGM. If current trends continue, 15 million additional girls will be subjected to it by 2030. Some communities believe the practice is religiously required. Others believe that FGM will deter pre-marital sex or promiscuity. It’s these entrenched believes that the United Nations Population Fund, (UNFPA) and other UN agencies like UNICEF are working to change.

“An estimated 19.9 million Nigerian women have undergone FGM/C meaning that approximately 16% of the 125 million FGM/C survivors worldwide are Nigerians (NPoPC 2014). The overall prevalence of FGM/C among girls and women aged 15-49 years in Nigeria (27%) is lower than in many countries (NDHS 2013)”, she stated.

According to Onadeko, who is also Community Health Physician and Consultant Reproductive/Family Health University College Hospital, Ibadan, FGM/C affects women and young girls in various ways such as: Infections (genital abscesses), Problems having sex. (pain), Depression and anxiety, Painful menstrual periods, Urinary problems, Vesico Vaginal Fistula (VVF) or Recto Vaginal Fistula (RVF), Problems in childbirth (need to cut the vagina to allow delivery and the trauma that results, often compounded by re-stitching).

She allayed the fears that women who were not circumcised are more prone to promiscuity than the circumcised ones, noting that about 99.9 per cent of commercial sex workers had their genitalia mutilateds.

Source :ThisDay Newspaper

Ebola can be transmitted through sex – WHO warns

The World Health Organisation (WHO) has issued an interim advice on the possibility of Ebola Virus of being sexually transmitted.

The WHO had directed all Ebola survivors and their sexual partners to receive counselling to guard against possible transmission of the disease.

This is contained in a statement made available by WHO to newsmen in Lagos on Saturday.

It indicated that the sexual transmission of the Ebola Virus was yet to be established.

“The sexual transmission of the Ebola Virus from males to females is a strong possibility, but has not yet been proven; less probable, but  theoretically possible.

“Studies have shown that Ebola virus can be isolated from semen up to 82 days after symptom onset.

“A recent case investigation identified genetic material (RNA) from the virus by nucleic acid amplification tests (such as RT-PCR)199 days after symptom onset.

“This is well beyond the period of virus detecting ability in the blood of survivors and long after recoveryfrom illness.

“The detection of virus genetic material many months after symptom onset is assumed to reflect the continuing, or at least very recent, presence of live and potentially transmissible Ebola virus.’’

“More surveillance data and research are needed on the risks of sexual transmission and particularly on the prevalence of viable and transmissible virus in semen over time, WHO said.


WHO recommends that, in the interim, all Ebola survivors and their sexual partners should receive counselling.

It added that this is to ensure safe sexual practices until their semen has twice tested negative; and survivors should be provided with condoms.

“Ebola survivors and their sexual partners should either abstain from all types of sex or observe safe sex through correct and consistent condom use until their semen has twice tested negative.

“Having tested negative, survivors can safely resume normal sexual practices without fear of Ebola virus transmission,’’ the statement added.

According to WHO, male Ebola survivors should be offered semen testing at three months after onset of disease.

It said that for those who tested positive, semen testing should be every month thereafter until their semen tests negative for virus twiceby RT-PCR, with an interval of one week between tests.

If an Ebola survivor’s semen has not been tested, he should continue to practice safe sex for at least six months after the onset of symptoms

“This interval may be adjusted as additional information becomes available on the prevalence of Ebola virus in the semen of survivors over time, it added.

The statement also noted that until such time when their semen has twice tested negative for Ebola, survivors should practice good hand washing with soap and water and other personal hygiene

“This should be after any physical contact with semen, including after masturbation; used condoms should be handled and disposed of safely, so as to prevent contact withseminal fluids,’’ it added.

It said that Ebola virus RNA had also been detected by RT-PCR in vaginal fluid from one woman 33 days after symptom onset.

“Live virus has never been isolated from vaginal fluids.

“With such limited data, it is not known for how long virus typically persists in vaginal fluids, or whether it can be sexually transmitted from females to males,’’ WHO explained.

The world health body advocate that all survivors, their partners and families should be shown respect, dignity and compassion.
(NAN)

Source: http://dailypost.ng/2015/05/09/ebola-can-be-transmitted-through-sex-who-warns/

Meet the Woman who was born without Womb, Cervix and Vagina b

When we first saw the doctor, my father put on a brave face. My mother, on the other hand, didn't take it so well. She blamed herself for the past 10 years. It was really heartbreaking to see her like that.

We didn't talk about it much for the first five years. I wasn't able to talk about it. I felt destroyed and incredibly weak. My mother believes she may have done something wrong in her pregnancy. I've explained to her that she didn't do anything wrong, it was just genes.
It's a condition that is stigmatised. The most hurtful thing was when I was abandoned after my former partner found out.

I was engaged when I was 21, living in Athens. When I told my fiance about the condition, he broke off the engagement. That all belongs in the past and I am OK now. For the past five years, fortunately, I have had a stable and loving relationship. He knew from the beginning that I have this condition and he chose to stay with me. He knows that maybe the future will be without children. He's OK with it. I'm also OK with that. I am one of the luckiest.


Joanna Giannouli, 27, has a condition which means she has no womb, cervix and upper vagina. Here, she explains the challenges of a syndrome that affects around one in 5,000 women.
My mother took me to our family doctor when I was 14 because I still wasn't menstruating. He didn't examine me because he wouldn't touch my private parts and when I became 16 he sent me to a hospital to be checked out. They realised that I didn't have a vaginal tunnel and I had Rokitansky syndrome. Because I was born without a functional vagina, the doctors had to make one in order for me to have sex.

It went well, really well. I stayed in a hospital for about two weeks, in order to recover. Then I had to be about three months laying on a bed - I couldn't get up. I did vaginal exercises in order to expand my new vaginal tunnel. The first sign of it is you have primal amenorrhea - you don't have any menstruation at all. Apart from that, you cannot have sexual intercourse. That's why I had major surgery aged 17. The doctors made me a new one. It was a revolutionary procedure in Athens.
The new vagina the doctors made was narrow and small, and it caused me a lot of pain while having sex, and I had to expand the perineum by doing vaginal exercises. It's a small area underneath the vagina. It's skin, it's tissue, and they had to cut it more in order to expand the entrance, as I call it.

After that I was OK physically, but I was not OK emotionally. It's a burden, like something that you cannot get rid of it. I had partners who emotionally abused me about this condition. I couldn't have a stable relationship for many years because of that. It is a haunting and unbearable situation. It steals your happiness, your mentality, your chances of having a good and stable relationship. It leaves you with a huge void that cannot be filled, it fills you with anger, guilt, and shame.

What is Rokitansky syndrome?


A condition referring to women who are born with an underdeveloped or absent womb, cervix and upper vagina

Women with Rokitansky syndrome have ovaries and external genitalia (vulva) and they still develop breasts and pubic hair as they get older

Often the first sign of Rokitansky syndrome is that a girl does not start having periods. Sex may also be difficult because the vagina is shorter than normal

Apart from that, it was hard afterwards. It was just taking a toll on me emotionally, psychologically - it was really, really hard.

Well, it's been almost 10 years. I'm still feeling bad about it but I'm not ashamed any more, it's been way too long. And I've realised that I cannot change it, it's just the way it is, I have to embrace it and live with it.

For the first few years, and still sometimes, I thought I was worthless. Damaged goods. Not worthy of being loved. I was a lost soul for many years. It can destroy your life. It puts you in a really hard position. I battled depression, anxiety, panic attacks, you name it.

It taught me a lesson. Although I don't believe in God, I do believe that this was a huge wake-up call - never take anything for granted.

I was reborn. It gave me a new life, a new identity. It changed the course of my life. Before, I was a typical teenager with ups and downs. Afterwards, I became really, really mature. I grew up rapidly. I am thankful for that.

This defined me as a person. I am living each day as it is. I am not making any future plans because I don't know if I'm going to be alive.

Not many people know this about me. I wanted to keep it a secret and my mum told family members. It wasn't the best experience because people pity you. I don't want people to feel sorry for me. I'm not dying, I'm not in danger. People had this pitiful look. It made me feel sadder about myself.

I couldn't talk about it because in Athens - in Greece generally - people are really close-minded. Sometimes it felt like I was living in the Middle Ages.

I couldn't find a support group in Greece, I couldn't find anyone else to talk about it. And I needed someone to talk about it! It was huge, and most women with the condition are ashamed, really. I've found a couple of women that were willing to talk about it, and after a while they disappeared because they were ashamed of it.

I would love to be a mother in some way, be it a biological, a surrogate mother or a foster mum. A mother is not the one who gives birth but is the woman who cares for a child.

At this stage of my life, I'm not thinking about it but maybe in the future I will have children. I love kids, we will see.

It is liberating to talk about it. I want to support every woman that has this condition because I have been through hell and I know what problems this can cause. Many women have committed suicide because of this. It can be really depressing.

I found the strength and courage because I want to help other women in the same position because if we don't help each other then who will? It gives me strength when I talk about it.

Source : BBC News

High-tech nurses leading the way

The U.S Department of Health and Human Services is projecting a near-term shortage of primary care physicians (PCPs) that amounts to an anticipated shortfall of 20,400 PCPs by 2020. The patient experience in the U.S. is clearly set to become a lot less hands-on. For many, technology will close that gap. Technology, after all, can take care of many of the patient’s strictly medical needs: it assists in diagnosis, enables advanced forms of surgery and optimizes the delivery of care. Health care professionals are expected to provide a compassionate, high quality and safe environment for promoting healing on a more fundamental level. The comprehensive focus on human elements fosters harmony of the mind, body and spirit — a harmony that some studies suggest can accelerate the healing process.



Today’s patients are not willing to compromise high touch for high tech — they expect both. The burden of meeting those expectations in the absence of adequate PCP staffing will almost certainly fall to nurses. Nurses who can combine technological knowledge with traditional bedside experience will become even more valuable in this new context. So where are the opportunities for nurses with technology competence? Here are a few areas where the combination is already making an impact.

Transitioning to home-based care

Hospital-based nurses are currently leveraging today’s user-friendly technology platforms to help patients make the transition from the hospital to their home. This process involves several steps:
• Developing an electronic care plan.
• Obtaining electronic consent from patients.
• Configuring medical devices for patient monitoring.
• Assisting patients with the use of medical devices and smart sensors until they are able to utilize them independently.
• Assigning the patient educational videos.
• Analyzing each patient’s electronic database on a regular basis.

Nurses who master technology-enabled remote patient monitoring platforms proactively are extremely valuable: they are the model high-tech practitioners, and hospitals and providers are rightly creating new high-paying positions to attract qualified people to fill them. Those organizations will be rewarded for attracting and retaining talent in these positions, as they will help implement advanced care interventions and thus reduce patient readmissions.

Real-time monitoring of current patients

Nurses are already on the front lines of patient care, but they can make even more of an impact when they are empowered to adjust instructions and prescriptions based on real-time monitoring. Nurses need to be certified on the specific EMR system used at the hospital, and must master the patient monitoring platform and its configuration screen. Nurses today regularly use these systems to schedule personalized alert messages and provide specific instructions for patients.

Soon, nurses should be involved in developing a comprehensive care plan for each patient using computer-based tools. More importantly, they must be equipped and trusted to analyze real-time data to detect when something abnormal is happening to the patient. In some instances, nurses could use this system to instruct prescription adjustments — say, when a congestive heart failure patient’s weight exceeds the daily limit.

Managing chronic diseases

Chronic disease management is where the combined approach stands to make the greatest difference. Nurses with chronic disease pathway expertise combined with advanced technology competence are in high demand. Even health insurance companies are announcing new high-paying positions for nurses who can handle members’ care management using a suite of technology platforms. Nurses in these positions must:

• Learn to effectively identify high-risk patients using advanced analytics platforms.
• Apply their knowledge of chronic diseases to configure the system and design a personalized chronic disease management pathway for each high-risk patient.
• Use smart technologies to alert patients about acute risks (detecting blood flow in the patient’s legs and informing them of a possible deep vein thrombosis).
• Interpret the data coming from wearable medical technology to educate and coordinate care for patients with chronic diseases.

The ability to analyze the continuous flow of patient data should enable nurses to spend meaningful one-on-one time understanding their patients and building a relationship with them.

Assisting in clinical research

Pharmaceutical companies want physicians to run human clinical trials for new drugs, but physicians do not have the time to enlist eligible patients because they are overwhelmed with requests. Nurses can step into this role, and can identify the right patients for these trials using sophisticated technology platforms to configure inclusion and exclusion criteria for each study

Nigerian-Turkish Hospital to commence open heart surgery

The Nigerian- Turkish Nizamiye Hospital, a pristine medical facility in Abuja is set to commence services for heart valve replacement and coronary artery bypass grafting otherwise known as open heart surgery in Abuja.

According to a statement by the management of the hospital in Abuja, “The Nigerian Turkish Nizamiye Hospital decided to commence this service after a careful analysis of the spate of heart diseases prevalent in the Federal Capital Territory Abuja.”

The statement added that “the focus would be coronary artery bypass grafting as well as heart valve replacement.”

The hospital said that it “has put in place all the required equipment and a team of experts from Turkey with a track record of excellence.”

The statement by the Public Relations Officer, Mr. Mohammed Abubakar, said that the hospital in its tradition of delivering quality services spared no expense in the composition of the team.

The five-man team is led by Dr Mustafa Kirman, a reputable cardiovascular surgeon from Turkey who is credited to have performed over 15, 000 heart surgeries with 99 per cent success rate.

In a chat with the Deputy Medical Director of the hospital, Dr Atilla Emiroglu, he said that the open heart surgery procedure being introduced was arguably the first of its kind in Abuja going by the quality of the surgeons and the medical facilities on ground.

Source : Vanguard Newspaper

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A client with pemphigus is being seen in the clinic regularly. The nurse plans care based on which of the following descriptions of this condition?
A. The presence of tiny red vesicles
B. An autoimmune disease that causes blistering in the epidermis
C. The presence of skin vesicles found along the nerve caused by a virus
D. The presence of red, raised papules and large plaques covered by silvery scales

The nurse is caring for a client in the coronary care unit. The display on the cardiac monitor indicates ventricular fibrillation. What should the nurse do first?
A. Perform defibrillation
B. Administer epinephrine as ordered
C. Assess for presence of pulse
D. Institute CPR
answer is C: Assess for presence of pulse .Artifact can mimic ventricular fibrillation on a cardiac monitor. If the client is truly in ventricular fibrillation, no pulse will be present.

The nurse is assigned to a newly delivered woman with HIV/AIDS. The student asks the nurse about how it is determined that a person has AIDS other than a positive HIV test. The nurse responds
A. "The complaints of at least 3 common findings."
B. "The absence of any opportunistic infection."
C. "CD4 lymphocyte count is less than 200."
D. "Developmental delays in children."
A answer C: "CD4 lymphocyte count is less than 200." CD4 lymphocyte counts are normally 600 to 1000.

The home care nurse is performing an assessment on a client who has been diagnosed with an allergy to latex. In determining the client’s risk factors associated with the allergy, the nurse questions the client about an allergy to which food item?
A. Eggs
B. Milk
C. Yogurt
D. Bananas
Answer: D

Initial step while detecting pulmonary embolism?
A. Start IV line
B. Check vitals
C. Administer morphine
D. Administer oxygen
Answer: D

Major health complications associated with maternal Zika virus infection?
A. Macrocephaly
B. Microcephaly
C. Rheumatic heart disease
D. Myasthenia gravis .
Answer: B

While assessing a client in an outpatient facility with a panic disorder, the nurse completes a thorough health history and physical exam. Which finding is most significant for this client?
A. Compulsive behavior
B. Sense of impending doom
C. Fear of flying
D. Predictable episodes
Answer is B: Sense of impending doom
The feeling of overwhelming and uncontrollable doom is characteristic of a panic attack.

Indications for fundoplication?
A. Hiatus hernia
B. Diaphragmatic hernia
C. GERD
D. All the above
Answer: D

Left ventricular pressure can be measured by using
A. C.V. C
B. Pulmonary artery catheter
C. Swanz - Ganz Catheter
D. All the above
E. Both B&C
Answer: E

United Nations decided to mark the importance of India’s former President and great scientist APJ Abdul Kalam and declared his birthday as ‘World Students Day’. The world students day is ....?
A. November 15
B. October 15
C. October 17
D. November 17
Answer: B

Sex education should be given to
A. Toddler
B. Preschooler
C. Schoolar
D. Adolescents
Answer: D

Dowager's hump is the forward curvature(kyphosis) of the spine resulting in a stoop, caused by collapse of the front edges of the thoracic vertebrae commonly seen in....?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Osteoporosis
D. Lumbar fracture
Answer; C

Cessation of breathing more than ....seconds is known as apnea
A. 5
B. 10
C. 15
D. 20
E. 30
Answer: D

While newborns vitals assessments , it should be
A. T,P,R
B. R,P,T
C. P,T,R
D. P,R,T
Answer: B

Koplik spots (also Koplik's sign) are a prodromic viral enanthem of ---- disease?
A. Chikun gunya
B. Diphtheria
C. Herpes zoster
D. Herpes simplex
E. Measles.
Answer: E


CVP is the pressure within
a)inferior venacava
b)pulmonary artery
c)pulmonary vein
d)subclavian vein

Anti - infective vitamin?
A. A
B. B12
C. C
D. D
Answer: A

Scilent killer in neonates?
A. Hypothermia
B hypoxia
C. Hypoglycemia
D. Dehydration
Answer: A

Which of the following condition Christmas disease ?
A. Leukemia
B. DIC
C. Hemophilia A
D. Hemophilia B
Answer : D

Zika is a viral diseases transmitted by mosquito
A. Culex
B. Ades
C. Anopheles
D. Asian tiger
Answer : B

Malnutrition landmark in children?
A. Head circumference
B. Chest circumference
C. Mid arm circumference
D. Milestone achievement
Answer: C

Trendelenburg test is used to detect
A. DVT
B. Varicose vein
C . vulvular disorder
Do thrombophlebitis

A reflex that is seen in normal newborn babies, who automatically turn the face toward the stimulus and make sucking motions with the mouth when the cheek or lip is touched.
A. Moro
B. Rooting
C. Sucking
D. Swallowing
Answer: B

Rh positive mother has to receive Rh immunoglobulin at
A. 14 weeks
B. 26 weeks
C. 32 weeks
D. None of these.
E. 28 weeks
F. After delivery
Answer: D

CA cervix caused by
A. HPV
B. H. Pylori
C. E coli
D. Treponema
E. Gardnerella vaginalis
Answer: A

" Vande matharam " project associated with
A. Immunization
B. Antenatal care
C. Breast feeding
D. Child care
Answer: B

Royal disease is....
A. DM
B. Hypertension
C. Hemophilia
D. Nephrotic syndrome
Answer: C

Immediately after amniotomy the nurse should check
A. Uterine tone
B. Bladder distension
C. FHS
D. BP
E. Cervical dilation
Answer: C

Degree 4 th , uterine prolapse?
A. uterine inversion
B. Uterine atony
C. Parametritis
D. procidentia
Answer: D

Toxic shock syndrome is due to
A. Streptococcus
B. Staphylococcus aureus.
C. Pneumococus
D. Haemophilus.
Answer: B
Toxic shock syndrome is a rare, life-threatening complication of certain types of bacterial infections. Often toxic shock syndrome results from toxins produced by Staphylococcus aureus (staph) bacteria, but the condition may also be caused by toxins produced by group A streptococcus (strep) bacteria.

Molloscum contagiosum is caused by...
A. Poxvirus
B. Candia
C. HPV
D. Variola
E. Gonorrhoea
Answer: A


Colostrum contains highest %
A. Carbohydrates
B. Proteins
C. Fats
D. Vitamins & minerals
Answer: B

Normal sperm densities range
A. 20 - 300 million/ ml
B. 10- 20 billion/ ml
C. 10000- 20000/ ml
D. None of these.
Answer: A

Mr.Ashok orients his staff on the patterns of reporting relationship throughout the organization. Which of the following principles refer to this?
A.Span of control
B. Hierarchy
C.Esprit d’ corps
D. Unity of direction
Answer: B

Centralized organizations have some advantages. Which of the following statements are TRUE?
A. Highly cost-effective
B. Makes management easier
C. Reflects the interest of the worker
D. Allows quick decisions or actions.
E. Both A&B
F. Both C&D
Answer: E

Which of the following guidelines should be least considered in formulating objectives for nursing care?
A. Written nursing care plan
B. Holistic approach
C. Prescribed standards
D. Staff preferences
Answer: D

Rh negative mother has to receive RH D immunoglobulin with in ----- days postpartum
A. 1
B. 2
C. 3
D. 7
E. None
Answer: C

Pelvic cellulitis
A. Parametritis
B. Vulvitis
C. Pelvic abscess
D. Perinitis
Answer: A

An opioid analgesic is administered to a client during surgery. The nurse assigned to care for the client ensures that which medication is readily available if respiratory depression occurs?
A. Betamethasone
B. Morphine sulfate
C.Naloxone (Narcan)
D. Meperidine hydrochloride (Demerol)
Answer: C

Fetal bradycardia means HR below
A. 80/mts
B. 100/mts
C. 120/mts
D. 140/mts
Answer: C

A good fetal outcome in contraction test ...?
A. Neutral
B. Positive
C. Negative
D. None of these.
Answer: C

Liquor amnie exceeds 2000ml
A. Hydramnios
B. Oligohydramnions
C. Polyhydramnions
D. Both A & C
Answer : D

MTP act enforced in ...?
A. 1927
B.1972
C. 1989
D. 1871
Answer: B

Early sign of DIC
A. Pain
B. Hematuria
C. Clot formation
D. Vascular obstruction
Answer: B

Highest degree of abortion seen among
A. Husband with A blood group and wife with O group
B. Husband with O blood group and wife with A group
C. Husband with A blood group and wife with B group
D. Husband with AB blood group and wife with O group
Answer: A

.Deferoxamine is administered in overdose of:
A. Iron
B. Calcium gluconate
C. Digoxin
D. Beta blockers
Answer: A

The nurse is preparing to teach a client how to use crutches. Before initiating the lesson, the nurse performs an assessment on the client.The priority nursing assessment should include which focus?
A. The client's feelings about the restricted mobility
B. The client's fear related to the use of the crutches
C. The client's muscle strength and previous activity level
D. The client's understanding of the need for increased mobility
Answer: C

Most specific enzyme for MI?
A.CPK-M,
B.CPK-MB,
C.CPK-BB,
D.LDH,
Answer: B

Which is the following largest and most muscular chamber of heart
a)right atrium
b)right ventricle
c)left ventricle
d)left atrium

Uterine contractions monitored by ......?
A. Friedman's curve
B. Tonometer
C.Tocodynamo meter
D. Fetoscope
Answer: c

Which of the following drug shows drug holiday
a)Ecospirin
b)streptokinase
c)morphine
d)digoxin

After TURP, the client having continues bladder irrigation. Which of these statements explain the reason for continuous bladder irrigation?
a. To remove clot from the bladder
b. To maintain the patency of the catheter
c. To maintain the patency of the bladder
d. To dilute urine
Answer: A

The nurse has developed a plan of care for a client diagnosed with anorexia nervosa. Which client problem should the nurse select as the priority in the plan of care?
A. Malnutrition
B. Inability to cope
C. Concern about body appearance
D. Lack of knowledge about nutrition
Answer: A

Which hormone is responsible for amenorrhoea after delivery or in postpartum period..(in proper lactating women)..??
A. Oxytocin
B. Prolactin
C. FSH
D. LH
Answer: B

Why should an infant be quiet and seated upright when the nurse checks his fontanels?
A. The mother will have less trouble holding a quiet, upright infant.
B. Lying down can cause the fontanels to recede, making assessment more difficult.
C. The infant can breathe more easily when sitting up.
D. Lying down and crying can cause the fontanels to bulge.
Answer: D

Which of the following is an appropriate nursing diagnosis for a client with renal calculi?
A. Ineffective tissue perfusion
B. Functional urinary incontinence
C. Risk for infection
D. Decreased cardiac output
Answer: C

Most common site of hematoma during postpartum period?
A. Uterine hematoma
B.Vaginal hematoma
C.cervical hematoma
D. Vulvar hematoma
Answer: D

Which trait is the most important for ensuring that a nurse-manager is effective?
A. Communication skills
B. Clinical abilities
C. Health care experience
D. Time management skills
Answer :A
Communication skills are a necessity for a successful nurse-manager. The manager must be able to communicate with the staff, clients, and family members. Clinical abilities, experience, and time management are also important to the manager's success, but without communication skills the manager won't be effective.

Which of the following ECG lead shows changes In IWMI
A. LEAD 2
B.AVL
C.LEAD 1
D. V3

Absence of recognizable QRS Complex in ECG indicate
1)Atrial fibrillation
2)Ventricular fibrillation
3)Sinus arrhythmias
4)paroxysmal VT

Another name Of Glucose?
A. Fruit sugar,
B. Cane Sugar,
C. Fructose,
D. Dextrose,
Answer: D

Daily Requirements of protein Is per Kilogram of Body weight?
A) 1 gm,
B) 10gm,
C) 20gm,
D) 30gm,
Answer: A

A client on prolonged bed rest has developed a pressure ulcer. The wound shows no signs of healing even though the client has received appropriate skin care and has been turned every 2 hours. Which factor is most likely responsible for the failure to heal?
A. Inadequate vitamin D intake
B. Inadequate protein intake
C. Inadequate massaging of the affected area
D. Low calcium level
Answer: B
Clients on bed rest suffer from a lack of movement and a negative nitrogen balance.

In Gynace ward , the find out a client, she is on PPH . What the nurse should do first?
A.monitor vitals
B. Call physician
C. Eliminate the blood loss
D. Stay with the client & call for help.
Answer: D
Client may goes to shock. So stay with client
Call help and ask another to call doctor.eliminate blood loss. Then monitor & record vitals

A client complains of abdominal discomfort and nausea while receiving tube feedings. Which intervention is most appropriate for this problem?
A. Giving the feedings at room temperature
B. Decreasing the rate of feedings and the concentration of the formula
C. Placing the client in semi-Fowler's position while feeding
D. Changing the tube feeding administration set every 24 hours
Answer: B
Decreasing the rate of feedings and the concentration of the formula. Its the higher priority.

which detail of a client's drug therapy is the nurse legally responsible for documenting?
A. Peak concentration time of the drug
B. Safe ranges of the drug
C. Client's socioeconomic data
D. Client's reaction to the drug
Answer: D
The nurse legally must document the client's reaction to the drug in addition to the time the drug was administered and the dosage given. The nurse isn't legally responsible for documenting the peak concentration time of the drug, safe drug ranges, or the client's socioeconomic data.

The Ward nurse administering mannitol and the doctor advised slowly to be given. Why?
The risk for ---?
A. cerebral embolism
B. Pulmonary edema
C.hypertension
D. Fluid overload
Answer: B
Rapid fluid shift will results pulmonary edema

The nurse is collecting data on a client before surgery. Which statement by the client would alert the nurse to the presence of risk factors for postoperative complications?
A "I haven't been able to eat anything solid for the past 2 days."
B. "I've never had surgery before."
C. "I had an operation 2 years ago, and I don't want to have another one."
D. "I've cut my smoking down from two packs to one pack per day."
Answer: D

The physician prescribes morphine 4 mg I.V. every 2 hours as needed for pain. The nurse should be on the alert for which adverse reaction to morphine?
A. Tachycardia
B. Hypertension
C. Neutropenia
D. Respiratory depression
Answer: D
The nurse should be alert for respiratory depression after morphine administration. Other adverse reactions include bradycardia (not tachycardia), thrombocytopenia (not neutropenia), and hypotension (not hypertension).

The nurse is auscultating a client's chest. How can the nurse differentiate a pleural friction rub from other abnormal breath sounds?
A. A rub occurs during expiration only and produces a light, popping, musical noise.
B. A rub occurs during inspiration only and may be heard anywhere.
C. A rub occurs during both inspiration and expiration and produces a squeaking or grating sound.
D. A rub occurs during inspiration only and clears with coughing.
Answer: C

A male client has been complaining of chest pain and shortness of breath for the past 2 hours. He has a temperature of 99° F (37.2° C), a pulse of 96 beats/minute, respirations that are irregular and 16 breaths/minute, and a blood pressure of 140/96 mm Hg. He's placed on continuous cardiac monitoring to:
A. prevent cardiac ischemia.
B. assess for potentially dangerous arrhythmias.
C. determine the degree of damage to the heart muscle.
D. evaluate cardiovascular function.
Answer: B

A client with mitral stenosis is scheduled for mitral valve replacement. Which condition may arise as a complication of mitral stenosis?
A. Left-sided heart failure
B. Myocardial ischemia
C. Pulmonary hypertension
D. Left ventricular hypertrophy
Answer: C
Mitral stenosis, or severe narrowing of the mitral valve, impedes blood flow through the stenotic valve, increasing pressure in the left atrium and pulmonary circulation.

INR Value of patient with mechanical valves
1)2.5-3.5
2)1-2
3)0-1
4)none of above

A client with chest pain doesn't respond to nitroglycerin (Nitrostat). On admission to the emergency department, the health care team obtains an electrocardiogram and administers I.V. morphine. The physician also considers administering alteplase (Activase). This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms?
A. Within 3 to 6 hours
B. Within 24 hours
C. Within 24 to 48 hours
D. Within 5 to 7 days
Answer: A

An unconscious infant received to the emergency department. Which pulse should the nurse palpate during rapid data collection of an unconscious infant?
A. Radial
B. Brachial
C. Femoral
D. Carotid
Answer: B
The brachial pulse is palpated during rapid data collection of an infant.
During rapid data collection, the nurse's first priority is to check the client's vital functions by checking his airway, breathing, and circulation.

The nurse places a neonate with hyperbilirubinemia under a phototherapy lamp, covering the eyes and gonads for protection. The nurse knows that the goal of phototherapy is to:
A. prevent hypothermia.
B. promote respiratory stability.
C. decrease the serum conjugated bilirubin level.
D. decrease the serum unconjugated bilirubin level.
Answer: D
Phototherapy is the primary treatment in neonates with unconjugated hyperbilirubinemia. Photoisomerism is the therapeutic principle working here.
This conjugated form of bilirubin is then excreted into the bile and removed from the body via the gut/urine.

The physician orders an I.M. injection for a client. Which factor may affect the drug absorption rate from an I.M. injection site?
A. Muscle tone
B. Muscle strength
C. Blood flow to the injection site
D. Amount of body fat at the injection site
Answer: C
Blood flow to the I.M. injection site affects the drug absorption rate. Muscle tone and strength have no effect on drug absorption.

What is the most appropriate method to use when drawing blood from a child with hemophilia?
A. Use finger punctures for lab draws.
B. Be prepared to administer platelets for prolonged bleeding.
C. Apply heat to the extremity before venipunctures.
D. Schedule all labs to be drawn at one time.
Answer: D

For a client with cirrhosis, deterioration of hepatic function is best indicated by:
A. fatigue and muscle weakness.
B. difficulty in arousal.
C. nausea and anorexia.
D. weight gain.
Answer: B
Hepatic encephalopathy, a major complication of advanced cirrhosis, occurs when the liver no longer can convert ammonia (a by-product of protein breakdown) into glutamine. This leads to an increased blood level of ammonia — a central nervous system toxin — which causes a decrease in the level of consciousness. Fatigue, muscle weakness, nausea, anorexia, and weight gain occur during the early stages of cirrhosis

New Zealand Registered Nurses can Now Prescribe

Registered nurses will gain the right to prescribe medicines under a regulation coming into force on 20 September.

After years of consultation, the Medicines (Designated Prescriber – Registered Nurses) Regulation 2016 has been introduced by Order in Council.



The regulation allows registered nurse prescribing for nurses who work in primary care and specialist teams, Nursing Council chief executive Carolyn Reed says in a statement.

The nurses must have completed  a postgraduate diploma in registered nurse prescribing for long-term and common conditions, Ms Reed says.

Academic and clinical requirements


The diploma includes a practicum with an authorised prescriber, four university papers and assessment for suitability by an authorised prescriber.

Nurses will also need to have been working for three years in the area where they want to prescribe.

A cabinet paper shows conditions for which registered nurses will be able to prescribe include diabetes, hypertension, respiratory diseases, eye health, anxiety, depression, heart failure, gout, palliative care, contraception, common skin conditions and infections.

Designated prescribers


College of Nurses executive director and Massey University professor of nursing Jenny Carryer says the qualification is the first half of the masters degree required to become a nurse practitioner.

Nurses who pass it will become “designated prescribers”, able to prescribe from a range of medicines (not all medicines).

Professor Carryer says the idea of nurse prescribers first emerged in New Zealand about 15 years ago, when the nurse practitioner role was launched.

Ms Reed says the Nursing Council was first invited to submit an application for registered nurse prescribing in 2012.

The move fits with efforts to enable the health workforce to do more, as part of increasing people’s access to care, Professor Carryer says.

The decision to go ahead with nurse prescribing is evidence based, she says. It follows a diabetes nurse prescribing pilot first introduced in 2011.

Professor Carryer reviewed the pilot and says it showed high levels of patient satisfaction and approval.

A responsibility to be shouldered


While the approval is a good thing, Professor Carryer says nurses do not always see medicalised developments as a positive.

Rather than being a “great kudos”, she says the change is a responsibility that needs to be shouldered, carrying a huge education commitment.

Health Workforce New Zealand funding of nursing education is spread thin, she says, and analysis of whether the funding is meeting the new training needs will need to be done.

Fantastic for patients


Opotiki GP Jo Scott-Jones says nurse prescribing is fantastic for patients, as it means improved access and registered nurses working at the top of their scope.

He was curious to know how much training nurses would need before being able to prescribe and says as highly competent graduate nurses get more clinical expertise, the value of university papers may seem less and less.

Dr Scott-Jones says standing orders still have a role: “I’d expect and hope to see an expansion of standing orders in primary care.”

Nurses working with standing orders do not need to do any further education and can still work at the peak of their scope, in Dr Scott-Jones’ view.

Concerns may remain


Asked whether GPs will feel threatened by the change, Dr Scott-Jones has no doubt they will.

He says it doesn’t make a lot of sense to increase the numbers of prescribers in the community.

GPs will feel threatened partly because they do not articulate enough the breadth and depth of experience that medical training provides, he says.

He says while there is a lot that nurses and doctors do in common and can do equally well, there are lots of things that nurses do that doctors don’t and vice versa.

“We should have more confidence in our profession, we provide a very good service.”

GPs and patients may have concerns that, with more prescribers, continuity of care may be interrupted or over-diagnosis may become a problem.

Source : Nz Doctor

Why the nurse matters by Dr. Kevin R. Stone an orthopedic surgeon

One of my nurses is my surgical assistant. My other nurse is my patient assistant in my office. Though insurance companies don’t seem to realize it, both nurses matter to you — if you are a patient — a great deal. Here are a few of the reasons:

My current surgical nurse has been my first assistant for more than 24 years. She sees every patient before surgery, operates on them with me and follows up with them after surgery — often for years after the procedure. Because she knows their specific issues, because she listens with different ears than I do, because she is there to guard them and help me, she provides an extra level of expertise and protection that every patient deserves. No matter how great a surgeon may be, every patient, every problem and every day has unique issues. Having more than one person pay attention and think about these issues substantially improves the quality and consistency of care.



The surgical nurse has a unique role that allows them to bring up issues and point out problems at each phase of surgery. Her skill with instruments, tissue preparation and positioning the patient continues to increase each year. The nurse also interfaces with the rest of the operating room staff in ways that build community and team dynamics. This dramatically decreases the stress and errors that come from miscommunication.

The office nurse plays a similar role. By interviewing patients before the surgeon sees them, a more complete picture of their problems, symptoms and goals is obtained. The bond between the nurse and the patient often provides assurance that their issues are being heard. By double-checking the patient’s dressings and medications after surgery, the office nurse diminishes the common, office-based errors that can lead to poor outcomes. The patient is confident that their medical record will be complete and that the care given will be intuitive and sensitive to their specific issues. Follow-up phone calls, post-op care and ongoing concern all expand the quality of care.

The nursing team elevates the “standard of care” to exceptional care. And, if things go wrong, the nurses are often first to know, to respond and to initiate corrective actions. Without their ears, eyes and hearts, the injuries and diseases that patients suffer from are seen with far less dimension.

When practiced as a team, medicine and surgery are an elegant display of caring and competence in the service of mankind.

Doesn’t it make you cringe when the insurance company denies payment for the assistant surgeon?

Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco.

Source : Sfexaminer

Kenyatta National Hospital to get organ donor equipment

Kenyatta National Hospital will soon acquire Sh30 million tissue typing equipment to determine the genetic compatibility of the donor and recipient before organ transplants.

This will reduce the need to send samples overseas for testing. It will make KNH the first facility in Kenya to obtain the advanced equipment, Health PS Nicholas Muraguri said.

The machine will be acquired under a partnership between the African Development Bank and the East African Community, which aims to set up centres of excellence in Kenya, Uganda, Tanzania, Rwanda and Burundi.

The partnership will establish a Sh3.67 billion East African Kidney Institute in Kenya and strengthen the country’s existing kidney transplant programme.

The equipment will be used for kidney, heart, liver, bone marrow and cornea transplants. It will also aid the screening of cancer, Alzheimer’s disease, genetic testing, infectious diseases and autoimmune diseases.

Muraguri, who made announcement last week, said the machine would reduce the time and overall cost of treatment. Sending samples to South Africa or India costs an average of Sh70,000.

It takes about three weeks before the results are released and if the test fails, another donor is sought and the tests repeated.

“Since the test is currently done outside Kenya, patients have to wait for some time before they get feedback. Time waste will therefore be avoided and speed in decision making will be enhanced,” the PS said.

The supplier will train Kenyan medics to operate the equipment, he said.

Muraguri further said the establishment of EAKI will increase the number of kidney specialists in Kenya through training.

At this time, there are only 15 nephrologists in the public health sector, with five stationed at KNH, and 50 nurses.

Although the construction of the EAKI complex is yet to kick off, training is already ongoing at the University of Nairobi.

Construction will begin in July next year and should be complete by 2019. It will be located on six acres within KNH grounds and have a 160-bed capacity, four operating theatres, lecture rooms, laboratories and a pharmacy.

Source : The Star