Multiple System Atrophy (MSA)
Members of the public have been advised to watch out for symptoms of a Slow Progressive neurological condition, commonly refers to as Multiple System Atrophy (MSA), that normally affects the brain nerves that control different functions to die off.
A Consultant Neurologist with the College of Medicine, University of Lagos, Professor Njideka Ogunbadejo, who delivered a lecture at the launch of a non-governmental organisation (NGO), Funmi Fashina Foundation (FFF), noted that, MSA may not be a common medical disorder, but 5 out of 100, 000 thousand people may be affected in a year.
Ogunbadejo said MSA patient may found it difficult to control the bladder, causing uncontrolled urination and retention of urine in the bladder, uncontrolled bowel and blood pressure and may also find movement difficult, stressing that these symptoms may arise due to other complications but warned that doctors must be consulted immediately they are experienced.
She defined MSA as “a progressive neurological disorder that affects adult men and women. It is caused by degeneration or atrophy of nerve cells in several (or multiple) areas of the brain which can result in problems with movement, balance and automatic functions of the body such as bladder and blood pressure control.”
According to the physician, MSA usually starts between the ages of 50-60 years, but it can affect people younger and older. MSA does not appear to be hereditary although current research is examining whether or not there is a genetic predisposition to develop the disease. The importance of environmental factors is not clear and there is still much to understand about the condition. We do know it is not infectious or contagious and has no connection with the much commoner neurological disease, multiple sclerosis (MS).
Ogunbadejo explained that, until recently, MSA was thought to be a very rare disorder, but as knowledge increases about the condition, it has become somewhat easier to recognise and diagnose it, noting that recent research suggests it affects about 5 people per 100,000 so that at any one time there are at least 3,000 people living with MSA in the UK, as Parkinson’s disease is about 36 times commoner, affecting about 180 per 100,000 in the UK.
For men, erectile dysfunction (unable to achieve or sustain an erection) is often the first symptom of MSA. Men often take medications for this problem such as sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra), however occasionally these medications can worsen blood pressure control. Seeking help on this issue is important and you should not be embarrassed to ask your doctor.
On why the foundation, was set up, Mr. Ajibade Fashina whose wife Funmi died as a result of the condition said, when his wife was hit by the disorder, the family did not know who to meet for help and what to take for cure, which caused them the pain to travel from United States of America (USA) to United Kingdom, without solution.
He explained further that, the foundation was set up for research and treatment of the disorder and to support patients and their families as well as carers, noting that anyone who may be a victim could consult the foundation on where to go and the type of drug that could be used in the management of the disorder. 4
The chronic stressors we face daily include: highly pressured work, marital/ love relationship problems, loneliness, financial worries, uncertainty on how to confront the future etc. For today’s discussion, I will emphasis more on how to handle routine highly pressured work which most people face daily as chronic stressor.
Job-related stress is likely to become chronic because it is such a large part of our daily life. And for sure, stress in turn reduces a worker’s effectiveness by impairing concentration, causing sleeplessness, and increasing the risk for illness and work-related accident, back problems, accidents, and lost time. Work stress can lead to harassment or even violence while on the job. At its most extreme, stress conditions that place such a burden on the heart and circulation may be fatal.
Pressurising stressors at work include the following scenario:
•Unrelenting and unreasonable demands for performance.
•Lack of effective communication and conflict-resolution methods among workers and employers.
•Lack of job security.
•Excessive time spent away from home and family.
•Office politics and conflicts between workers.
•Having no participation in decisions that affect one’s responsibilities.
• Wages not commensurate with levels of responsibility.
Handling Job Stress
As I had often added when discussing related topics on stress, there is no doubting the fact that one general approach for treating stress can be found in the statement by Reinhold Niebuhr:
“Grant me the courage to change the things I can change, the serenity to accept the things I can’t change, and the wisdom to know the difference.”
One thing to note meanwhile is that the process of learning to control stress is life-long and will not only contribute to better health but a greater ability to succeed in one’s own agenda.
In choosing specific strategies for treating stress, several factors should be considered.
1.No single method is uniformly successful: a combination of approaches is generally most effective.
2.What works for one person does not necessarily work for someone else.
3.Stress can be positive as well as negative.
Appropriate and controllable stress provides interest and excitement and motivates the individual to greater achievement, while a lack of stress may lead to boredom and depression.
Finally, stress may play a part in making people vulnerable to illness.
A doctor or a clinical psychologist should be consulted if there are any indications of accompanying medical or psychological conditions, such as cardiac symptoms, significant pain, anxiety, or depression.
Often people succeed in relieving stress for the short-term but resort to previous ways of stressful thinking and behavior because of outside pressure or entrenched beliefs or habits.
One major obstacle to reducing stress is the strong biologic urge for fight or flight itself. The very idea of relaxation can feel threatening, because it is perceived as letting down one’s guard. For example, an over-demanding boss may put a subordinate into a psychological state of fighting-readiness, even though there is no safe opportunity for the subordinate to fight back, or even express anger. Stress builds up, but the worker has the illusion, even subconsciously, that the stress itself is providing safety or preparedness, so does nothing to correct the condition.
Many people are afraid of being perceived as selfish if they engage in stress-reducing activities that benefit only themselves. The truth is that self-sacrifice may be inappropriate and even damaging if the person making the sacrifice is unhappy, angry, or physically unwell.
It is essential to remember that reducing stress and staying relaxed clears the mind so it can initiate appropriate actions to get rid of the stress-ridden conditions.
Cognitive-behavioral methods are the most effective ways to reduce stress. They include identifying sources of stress, restructuring priorities, changing one’s response to stress, and finding methods for managing and reducing stress.
It is useful to start the process of stress reduction with a diary that keeps an informal inventory of daily events and activities. While this exercise might itself seem stress producing, it need not be done in rigid-form detail.
The first step is to note activities that put a strain on energy and time, trigger anger or anxiety, or precipitate a negative physical response (e.g. a sour stomach or headache).
Also note positive experiences, such as those that are mentally or physically refreshing or produce a sense of accomplishment.
After a week or two, try to identify two or three events or activities that have been significantly upsetting or overwhelming.
A healthy lifestyle is an essential companion to any stress-reduction program. General health and stress resistance can be enhanced by a regular exercise, a diet rich in a variety of whole grains, vegetables, and fruits, and by avoiding excessive alcohol, caffeine, and tobacco.
Questioning the Sources of Stress.
Individuals should then ask themselves the following questions:
Do these stressful activities meet their own goals or someone else’s?
Have they taken on tasks that they can reasonably accomplish?
Which tasks are in their control and which ones aren’t?
The next step is to attempt to shift the balance from stress-producing to stress-reducing activities. Eliminating stress is rarely practical or feasible, but there are many ways to reduce its impact. One finding indicates that adding daily pleasant events has more positive effects on the immune system than reducing stressful or negative ones. In most cases, small daily decisions for improvement accumulate and reconstruct a stressed existence into a pleasant and productive one. Consider as many relief options as possible: examples include the following:
• Take long weekends or, ideally, vacations. If the source of stress is in the home, plan times away, even if it is only an hour or two a week.
•Replace unnecessary time-consuming activities with pleasurable or interesting activities.
•Make time for recreation. This is as essential as paying bills or shopping for groceries.
Although, the idea of communication and “letting your feelings out” has been so excessively promoted and parodied that it has nearly lost its value as good psychologic advice. Nevertheless, feelings of anger or frustration that are not expressed in an acceptable way may lead to hostility, a sense of helplessness, and depression.
Expressing feelings does not mean venting frustration on waiters and subordinates, boring friends with emotional complaints, or wallowing in self-pity. In fact, because blood pressure may spike when certain chronically hostile individuals become angry, it is strongly advise that just talking, not simply venting anger, is the best approach, especially for these people.
The primary goal is to explain and assert one’s needs to a trusted individual in as positive a way as possible. Direct communication may not even be necessary. Writing in a journal, writing a poem, or composing a letter that is never mailed may be sufficient.
Keeping a sense of humor during difficult situations is also highly recommended. Laughing releases the tension of pent-up feelings and helps keep perspective. It has been shown that humor is a very effective mechanism for coping with acute stress.
It is not uncommon for people to recall laughing intensely even during tragic events, such as the death of a loved one, and to remember this laughter as helping them to endure the emotional pain.
Reducing Stress on the Job
Many institutions within the current culture, while paying lip service to stress reduction, put intense pressure on individuals to behave in ways that promote tension. It had been argued that employers should be held responsible for taking measures to prevent stress from work overload and should provide help to deal with work-related stress.
Treating stress has a number of benefits, not only for the individual but also for the employer. A pointing example here is the finding In a U.S research study on job-related stress, in which a company set up a two-year stress management educational program, the savings to the company in workmen’s compensations costs were nearly $150,000, compared to the cost of the program, which was only $150 per participant for a total of $6,000. Thus, when employers spent some money on workforce per job-related stress coping training, it is indeed a great formula for improved workmen productivity and a cost-effective venture on the long runs.
Typhoid vaccine failure
More than 700,000 people recently immunised against typhoid may not have full protection because of a dud vaccine that has now been recalled, say experts. Manufacturer Sanofi Pasteur MSD has recalled 88 per cent of its stock - 16 batches - of Typhim Vi vaccine because tests found some samples were too weak. Anyone immunised with the vaccine since January 2011 could be affected, just as Officials stress that the vaccine was safe and posed no health threat. But it could mean as many as 729,606 people who potentially received the affected vaccine are not fully immunised against typhoid, according to the body that regulates drugs in the UK, the Medicines and Healthcare products Regulatory Agency (MHRA). Anyone who has been to a typhoid region of the world and has a fever, abdominal pain and vomiting should contact a healthcare professional” Experts say people should not get revaccinated but should take precautions against typhoid when abroad. If you received this vaccine and have recently returned from abroad, and are unwell, you should contact your doctor. Typhoid fever is uncommon in the UK, but people visiting South Asia and South East Asia, where the life-threatening bacterial disease is most common, are at greater risk.
US medical warning
Doctors and hospitals in the US are being urged to stop using products from a firm linked to a widening outbreak of a rare form of fungal meningitis. The Centers for Disease Control (CDC) says investigators found contamination in a sealed steroid vial at the New England Compounding Center. Over 35 people in six states have been ill from the disease. Five have died. The firm recalled the steroid doses and has shut down operations, but the vials have been shipped to 23 states. It is not yet clear how many patients may have been exposed to any contamination, and the fungal meningitis can have a lengthy incubation period. Meningitis is an inflammation of the lining of the brain and spinal cord. Symptoms include severe headache, nausea, and fever as well as slurred speech and difficulty walking. A briefing by the CDC and the Federal Drug Administration (FDA) said a fungus linked to the steroid medication had been identified in tests of five patients. “Out of an abundance of caution, we advise all health care practitioners not to use any product” from the company, said Ilisa Bernstein, director of compliance for the FDA’s Center for Drug Evaluation and Research. New England Compounding Center is a type of pharmacy that mixes ingredients for customised medicines. The steroid in question was three lots of methylprednisolone acetate from the firm.
Stem Cell Works
Two pioneers of stem cell research have shared the Nobel prize for medicine or physiology. John Gurdon from the UK and Shinya Yamanaka from Japan were awarded the prize for changing adult cells into stem cells, which can become any other type of cell in the body. Gurdon used a gut sample to clone frogs and Prof Yamanaka altered genes to reprogramme cells. The Nobel committee said they had “revolutionised” science. The prize is in stark contrast to Gurdon’s first foray into science when his biology teacher described his scientific ambitions as “a waste of time”. “I believe Gurdon has ideas about becoming a scientist; on his present showing this is quite ridiculous; if he can’t learn simple biological facts he would have no chance of doing the work of a specialist, and it would be a sheer waste of time, both on his part and of those who would have to teach him.” When a sperm fertilises an egg there is just one type of cell. It multiplies and some of the resulting cells become specialised to create all the tissues of the body including nerve and bone and skin. It had been though to be a one-way process - once a cell had become specialised it could not change its fate. In 1962, John Gurdon showed that the genetic information inside a cell taken from the intestines of a frog contained all the information need to create a whole new frog. He took the genetic information and placed it inside a frog egg. The resulting clone developed into a normal tadpole.