Cytomegalovirus (CMV) is a viral infection that can be passed on through contact with saliva that contains the virus.

Cytomegalovirus (CMV) is a viral infection that can be passed on through contact with saliva that contains the virus.

It can also be transmitted through the following fluids that contain CMV such as urine, blood, semen and breast milk.

It’s considered an STI because it’s often transmitted through oral, anal, and genital contact too. Symptoms of CMV includes, fatigue, sore throat, fever and body aches.

CMV isn’t curable but someone with CMV may never have symptoms.

Like herpes, CMV can cause symptoms if you have a compromised immune system.


Meningitis is a serious disease that causes inflammation of the lining of the brain and spinal cord.

Meningitis is a serious disease that causes inflammation of the lining of the brain and spinal cord.

This disease can be spread from one person to another via respiratory secretions.

A means by which the illness can be passed along to someone else is via the exchange of saliva while kissing. In 2017, there were over 1000 deaths in Nigeria during the meningitis outbreak.

Symptoms include fever, headache, stiff neck, nausea, sensitivity to light and vomiting. This disease has no medication but staying healthy with a strong immune system helps to get the better of it.

Meningitis treatments:

Commonly used meningitis treatments include a class of antibiotics called cephalosporins, especially Claforan (cefotaxime) and Rocephin (ceftriaxone). Various penicillin-type antibiotics, aminoglycoside drugs such as gentamicin, and others, are also used.


A urinary tract infection (UTI) is an infection from microbes. These are organisms that are too small to be seen without a microscope.

Introduction – Urinary tract infection

A urinary tract infection (UTI) is an infection from microbes. These are organisms that are too small to be seen without a microscope. Most UTIs are caused by bacteria, but some are caused by fungi and in rare cases by viruses. UTIs are among the most common infections in humans.

A UTI can happen anywhere in your urinary tract. Your urinary tract is made up of your kidneys, ureters, bladder, and urethra. Most UTIs only involve the urethra and bladder, in the lower tract. However, UTIs can involve the ureters and kidneys, in the upper tract. Although upper tract UTIs are rarer than lower tract UTIs, they’re also usually more severe.

Types of UTIs

An infection can happen in different parts of your urinary tract. Each type has a different name, based on where it is.

Cystitis (bladder): You might feel like you need to pee a lot, or it might hurt when you pee. You might also have lower belly pain and cloudy or bloody urine.

Pyelonephritis (kidneys): This can cause fever, chills, nausea, vomiting, and pain in your upper back or side.

Urethritis (urethra): This can cause a discharge and burning when you pee.

Pathophysiology of urinary tract infection

Uropathogenic bacteria, derived from a subset of fecal flora, have traits that enable adherence, growth, and resistance of host defenses. These traits facilitate colonization and infection of the urinary tract.

Adhesins are bacterial surface structures that enable attachment to host membranes. In E coli infection, these include both pili (ie, fimbriae) and outer-membrane proteins (eg, Dr hemagglutinin). P fimbriae, which attach to globoseries-type glycolipids found in the colon and urinary epithelium, are associated with pyelonephritis and cystitis and are found in many E coli strains that cause urosepsis.

Type 1 fimbriae bind to mannose-containing structures found in many different cell types, including Tamm-Horsfall protein (the major protein found in human urine). Whether this facilitates or inhibits uroepithelial colonization is the subject of some debate.

Other factors that may be important for E coli virulence in the urinary tract include capsular polysaccharides, hemolysins, cytotoxic necrotizing factor (CNF) protein, and aerobactins. Several Kauffman serogroups of E coli that contain these virulence factors may be more likely to cause UTIs, including O1, O2, O4, O6, O16, and O18.

Another example of bacterial virulence is the swarming capability of Proteus mirabilis. Swarming involves the expression of specific genes when these bacteria are exposed to surfaces such as catheters. This results in the coordinated movement of large numbers of bacteria, enabling P mirabilis to move across solid surfaces. This likely explains the association of P mirabilis UTIs with instrumentation of the urinary tract.

Causes of urinary tract infection

Large numbers of bacteria live in the area around the vagina and rectum, and also on your skin. Bacteria may get into the urine from the urethra and travel into the bladder. They may even travel up to the kidney. But no matter how far they go, bacteria in the urinary tract can cause problems.

Just as some people are more prone to colds, some people are more prone to UTIs. Women are more likely to get a UTI than men because women have shorter urethras than men, so bacteria have a shorter distance to travel to reach the bladder.

Some factors that can add to your chances of getting a UTI are:

Body Factors

Women who have gone through menopause have a change in the lining of the vagina and lose the protection that estrogen provides, which lowers the chance of getting a UTI. Some women are genetically predisposed to UTIs and have urinary tracts that make it easier for bacteria to cling to them. Sexual intercourse can also affect how often you get UTIs.

Birth Control

Women who use diaphragms have also been found to have a higher risk of UTIs when compared to those who use other forms of birth control. Using condoms with spermicidal foam is also known to be linked to a greater risk of getting UTIs in women.

Abnormal Anatomy

You are more likely to get a UTI if your urinary tract has an abnormality or has recently had a device (such as a tube to drain fluid from the body) placed in it. If you are not able to urinate normally because of some type of blockage, you will also have a higher chance of a UTI.

Anatomical abnormalities in the urinary tract may also lead to UTIs. These abnormalities are often found in children at an early age but can still be found in adults. There may be structural abnormalities, such as outpouchings called diverticula, that harbor bacteria in the bladder or urethra or even blockages, such as an enlarged bladder, that keep the body from draining all the urine from the bladder.

Immune System

Issues such as diabetes (high blood sugar) also put people at higher risk for UTIs because the body is not able to fight off germs as well.

Risk factors of urinary tract infection

Some people are at higher risk of getting a UTI. UTIs are more common in women and girls because their urethras are shorter and closer to the rectum, which makes it easier for bacteria to enter the urinary tract.

Other factors that can increase the risk of UTIs:

  • A previous UTI
  • Sexual activity, and especially a new sexual partner
  • Changes in the bacteria that live inside the vagina (vaginal flora), for example, caused by menopause or use of spermicides
  • Pregnancy
  • Age (older adults and young children are more likely to get UTIs)
  • Structural problems in the urinary tract, such as prostate enlargement.
  • Poor hygiene, particularly in children who are potty-training

What are urinary tract infection symptoms and signs?

Lower urinary tract infection (infections of the bladder or urethra)

  • Bladder (cystitis, or bladder infection): The lining of the urethra and bladder becomes inflamed and irritated.
  • Dysuria: pain or burning during urination
  • Frequency: more frequent urination (or waking up at night to urinate, sometimes referred to as nocturia); often with only a small amount of urine
  • Urinary urgency: the sensation of having to urinate urgently
  • Cloudy, bad-smelling, or bloody urine
  • Lower abdominal pain or pelvic pressure or pain
  • Mild fever (less than 101 F), chills, and “just not feeling well” (malaise)
  • Urethra (urethritis): Burning with urination

Upper urinary tract infection (pyelonephritis, or kidney infection)

Symptoms develop rapidly and may or may not include the symptoms of a lower urinary tract infection.

  • Fairly high fever (higher than 101 F)
  • Shaking chills
  • Nausea
  • Vomiting
  • Flank pain: pain in the back or side, usually on only one side at about waist level

In newborns, infants, children, and elderly people, the classic symptoms of a urinary tract infection may not be present. Other symptoms may indicate a urinary tract infection.

  • Newborns: fever or hypothermia (low temperature), poor feeding, jaundice
  • Infants: vomiting, diarrhea, fever, poor feeding, not thriving
  • Children: irritability, eating poorly, unexplained fever that doesn’t go away, loss of bowel control, loose bowels, change in urination pattern
  • Elderly people: fever or hypothermia, poor appetite, lethargy, change in mental status

Pregnant women are at increased risk for a UTI. Typically, pregnant women do not have unusual or unique symptoms. If a woman is pregnant, her urine should be checked during prenatal visits because an unrecognized infection can cause pregnancy health complications.

Although most people have symptoms with a urinary tract infection, some do not.

The symptoms of urinary tract infection can resemble those of sexually transmitted diseases

Urinary tract infection – Complications

When treated promptly and properly, lower urinary tract infections rarely lead to complications. But left untreated, a urinary tract infection can have serious consequences.

Complications of a UTI may include:

  • Recurrent infections, especially in women who experience two or more UTIs in a six-month period or four or more within a year.
  • Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
  • Increased risk in pregnant women of delivering low birth weight or premature infants.
  • Urethral narrowing (stricture) in men from recurrent urethritis, previously seen with gonococcal urethritis.
  • Sepsis, a potentially life-threatening complication of an infection, especially if the infection works its way up to your urinary tract to your kidneys.

Diagnosis and Test

Female cystoscopy Open pop-up dialog boxCystoscopy exam for a man

Tests and procedures used to diagnose urinary tract infections include:

Analyzing a urine sample. Your doctor may ask for a urine sample for lab analysis to look for white blood cells, red blood cells, or bacteria. To avoid potential contamination of the sample, you may be instructed to first wipe your genital area with an antiseptic pad and to collect the urine midstream.

Growing urinary tract bacteria in a lab. Lab analysis of the urine is sometimes followed by a urine culture. This test tells your doctor what bacteria are causing your infection and which medications will be most effective.

Creating images of your urinary tract. If you are having frequent infections that your doctor thinks may be caused by an abnormality in your urinary tract, you may have an ultrasound, a computerized tomography (CT) scan, or magnetic resonance imaging (MRI). Your doctor may also use a contrast dye to highlight structures in your urinary tract.

Using a scope to see inside your bladder. If you have recurrent UTIs, your doctor may perform a cystoscopy, using a long, thin tube with a lens (cystoscope) to see inside your urethra and bladder. The cystoscope is inserted in your urethra and passed through to your bladder.

How a Urinary Tract Infection is treated?

Your health care provider must first decide if the infection is just in the bladder, or if it has spread to the kidneys and how severe it is.

Mild bladder and kidney infections

  • Most of the time, you will need to take an antibiotic to prevent the infection from spreading to the kidneys.
  • For a simple bladder infection, you will take antibiotics for 3 days (women) or 7 to 14 days (men).
  • If you are pregnant or have diabetes, or have a mild kidney infection, you will most often take antibiotics for 7 to 14 days.
  • Finish all of the antibiotics, even if you feel better. If you do not finish the whole dose of medicine, the infection may return and be harder to treat later.
  • Always drink plenty of water when you have a bladder or kidney infection.
  • Tell your provider if you might be pregnant before taking these drugs.

Recurrent bladder infections

Some women have repeated bladder infections. Your provider may suggest that you:

  • Take a single dose of an antibiotic after sexual contact to prevent an infection.
  • Have a 3-day course of antibiotics at home to use if you develop an infection.
  • Take a single, daily dose of an antibiotic to prevent infections.

More severe kidney infections

You may need to go into the hospital if you are very sick and cannot take medicines by mouth or drink enough fluids. You may also be admitted to the hospital if you:

  • Are an older adult
  • Have kidney stones or changes in the anatomy of your urinary tract
  • Have recently had urinary tract surgery
  • Have cancer, diabetes, multiple sclerosis, spinal cord injury, or other medical problems
  • Are pregnant and have a fever or are otherwise ill

At the hospital, you will receive fluids and antibiotics through a vein.

Some people have UTIs that do not go away with treatment or keep coming back. These are called chronic UTIs. If you have a chronic UTI, you may need stronger antibiotics or to take medicine for a longer time.

You may need surgery if the infection is caused by a problem with the structure of the urinary tract.

Natural remedies

You could try taking:

  • A supplement called D-mannose
  • Cranberry juice or tablets
  • A probiotic called lactobacillus
  • Research suggests D-mannose might help prevent UTIs in women who are not pregnant.
  • It’s not clear if cranberry products or lactobacillus help.
  • Be aware that D-mannose and cranberry products can contain a lot of sugar.

Prevention of urinary tract infection

There are several measures that can be taken to reduce the risk of developing a UTI:

  • Drink lots of water and urinate frequently.
  • Avoid fluids such as alcohol and caffeine that can irritate the bladder.
  • Urinate shortly after sex.
  • Wipe from front to back after urinating and bowel movement.
  • Keep the genital area clean.
  • Showers are preferred to baths and avoid using oils.
  • Sanitary pads or menstrual cups are preferred to tampons. If you want to buy menstrual cups, then there is an excellent selection on Amazon with thousands of customer reviews.
  • Avoid using a diaphragm or spermicide for birth control.
  • Avoid using any perfumed products in the genital area.
  • Wear cotton underwear and loose-fitting clothing to keep the area around the urethra dry.

Individuals are advised to contact a doctor if they develop the symptoms of a UTI, especially if they have developed the symptoms of a potential kidney infection.

Anterior cruciate ligament injury passes in front of another ligament, the posterior cruciate ligament (PCL).


Anterior cruciate ligament injury passes in front of another ligament, the posterior cruciate ligament (PCL). The cruciate ligaments get their name from the fact they form a cross within the knee as they run in different directions from the thigh to the shin bone. Along with the other ligaments in your knee, your ACL keeps your knee stable and prevents your thigh and shin bones moving out of place.

When your knee ligaments are stretched but not torn, they’re called a sprain. Knee ligament injuries are given different grades depending on how severe they are. Around half of all people with an ACL injury will have injuries to other parts of their knee as well, such as a meniscus tear.

Anatomy of knee

Where is the ACL located in the anatomy of the knee?

The ACL is one of four main ligaments in the knee that attach the thigh bone (femur) to the shin bone (tibia). The kneecap (patella) located in the front of the knee, protects the ACL and other knee ligaments. The ACL and another ligament called the posterior cruciate ligament (PCL) run through the center of the knee. These ligaments prevent the shin bone from sliding too far forward or backward under the thigh bone.

Two other ligaments run along either side of the knee, the medial collateral ligament (MCL) and lateral collateral ligament (LCL). These ligaments prevent the knee from bending too far to either side of the leg. The meniscus provides padding and shock absorption for the knee. There are two menisci in each knee. Without these wedge-shaped pieces of cartilage, the thigh bone and shin bone would rub painfully against each other.


The ACL injury grading system

An ACL injury may be diagnosed when the ligament is overstretched or torn. The tear may be partial or complete; a complete tear of the ACL is also known as an ACL rupture.

  • Grade I tears refer to a slightly stretched ACL. Symptoms are typically mild. The ligament can still keep the knee stable.
  • Grade II tears refer to stretching of the ACL to the point of looseness. These injuries are often referred to as “partial” tears. Symptoms are more severe than Grade I tears. Range of motion may be restricted and the knee may occasionally feel unstable (the knee feels like it is “giving out”).
  • Grade III tears (ligament rupture) are complete tears (the ACL has been split in two). Grade III tears may also be referred to as an ACL rupture. A person may not be able to bear weight on the injured leg.

ACL tears can produce a range of symptoms, which can make it difficult to diagnose without further examination from a doctor.

Risk factors of Anterior cruciate ligament injury

There are a number of factors that increase your risk of an ACL injury, including:

  • Being female possibly due to differences in anatomy, muscle strength and hormonal influences
  • Participating in certain sports, such as soccer, football, basketball, gymnastics and downhill skiing
  • Poor conditioning
  • Using faulty movement patterns, such as moving the knees inward during a squat
  • Wearing footwear that doesn’t fit properly
  • Using poorly maintained sports equipment, such as ski bindings that aren’t adjusted properly
  • Playing on artificial turf


ACL injuries can be caused by:

  • Stopping suddenly while running
  • Slowing down while running
  • Changing directions rapidly while running
  • Jumping or landing incorrectly
  • Contact injuries, such as a football tackle
  • Overuse of the leg from repetitive impact activity such as jumping, running, twisting or pivoting

Anterior cruciate ligament injury symptoms

Symptoms of an acute ACL injury include:

  • Feeling or hearing a pop in the knee at the time of injury.
  • Pain on the outside and back of the knee.
  • The knee swelling within the first few hours of the injury. This may be a sign of bleeding inside the knee joint. Swelling that occurs suddenly is usually a sign of a serious knee injury.
  • Limited knee movement because of pain or swelling or both.
  • The knee feeling unstable, buckling, or giving out.

After an acute injury, you will probably have to stop whatever you are doing because of the pain, but you may be able to walk.

The main symptom of chronic ACL deficiency is the knee buckling or giving out, sometimes with pain and swelling. This can happen when an ACL injury is not treated.


Some complications it may cause include:

  • Risk of developing knee osteoarthritis
  • Deterioration of joint cartilage
  • Less range of motion
  • Limping

Diagnosis and test

Your doctor will want to hear exactly how you injured your knee. They’ll look at both knees to see if the sore one looks different. They may also order any of the following:

Tests: Your doctor may ask you to lie on your back and bend your hips and/or your knees at certain angles. They’ll then place their hands on different parts of your leg and gently shift you around. If any of your bones move in a way that isn’t normal that could be a sign that your ACL is damaged.

X-ray: Soft tissues like the ACL don’t appear on X-rays, but your doctor may want to rule out broken bones.

MRI or ultrasound: These exams can show both soft tissue and bone. If you have a damaged ACL, it should appear on the images.

Arthroscopy: This literally means to “look within the joint.” During the exam, an orthopedic surgeon makes a small cut in your skin. They insert a pencil-sized tool that contains a lighting system and lens (arthroscope) into the joint. The camera projects an image of the joint onto a TV screen. Your doctor can see what type of injury you have and repair or correct it, if needed.

Treatment of anterior cruciate ligament injury

Treatment for an ACL tear will vary depending upon the patient’s individual needs. For example, the young athlete involved in agility sports will most likely require surgery to safely return to sports. The less active, usually older, individual may be able to return to a quieter lifestyle without surgery.

Nonsurgical Treatment

A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options.

Bracing: Your doctor may recommend a brace to protect your knee from instability. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.

Physical therapy: As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.

Surgical Treatment

Rebuilding the ligament: Most ACL tears cannot be sutured (stitched) back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Your doctor will replace your torn ligament with a tissue graft. This graft acts as scaffolding for a new ligament to grow on.

Grafts can be obtained from several sources. Often they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts. Sometimes a quadriceps tendon, which runs from the kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.

There are advantages and disadvantages to all graft sources. You should discuss graft choices with your own orthopaedic surgeon to help determine which is best for you.

Because the regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.

Procedure: Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times.


Whether your treatment involves surgery or not, rehabilitation plays a vital role in getting you back to your daily activities. A physical therapy program will help you regain knee strength and motion.

If you have surgery, physical therapy first focuses on returning motion to the joint and surrounding muscles. This is followed by a strengthening program designed to protect the new ligament. This strengthening gradually increases the stress across the ligament. The final phase of rehabilitation is aimed at a functional return tailored for the athlete’s sport.

Prevention of anterior cruciate ligament injury

Many ACL injuries can be prevented if the muscles that surround the knees are strong and flexible.

Prevention focuses on proper nerve and muscle control of the knee. Exercises aim to increase muscle power, balance, and improve core strength and stability.

The following training tips can reduce the risk of an ACL injury:

  • Train and condition year round.
  • Practice proper landing technique after jumps.
  • When you pivot, crouch and bend at the knees and hips. This reduces stress on the ACL.
  • Strengthen your hamstring and quadriceps muscles. The hamstring muscle is at the back of the thigh; the quadriceps muscle is at the front. The muscles work together to bend or straighten the leg. Strengthening both muscles can better protect the leg against knee injuries.

An anal fissure is a tear in the lining of the lower rectum (anal canal) that causes pain during bowel movements.

What is an anal fissure?

An anal fissure is a tear in the lining of the lower rectum (anal canal) that causes pain during bowel movements. Anal fissures don’t lead to more serious problems.

Most anal fissures heal with home treatment after a few days or weeks. These are called short-term (acute) anal fissures. If you have an anal fissure that hasn’t healed after 8 to 12 weeks, it is considered a long-term (chronic) fissure. A chronic fissure may need medical treatment. Anal fissures are a common problem. They affect people of all ages, especially young and otherwise healthy people.

Pathophysiology and Etiology

The exact etiology of anal fissures is unknown, but the initiating factor is thought to be trauma from the passage of a particularly hard or painful bowel movement. Low-fiber diets (eg, those lacking in raw fruits and vegetables) are associated with the development of anal fissures. No occupations are associated with a higher risk for the development of anal fissures. Prior anal surgery is a predisposing factor because scarring from the surgery may cause either stenosis or tethering of the anal canal, which makes it more susceptible to trauma from the hard stool.

Initial minor tears in the anal mucosa due to a hard bowel movement probably occur often. In most people, these heal rapidly without long-term sequelae. In patients with underlying abnormalities of the internal sphincter, however, these injuries progress to acute and chronic anal fissures. Studies of the internal anal sphincter and of anal canal physiology have been performed with varied results, but at least one abnormality is likely to present in the internal anal sphincter of many anal fissure patients.

The most commonly observed abnormalities are hypertonicity and hypertrophy of the internal anal sphincter, leading to the elevated anal canal and sphincter resting pressures. The internal sphincter maintains the resting pressure of the anal canal; anal-rectal manometry can be used to measure this pressure. Most patients with anal fissures have elevated resting pressure, which returns to normal levels after surgical sphincterotomy.

The posterior anal commissure is the most poorly perfused part of the anal canal. In patients with hypertrophied internal anal sphincters, this delicate blood supply is further compromised, thus rendering the posterior midline of the anal canal relatively ischemic. This relative ischemia is thought to account for why many fissures do not heal spontaneously and may last for several months.

Pain accompanies each bowel movement as this raw area is stretched and the injured mucosa is abraded by the stool. The internal sphincter also begins to spasm when a bowel movement is passed. This spasm has two effects: First, it is painful in itself, and second, it further reduces the blood flow to the posterior midline and the anal fissure, contributing to the poor healing rate.

What causes an anal fissure?

Anal fissures can be caused by trauma to the anus and anal canal. The trauma can be caused by one or more of the following:

  • Chronic (long-term) constipation
  • Straining to have a bowel movement, especially if the stool is large, hard and/or dry
  • Prolonged diarrhea
  • Anal sex, anal stretching
  • Insertion of foreign objects into the anus

Causes other than trauma include:

  • Longstanding poor bowel habits
  • Overly tight or spastic anal sphincter muscles (muscles that control the closing of the anus)
  • Scarring in the anorectal area
  • An underlying medical problem, such as Crohn’s disease and ulcerative colitis (types of inflammatory bowel disease); anal cancer; leukemia; infectious diseases (such as tuberculosis); and sexually transmitted diseases (such as syphilis, gonorrhea, Chlamydia, chancroid, HIV)
  • Decreased blood flow to the anorectal area

Anal fissures are also common in young infants and in women after childbirth.

Risk factors of anal fissure

Factors that may increase your risk of developing an anal fissure include:

  • Straining during bowel movements and passing hard stools increase the risk of tearing.
  • Anal fissures are more common in women after they give birth.
  • Crohn’s disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing.
  • Anal intercourse.
  • Anal fissures can occur at any age but are more common in infants and middle-aged adults.

What are the signs and symptoms of anal fissures?

People with anal fissures almost always experience anal pain that worsens with bowel movements.

  • The pain following a bowel movement may be brief or long-lasting; however, the pain usually subsides between bowel movements.
  • The pain can be so severe that patients are unwilling to have a bowel movement, resulting in constipation and even fecal impaction. Moreover, constipation can result in the passage of a larger, harder stool that causes further trauma and makes the fissure worse.
  • The pain also can affect urination by causing discomfort when urinating (dysuria), frequent urination, or the inability to urinate.
  • Bleeding in small amounts, itching (pruritus ani), and a malodorous discharge may occur due to the discharge of pus from the fissure.

As previously mentioned, anal fissures commonly bleed in infants.

Complications of anal fissure

Complications seen with anal fissures include:

  • Pain and discomfort
  • Reduced quality of life
  • Difficulty with bowel movements. Many people even avoid going to the bathroom because of the pain and discomfort it causes
  • Possible recurrence even after treatment
  • Clotting
  • Uncontrolled bowel movements and gas


Your doctor will likely ask about your medical history and perform a physical exam, including a gentle inspection of the anal region. Often the tear is visible. Usually, this exam is all that’s needed to diagnose an anal fissure.

An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has a deeper tear and may have internal or external fleshy growths. A fissure is considered chronic if it lasts more than eight weeks.

The fissure’s location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn’s disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition:

Anoscopy. An anoscope is a tubular device inserted into the anus to help your doctor visualize the rectum and anus.

Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you’re younger than 50 and have no risk factors for intestinal diseases or colon cancer.

Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea.


Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing.

If your symptoms persist, you’ll likely need further treatment.

Nonsurgical treatments

Your doctor may recommend:

  • Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headaches, which can be severe.
  • Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.
  • Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.
  • Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects.


If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing.

Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence.

Self-help for anal fissures

Be guided by your health care professional, but general suggestions include:

  • Apply petroleum jelly to the anus.
  • See your chemist for advice on ointments specific for anal pain.
  • Take regular sitz (salt bath) baths, which involves sitting in a shallow bath of warm water for around 20 minutes.
  • Use baby wipes instead of toilet paper.
  • Shower or bathe after every bowel motion.
  • Drink six to eight glasses of water every day.

How can an anal fissure be prevented?

An anal fissure can’t always be prevented, but you can reduce your risk of getting one by taking the following preventive measures:

  • Keeping the anal area dry
  • Cleansing the anal area gently with mild soap and warm water
  • Drinking plenty of fluids, eating fibrous foods, and exercising regularly to avoid constipation
  • Treating diarrhea immediately
  • Changing infants’ diapers frequently

Vaginal dryness is a common problem experienced by up to one in three women, particularly those who are going through menopause or those who experience early menopause symptoms.


Vaginal dryness is a common problem experienced by up to one in three women, particularly those who are going through menopause or those who experience early menopause symptoms. The female sex hormone estrogen is responsible for maintaining your natural lubricant. When your estrogen levels decrease you are more likely to experience vaginal dryness.

Normally, glands in your cervix produce a natural lubricant that keeps your vagina moist. This natural lubricant travels down your vagina, which helps to maintain a clean and healthy environment. A small amount of white discharge is a healthy sign of your vagina that is naturally well lubricated and keeping itself clean.


Vaginal dryness can occur at any age, with prevalence ranging from 13% to 31%, although rates are significantly higher for postmenopausal women (50%) and women treated for breast cancer (63%).

Risk factors of Vaginal dryness

Besides low estrogen, other unconventional risk factors include:

  • Use of specific soaps, perfumes, lotions, and douches (that alters the chemical balance in the genital tract may also cause dryness
  • Certain drugs such as antihistamines and anti-depressants can also present with vaginal dryness as an adverse effect. Antihistamines are a class of drugs that are used for the management of asthma, allergies, and cold. These drugs can lead to vaginal dryness, as most of these drugs exert their action by drying the secretions of the body.
  • Moreover, a rare autoimmune disease – Sjogren’s syndrome can also present with dryness of vagina along with dryness of eyes and mouth.
  • Anxiety and depression are unhealthy mental states that not only influence psychological health but may also affect sexual health. When a person is stressed or depressed, sexual desires or libido also decrease which may lead to vaginal dryness.

Low libido or other sexual problems can lead to vaginal dryness. Similarly, this disease can worsen a low sexual drive.

Vaginal dryness causes

In many cases, women have vaginal dryness when estrogen hormone levels decrease. Treatments for other conditions can also cause this symptom. Vaginal dryness can result from:

  • Breastfeeding and childbirth
  • Cancer treatments including chemotherapy and hormonal therapy
  • Diabetes
  • Medications including allergy and cold drugs
  • Menopause
  • Removal of the ovaries
  • Sjogren’s syndrome (an autoimmune disorder that can cause dryness throughout the body)

Douching and other irritants: Certain soaps, lotions, perfume, and douches can disrupt the natural balance of chemicals in your vagina, leading to dryness.

Other medicines: Allergy, cold, and asthma medicines that contain antihistamines can have a drying effect on the body and contribute to reduced vaginal lubrication.

Certain antidepressants may also lead to a reduction in vaginal secretions.

Anxiety: Stress and anxiety can affect sexual desire and may lead to vaginal dryness.

Sjogren’s syndrome: This rare autoimmune disease can cause dryness in the eyes, mouth, and vagina.

Low sexual desire: A low libido or other sexual problems may give way to dryness, and conversely, the dryness may worsen libido.

Symptoms of Vaginal dryness

The changes described above can occur without causing any symptoms or discomfort. However, some of the following symptoms may develop in some women. Vaginal dryness is a common (and usually treatable) cause of the following problems. However, these problems can also be caused by other medical conditions.

Pain when you have sex: This may occur because your vagina is smaller, drier and less likely to become lubricated during sex compared with how it was before the menopause. Also, the skin around your vagina is more fragile and this can make the problem worse.

Discomfort: If your vulva or vagina is sore and red.

Vaginal discharge: There may be a white or yellow discharge. Sometimes this is due to an infection. Infection is more likely if the discharge is smelly and unpleasant.

Itch: The skin around your vagina is more sensitive and more likely to itch. This can make you prone to scratching, which then makes your skin more likely to itch, and so on. This is called an itch/scratch cycle which can become difficult to break and can be distressing.

Urinary problems: Vaginal dryness may contribute to various urinary problems. This is because of thinning and weakening of the tissues around the neck of your bladder, or around the opening for urine to pass (the urethra). For example, urinary symptoms that may occur include an urgency to get to the toilet and recurring urinary tract infections.

Complications of Vaginal dryness

Vaginal dryness can:

  • Make you more likely to get yeast or bacterial infections of the vagina.
  • Cause sores or cracks in the walls of the vagina.
  • Cause pain with sexual intercourse, which may affect your relationship with your partner or spouse. (Talking openly with your partner may help.)

Diagnosis and test

  • If you have vaginal dryness, your doctor can perform a pelvic exam to determine whether the walls of your vagina are thin, pale, or red.
  • You may also undergo testing of your hormone levels to see if you’re going through menopause.
  • Your doctor may also test your vaginal discharge to check for other causes of dryness.
  • Visit your doctor if you have symptoms of vaginal dryness that are severe or don’t go away.

Vaginal dryness treatment

There are two main ways to help with or treat vaginal dryness: lubricants and estrogen therapy.

Topical, short-term solutions

Using vaginal moisturizers and lubricants can help relieve vaginal dryness and painful sexual intercourse. You can buy moisturizers and lubricants over the counter. Check with your provider to find which one may be the right choice for you as there are many options.

Estrogen therapy

Estrogen therapy is a long-term solution to vaginal dryness. There are a few therapy options for women, including:

Local estrogen therapy: Low-dose vaginal estrogen therapy (such as vaginal creams, vaginal rings, and vaginal tablets), release a small dose of estrogen directly into the vaginal tissue. The estrogen helps restore the natural thickness and elasticity to the vaginal lining and also relieves dryness and irritation.

Systemic estrogen therapy: With this type of estrogen therapy (pills, skin patches, or gels or sprays applied to the skin), estrogen is released into the bloodstream and travels to the organs and tissues where it is needed.

Laser estrogen therapy: It’s a fast, simple, and safe laser treatment that takes less than 5 minutes called MonaLisa Touch. This laser treatment can help restore your gynecologic health especially when estrogen levels decline after menopause. The machine delivers gentle laser energy to the vaginal wall tissue that stimulates a healing response in the vaginal canal. A typical course of treatment is three procedures over 18 weeks.

Non-Hormonal Remedies

The following non-hormonal remedies may provide relief for vaginal dryness and discomfort:

Vaginal lubricants: Reduce discomfort with sexual activity when the vagina is dry by decreasing friction during intercourse. Water-soluble products are effective, as well as olive and coconut oils.

Vaginal moisturizers: Line the wall of the vagina and maintain vaginal moisture. Like your face or hands, your vagina should be moisturized on a regular basis- several times weekly, at bedtime.

Regular sexual stimulation: Promotes blood flow and secretions to the vagina. Sexual stimulation can improve vaginal health.

Pelvic floor exercises: Can both strengthen weak vaginal muscles and relax tight ones.

Expanding your views of sexual pleasure: Options such as extended caressing, mutual masturbation, and massage. Trying different options can help make painful intercourse more comfortable or allow you to remain sexually intimate without intercourse.

Prevention of Vaginal dryness

A water-soluble vaginal lubricant can be used to moisten the tissues and prevent painful sexual intercourse. Regular sexual activity also can help to prevent symptoms. This is because sexual intercourse improves blood circulation to the vagina, which helps to maintain vaginal tissue.

Man stabs his elder Brother to death with a knife in Jigawa State.

An eyewitness told oneworld news line that Alfred stabbed his elder brother (Augustine) with a knife, leading to his death.

According to a report a 22 years old man, Alfred Julius has been arrested for allegedly stabbing his elder brother to death in Dutse Local Government Area of Jigawa State.

The incident happened yesterday at Sabuwar, following a misunderstanding between the suspect and his 30 years old elder brother, Augustine Julius, leading to physical combat.

Police Public Relations Officer, ASP Lawan Shiisu Adam confirmed the incident to newsmen.

He explained that “on 5/1/2021, at about 2200hrs, police received information that there was a wounded victim taken to Rashid Shekoni Teaching Hospital, Dutse, after a fight.”

He said the police swung into action and rushed to the hospital and discovered that one Augustine Julius was stabbed with a knife by his younger brother after having a disagreement.

Shiisu said the victim was confirmed dead by a medical doctor while receiving treatment.

He said the suspect took to his heels after he committed the crime, and that effort was on top gear with the assistance of his relatives to get him arrested and brought to book.


Governor Samuel Ortom of Benue State has reacted to President Muhammadu Buhari’s tagging of the People’s Democratic Party, PDP as a failure.

It was reported that Governor Samuel Ortom of Benue State has reacted to President Muhammadu Buhari’s tagging of the People’s Democratic Party, PDP as a failure in his recent statement.

Furthermore: Recall that President Buhari, during an interview with Channels Television on Wednesday, said what comes to his mind when ever he remembers or when, PDP is mentioned, is failure.

Reacting, Governor Ortom in a statement issued on Thursday by his Chief Press Secretary, Nathaniel Ikyur said it is the ruling All Progressives Congress that failed Nigerians by retrogressing the affairs of the nation.

He said, as a critical stakeholder of the PDP, this is completely false. If anyone has failed, it is the Buhari led APC federal government that has failed by taking Nigeria from top to bottom.

The PDP is ready to rescue Nigeria from the insecurity and economic horror placed on Nigerians by the APC”.

He stressed that the party is better prepared with laudable programmes on the welfare of Nigerians and to rebuild the nation from the APC tale of woes.

The governor added that from all indications, the APC administration has since run out of ideas pointing out that “they have exhausted all their lies and have nothing more to tell Nigerians”.

Governor Ortom also tasked the President to do all that is necessary to revamp the ailing economy and save citizens from poverty saying “Nigerians have absorbed enough hunger and misery in the hands of the All Progressives Congress (APC) misrule.

Or is it possible that Mr. President is not aware that Nigerians are dying from his misrule?


Son paid Assassin the sum of N110,000 to assasinate his father just to inherit his properties in Niger state.

It has been reported that, Son paid Assassin the sum of N110,000 to assasinate his father and he dumped the body in a bush in order for him to inherit his properties has been arrested by the Niger State Police Command, the command announced in this through a statement on Thursday, January 6.

The son, whose name is Abubakar Mohammed Buba, aged 25 years, was arrested by police operatives attached to the Chanchaga Division of the state police command for criminal conspiracy and murder of his father, Alhaji Mohammed Buba, aged 52 years, who was attacked and stabbed to death in his residence at Korokpan, Paikoro Local Government Area of the state.

According to a statement on the incident by the state police command through its Public Relations Officer, Wasiu Abiodun, posted on the Facebook wall of the command, Buba hired the services of one Aliyu Mohammed, who is presently at large, to kill his father for the sum of N110,000 in order to inherit the father’s properties.

According to the statement, he was said to have paid the sum of N50,000 as initial deposit and later paid the balance of N60,000 after selling some of the properties of his father. 

It was gathered that following a report lodged at the police division, policemen launched a manhunt for him and he was subsequently arrested and during his interrogation, he was said to have admitted that he hired Aliyu Mohammed for the act, saying he decided to kill his father in order to quickly inherit his properties.

He was also said to have led police operatives to the bush where the body of the father was packed inside a sack.

The police said he had given useful information about the incident and he will be prosecuted at the end of the investigation, while efforts are ongoing to arrest the fleeing Aliyu Mohammed.