Prof. Wole Soyinka contended that Buhari has breached that agreement, hence, he should be impeached.

Nigerian Nobel laureate, Professor Wale Soyinka, on Tuesday, backed the six weeks ultimatum given to the President, Muhammadu Buhari, by some federal lawmakers to find a solution to terrorism or be impeached.

Recall that the Senate minority caucus and members of the Federal House of Representatives elected on the platform of the main opposition the Peoples Democratic Party (PDP) had last week given President Muhammadu Buhari six weeks ultimatum to end the lingering insecurity in the country or face impeachment.

During an interactive session organized to celebrate the 50th anniversary of the Abeokuta Club. Prof. Soyinka revealed that “Democracy indicates a contract, that is why the candidate puts on a manifesto. Based on that manifesto, the candidate is either accepted or rejected.

Prof. Soyinka contended that Buhari has breached that agreement, hence, he should be impeached.

Similarly, a Senior Advocate of Nigeria SAN Femi Falana expresses a similar opinion on the current state of the nation.

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The Benue state governor Samuel Orton have successfully launch state security outfit.

Governor Samuel Ortom of Benue State has launched a security outfit tagged “Benue State Community Volunteer Guard.

According to Homepage news channel, it was learnt that the security outfit was launched to tackle terrorists terrorising the state.

Benue State has been attacked severally by bandits and other criminal elements, killing many people.

During the launch, Governor Ortom charged the members of the security outfit to protect the people of Benue State.

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Twitter accused Musk of sabotaging the deal because it no longer served his interests.

Twitter Inc on Thursday dismissed Elon Musk’s claims in a Delaware court filing that he was hoodwinked into signing the deal to buy the social media company, saying that it was implausible and contrary to fact.

Musk made the claims in a countersuit that he filed under seal last Friday, which was made public on Thursday.

According to Musk, he the billionaire founder of multiple companies, advised by Wall Street bankers and lawyers was hoodwinked by Twitter into signing a $44 billion merger agreement.

That story is as implausible and contrary to fact as it sounds, the filing released by Twitter on Thursday said.

Twitter’s filing is the latest salvo in what is building up to be a major legal showdown between the world’s richest person and the social media giant.

The San Francisco-based company is pushing to resolve months of uncertainty over its fate as Musk tries to walk away from the deal for what he says is Twitter’s misrepresentation of fake accounts.

Musk, the chief executive of electric car company Tesla Inc, offered to buy Twitter for $54.20 per share in April, saying he believed in its potential as a global platform for free speech.

But he soured on Twitter as its stock price lagged his takeover bid, and began expressing skepticism that bot and spam accounts represented less than 5 per cent of users.

Musk sought to back out on July 8 without paying a $1 billion breakup fee, citing Twitter’s failure to provide details on bot and spam accounts. Twitter sued him four days later.

The company accused Musk of sabotaging the deal because it no longer served his interests, and casting a pall that disrupted its work and hurt shareholders.

An Oct. 17 trial is scheduled.

Earlier this week, Twitter issued dozens of subpoenas to banks, investors and law firms that backed Musk’s takeover bid, while Musk issued subpoenas to Twitter’s advisers at Goldman Sachs and JP Morgan over their work.

Legal experts have said Twitter’s requests suggested the company wanted to know why Musk turned against it, or whether he reneged on his obligation to obtain sufficient financing.

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Singapore record 13 case of monkey pox since June.

The Ministry of Health (MOH) reported one more case of monkeypox infection on Wednesday (Aug 3), bringing the total number of infections in the country since June to 13.

The patient is a 33-year-old man with no recent travel history, said MOH in an update on its website.

The man tested positive for the virus on Tuesday and his infection is classified as a local unlinked case.  

Another local unlinked case was also confirmed on Monday, a 59-year-old man with no recent travel history.

Of the 13 monkeypox cases announced in Singapore since June this year, five are imported and eight are local. None of the cases so far are linked.

According to the Health Ministry, monkeypox is a viral disease that is caused by infection with the monkeypox virus. It is typically a self-limiting illness that presents with fever and rash. However, serious complications or death can occur in some individuals.

Those infected usually experience fever, headache, muscle ache, backache, swollen lymph nodes, chills and lethargy. 

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As the disease progresses, infected persons develop a rash, often starting from the face before spreading to other parts of the body, including the palms and soles.

Symptoms may appear from five to 21 days following infection. These individuals are generally infectious from onset of fever until the skin lesions have scabbed over, said MOH. 

On Monday, MOH said monkeypox cases assessed by public hospitals to be clinically stable will be transferred to a dedicated isolation facility where they will have access to round-the-clock telemedicine support. 

“These cases will recover in the monkeypox isolation facility until they are deemed to be non-infectious and fit for discharge,” said MOH.

Previously, all confirmed cases of monkeypox were isolated in hospitals until they were non-infectious.

The quarantine period for close contacts of monkeypox cases has also been adjusted to 14 days, followed by seven days of monitoring for symptoms via regular phone calls. 

According to the ask.gov.sg website, those on phone surveillance can leave their home as long as they are well. They should contact a Health Ministry duty officer if they are unwell. 

MOH said that these updated public health measures are in line with the latest local and international data, including those from the World Health Organization (WHO).

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6,600 monkey pox case recorded accross US.

The United States has declared monkeypox a public health emergency, the health secretary said Thursday (Aug 4), a move expected to free up additional funding and tools to fight the disease.

The declaration comes as the tally of cases crossed 6,600 in the United States on Wednesday, almost all of them among men who have sex with men.

We’re prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously,” Health and Human Services Secretary Xavier Becerra said at a briefing.

The declaration will also help improve the availability of monkeypox data, US Centers for Disease Control and Prevention Director Rochelle Walensky said, speaking alongside Bacerra.

The World Health Organization has also dubbed monkeypox a “public health emergency of international concern”, its highest alert level.

The WHO declaration last month was designed to trigger a coordinated international response and could unlock funding to collaborate on vaccines and treatments.

Biden earlier this month appointed two top federal officials to coordinate his administration’s response to monkeypox, following declarations of emergencies by California, Illinois and New York.

First identified in monkeys in 1958, the disease has mild symptoms including fever, aches and pus-filled skin lesions, and people tend to recover from it within two to four weeks, according to the World Health Organization. It spreads through close physical contact and is rarely fatal.

Anthony Fauci, Biden’s chief medical adviser, told Reuters on Thursday that it was critical to engage leaders from the gay community as part of efforts to rein in the outbreak, but cautioned against stigmatizing the lifestyle.

“Engagement of the community has always proven to be successful,” Fauci said.

Unlike when COVID-19 emerged, there are already vaccines and treatments available for monkeypox, which was first documented in Africa in the 1970s.

The US government had distributed 156,000 monkeypox vaccine doses nationwide through mid-July. It has ordered an additional 2.5 million doses of Bavarian Nordic’s vaccine.

The first US case of monkeypox was confirmed in Massachusetts in May, followed by another case in California five days later.

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Osteoid osteomas is a type of bone tumor. It is not cancer (benign).

Definition

Osteoid osteomas is a type of bone tumor. It is not cancer (benign). It remains in the same place it starts. It will not spread to other bones or parts of your body. The center of an osteoid osteoma is the nidus. It consists of growing tumor cells, blood vessels, and cells that eventually form bone. A bony shell surrounds the nidus.

Usually, osteoid osteomas are small tumors that measure less than an inch across. They typically form in the long bones, especially the thigh (femur) and shin (tibia) bones. They may also develop in the bones of the spine, arms, hands, fingers, ankles, or feet. They can occur in other bones. But that is much less common.

Osteoid osteomas tend to be painful. They cause a dull, achy pain that can be moderate to severe. The pain is often worse at night. Osteoid osteomas occur more often in men than in women. They typically occur in children and young adults up to about age 24. But they can occur at any age.

Prevalence

Osteoid osteomas account for 1/8 to 1/10 of symptomatic bone tumors and 5% of all primary bone tumors. Osteoid osteomas are the 2nd most common benign primary bone tumors resulting in 10-12% of all benign tumors. Osteoid osteomas occur in children and young adults between the ages of 7 and 25. All ages can be effected but 75-80% of patients are less than 25 years of age. The male to female ratio is 2-3:1 putting boys and young males at the greatest risk for developing osteoid osteomas.

Classification of Osteoid Osteomas

There are two classification schemes for osteoid osteoma, both of which describe the location of the tumor in bone.

With the first scheme, tumors are classified as cortical, medullary (cancellous), or subperiosteal on the basis of radiographic findings. This method is more traditional and more frequently used than the other classification scheme.

With this scheme, cortical osteoid osteomas are the most common. They usually occur in the shaft of the long bones, especially the femur and tibia.

Subperiosteal osteoid osteomas are the least common. With the other, recently suggested classification scheme, tumors are categorized as subperiosteal, intracortical, endosteal, or intramedullary on the basis of computed tomographic (CT) and magnetic resonance (MR) imaging findings. With the use of cross-sectional imaging, it has been suggested that subperiosteal osteoid osteomas are more common than was initially believed. It also has been postulated that intracortical and medullary lesions migrated from subperiosteal origins as a result of bone remodeling, with subperiosteal deposition and endosteal erosion.

Causes of Osteoid Osteomas

Researchers are still working to understand what causes osteoid osteomas to form. They seem to start with inflammation in the bone. When that occurs, blood vessels in the area start to expand and grow. Bone-producing cells called osteoblasts soon start to multiply.

They lay down the building blocks for bone. Cells that break down bone, called osteoclasts, also become part of the osteoma. The growing tumor puts pressure on the surrounding bone. This hardens and forms a shell around the tumor.

Often there is no history of injury or infection at the site where the osteoid osteoma forms.

Osteoid Osteomas Symptoms

The main symptom of an osteoid osteoma is achy, dull pain. This pain often gets worse at night. Activity has no effect on the pain.

Other symptoms may include:

Bone deformity.

Gait disorders.

Joint pain and stiffness.

Decrease in muscle size (atrophy).

One leg being longer than the other (with a thigh or shin tumor).

Sciatica and scoliosis (with a spine tumor).

Swelling.

Symptoms of a tumor near your joint may include:

Joint effusion (swollen joint).

Osteoarthritis.

Stiffening and tightening (joint contractures).

Complications of Osteoid Osteomas

Osteoid osteomas can be quite painful. A few complications can occur because of swelling linked to the bone and the location of the osteoma. Examples include:

Scoliosis. This can occur if the osteoid osteoma is in the spine.

Enlargement or deformity of a bone. This can occur if the osteoid osteoma is in a small bone.

Deformity or stiffness of a joint. This can occur if the osteoid osteoma is at the end of a bone.

Osteoid Osteomas Diagnosis

The doctor will perform a physical examination and use imaging studies and other tests to diagnose your or your child’s tumor.

Imaging Studies

X-rays: X-rays create clear pictures of dense structures such as bone and are helpful in diagnosing an osteoid osteoma. An X-ray of the painful area may reveal thickened bone surrounding a small central core of lower density – a distinctive characteristic of the tumor.

Computerized tomography (CT) scan: A CT scan provides a cross-sectional image of your bone and can also be helpful in evaluating the lesion. A CT scan will commonly show the nidus, or center of the tumor.

Biopsy: A biopsy may be necessary to confirm the diagnosis of osteoid osteoma. In a biopsy, a tissue sample of the tumor is taken and examined under a microscope. The doctor may give you or your child a local anesthetic to numb the area and take a sample using a needle. A biopsy can also be performed as a small operation.  If imaging studies are highly suggestive of an osteoid osteoma, the doctor may not perform a biopsy.

Other tests: To exclude other possible bone problems such as an infection or malignant tumor, the doctor may order additional imaging studies. Certain blood tests may also be used to rule out an infection.

Treatment of Osteoid Osteomas

Traditional treatments for osteoid osteoma

Most of these tumors can be successfully treated. However, they can come back. Prompt medical attention and aggressive therapy are important for the best prognosis. Regular follow-up care is essential for your child.

Treatment may include:

Percutaneous radiofrequency ablation: A minimally invasive day procedure, percutaneous radiofrequency ablation uses radiofrequencies passed beneath the skin through a needle to kill the tumor cells by heating them to a high temperature.

Curettage and bone grafting: During this operation, the tumor is scraped out of the bone with a special instrument. The remaining cavity is then packed with donor bone tissue (allograft), bone chips taken from another bone (autograft), or other materials.

En bloc resection: The surgical removal of bone containing the tumor is necessary if the tumor is located in the pelvis or some other site. Internal fixation, with pins, may be required to restore the structural integrity of the bone. This option is rare for patients with osteoid osteoma.

Head and neck cancer is a term that describes a range of cancers that begin in the head and neck region.

What are head and neck cancers?

Head and neck cancer is a term that describes a range of cancers that begin in the head and neck region. Cancer can occur inside the sinuses, nose, mouth and salivary glands down through the throat. Although these cancers are different, they are treated similarly, so are considered as a group.

Skin cancers that start in the head and neck area have recently been classified as a type of head and neck cancer. Cancers that start in the eye, brain, oesophagus, thyroid and trachea, or in bone or muscle of the head and neck area are not usually classified as head and neck cancers.

Types of head and neck cancer

There are 5 main types of head and neck cancer, each named according to the part of the body where they develop. For more information about a specific type, visit the guide dedicated to that type of head and neck cancer on this same website.

Laryngeal and hypopharyngeal cancer. The larynx is commonly called the voice box. This tube-shaped organ in the neck is important for breathing, talking, and swallowing. It is located at the top of the windpipe, or trachea. The hypopharynx is also called the gullet. It is the lower part of the throat that surrounds the larynx.

Nasal cavity and paranasal sinus cancer. The nasal cavity is the space just behind the nose where air passes on its way to the throat. The paranasal sinuses are the air-filled areas that surround the nasal cavity.

Nasopharyngeal cancer. The nasopharynx is the air passageway at the upper part of the throat behind the nose.

Oral and oropharyngeal cancer. The oral cavity includes the mouth and tongue. The oropharynx includes the middle of the throat, from the tonsils to the tip of the voice box.

Salivary gland cancer. The salivary gland produces saliva. Saliva is the fluid that is released into the mouth to keep it moist and that contains enzymes that begin breaking down food.

What are the causes and risk factors of head and neck cancers?

Alcohol and tobacco use (including smokeless tobacco, sometimes called “chewing tobacco” or “snuff”) are the two most important risk factors for head and neck cancers, especially cancers of the oral cavity, oropharynx, hypopharynx, and larynx. At least 75% of head and neck cancers are caused by tobacco and alcohol use. People who use both tobacco and alcohol are at greater risk of developing these cancers than people who use either tobacco or alcohol alone. Tobacco and alcohol use are not risk factors for salivary gland cancers.

Infection with cancer-causing types of human papillomavirus (HPV), especially HPV type 16, is a risk factor for some types of head and neck cancers, particularly oropharyngeal cancers that involve the tonsils or the base of the tongue. In the United States, the incidence of oropharyngeal cancers caused by HPV infection is increasing, while the incidence of oropharyngeal cancers related to other causes is falling.

Other risk factors for cancers of the head and neck include the following:

Paan (betel quid). Immigrants from Southeast Asia who use paan (betel quid) in the mouth should be aware that this habit has been strongly associated with an increased risk of oral cancer.

Preserved or salted foods. Consumption of certain preserved or salted foods during childhood is a risk factor for nasopharyngeal cancer.

Oral health. Poor oral hygiene and missing teeth may be weak risk factors for cancers of the oral cavity. Use of mouthwash that has a high alcohol content is a possible, but not proven, risk factor for cancers of the oral cavity.

Occupational exposure. Occupational exposure to wood dust is a risk factor for nasopharyngeal cancer. Certain industrial exposures, including exposures to asbestos and synthetic fibers, have been associated with cancer of the larynx, but the increase in risk remains controversial. People working in certain jobs in the construction, metal, textile, ceramic, logging, and food industries may have an increased risk of cancer of the larynx. Industrial exposure to wood or nickel dust or formaldehyde is a risk factor for cancers of the paranasal sinuses and nasal cavity.

Radiation exposure. Radiation to the head and neck, for noncancerous conditions or cancer, is a risk factor for cancer of the salivary glands.

Epstein-Barr virus infection. Infection with the Epstein-Barr virus is a risk factor for nasopharyngeal cancer and cancer of the salivary glands.

Ancestry. Asian ancestry, particularly Chinese ancestry, is a risk factor for nasopharyngeal cancer

Head and neck cancer symptoms

Symptoms of head and neck cancer depend on the area where the cancer develops and how it spreads.

For example, tumors in the larynx or pharynx may appear as a lump in the throat. Cancer cells in the mouth may cause sores in the mouth or swelling of the jaw.

Some common symptoms for cancers of the head and neck include:

A lump in the nose, neck or throat, with or without pain

A persistent sore throat

Trouble swallowing (dysphagia)

Unexplained weight loss

Frequent coughing

Change in voice or hoarseness

Ear pain or trouble hearing

Headaches

A red or white patch in the mouth

Bad breath that’s unexplained by hygiene

Nasal obstruction or persistent congestion

Frequent nose bleeds or unusual discharge

Trouble breathing

Other symptoms are similar to those for less serious conditions, such as the common cold. Changes in voice, headaches, sore throat or a cough may be symptoms of throat cancer. Pain or ringing in the ears may also accompany certain head and neck cancers.

Head and Neck Cancer Diagnosis

Before you begin treatment, your care team will need to diagnose which type of head and neck cancer you have. This is a key first step in developing the best treatment plan for you.

Physical Exam for Head and Neck Cancer

Your doctor will thoroughly examine the head and neck area, feeling for abnormalities, looking inside the mouth and throat, and using mirrors and lights to examine hard-to-see areas. An experienced doctor may be able to detect problems that a less-experienced one might not observe.

Endoscopy

In some cases, your doctor may use an endoscope (a thin lighted tube with a camera at its tip). This tool is helpful in examining areas of the head and neck that are more difficult to reach. The tube may be inserted through the nose or mouth. A topical anesthetic (a medication applied directly to the nose and throat) can make the examination more comfortable for you.

The exact name of the endoscopy procedure depends on where the tumor is located. For example, you may need a nasopharyngoscopy, pharyngoscopy, or laryngoscopy. Occasionally, a doctor will perform a more thorough type of endoscopic examination called a panendoscopy. This procedure requires general anesthesia.

Biopsy

Your doctor may be able to make a diagnosis based on a needle aspiration of the tumor. However, many people need to have a surgical biopsy. During a biopsy, a surgeon removes a small amount of abnormal tissue from the area where the cancer is suspected. A pathologist then examines the sample under a microscope and works with the other members of the care team to make a diagnosis.

Biomarker testing of the tumor

Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. This may also be called molecular testing of the tumor. Results of these tests can help determine your treatment options.

Diagnostic Imaging for Head and Neck Cancer

X-ray/barium swallow. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation. A barium swallow may be required to identify abnormalities along the swallowing passage. During a barium swallow, a person swallows a liquid containing barium, and a series of x-rays are taken. Barium coats the lining of the esophagus, stomach, and intestines, so tumors or other abnormalities are easier to see on the x-ray. A special type of barium swallow called a modified barium swallow may be needed to evaluate specific swallowing difficulties. If there are signs of cancer, the doctor may recommend a computed tomography (CT) scan (see below).

Panoramic radiograph. A panoramic radiograph is a rotating, or panoramic, x-ray of the upper and lower jawbones to detect cancer or evaluate the teeth before radiation therapy or chemotherapy. This is often called a panorex.

Ultrasound. An ultrasound uses sound waves to create a picture of internal organs.

Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the tonsils and base of the tongue. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The amount of radiation in the tracer is too low to be harmful. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears lighter to the camera, and areas of injury, such as those caused by cancer, stand out on the image. This test may be done to see if cancer has spread to the bones.

Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body.

The Next Step: Staging

Once it’s been determined that you have a head or neck cancer, the next step is called staging: a way of describing where the cancer is located, the size of the tumor, and whether or not it has spread and is affecting other parts of the body. Your doctor will use the results from your diagnostic tests and scans to determine where your cancer falls in the TNM staging system:

Tumor (T): Where is it and how large is it?

Node (N): Has the cancer spread to any lymph nodes tiny, bean-shaped organs that help fight infection and if so, where and how many?

Metastasis (M): Has the cancer spread to other parts of the body, and if so, where and how much?

The results are then combined to determine the stage and the best course of treatment. There are five different stages, ranging from 0 (precancer) to 4, which is a cancer that has metastasized to another part (or parts) of the body.

Each type of head and neck cancer has a different staging system. For example, let’s say you have an HPV-related oropharyngeal cancer. Your stage would first be evaluated depending on whether any lymph nodes were removed during surgery. If they were, your cancer would get a pathological staging—that’s why you see the little “p” before the “N” (node) ranking below. If lymph nodes weren’t removed (sometimes they can’t be or don’t need to be), you’d get what’s known as clinical staging instead. (We know, it’s complicated!) Here’s the breakdown:

Stage I: The tumor is 4 cm or smaller. The cancer involves 4 or fewer lymph nodes. Cancer has not spread to other parts of the body (T0 to T2, pN0 or pN1, M0).

Stage II: Either the tumor is 4 cm or smaller, cancer has spread to more than 4 lymph nodes, and there is no spread to other parts of the body (T0 to T2, pN2, M0). Or the tumor is larger than 4 cm, it has invaded nearby structures, it involves 4 or fewer lymph nodes, and it has not spread to other parts of the body (T3 or T4, pN0 or pN1, M0).

Stage III: The tumor is larger than 4 cm or it has invaded nearby structures. Cancer has spread to more than 4 lymph nodes. There is no spread to other parts of the body (T3 or T4, pN2, M0).

Stage IV: Cancer has spread to other parts of the body (any T, any pN, M1).

Treatment

What kind of treatment you’ll get depends on a few things, such as:

Where the cancer is located

What stage the cancer is in

How old you are

Your general health

If you have HPV

You might get just one kind of treatment, or you might get a combination of them. Options include surgery, radiation, chemotherapy, and targeted therapy.

Surgery. Your doctor might zap the cancer with a laser or take out the tumor and some of the healthy tissue around it. If there’s a chance the cancer has spread, your doctor might take out some of the small glands called lymph nodes in your neck.

The side effects and risks depend on what kind of surgery you get. They include:

Losing your voice

Hearing loss

Trouble chewing or swallowing

Swelling of the mouth or throat

If the surgery changes your face a lot, or it makes it hard to eat and breathe, you might need another surgery.

Radiation. Your doctor might use X-rays or other energy particles to kill the cancer cells. Some of the side effects include:

Pain or trouble swallowing

Changes in your voice

Loss of appetite

Red or irritated skin

Thick spit or an extremely dry mouth

Feeling sick to your stomach

Being tired

Sore throat

Sores in your mouth

Chemotherapy (“Chemo”). You’ll be given medication to stop the cancer cells from growing and dividing, which should destroy them. The following are possible side effects:

Feeling tired

Infection

Feeling sick to your stomach

Hair loss

Loss of appetite

Diarrhea

Targeted therapy. You’ll be given medications that work on the genes, proteins, and other parts of the cancer cells. Side effects of target therapy depend on the medication that is used. But often, they include problems with your skin, hair, nails, or eyes.

Immunotherapy. This treatment uses parts of your immune system to help fight cancer. Doctors can either stimulate your immune system to attack cancer cells, or they can give you man-made proteins to strengthen your immune system.

Head and Neck Cancer Treatment Complications

If you like to talk, smile, breathe, smell, and eat (in other words, if you’re human), the potential for complications from head and neck cancers can be huge. Some complications are temporary side effects of treatment while others may last a long time or forever. Here’s what you might experience, depending on your cancer and form of treatment:

Surgery Complications:

Decreased thyroid gland function

Difficulty chewing or swallowing, which may require a feeding tube

Facial disfigurement that requires reconstructive surgery

Hearing loss

Impaired speech

Stiffness or weakness in the shoulder or neck, or an abnormal buildup of fluid (lymphedema), if lymph nodes were removed

Swelling of the mouth and throat area that may make it difficult to breathe and require a temporary tracheotomy, which creates a hole in the windpipe

Temporary or permanent loss of normal voice

Radiation Complications:

Changes in voice due to swelling or scarring

Decreased thyroid gland function

Dry mouth or thickened saliva

Hearing loss or earaches due to a buildup of fluid or earwax and scarring

Loss of appetite due to change in the sense of taste

Short or long-term pain or difficulty swallowing

Temporary side effects during treatment may include redness or skin irritation, bone pain, nausea, fatigue, sore throat, mouth sores

Tooth decay

Chemo and Other Drug Complications:

Diarrhea

Fatigue

Flu-like symptoms

Hair loss

Loss of appetite

Nausea and vomiting

Risk of infection due to lowered immunity

Skin reactions

How can I protect myself from head and neck cancer?

Head and neck cancers are very preventable. Here are three important steps:

Quit tobacco. Tobacco use is the most common cause of head and neck cancers. Eighty-five percent of these cancers are linked to tobacco use. To reduce your risk of head and neck cancer, quit using all forms of tobacco (cigarettes, cigars, pipes, snuff, and chewing tobacco).

Cut back on drinking. Alcohol use has also been determined to contribute to head and neck cancer. Reducing your alcohol intake can reduce your risk of these cancers.

Consider getting the HPV vaccine. Human papillomavirus can cause some types of head and neck cancers, particularly oropharyngeal cancer. Talk to your provider to see if you would benefit from the vaccine. It’s most effective in preventing HPV if given at a young age (up to age 26).

If you have already had cancer, cutting out tobacco and alcohol can reduce the risk of your cancer recurring. Seeing your physician at the first sign of symptoms can also prevent cancers from progressing.

Muscular dystrophy refers to a group of more than 30 inherited (genetic) diseases that cause muscle weakness.

What is muscular dystrophy?

Muscular dystrophy refers to a group of more than 30 inherited (genetic) diseases that cause muscle weakness.

These conditions are a type of myopathy, a disease of the skeletal muscles. Over time, muscles shrink and become weaker, affecting your ability to walk and perform daily activities like brushing your teeth. The disease also can affect your heart and lungs.

Some forms of muscular dystrophy are apparent at birth or develop during childhood. Some forms develop later during adulthood. Currently, there isn’t a cure.

Types of muscular dystrophy

There are many different types of MD, each with somewhat different symptoms. Not all types cause severe disability and many don’t affect life expectancy.

Some of the more common types of MD include:

Duchenne MD – one of the most common and severe forms, it usually affects boys in early childhood; people with the condition will usually only live into their 20s or 30s

Myotonic Dystrophy – a type of MD that can develop at any age; life expectancy isn’t always affected, but people with a severe form of myotonic dystrophy may have shortened lives

Facioscapulohumeral MD – a type of MD that can develop in childhood or adulthood; it progresses slowly and isn’t usually life-threatening

Becker MD – closely related to Duchenne MD, but it develops later in childhood and is less severe; life expectancy isn’t usually affected as much

Limb-Girdle MD – a group of conditions that usually develop in late childhood or early adulthood; some variants can progress quickly and be life-threatening, whereas others develop slowly

Oculopharyngeal MD – a type of MD that doesn’t usually develop until a person is between 50 and 60 years old, and doesn’t tend to affect life expectancy

Emery-Dreifuss Md – a type of MD that develops in childhood or early adulthood; most people with this condition will live until at least middle age

Pathophysiology

Multiple proteins are involved in the complex interactions of the muscle membrane and extracellular environment. For sarcolemmal stability, dystrophin and the dystrophin-associated glycoproteins (DAGs) are important elements.

The dystrophin gene is located on the short arm of chromosome X near the p21 locus and codes for the large protein Dp427, which contains 3685 amino acids. Dystrophin accounts for only approximately 0.002% of the proteins in striated muscle, but it has obvious importance in the maintenance of the muscle’s membrane integrity.

Dystrophin aggregates as a homotetramer at the costomeres in skeletal muscles, as well as associates with actin at its N-terminus and the DAG complex at the C-terminus, forming a stable complex that interacts with laminin in the extracellular matrix. Lack of dystrophin leads to cellular instability at these links, with progressive leakage of intracellular components; this results in the high levels of creatine phosphokinase (CPK) noted on routine blood workup of patients with Duchenne MD.

Less active forms of dystrophin may still function as a sarcolemmal anchor, but they may not be as effective a gateway regulator because they allow some leakage of intracellular substance. This is the classic Becker dystrophy. In both Duchenne and Becker MD, the muscle-cell unit gradually dies, and macrophages invade. Although the damage in MD is not reported to be immunologically mediated, class I human leukocyte antigens (HLAs) are found on the membrane of dystrophic muscles; this feature makes these muscles more susceptible to T-cell mediated attacks.

Selective monoclonal antibody hybridization was used to identify cytotoxic T cells as the invading macrophages; complement-activated membrane attack complexes have been identified in dystrophic muscles as well. Over time, the dead muscle shell is replaced by a fibrofatty infiltrate, which clinically appears as pseudohypertrophy of the muscle. The lack of functioning muscle units causes weakness and, eventually, contractures.

Other types of MDs are caused by alterations in the coding of one of the DAG complex proteins. The gene loci coding for each of the DAG complex proteins is located outside the X chromosomes. Gene defects in these protein products also lead to alterations in cellular permeability; however, because of the slightly different mechanism of action and because of the locations of these gene products within the body, there are other associated effects, such as those in ocular and limb-girdle type dystrophies (see the image below).

Causes

Genetic changes cause MD, and each type is due to a different set of mutations. However, all the mutations prevent the body from producing dystrophin, a protein essential for building and repairing muscles.

Although dystrophin makes up a small percent of the total proteins in muscles, it is an essential molecule for their normal function. It glues various parts of muscle tissue together and links them to the sarcolemma, or the outer membrane.

If dystrophin is absent or deformed, this process does not work correctly. This weakens the muscles and can damage the muscle cells.

In DMD, dystrophin is almost entirely absent. Conversely, in BMD, dystrophin is smaller or in short supply.

Risk factors

Muscular dystrophy occurs in both sexes and in all ages and races. However, the most common variety, Duchenne, usually occurs in young boys. People with a family history of muscular dystrophy are at higher risk of developing the disease or passing it on to their children.

What are the symptoms of muscular dystrophy?

Muscle weakness is the primary symptom of muscular dystrophy. Depending on the type, the disease affects different muscles and parts of the body. Other signs of muscular dystrophy include:

Enlarged calf muscles.

Difficulty walking or running.

Unusual walking gait (like waddling).

Trouble swallowing.

Heart problems, such as arrhythmia and heart failure (cardiomyopathy).

Learning disabilities.

Stiff or loose joints.

Muscle pain.

Curved spine (scoliosis).

Breathing problems.

Complications

The complications of progressive muscle weakness include:

Trouble walking. Some people with muscular dystrophy eventually need to use a wheelchair.

Trouble using arms. Daily activities can become more difficult if the muscles of the arms and shoulders are affected.

Shortening of muscles or tendons around joints (contractures). Contractures can further limit mobility.

Breathing problems. Progressive weakness can affect the muscles associated with breathing. People with muscular dystrophy might eventually need to use a breathing assistance device (ventilator), initially at night but possibly also during the day.

Curved spine (scoliosis). Weakened muscles might be unable to hold the spine straight.

Heart problems. Muscular dystrophy can reduce the efficiency of the heart muscle.

Swallowing problems. If the muscles involved with swallowing are affected, nutritional problems and aspiration pneumonia can develop. Feeding tubes might be an option.

Muscular dystrophy diagnosis

A number of tests can help your doctor diagnose muscular dystrophy. Your doctor can perform:

Blood testing. High levels of serum creatine kinase, serum aldolase, and myoglobin may all signal the need for further testing to confirm or rule out muscular dystrophy.

Genetic testing. High levels of creatine kinase and signs of insufficient dystrophin may indicate a need for genetic testing. This type of testing looks for a large mutation of the dystrophin (DMD) gene. If there’s no large mutation, the next set of genetic tests will look for small mutations.

Electromyography (EMG). EMG measures the muscle’s electrical activity using an electrode needle that enters your muscle. It can help doctors to distinguish muscular dystrophy from a nerve disorder.

Neurological physical exam. This exam rules out nervous system disorders and identifies the state of muscle strength and reflexes.

Cardiac testing. Cardiac testing identifies heart problems that sometimes occur with muscular dystrophy. Tests include an echocardiogram to look at the structure of the heart.

Imaging tests. MRI and ultrasound help doctors see the amount of muscle inside the body.

Exercise assessments. Exercise assessments look at muscle strength, breathing, and how exercise affects the body.

Treatment

Right now, there’s no cure for the disease. But there are many treatments that can improve symptoms and make life easier for you and your child.

Your doctor will recommend a treatment based on the type of muscular dystrophy your child has. Some of them are:

Physical therapyuses different exercises and stretches to keep muscles strong and flexible.

Occupational therapy teaches your child how to make the most of what their muscles can do. Therapists can also show them how to use wheelchairs, braces, and other devices that can help them with daily life.

Speech therapy will teach them easier ways to talk if their throat or face muscles are weak.

Respiratory therapy can help if your child is having trouble breathing. They’ll learn ways to make it easier to breathe, or get machines to help.

Medicines can help ease symptoms. They include:

Eteplirsen (Exondys 51), golodirsen (Vyondys53), and vitolarsen (Viltepso) for treating DMD. They are injection medications that help treat individuals with a specific mutation of the gene that leads to DMD, specifically by increasing dystrophin production. Talk to your child’s doctor about possible side effects.

Anti-seizure drugs that reduce muscle spasms.

Blood pressure medicines thathelp with heart problems.

Drugs that turn down the body’s immune systemcalled immunosuppressants; they may slow damage to muscle cells.

Steroids like prednisone and defkazacort (Emflaza) that slow down muscle damage and can help your child breathe better. They can cause serious side effects, such as weak bones and a higher risk of infections.

Creatine, a chemical normally found in the body that can help supply energy to muscles and improve strength for some people. Ask your child’s doctor if these supplements are a good idea for them.

Surgery can help with different complications of muscular dystrophy, like heart problems or trouble swallowing.

Scientists also are looking for new ways to treat muscular dystrophy in clinical trials. These trials test new drugs to see if they are safe and if they work. They often are a way for people to try new medicine that isn’t available to everyone. Your doctor can tell you if one of these trials might be a good fit for your child.

Taking Care of Your Child

It’s hard when your child loses strength and can’t do the things other kids can do. Muscular dystrophy is a challenge, but it doesn’t have to keep your child from enjoying life.

There are many things you can do to help them feel stronger and get the most out of life.

Eat right. A healthy, well-balanced diet is good for your child in general. It’s also important for helping them stay at a healthy weight, which can ease breathing problems and other symptoms. If it’s hard for them to chew or swallow, talk to a dietitian about foods that may be easier to eat.

Stay active.Exercise can improve your child’s muscle strength and make them feel better. Try low-impact activities like swimming.

Get enough sleep. Ask your doctor or therapist about certain beds or pads that can make your child more comfortable and rested.

Use the right tools. Wheelchairs, crutches, or electric scooters can help your child if they have trouble walking.

The disease will most likely have a big impact on your family. Remember that it’s OK to ask a doctor, counselor, family, or friends for help with any stress, sadness, or anger you may feel. Support groups are also good places to talk to other people who have lived with muscular dystrophy. They can help your child connect with others like them and give you and your family advice and understanding.

How can I prevent muscular dystrophy?

Unfortunately, there isn’t anything you can do to prevent getting muscular dystrophy. If you have the disease, these steps can help you enjoy a better quality of life:

Eat a healthy diet to prevent malnutrition.

Drink lots of water to avoid dehydration and constipation.

Exercise as much as possible.

Maintain a healthy weight to prevent obesity.

Quit smoking to protect your lungs and heart.

Get flu and pneumonia vaccines.

NNPP) has urged the Federal Government to proclaim a state of emergency in parts of the North-West and North-Central states.

The New Nigeria People’s Party (NNPP) has urged the Federal Government to proclaim a state of emergency in parts of the North-West and North-Central states over the prevailing state of insecurity in the areas.

Speaking at a press conference in Katsina on Thursday, the NNPP state Chairman, Hon. Sani Liti, warned that the scheduled general elections may not actually hold in Katsina, Kaduna, Zamfara, Niger and Sokoto states due to what he described as the festering insecurity situation.


It’s an illusion to believe that credible elections can hold in these states except the Federal Government takes measures to resolve the issue of insecurity before 2023, Liti said, adding that the recommended state of emergency should be for a duration of six months.

He noted that declaration of state of emergency rule in parts of the country is not a new thing in Nigeria arguing that the level of insecurity of lives and property in parts of the North-West and North-Central has made it imperative for the Federal Government to act without further delay.

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