THE World Health Organisation’s world mental health report says mental health is the leading cause of disability. How did the pandemic impact our mental health?
What are the signs and how can we keep ourselves mentally healthy? WHO’s Dr Mark Van Ommeren explains;

Q: The WHO report says that mental health is a leading cause for disability. Explain please.
OMMEREN: WHO does advanced calculations to come up with such a conclusion.
The calculations are reached from different sources of information.
One of them is that when an individual has a mental health condition such as depression, it’s impairing.
In many workplaces, the leading cause of people on sick leave is mental health conditions, although that’s often not said.
They start in their teenage years, in adolescent years, and largely untreated.
Less than one in three people around the world are getting mental health care for their condition.

​One in eight women will be diagnosed with breast cancer in their lifetime.
Here are some tips to help women detect any such symptoms well in time.

• LOWER your daily caffeine and alcohol intake for reduction in breast pain caused by tenderness.
• WEAR a sports bra during jogging to prevent bouncing that can stretch the ligaments. This is the easiest breast health care tip that one can imply immediately.
• SELF-EXAMINE regularly. Be aware for any unusual changes, such as a lump.
• GET plenty of Vitamin D in your diet. Take a supplement or better still, go in the sun occasionally.
• WHEN health tips for women involve dark chocolate, what more can you ask for! Research shows that eating dark chocolate helps fight fast growing cancers.

You can follow the following simple ways protect yourself from Corona virus or covid-19.

1. ​Wash Your Hands Frequently. Washing your hands with soap and water or using alcohol based  hand rub kills the virus that may be on your hands.
2. Maintaining Social Distancing. Maintain at least one meter between yourself and another person in order to minimize the spread of any virus present.
3. Wearing a Face Mask: The virus is air borne in fine  droplets from your breath. If you are carrying t he virus the mask is designed to prevent you spreading the virus to another person.
4. Avoid touching eyes, nose and mouth. The virus can enter the body in air borne droplets through  the eyes, nose and mouth. Your hands touch many surfaces and can transfer the virus in this way.
5. Practice Respiratory hygiene. Covering your mouth and nose will contain coughs and sneezes. Mucous  material must be disposed of in a toilet using tissues immediately. Masks must be washed as necessary on the premises or at home.
6.  Stay home if you feel unwell. If you have fever, cough and any difficulty breathing, seek medical attention and do not come to the work place.

By Dr. James Naipao,
Coronavirus (Covid-19): 105, 300 coronavirus cases confirmed world wide. This figure will increase by the day. 

• 3,500 deaths globally. 
• 416 died outside of China. 
• 95 countries have confirmed the coronavirus. More countries will be added to this list because none are immune to this virus. 

Developed countries such as Italy and South Korea are struggling to contained this virus. 
Our nearest neighbours have confirmed this virus. 
This virus whom virologists thought the incubation period is two weeks, but it seems to be unpredictable, and the incubation period now stands at three weeks.

​Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. Most sexually active women and men will be infected at some point in their lives and some may be repeatedly infected.
The peak time for acquiring infection for both women and men is shortly after becoming sexually active. HPV is sexually transmitted, but penetrative sex is not required for transmission. Skin-to-skin genital contact is a well-recognized mode of transmission.
There are many types of HPV, and many do not cause problems. HPV infections usually clear up without any intervention within a few months after acquisition, and about 90% clear within 2 years. A small proportion of infections with certain types of HPV can persist and progress to cervical cancer.
Cervical cancer is by far the most common HPV-related disease. Nearly all cases of cervical cancer can be attributable to HPV infection.
The infection with certain HPV types also causes a proportion of cancers of the anus, vulva, vagina, penis and oropharynx, which are preventable using similar primary prevention strategies as those for cervical cancer.

By Dr. Mathias Sapuri 

40 years ago obesity in our women population in PNG was only 3 percent. Today the incidence is about 18 percent with BMI of 30 plus. This is associated with endometrial hyperplasia. Today in PNG endometrial hyperplasia is the second commonest indication for a D&C following miscarriages. Below a few hysteroscopic images from my weekly surgery lists and patients Q&A narrative from ACOG.

From ACOG

What is endometrial hyperplasia?
Endometrial hyperplasia occurs when the endometrium, the lining of the uterus, becomes too thick. It is not cancer, but in some cases, it can lead to cancer of the uterus.
How does the endometrium normally change throughout the menstrual cycle?
The endometrium changes throughout the menstrual cycle in response to hormones. During the first part of the cycle, the hormone estrogen is made by the ovaries. Estrogen causes the lining to grow and thicken to prepare the uterus for pregnancy. In the middle of the cycle, an egg is released from one of the ovaries (ovulation). Following ovulation, levels of another hormone called progesterone begin to increase. Progesterone prepares the endometrium to receive and nourish a fertilized egg. If pregnancy does not occur, estrogen and progesterone levels decrease. The decrease in progesterone triggers menstruation, or shedding of the lining. Once the lining is completely shed, a new menstrual cycle begins.

​By Dr. Mathias Sapuri 

About the uterus
The pear-shaped uterus is hollow and located in a woman’s pelvis between the bladder and rectum. The uterus, also known as the womb, is where a baby grows when a woman is pregnant. It has 3 sections: the narrow, lower section called the cervix; the broad section in the middle called the isthmus; and the dome-shaped top section called the fundus. The wall on the inside of the uterus has 2 layers of tissue: endometrium (inner layer) and myometrium (outer layer), which is muscle tissue.
During a woman's childbearing years, her ovaries typically release an egg every month and the lining of the uterus grows and thickens in preparation for pregnancy. If the woman does not get pregnant, this thick lining passes out of her body through her vagina, a process known as menstruation. This process continues until menopause, when a woman’s ovaries stop releasing eggs.
About uterine cancer

Many people with hepatitis experience either mild symptoms or none at all. The initial phase of hepatitis is called the acute phase.
The symptoms are like a mild flu and may include:
- Diarrhoea
- Fatigue
- Loss of appetite
- Mild fever
- Muscle or joint aches
- Nausea
- Slight abdominal pain
- Vomiting
- Dark urine
- Light-coloured stools
- Jaundice (yellowing of the skin and whites of the eyes)

If you are experiencing many of these symptoms, please see your doctor at your local urban health clinic and get tested.

Tests and Diagnosis and Treatment     

Hepatitis A Treatment - There is no treatment specifically for hepatitis A. The doctor will advise the patient to abstain from alcohol and drugs during the recovery. The vast majority of patients with hepatitis A will recover spontaneously.    

Hepatitis B Treatment - There is no treatment for “acute” hepatitis B as most adults will naturally clear the virus.  Treatment is available for “chronic” hepatitis B. Your doctor will advise which method is right for you. 

Hepatitis C Treatment – Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body. Your doctor may recommend a combination of medications.

Hepatitis D Treatment - There is no specific treatment for hepatitis D. 

Hepatitis E Treatment – There is no treatment for hepatitis E. Hepatitis E is caused by a virus which means antibiotics are of no value in the treatment of the infection. Treatment of hepatitis E infection is supportive and involves bed rest and fluid replacement.               

Remember: If you think you may have hepatitis it is important to see your doctor at your local urban health clinic and get tested. 

Related Post

• How does Hepatitis  Spread? 

How is Hepatitis A Spread? 
A person can get hepatitis A from:
- Eating food or drinking water carrying the virus. (Infected food and water is usually a problem in developing nations where poor sanitation is common).

Prevention of Hepatitis A
- Wash your hands with soap after going to the toilet
- Only consume food that have just been cooked
- Only drink commercially bottled water, or boiled water if you're unsure of water sanitation
- Only eat fruits that you can peel if you are somewhere where sanitation is unreliable
- Only eat raw vegetables if you are sure they have been cleaned/disinfected thoroughly
- Get a vaccine for hepatitis A if you live or travel to places where hepatitis may be endemic.

Hepatitis B - Hepatitis B is a viral infection that causes liver inflammation and can lead to serious illness or death. It is spread through unsafe sex and other activities where blood or body fluids are exchanged. It can also be passed from an infected mother to her baby.  Once infected, a person can spread the virus even if he or she does not feel sick. Immunisation is the best way to reduce the risk of infection.

Most people recover from the virus within six months, but sometimes the virus will cause a lifelong, chronic infection, possibly resulting in serious liver damage. 

How is Hepatitis B Spread?  
Hepatitis B may be transmitted by:
- Having sex with an infected person.
- Sharing dirty needles.
- Being in direct contact with infected blood.
- Getting needle stick injuries.
- Mother to unborn child.
- Being in contact with an infected person's body fluids.

Prevention of Hepatitis B 
- Tell the partner if you are a carrier, ask your partner if they are a carrier
- Practice safe sex
- Only use clean syringes that have not been used by anyone else
- Do not share toothbrushes, razors, or manicure instruments
- Have a hepatitis B series of shots if you are at risk
- Only allow well-sterilized skin perforating equipment (tattoo, acupuncture, etc.).

Hepatitis C - Hepatitis C is a blood-borne virus that causes inflammation of the liver. It is commonly spread through sharing unsterile needles, syringes and other injecting drug equipment. There is currently no vaccine to prevent hepatitis C infection, but treatment is effective for some people. When the initial infection lasts for more than six months, it is called chronic hepatitis C, which may lead to cirrhosis and liver cancer. Hepatitis C is considered to be among the most serious of the hepatitis viruses. 

Many people may not feel ill when first infected with hepatitis C while others may find their urine becomes dark, and their eyes and skin turn yellow (this is known as jaundice), or they may experience a minor flu-like illness. These symptoms may disappear within a few weeks, but this does not necessarily mean that the infection has been cleared. 

How is Hepatitis C Spread?  
Hepatitis C may be transmitted by:
- Tattoo and body piercing equipment that has not been properly cleaned, disinfected or sterilised
- Sharing toothbrushes, razor blades or other personal items that could have small amounts of blood on them
- One person’s blood coming into contact with open cuts on another person
- Pregnancy or childbirth – there is a five percent chance of a mother with chronic hepatitis C infection passing on the virus to her baby during pregnancy or childbirth. Breastfeeding is safe unless nipples are cracked or bleeding
- Blood-to-blood contact during sex – sexual transmission rates of hepatitis C are very low, but the risk is increased with certain sexual practices or circumstances where there is the possibility of blood-to-blood contact (for example, sex during menstruation, and rough sex that can cause a tear. 

Prevention of Hep C - 
- Never share needles.
- Avoid direct exposure to blood or blood products. 
- Don't share personal care items. 
- Choose tattoo and piercers
- Practice safe sex. (It is rare for hepatitis C to be transmitted through sexual intercourse, but there is greater risk of getting hepatitis C if you have a sexually transmitted disease, HIV, or multiple sex partners or if you engage in rough sex). 

Hepatitis D ​- Only a person who is already infected with hepatitis B can become infected with hepatitis D. Hepatitis D infection can occur as a co-infection, which means it occurs at the same time as hepatitis B infection; or it can occur as a superinfection in people who already have chronic hepatitis B. Infection is through contact with infected blood, unprotected sex, and perforation of the skin with infected needles. The liver of a person with Hepatitis D swells. 

Prevention - Use the same guidelines as for hepatitis B. Only a person who is infected with hepatitis B can become infected with hepatitis D. 

Hepatitis E - Hepatitis E is transmitted via the faecal-oral route and can be spread by eating or drinking contaminated food or water. The highest rates of hepatitis E infection occur in regions where there is poor sanitation and sewage management that promotes the transmission of the virus.  Hepatitis E causes an acute (short-term) illness but does not cause a chronic (life-long) infection.

Prevention - At present, no vaccine exists for the prevention of hepatitis E. As hepatitis E is spread through the fecal-oral route, prevention of hepatitis E relies primarily on having access to clean drinking water and using good personal hygiene.

Related Post

• What is Hepatitis? 
  

What Is Hepatitis? 
Hepatitis is inflammation (swelling and pain) of the liver and affects millions of people worldwide causing acute and chronic liver disease and killing close to 1.4 million people every year. The various forms of viral hepatitis include hepatitis A, B, C, D and E. While all these viruses affect the liver, they are spread in different ways and have different treatments. Most liver damage is caused by 3 hepatitis viruses A, B, and C. 

Hepatitis can be caused by alcohol and some other toxins and infections, as well as from our own autoimmune process (the body attacks itself). About 250 million people globally are thought to be affected by hepatitis C, while 300 million people are thought to be carriers of hepatitis B. Not all forms of hepatitis are infectious. Alcohol, medicines, and chemicals may be bad for the liver and cause inflammation. Other viruses may also cause hepatitis, such as the yellow fever virus and the virus that causes glandular fever. ‘Chronic hepatitis’ means ongoing inflammation of the liver, regardless of the underlying cause.

Remember: The liver is important for a range of functions in the body. These include regulating metabolism, making proteins, storing vitamins and iron, removing toxins and producing bile.  If the liver doesn’t work properly, it can cause serious illness or sometimes even death. 

Health Risks of Hepatitis - 
Viral hepatitis is often preventable. However, it is still considered a serious health risk because it can:
- Destroy liver tissue.
- Spread from person to person.
- Weaken the body's immune system.
- Cause the liver to fail.
- Cause liver cancer (hepatitis B and C).
- Cause death.

Types of Hepatitis

Hepatitis A - Hepatitis A is a viral disease that affects the liver. It most commonly comes from contaminated food or water. This form of hepatitis never leads to a chronic infection and does not cause chronic liver disease. Symptoms may last for several weeks, but full recovery usually occurs. Occasional deaths from hepatitis A have occurred due to chronic liver infection.

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• Best Health Tips for Papua New Guineans