1. YOU AND YOUR HEALTH 4/23/20151

2. PRESENTED @ Christ Life Church, Olubadan Estate, Ibadan Sunday 28th February 2010 4/23/20152

3. 3 by Dr Olugbenga Bejide M.B.,B.S.,M.B.A.,M.P.H.,F.N.I.M.

4. TODAY ………..is the day the Lord has made We shall rejoice and be glad in Him 4/23/20154

5. COVERAGE INTRODUCTION HEALTHY LIFESTYLE TIPS COMPREHENSIVE HEALTH SCREENING CANCER SCREENING THE MENACE OF NOISE HEALTH INSURANCE HIV/AIDS SUMMARY AND CONCLUSION 4/23/20155

6. YOUTH Defining YOUTH Describing YOUTH 4/23/20156

7. HEALTH Defining HEALTH Describing HEALTH 4/23/20157

8. 8 DEFINITION OF HEALTH ……the state of physical, mental and social well-being and not just the absence of disease or infirmity………… (WHO, 1948)

9. SUCCESS PLAN PURPOSEFULLY PREPARE PRAYERFULLY PROCEED POSITIVELY PURSUE PERSISTENTLY 4/23/20159

10. PERSONAL VISION STATEMENT Please state yours 4/23/201510

11. PERSONAL MISSION STATEMENT Please state yours 4/23/201511

12. ROLE OF ATTITUDE Its your ATTITUDE rather than your APTITUDE that determines your ALTITUDE in life 4/23/201512

13. KEYNOTES IN NIGERIA The most religious in the world The happiest people in the world The most populous African country Houses the highest number of sicklers in the entire world Houses the highest number of multiple pregnancies in the world Has the highest number of PLWHA 4/23/201513

14. SCRIPTURAL HIGHLIGHTS Hosea 4: 6 My people perish for lack of knowledge Proverbs 23: 7 As a man thinketh, so he is Ecclesiastes 1: 18 He that increaseth knowledge increaseth sorrow Ecclesiastes 3: 1-8 To everything there is a season, and a time to every purpose under the heaven Matthews 25:14-30 The parable of the talent 4/23/201514

15. SCRIPTURAL HIGHLIGHTS(2) Exodus 23:20 Behold I send an angel before thee to keep thee in the way and to bring thee into the place I have prepared Exodus 23 :25 and I will take sickness away from their midst Luke 1:37 For with God nothing shall be impossible Numbers 21: 1-9 The story of the serpent of brass Revelations 22:11 He that is filthy, … 4/23/201515

16. SOME HEALTHY LIFESTYLE TIPS 4/23/201516

17. HEALTH TIPS(1) A healthy day is spent thus: 1/3 work, 1/3 sleep and 1/3 recreation Please note that you are what you eat Eat and drink moderately Take plenty of vegetables and fruits 4/23/201517

18. HEALTH TIPS (2) Eat beans and bean products regularly Avoid junk food items Avoid red meat, fresh fish and dairy products Skip dinner if you can or make it very light 4/23/201518

19. HEALTH TIPS (3) Avoid eating in between meals Avoid additional salt or sugar Please note that the slimmer you are, the healthier(aim at right weight for height) Regular dedicated physical exercise vital 4/23/201519

20. HEALTH TIPS(4) Take at least 8 glasses of water/day Note that LOW ALCOHOL INTAKE is healthier than NO ALCOHOL INTAKE Avoid smoking in any form Avoid unprescribed drugs 4/23/201520

21. HEALTH TIPS(5) Always use correct lifting techniques to avoid musculo-skeletal disorders Always use your seat belt while driving Avoid casual sex Periodic health assessment/check-up vital 4/23/201521

22. 4/23/201522 COMPREHENSIVE HEALTH SCREENING aka PERIODIC HEALTH ASSESSMENT

23. 4/23/201523 NOTE Your health is your greatest ASSET

24. 4/23/201524 NOTE Sometimes you don’t appreciate what you have until you lose it! e.g. sleep

25. 4/23/201525 PREVENTIVE MAINTENANCE.......of machines including vehicles, generators, air-conditioner units and even computers

26. 4/23/201526 WHEREAS Man is the most complex MACHINE in the entire world!

27. 4/23/201527 LIFE SPAN:n ature & n urture Japan Denmark USA Nigeria

28. 4/23/201528 GENERAL GUIDE FOR CHECK-UPS < 30 years Once 30 - 40 years Once in 5 years 40 - 50 years Once in 2 years 50 - 60 years Every year 60 - 70 years Every six months > 70 years Every three months

29. 4/23/201529 MEDICAL CHECK CLASSES AAdvanced BBasic CClassical DDiamond EElementary

30. 4/23/201530 CLASS E General Physical Examination Weight, Height (BMI), Blood Pressure, Pulse, Visual Acuity FBC + FBS + FU ABO Blood Grouping + Haemoglobin Genotype

31. 4/23/201531 CLASS D Class E + Hepatitis B Screening Hepatitis C Screening Retroviral Screening Faecal Occult Blood H. pylori

32. 4/23/201532 CLASS C Class D + Chest Xray Fundoscopy Lipid Profile Liver Function Tests

33. 4/23/201533 CLASS B Class C + Electrocardiograph (ECG) Abdominal Ultrasound Renal Function Tests

34. 4/23/201534 CLASS A Class B + PSA/Pap’s Smear ENT

35. 4/23/201535 STEPS (1) 1Preparatory Chat 2Health Questionnaire 3Visit to the Nurse (Class E/D) 4Visit to external laboratories (Class C/B) 5Visit to specialists (Class C/B/A)

36. 4/23/201536 STEPS (2) 6Collation of results 7Compilation of results 8Discussion with clients 9Follow up visits 10Seeking Spouse cooperation

37. 4/23/201537 MEDICAL REPORT Comprehensive Medical Report Highlighting key positive findings Summary and Conclusion Medical advice

38. 4/23/201538 METABOLIC SYNDROME Total Cholesterol Trigylicerides FBSFasting Blood Sugar BMI Body Mass Index ACAbdominal Circumference

39. 4/23/201539 BENEFITS Health Score Card Preventive Maintenance Taking Responsibility for Your Health Improved Quality of Life Lifestyle Modification

40. 4/23/201540 REMEMBER God’s promise: …....I will take sickness away from thy midst Exodus 23:25

41. CANCER SCREENING 4/23/201541

42. What Is Cancer? Cancer is the name given to a large number of diseases

43. Breast Cancer BREAST CANCER

44. Breast Structure

45. MC female cancer, worldwide & Nigeria Leading cause of female cancer deaths in Nigeria Incidence  with age All women are at risk Breast Cancer Facts

46. GENDER - All women are at risk Age Family/Personal History Reproductive History Menstrual History Race Genetic Factors Breast Cancer Risk Factors that cannot be changed Radiation Treatment with DES

47. All women are at risk Obesity Breastfeeding Not having children Birth Control Pills Alcohol Hormone Replacement Therapy Exercise All women are at risk Obesity Breastfeeding Not having children Birth Control Pills Alcohol Hormone Replacement Therapy controlled Breast Cancer Risk Factors that can be controlled Exercise

48. A Good Breast Health Plan 1. Mammograms 2. Clinical Breast Examination (CBE) 3. Self Awareness (Monthly Self Exams) (BSE)

49. A Good Breast Health Plan 1. Mammograms 2. Clinical Breast Examination (CBE) 3. Self Awareness (Monthly Self Exams) (BSE)

50. Mammography Average-size lump found by woman practicing occasional breast self- exam (BSE) Average-size lump found by woman practicing regular breast self-exam (BSE) Average-size lump found by first mammogram Average-size lump found by getting regular mammograms

51. BREAST SELF EXAMINATIONS

52. Warning signs and symptoms : Painless lump or thickening Thickening or swelling that persist Nipple pain or retraction Breast skin irritation or dimpling Spontaneous discharge Early breast cancer may not have symptoms. Warning Signs

53. American Cancer Society Screening Recommendations n Annual mammograms, starting at age 40 n Clinical breast exams – every year starting at age 40 – every 3 years for women age 20-39 n Self-breast exams monthly, starting at age 20

54. Nutrition Guidelines Eat a variety of healthful foods, with an emphasis on plant sources. Adopt a physically active lifestyle. Maintain a healthful weight throughout life. If you drink alcoholic beverages, limit consumptions.

55. Cervical Cancer CERVICAL CANCER

56. What Is The Cervix [Ser-vix]? The cervix is one of the female genital organs Other female organs include the: –Vulva [vul-vah] –Vagina [ve-juy- nah] –Uterus [yoo-tuh- ris] –Fallopian tubes [fuh-loh-pee-an toobs] –Ovaries [o-vuh- reez]

57. Cervical Cancer Facts 2 nd commonest female cancer in Nigeria 2 nd MCC of cancer deaths The easiest female cancer to prevent through screening

58. What Causes Cervical Cancer? Human Papillomavirus (HPV) ▪Genital HPV is a virus that is spread by sex You could have been infected with HPV years ago but only recently had it found on a test There are many different types of HPV Certain “high-risk” HPV types can cause cell changes and cervical cancer

59. Early Cell Changes

60. How Common Is HPV? Most men and women who have had sex have been exposed to HPV Most sexually active women (at least 80%) have been exposed to HPV by age 50

61. Who Is At Higher Risk For HPV? Anyone who has had more than one sex partner Anyone whose sex partner(s) has had more than one sex partner

62. Does HPV = Cancer? No! Most people get HPV infection, but very few get cervical cancer In most cases, HPV infection goes away on its own Sometimes, the HPV infection does not go away after many years. This type is called “persistent”. It can lead to cervical cancer

63. How Do I Know If I Have HPV? Abnormal Pap smear results are often a sign of HPV

64. What Is A Pap Smear? Cells are collected from the surface of your cervix by a doctor These cells are then checked under a microscope for any abnormalities If abnormal (or precancerous) cells are found, they can be treated before they turn into cancer Cervical cancer can be found in the early stages, when it is easier to treat

65. Early Cell Changes Normal cervical cells Precancer cells

66. Who Is At Risk For Cervical Cancer? Women who do not have Pap tests Women who do not follow up with testing or treatment after an abnormal Pap test, as told by their health care provider Women who have persistent HPV Women who smoke

67. Who Is At Risk For Cervical Cancer? Women with immune problems HIV Transplanted organs Steroid medications Chemotherapy Women whose mothers took the drug, DES

68. How Do I  My Risk Of Cervical Ca? Get regular Pap tests and follow up, if necessary Abstain till marriage and choose a spouse who has had no or few prior sex partners. Be faithful in marriage. Do not smoke cigarettes Keep a healthy diet and lifestyle (Condom use)

69. What Will A Pap Smear Tell Me? That The Cells In Your Cervix Are… Normal Abnormal: –Minor Cell Changes Of Unknown Importance, Possibly Unrelated To Precancer –Minor Cell Changes –Moderate Cell Changes –Severe Cell Changes Possibly Cancerous

70. How Often Do I Need A Pap Smear? First Pap –No more than 3 years after you first have sex –No later than age 21 Subsequently –Every year until age 30 –After age 30, if you have had only normal results, you may have them every 2 to 3 years (after talking with your health care provider about your level of risk)

71. Why Do I Need To Keep Getting Tested? Just like mammogram screening, Pap testing is not a one-time test The test is not perfect New changes (abnormalities) can occur after you get tested, even if you have not had new partners It could take many years for changes to develop or to be noticed Your risk changes if you have new partners, or if your partner has other partners

72. What Can I Do To Make My Pap Smear As Accurate As Possible? Schedule your Pap smear when you are not having a menstrual period Do not have sex for 2 days before the test Do not douche for 2 days before the test Do not use tampons, birth control foams, jellies, or other vaginal creams and drugs for 2 days before the test.

73. What Can I Do To Make My Pap Smear As Accurate As Possible? Schedule your Pap smear when you are not having a menstrual period Do not have sex for 2 days before the test Do not douche for 2 days before the test Do not use tampons, birth control foams, jellies, or other vaginal creams and drugs for 2 days before the test.

74. What Should I Expect When I Have a Pap Smear?

76. Follow-Up For Pap Smear Results You can call or re-visit your doctor for your results. If you have an abnormal result, it is extremely important to show up for follow-up appointments and get the recommended testing Even after a normal Pap test, it is still important to report any symptoms of abnormal vaginal bleeding, discharge, or pain to your health care provider

77. PROSTATE CANCER PROSTATE GLAND

78. What Is The Prostate Gland? Part of the male reproductive system Makes a fluid that mixes with sperm and other fluids during ejaculation. A normal prostate is about the size of a walnut.

79. Prostate Cancer Facts 5 th MC cancer worldwide MC cancer in men in Nigeria (11%) Risk factors –Age (>50) –Race (Blacks) –Family history –High fat diet/obesity Many tumours are only histologically evident, never develop clinically significant disease

80. Possible Symptoms of Prostate Cancer Call your doctor if you have any of these symptoms: –Difficulty starting to urinate –Less force to the stream of urine –Dribbling after you finish urinating –Frequent urination –Blood or pus in the urine –Pain or burning feeling while urinating –Pain with ejaculation –Hip or back pain that does not go away over time

81. Prostate Cancer Screening Screening tests for prostate cancer –Prostate Specific Antigen Blood test <4 ng/ml Normal >10ng/ml High 4-10ng/ml Intermediate Also  in BPH & Prostatitis –Digital Rectal Exam

82. Prostate Cancer Screening Insufficient evidence from studies abroad to recommend routine prostate screening Many studies failed to show improvement in mortality or morbidity from screening Recent data that treatment of early detected ca (other than discovered by screening) decreases mortality However, no evidence that screening decreases mortality

83. THE MENACE OF NOISE 4/23/201583

84. 84 HEARING CONSERVATION PROGRAMME : LOCAL STUDIES Agodi Motor Park, Agodi Gate Ayons Musical Centre, Sanngo Dupsy Grinders Shop, Bodija Market

85. 85 OTHER POTENTIALS Noisy musical neighbours Car stereo Office music Religious noise to the Lord!! Market cacophony Ear phones/hand-free sets Airport environment

86. 86 PRESBYACUSIS …..means natural progressive age-related loss of hearing commencing from the age of 40

87. 87 NOISE LEVELS < 85 decibels over 8 hours Sound level meter Personal dosimeter Noise survey Noise map

88. 88 CONTROLS Engineering Administrative Epidemiological

89. 89 DEVICES Encasement/glass panels Ear muffs Ear plugs -standard -- customised

90. 90 INTERVENTION Drugs e.g. vitamin supplements, nasal drops Hearing aids Surgery(ENT)

91. 91 PREVENTION ` i s however better than CURE!!

92. INSURING YOUR HEALTH 4/23/201592

93. THE PEOPLE SAY: HEALTH is WEALTH

94. WHO says: ….the state of physical, mental and social well being and not just the absence of disease or infirmity! (WHO 1948)

95. NOTE Your health is your greatest ASSET

96. WHAT DO THESE HAVE IN COMMON? AIR SLEEP HEALTH

97. HEALTH CARE is no longer a pay as you go affair

98. HEALTH CARE FINANCING OPTIONS Relations Community Government (federal, state, local) Employer Personal (out-of-pocket) Trade by barter Health insurance

99. HEALTH INSURANCE National Health Insurance Scheme (NHIS) Health Maintenance Organisations (HMO) e.g. Total Health Trust(THT), Hygeia

100. CAPITATION SCHEME Pre-paid Per head (capitus) Option of choice and transfer ID Badges provided ID badges usable anywhere in the network Different Categories No age barrier

101. CATEGORIES Standard plan Silver plan Gold plan

102. MEDICAL EXCLUSIONS(I) Evacuation Intensive care treatment Optical care Cytotoxic drugs Radiotherapy Plastic/cosmetic surgery Transplant surgery

103. MEDICAL EXCLUSIONS(II) Prostheses Specific treatment of HIV/AIDS Infertility Advanced radiology e.g. CT scan, MRI, etc Overseas treatment Dental care Embalment and autopsy

104. THE TAKE HOME ENSURE Your health By INSURING Your health TODAY

105. HIV/AIDS CURRENTLY THE GREATEST PANDEMIC OF MANKIND MORE DEVASTATING THAN ALL THE WARS COMBINED 4/23/2015105

106. 106 ABC OF HIV PREVENTION AABSTINENCE BBE FAITHFUL C CORRECT CONSISTENT CONDOM USE

107. ATM OF HIV PREVENTION Aabstinence Ttill Mmarriage 4/23/2015107

108. 108 HIGH RISK TARGET GROUPS Long distance truck drivers Employees who live far apart from their families Employees in Sales Division Employees involved in promotional activities Health Care Workers

109. 2008 National HIV Sero- Prevalence Sentinel Survey Among the Antenatal Clinic Attendees Preliminary Findings

111. HIV prevalence by zone

112. HIV Prevalence by age group

113. National HIV Prevalence Trend 1991 – 2008

114. Summary of findings Overall HIV Prevalence was 4.6%. Prevalence range: 1.0% in Ekiti to 10.6% in Benue All states and FCT had prevalence greater than 1% 17 states and FCT had prevalence greater than 5% In 7 of the states and FCT the prevalence was 7% and above; 4 of the states were from the SS, 2 and FCT from NC and 1 from the NW geo-political zones There was higher urban prevalence to rural in most states except 9 where the reverse was the case

115. Summary of findings cont. Bwari in FCT had the highest site prevalence of 22.0% while the least (0.0%) was recorded in Igbara Odo (Ekiti), Ganawuri (Plateau), Taura (Jigawa) and Tudun wada (Kano State) The prevalence was higher among those with primary and secondary level education and least among those with Qur’anic only There was a declining HIV prevalence trends among women aged 15-24yrs from 2001-2008 5 states showed a declining HIV prevalence trend from 2001-2008 while one showed an increasing trend. About 3 million PLWH out of which 833,000 require ART

116. RECAP INTRODUCTION HEALTHY LIFESTYLE TIPS COMPREHENSIVE HEALTH SCREENING CANCER SCREENING THE MENACE OF NOISE HEALTH INSURANCE HIV/AIDS SUMMARY AND CONCLUSION 4/23/2015116

117. SUMMARY We all need to take ownership of our health 4/23/2015117

118. CONCLUSION Are you ready to take ownership of your health? 4/23/2015118

119. 4/23/2015119 THANK YOU!

120. 4/23/2015120 QUESTIONS AND ANSWERS