Aga Khan University Hospital has carried out the balloon pulmonary valvuloplasty procedure, a first in Kenya.

The non-surgical process treats pulmonic stenosis — obstruction of normal blood flow in the pulmonary arterial system.

“There are four valves in the heart — aortic, pulmonary, mitral and tricuspid. The valves open and close to regulate blood flow from one chamber to the other and are vital to the efficient functioning of the heart.

“Pulmonic Stenosis causes reduced opening of the pulmonary valve leading to increased pressure build up in the heart. Overtime this causes the heart muscle to work harder and may eventually fail.

The condition is normally detected and treated in childhood by stretching open the tight pulmonic valve by a balloon. Adults presenting with this condition is not very common,” says Harun A Otieno, an interventional cardiologist at Aga Khan Hospital who assisted Neil Brass, an interventional cardiologist at the Royal Alexander Hospital in Canada to perform the procedure. But if the condition is severe open-heart surgery is necessary.

Narrow valves

Balloon pulmonary valvuloplasty treatment is a minimal invasive procedure used to open the narrowed pulmonary valves and improve blood flow. A thin tube (catheter) with a small-deflated balloon at its tip is inserted through the patient’s skin in the groin area into a blood vessel then threaded up to the narrowed heart valve.

The balloon is inflated to stretch the valve open and relieve the obstruction. The hospitals’ cardiologists are working with doctors from the Royal Alexandra Hospital and University of Alberta, Canada to develop the first radial arterial access laboratory in the region

The hospital expects to have a second cardiac catheterisation laboratory and comprehensive cardiac surgery operating theatre and intensive care unit in 2010.

Published on the Standard on 30/07/2009

The prevalence of the disease that is characterised by reduced supply of blood to the heart muscle and related morbidity may be increasing as a result of adverse behaviour and lifestyle changes associated with urbanisation.

The major risk factors for IHD in sub-Saharan Africa include hypertension, smoking, diabetes, abdominal obesity and dyslipidaemia — abnormalities in the blood. Many cost-effective interventions exist and they are likely to have a significant health impact in Africa. An aggressive approach that combines environmental policy and legislative interventions for health promotion and primary prevention, coupled with improved access to evaluation, treatment and control of hypertension and other major risk factors, provides the best strategy for averting an epidemic of IHD in sub-Saharan.

WHO estimated that in 2005, IHD caused 361 000 deaths in Africa and current projections suggest that this number will nearly double by 2030.

Cause of death

Considering that IHD was regarded as rare in Sub-Saharan Africa barely 50 years ago, these observations are remarkable and highlight the emerging burden of chronic non-communicable diseases that is now superimposed on the huge burden of HIV and Aids, other infectious and parasitic diseases, and the ravages of famine, malnutrition, and social conflict that constitute Africa’s health challenges today.

Fundamental approaches to the prevention and control of IHD are to promote cardiovascular health beginning early in life to prevent development of risk factors, screen for, identify, treat and prevent first-time IHD, treat acute cases promptly so as to reduce case fatalities, apply effective interventions in people who survive first-time IHD events to prevent complications.

Education on healthier lifestyle choices such as weight reduction, increased intake of fruits, vegetables, smoking cessation and greater physical activity is crucial.

Published on 30/07/2009 by DR J A ALUOCH

— The writer is a Nairobi based doctor.

I also learnt that many children on drugs are quiet, reliable, conservative, and well mannered, but they are also easily influenced and like pleasing others.

Take this from me, just because this nightmare has never sneaked into your family is no assurance that it never will.

The drug rehabilitation counsellor who invited me was right that unless one participated in the daily group discussions held by recovering addicts, they would never know the magnitude of the problem and how difficult it is for anyone to grapple with drug addiction, least of all a child. I had to pretend to be on drugs for members to accept me in their discussion.

What struck me most was that the youngest in the group was a 13-year-old boy. And if you pictured in your mind, like I had, that his family lives in some slum, you are wrong. They live in one of the leafy suburbs of Nairobi; his parents are well educated and hold high level jobs.

He confessed to have had a good education, attended church every Sunday with his family and was generally well-behaved. Then what went wrong, I wondered?

Since the age of nine, his father openly smoked cigarettes and together with his wife, they drank from the bar in their house. This gave him the impression that there was nothing wrong with smoking or drinking alcohol. He started by picking cigarettes butts his father dropped and, before long, he could not do without a puff.

Emulating the parents

As psychiatrists reveal, children learn to abuse drugs from their parents because they are wont to emulate them. This boy’s case was the ideal example. He said: “I watched my father smoke and it appeared very exciting as he exhaled the smoke. I was sucked into it. I didn’t see any harm in that”.

I wondered how many parents are unknowingly contributing to their children’s drug habits, especially those who keep and drink alcohol in the house.

A research conducted among students in high schools in New York found that the major influence on whether a student might use drugs was parental habits. The survey designed specific questions to determine how frequently parents smoked cigarettes, took alcohol or other drugs such as sleeping pills, and argued in front of their children. Drinking habits of parents had the greatest effect — specifically how many bottles or glasses the parents drink and how often they got drunk. The drinking habits of mothers had greater influence on children.

A pill for every problem

How a parent handles his or her anxieties and frustrations contributes significantly to how a child perceives such problems should be resolved. If, for instance, a parent runs to the medicine cabinet when faced with a crisis, the child learns that every problem can be fixed with a pill. If a child sees his mother or father swallow pills every night to induce sleep, or take alcohol whenever they are stressed up, chances are high that the child will copy this behaviour.

On the other hand, we are bombarded with media messages offering drugs and medicines to cure the most insignificant of symptoms of real or imagined illnesses or to provide escape from reality. This subtly ingrains in the child’s mind the notion that there should be a chemical solution for all life’s problems, including pain, boredom and anxiety. Young children are usually conditioned by what they see on TV.

Need for acceptance

Psychiatrists agree that children or teenagers who take drugs usually display severe emotional problems. That explains why young people with emotional problems, those who feel alienated, or are grappling with day-to-day difficulties may feel inclined to join drug-oriented groups in which they can find acceptance. It is important, therefore, to ensure your child is emotionally secure. It assures him or her of parental love and that they are always there for him or her.

Warning signs

Addicted persons usually have needle marks on arms or legs.

Red, watery eyes; small pupils in the eyes; furtive glances and chronic drowsiness.

Marked restlessness with body spasms and a tendency to walk fast.

Easily upset stomach; uncontrollable giddiness; ulcerous sores on arms, legs and body.

Strong body odour, habitual dizziness; obvious mental and physical deterioration, depression and despondency; persecution complex and chronic sleepiness;

Loss of interest in school; inability to concentrate on studies and disinterest in athletics or other forms of exercise.

Irritability; telling of stupid lies and refusal to talk because they are preoccupied with self.

Way forward

A good drug education program as part of the curriculum from nursery school to secondary school is essential. One of the counsellors leading the group discussion during our visit to the rehabilitation said he has never visited a school in Kenya where at least a teacher, staff, pupil or student is not on drugs!

He has helped children who started taking alcohol or smoking cigarettes when only eight years of age, then graduated to bhang and other hard drugs.

The most disheartening news is how children influence each other into taking drugs. Undoubtedly, if our children are to be protected from drugs as early as possible, then a good drug education as part of the curriculum is a must.

On the other hand, the value of strong family relationship where members respect and love each other cannot be overemphasised. Mutual respect gives new meaning to the home situation so that the child matures in a healthy environment.

In addition, parents must set good examples to their children. Thus, drug prevention starts with you as a parent.

Published on the Standard on 01/08/2009

Peter ole Kampus (real name withheld on request) stops to read a text message from his cell phone. The one-word message is coded but he understands what it means. It reminds him to take his antiretroviral drugs and he rushes back to the house for the medicine.Telemedicine — this is how HIV/Aids is being tackled in Kajiado,150km from Nairobi.

“Sometimes I forget the drugs and the SMS reminds me. This way, I keep the prescription schedule,” Kampus explains.

Perhaps, somebody else could also remind him about his drugs responsibility but Kampus doesn’t want to go public about his status and that is why this interview was granted on condition that his identity is never revealed.

But he says he has found ‘someone’ empathetic — a cell phone and is at ease with this arrangement.

Hundreds of residents in this region have enrolled in the telemedicine project, a new concept (in Kenya) that is popular among HIV/Aids patients in Kajiado.

The messages are coded and can only be understood by intended recipients.

This concept is a brainchild of a project, Weltel/Afyatel, a joint collaboration between the University of Manitoba (Canada) and University of Nairobi. The project managers say most remote areas would be ringing with alerts soon.

“The response is quite positive. Many patients have stuck to their drugs schedule. Besides, they are just happy that someone cares. They also want the cell phone programme to continue,” says Ms Sarah Karanja, the project co-ordinator.

Dr Richard Lester, the principal researcher, says non-adherence to antiretroviral therapy (ART) poses a risk in HIV management. It results in resistance and drug failure.

This explains why the cell phone concept would be critical to augment patient healthcare support and monitoring. No doubt, the ingenuity is likely to revolutionise the medical sector.

Since the inception of Highly Active Antiretroviral Treatment (Haart), mortality rates occasioned by Aids have significantly dropped. In Haart, multiple anti-HIV drugs are dispensed to patients before they develop Aids symptoms.

However, the Weltel/Afyatel project is the only programme that is pioneering Haart through cell phones.

Platform still basic

“Our cell phone study is a clinic-based phone communication system to support and monitor patients on ARVs. Healthcare workers initiate weekly text messaging to patients as a reminder and to keep in touch,” Karanja explains.

The technology platform is still primitive. It uses an ordinary telephone handset where coded messages are sent to many recipients. However, Karanja promises: “We are working on a scalable server-based and smart-phone-based SMS application that will send automated weekly SMS to patients on ARVs.”

The initiative was inspired by a 2005 study in Pumwani and Majengo, Nairobi. Residents who attended HIV care clinics requested the cell phone alerts.

“The patients are happy and confident,” says Cynthia Sitait, a clinical officer at the Kajiado Afyatel site. She says they also call when they are out of the district to find out how and where they can get the drugs.

“Some even call just to have a chat with us. This implies they are happy to have someone they can open up to. The stigma has significantly reduced,” she says.

Part of this study, Mobile Phones: Exceptional Tools for HIV/Aids, Health and Crisis Management, has been published in a medical journal, Lacet.

Even during post-election crisis, the SMS concept proved handy. Many people who were far away from their clinics used to get assistance on ARV or any other medical support.

Experts also used the cell phones to counsel their patients. In Lacet, the researchers say after the violence, one patient was so distressed that she almost stopped taking medicine. But the phone helped much.

“She had severe emotional distress during the crisis but a counsellor provided telephone support, and she succeeded in taking her medications until she could later be seen at the clinic,” the report says.

This pilot project is also going on in Nairobi at Coptic Hospital and Pumwani Maternity Hospital.

Telemedicine capitalises on the expanding cell phone network revolution where even remote areas are covered.

“Mobile phones offer low cost, instantaneous and increasingly ubiquitous communications medium, and are unrestricted to location,” says the Lacet report.

Low workload

Apart from easing the administration of drugs, health workers say the project has reduced their workload and is timesaving. The quality of healthcare is also improved.

Even WHO and Unaids consider the use of ICT as a priority in settings where healthcare resources are limited.

“To meet the vast challenge of global access to ART, efficient and sustainable communication systems must be constructed to meet patient counselling, monitoring and long term follow-up goals,” Lester and others wrote in another study, Cell Phones: Tightening the Communication Gap in Resource Limited Antiretroviral Programmes?

This explains why Kampus is happy.

“I can’t stay without this phone,” he says pointing at his rusty handset. “If I get flu or have rashes on my face, I call the doctor and she advises me. She tells me which medicine to take or just assures me the problem is normal and would soon disappear,” he says.

Published on the Standard on 08/08/2009 By Erick Wamanji

ewamanji@yahoo.co.uk

Ms Faith Barasa’s failed search for internship after her third year of study at Moi University was to become a blessing for children suffering from Retinoblastoma. Barasa, a fourth year micro-enterprise Management student, had a lot of free time. A goodwill volunteer, she sought a place to expend her energies.

A talk with a neighbour Mr Brian Ouma CEO of Daisy’s Eye Cancer Foundation (DECF) an NGO working to fight retinoblastoma deaths, was to determine how she would spend her vacation. She would create awareness on retinoblastoma. Barasa spends her days in Ward 11 at Kenyatta National Hospital (KNH).

Retinoblastoma affects children below the age of seven and is caused by a genetic mutation, which can be passed from parent to child. About 1,500 children are affected annually in Africa.

When discovered early, it is a cheap cancer to cure. One or both eyes may be affected. Early diagnosis and treatment prevents it from spreading to the optic nerve and brain, or to the bone marrow.

Once tumours have spread outside the eye, the chances of survival are limited. Due to the high cost of cancer treatment, many children stay in hospital for long.

Kahaki Kimani, an eye surgeon at KNH and a consultant for Daisy’s Eye Cancer Fund says removing an affected eye costs about Sh10,000. However, once the cancer has spread, treatment averages Sh300,000 to Sh500,000.

Celebrate life

Barasa was touched by the plight of affected children at KNH and marshalled four volunteers to start a Kenyan version of Art for Eyes Project. Art for Eyes is an Art Day, Global Gallery and Auction that celebrate life, while raising awareness of eye cancer across the globe. It was founded in 2005 in Canada. The project kept children engaged with painting and beadwork.

“Since I didn’t know how to draw, I sold the idea to the volunteers I could reach,” she says.

While painting with the children, she came across volunteers from Rahimtulla Museum of Modern Arts (RaMoMa) who were drawing with children and the idea to partner with the museum was born. RaMoMa gave free exhibition space for two weeks.

On August 5, DECF began a two-week art project with Retinoblastoma patients at Kenyatta National Hospital.

The works of art by the children and their parents have been on exhibition to raise awareness of Retinoblastoma. The works of art will later be auctioned.

“Retinoblastoma has been neglected yet it is a killer disease. Awareness could solve 90 per cent of the cases,” says Barasa.

As a business management student, Barasa teaches business skills to women in Eldoret. She intends to further Art for Eyes project with the children in Moi Teaching and Referral Hospital.

Fatality rate

According to Dr Kahaki Kimani, an eye specialist with special interest in the disease, retinoblastoma is almost 100 per cent curable if diagnosed early. She attributes its high fatality rate to the fact that many do not know about it.

“Even when parents notice something wrong with the eye, many ignore,” she says.

Some early symptoms include squinty eye as the tumour pushes through, red eyes and the most common is “leukocoria” – a white glow in the eye, which may be seen in low light or flash photography.

“The eye glows like that of a cat when lights are switched on. By the time you see the white blob at day time, it is a big tumour,” she says.

Any hospital with an eye specialist can treat RB. Treatment involves removal of the eye, although in early detection, the eye can be treated.

Kimani says that about three quarter of cases presented at the hospital come when the cancer has spread beyond the eye. She advises parents to see an optician for any problem with children’s eyes.

Published on the Standard on 12/08/2009 By Brenda Kageni

Take uterine fibroids for example; most women know so little about them or have such misconceptions that they are devastated when they are diagnosed with fibroids. And of course, there is always the fear of it being cancer.

All women are at risk of developing fibroids but they occur three to nine times more frequently in black than in white women. The actual cause for this is not known. Fibroids start to grow once menstruation begins at puberty but no one knows what triggers this. Their growth depends on the female sex hormone estrogen because they increase in size during the reproductive years when estrogen levels are high and then stop growing and shrink after menopause when estrogen levels dip.

Related to number of children

They are also more common in women who have few children or none at all because the uterus remains exposed to high estrogen levels without the interruption of pregnancy for long periods. Most fibroids do not grow during pregnancy.

Fibroids are not cancerous. They grow from the muscle cells that make up the walls of the uterus and look like the stuff cutting boards are made of. They may be very tiny or grow to the size of a football, weighing several kilos. The symptoms they present depend on their position and size.

Intramural fibroids grow within the muscular wall of the uterus and are the commonest type. Subserosal fibroids grow outwards from the wall while Submucosal fibroids grow within the uterus protruding into the uterine cavity. The latter are least common but they cause the most severe symptoms. Pedunculated fibroids grow on a stalk and hang within the cavity of the uterus or outside it.

Most women develop symptoms in their late 30s or 40s but this can happen as early as a woman’s 20s. Not all women with fibroids will have symptoms. In fact most women only discover that they have fibroids when they start causing trouble or when they have gone in to see the doctor for something totally different.

Common symptoms

Heavy bleeding is the most common problem caused by fibroids and, thus, severe anaemia requiring transfusion. They cause heavy bleeding by interfering with the muscular contractions of the uterus that help it control bleeding during a woman’s period. Fibroids also dilate and engorge the veins in the uterine walls making the bleeding heavier with clots and severe cramping.

Large fibroids cause heaviness, bloating, and discomfort in the pelvis and may compress nerves, causing pain in the legs, flanks and back. Fibroids can also block the outflow of urine from the bladder, forcing the woman to empty her bladder frequently, especially at night. If this obstruction is not relieved, it can eventually cause kidney damage. Fibroids can also cause pain when passing stool, constipation, and even intestinal obstruction if they are large enough.

There’s severe pain if the stalk of a Pedunculated fibroid gets twisted, cutting off its blood supply, or if a fibroid degenerates or gets infected. Submucosal fibroids can also cause miscarriages and infertility.

Treatment options

When fibroids are small, no treatment is required. The woman can be seen by her doctor regularly just to ensure that the fibroids are not growing and they will shrink when she gets to menopause. It is only when fibroids cause severe bleeding; interfere with fertility, cause severe pain and pressure symptoms or when they start growing rapidly that something has to be done.

There are NO drugs that can cure fibroids. The only absolute cure for fibroids is their surgical removal. The fibroids alone may be removed if the woman still wants to have children or wants to preserve her uterus because the uterus has great psychological significance for many women, especially in some cultures.

A myomectomy is the surgical removal of only the fibroids from the uterus, but fibroids can grow again after this. A hysterectomy is the surgical removal of the whole uterus with the fibroids and is the treatment of choice if the woman has had her family.

There are some hormonal preparations available to shrink fibroids and make them easier to remove, and these are usually prescribed for women preparing for a myomectomy because the fibroids immediately start growing once these drugs are stopped and attain their original size within four months of stopping the hormonal treatment. There are no natural remedies for fibroids.

Published on the Standard on 15/08/2009 By Dr Brigid Monda

It is Saturday morning and people are flocking into a makeshift open-air market along bus station near the city centre.Many of the shoppers have parked their cars along the narrow street and are selecting the leafy vegetables, almost making movement to other road users impossible.

“The number of customers has increased tremendously in the past few years and I am making good sales,” says Jacinta Kemunto, a vegetable vendor at the market.

Kemunto, who transports her vegetables from the Kisii highlands in Nyanza Province, attributes the high demand for traditional vegetables to the increasing popularity of fresh greens grown in the natural environment.

The scenario is similar to what goes on in Uganda where Nakawa and Nakasero markets in the outskirts of Kampala city are crowded with people buying the once abandoned traditional vegetables.

Primitive

“The people have realised the importance of local vegetables as opposed to previous beliefs that those consuming them were primitive,” says Dr David Hafashimana, a senior research officer with Uganda National Forestry Resources Research Institute.

Hafashimana says that markets and restaurants in Kampala and other major towns in Uganda are doing roaring business following a sudden change in attitude towards the vegetables. “The fact that our grandfathers consistently ate the traditional vegetables and rarely became ill is an indication that the vegetables are not outdated but more medicinal,” he explains .

An Ethnobotanist at Diversity International, Patrick Maundu, says that even though preference for exotic vegetables like white cabbage, Swiss chard (spinach beet) and kale (sukuma wiki) still exists, high levels of minerals and vitamins in traditional vegetables is attracting more consumers.

The vegetables are high in micronutrients that is capable of protecting people from contracting anaemia and blindness as well as helping in protecting 42.2 per cent of children in sub-Sahara Africa from risk of Vitamin A deficiency.

Maundu says that traditional vegetables, unlike the exotic species, have a better ability to cope with climate change, pests, water stress and diseases. “They are also a major source of income for people who grow them in plenty,” he says.

The vegetables have the potential for value addition and also extraction of oil from the seeds. He says vegetables like pumpkin leaves, cowpea leaves, okra, bean leaves, corchorus (mlenda) leaves, cassava leaves, moringa and desert date should be dried and sold either in powder form or chopped. Prof Abukutsa-Onyango says bitter vegetables have medicinal properties.

Published on the Standard on 13/08/2009 By Duncan Mboyah

Fibroids - non-cancerous growths in the uterus - do not always require an operation to remove the uterus.

Now, you may treat your fibroids with alternative methods.

Fibroids are common and found in a quarter of women in their reproductive years. Unfortunately science has not found out what triggers their growth. They are two-three times more common in black women and are found during their reproductive years and usually shrink after menopause.

Studies have shown oestrogen and progesterone and genes, which control cell growth, may affect their growth. Most women with fibroids have no problems conceiving and carry a pregnancy to term without complications. Fibroids impact fertility less than five per cent of the time. Growths within the uterine cavity however may affect implantation and are more likely to cause fertility problems.

Be reassured that fibroids do not have to be treated unless they are causing symptoms. You should seek treatment if you have the following symptoms: Heavy, painful and irregular periods. Others are feeling heavy in the abdomen and a need to urinate frequently. Uncomfortable and painful sex are other signs.

Although most women may feel anxious when diagnosed with fibroids, there are many treatment and management options.

Medications

Mild occasional pain or cramping may be treated with medications such as Diclofenac. Anaemia caused by excessive bleeding may be treated with iron. Oral contraceptive pills and Depo- provera may help reduce the amount of bleeding by making the uterine lining very thin while anti-oestrogen hormones, such as leuprolide shrink fibroids, improve pain and reduce bleeding.

This is a minimally invasive procedure done by an interventional radiologist. A small nick is placed in the skin and a tiny catheter is passed into a blood vessel to the uterine arteries. A substance is placed into these arteries blocking them. This limits blood flow to fibroids causing them to shrink. Many women are able to go home the day after the procedure.

In some cases surgery is an option. Myomectomy- is indicated for women who still wish to bear children while hysterectomy involves removal of the entire uterus.

Published on the Standard on 27/08/2009 by Dr Patricia Muthaura

The writer is a consultant obstetrician and gynaecologist at the Aga Khan University Hospital

Ms Phyllis Wambui, 29, has delayed naming her first child until doctors establish whether it is a boy or a girl. “My pregnancy was normal and I delivered on time … nurses could however, not tell the sex of my baby,” Wambui says.

Some of her neighbours in Kiambu say the five-month baby could be a curse and threaten to kick her out.

“Doctors at KNH told me the disorder of my baby can be surgically corrected,” she says.

Her child is among many born with complications on sexual and reproductive organs but lucky to seek medical correction early. “I have not even started the process of acquiring a birth certificate since I don’t know which gender to indicate,” she says.

Doctors told Wambui her baby has ambiguous genitalia, a situation that makes it difficult to determine the sex.

Aga Khan University Hospital Consultant Paediatrician Mary Limbe says although more cases of hormonal disorders are being reported by hospitals, some parents hid their children believing that the complications are a curse.

Ambiguous genitalia

She says common abnormalities include ambiguous genitalia, undescended testicles and diabetes.

Hormone disorders involve either an overproduction by hyperactive glands or a deficiency of a certain hormone by hypoactive glands.

The disorders may result from problems in the endoctrine gland that is responsible for production of the hormone and pituitary gland thus, sending wrong signals to the body.

There are many different causes of hormonal disorders and some may be genetically linked like diabetes or involve nutritional factors.

Several mothers whose babies had similar reproductive disorders attend a free paediatric endocrinology programme in hospitals in Nairobi. The programme deals in with abnormal physical and sexual development, diabetes and general hormonal disorders in children.

Detected early

Limbe says the reproductive conditions are mainly attributed to hormonal disorders.

“Ambiguous genitalia are among the disorders children are born with that can be corrected if detected early,” Dr Limbe says.

She says cases of children born with myriad complications on their private parts are neither new nor taboo.

“We have handled cases of boys born with scrotums but no testis – a disorder is referred to as undescended testicles,” Limbe says.

Testicles of babies should move down in the abdomen through abdominal wall and groin to take its normal position in the scrotum before birth.

Medical journals say undescended testicles are higher in premature babies while three quarters of the cases descend within the first three months of life.

Published on the Standard on 30/07/2009 By Harold Ayodo

The disease is not just a cosmetic problem but also a symptom that something may be wrong with your body chemistry, diet or skin cares routine.

Proper diet, nutritional supplements, medical treatment and the right skin care products may be all you need to correct the problem.

Eat a high fibre diet to keep the colon clean and rid the body toxins and increase your intake of raw foods including almonds, beans and cashew nuts to clear and heal your skin.

Fruits and vitamins

Plenty of fruits are good for the skin because of they are high in nutrition and water. Grapes, strawberries, pineapple are rich in alpha-hydroxyl acids that help to exfoliate the skin by removing the dead skin cells that clog the oil glands.

Eat foods rich in zinc including fish, soybeans, whole grains, sunflower seeds, and small amount of raw nuts daily. Zinc is an anti-bacterial agent and a necessary element in the oil producing glands of the skin.

Ensure your diet contains vitamins A, C and E, and essential fatty acids. Vitamin A is important in fighting acne and vitamin E prevents searing of skin and regulates vitamin A.

Drink eight glasses of water and avoid alcohol, butter, caffeine, and dairy products. Stay away from all forms of sugar as too much can cause ‘skin diabetes’. Sugar also promotes the growth of Candida, which may be a contributing factor to Acne.

Your hands are the dirtiest part of your body so restrain from touching your face.

If you are allergic to fats, avoid eating out.

If the problem persists see a dermatologist.

Published on the Standard on 30/07/2009 A Ndong