Gurei Medical Center - GMC

Our Fourth Episode About "Yellow Fever".

We are with you on your journey to better health. Visit Gurei Medical Center - GMC and consult with our team of doctors.

What is yellow fever?

o Yellow fever is an infectious disease caused by a virus that is transmitted by mosquitoes.
o The disease can range from mild to severe and can be potentially fatal.
o Yellow fever causes approximately 200 000 infections each year, mainly in sub-Saharan Africa, and the number is increasing.
o Overall mortality is around 15%, although this varies widely.

How does yellow fever transmitted?

o Yellow fever spreads through the bites of infected mosquitoes, mainly of the Aedes and Haemagogus species.
o These mosquitoes are active during the day and breed in tropical and subtropical areas of Africa and South America.
o Mosquitoes that live in different places have different breeding habits: Some reproduce near homes (domestic), some in the jungle (wild), and some in both places (semi-domestic).
o There are 3 ways of spreading the disease:
1. Jungle (Sylvatic) yellow fever: In the tropical jungle, wild mosquitoes bite monkeys, who are the main source of the virus. Sometimes people who work or travel in the jungle get bitten by these mosquitoes and catch the virus.
2. Urban yellow fever: Big outbreaks happen in cities when people who have the virus bring it to crowded areas where most people are not immune and there are many Aedes Aegyptus mosquitoes. The virus passes from person to person through the bit of Aegyptus mosquitoes.
3. Intermediate yellow fever: mosquitoes that live in both the forest and near homes (semi-domestic) bite both monkeys and humans and infect them. The more people and mosquitoes come in contact, the more the virus spreads.
o People who travel to or live in these regions are at risk of getting yellow fever.

How a patient presented?

The incubation period (the time between exposure and onset of symptoms) for yellow fever ranges from 3 to 6 days after infection. Common symptoms are includes:
o Fever
o Headache
o Muscle pain
o Nausea and vomiting
o Backache
o Loss of appetite
o Jaundice (yellowing of the skin and eyes)
o In some cases, it can lead to severe complications such as bleeding, organ failure, and death.

How is yellow fever diagnosed?

o Yellow fever is diagnosed by a combination of clinical symptoms and signs, travel history, and laboratory tests.
o The symptoms of yellow fever can be similar to other diseases, such as malaria, dengue, or hepatitis.
o Therefore, it is important to inform the health care provider of any recent travel to areas where yellow fever is present.
o Laboratory tests can detect the virus or the antibodies in the blood.
o Some of the tests used are polymerase chain reaction (PCR), blood culture, and enzyme-linked immunosorbent assay (ELISA).

How is yellow fever treated?

o There is no specific antiviral drug for yellow fever.
o Treatment is mainly supportive and aims to relieve the symptoms and prevent complications.
o Depending on the severity of the illness, patients may need to rest, drink fluids, take painkillers, receive blood transfusions, or be hospitalized.
o Antibiotics may be given to treat secondary bacterial infections.
o Patients with yellow fever should be isolated from mosquitoes to avoid further transmission of the disease.
o Usually resolves within 3-4 days.

What are the complications of yellow fever?

o About 15% of patients with yellow fever develop a more severe form of the disease, called the toxic phase.
o This occurs after a brief period of improvement following the initial symptoms.
o In the toxic phase, patients may experience high fever, jaundice, abdominal pain, vomiting, bleeding, and shock.
o The organs most affected are the liver and the kidneys. The mortality rate of the toxic phase is about 50%.

How can yellow fever be prevented?

o The best way to prevent yellow fever is to get vaccinated before traveling to areas where the disease is endemic or has outbreaks.
o A single dose of yellow fever vaccine provides life-long protection for most people.
o The vaccine is safe and effective, highly efficacious, and protecting individuals for at least 10 years, but it may have some side effects or contraindications for certain groups of people.
o Vaccination is contraindicated among immunosuppressed (low immunity status) individuals (e.g. HIV infected, transplant recipients
o Another way to prevent yellow fever is to avoid mosquito bites by using insect repellent, wearing long-sleeved shirts and long pants, and staying in places with screens or nets.
o It is also advisable to clear stagnant water and dispose of trash that may serve as mosquito breeding sites.
o Surveillance systems allow for early detection and response to yellow fever outbreaks. Rapid identification, isolation of cases, and contact tracing can help contain the spread of the disease.
Impact on Public Health:
o Global Burden: Yellow fever is estimated to cause around 200,000 cases and 30,000 deaths annually, with the majority occurring in African countries.
o Economic Impact: Yellow fever outbreaks can have a significant socioeconomic impact on affected countries, jeopardizing tourism, trade, and overall economic development due to travel restrictions and international trade limitations.
o Eradication Efforts: Several successful vaccination campaigns and mosquito control strategies have resulted in the elimination of yellow fever in some regions, demonstrating the feasibility of eradication.

To obtain further details, please visit our health facility (Gurei Medical Center - GMC) and meet our medical experts.

In case you are interested to access our health services kindly below are our contacts:

0926148777/0928884520/0922738333.

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Our Weekly Medical News Update about Diabetes Mellitus and it's treatment:

Greetings Citizens, followers and lovers of Gurei Medical Center - GMC , we request you to share our page if you find the article interesting in order to reach people who are seeking for help medically.

1). Definition of Diabetes Mellitus:
o Diabetes Mellitus is a chronic metabolic disorder characterized by high blood glucose (sugar) levels due to either insulin deficiency or insulin resistance.
o Glucose (sugar) is an important source of energy for the cells that make up the muscles and tissues
o Insulin is a hormone produced by the pancreas that regulates blood glucose (sugar) levels and allows cells to use glucose for energy.
o In diabetes, the body either does not produce enough insulin or cannot effectively use the insulin it produces.

2). Epidemiology and prevalence worldwide:
o Diabetes Mellitus is a global health issue, with an increasing prevalence in both developed and developing countries.
o According to the International Diabetes Federation (IDF), in 2019, approximately 463 million adults aged 20-79 years were living with diabetes worldwide.
o Diabetes is the leading cause of cardiovascular disease, chronic kidney disease, visual loss and non-traumatic amputations worldwide.

3). Types of Diabetes Mellitus:
The traditional thinking that type 2 diabetes as the disease of adults and type 1 diabetes as the disease of children is not accurate as both diseases can occur in both age groups.
The main types of Diabetes Mellitus include Type 1 Diabetes, Type 2 Diabetes, and Gestational Diabetes.
o Type 1 Diabetes is an autoimmune disorder where the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas.
o Type 2 Diabetes occurs when the body becomes resistant to the effects of insulin or fails to produce enough insulin.
o Gestational Diabetes occurs during pregnancy and resolves after delivery.

4). The risk factors:
o Age
o Family history (genetic factors)
o Exposure to certain viral pancreatic infections
o Obesity
o Sedentary lifestyle (Low levels of physical activity)
o Unhealthy diets
o Ethnicity
o Smoking
o Excessive alcohol intake
o High blood pressure
o Previous history of diabetes during pregnancy
Causes
I. Type 1 Diabetes Mellitus
o Type 1 Diabetes is characterized by the immune system mistakenly attacking the insulin-producing beta cells in the pancreas, leading to a deficiency of insulin (the pancreas produces little or no insulin).
o This results in uncontrolled glucose levels in the blood.
o Insulin plays a crucial role in glucose metabolism by facilitating the uptake of glucose from the blood into cells.
o In Type 1 Diabetes, the lack of insulin leads to high levels of glucose in the blood, causing various complications.
II. Type 2 Diabetes Mellitus
o Type 2 Diabetes is characterized by insulin resistance, where the body's cells become less responsive to the effects of insulin, leading to elevated blood glucose levels.
o This type is primarily caused by a combination of genetic and lifestyle factors.
o Genetic predisposition, obesity, physical inactivity, and poor diet are some of the contributing factors.
o Insulin resistance occurs when the body's cells do not respond properly to insulin.
o Over time, this may lead to diminished beta cell function and insulin deficiency.
o It is the most common form of diabetes and is often associated with lifestyle factors such as obesity and physical inactivity.

5). Clinical presentation and symptoms:
In type I diabetes symptoms often develop rapidly, while symptoms of type 2 diabetes may develop gradually or go unnoticed for a long time.
The symptoms of diabetes can vary depending on the type and severity of the condition. Common symptoms include:
o Frequent urination
o Excessive thirst
o Unintended weight loss
o Fatigue
o Blurred vision
o Increased hunger
o Slow wound healing
o Recurrent infections
o Burning sensation of feet
o Some individuals with type 2 diabetes may not experience noticeable symptoms initially
o Recurrent itching of external female genitalia (v***a)
o Numbness or pain over the lower limbs
o Body swelling

6). Diagnosis and screening methods:
The diagnosis of diabetes mellitus involves various tests, including:
o Fasting blood glucose (FBG) test: Measures blood sugar levels after an overnight fast.
o Random Blood glucose (RBG) test: Measures blood sugar levels at any time of the day, regardless of when the person last ate.
o Oral glucose tolerance test (OGTT): Measures blood sugar levels before and two hours after consuming a glucose-rich drink.
o Hemoglobin A1c (HbA1c) test: Provides an average of blood sugar levels over the past two to three months.
o Once a diagnosis of diabetes is confirmed, further tests are required to initiate treatment and detect any potential complications. Such tests are including: Total blood count (CBC), Urine test (UA), kidney functional test (RFT), Electrolytes, Lipid profiles (LP), cardiac markers, Electrocardiogram (ECG), Echocardiogram (Eco), Ophthalmoscopy

7). Treatment of diabetes Mellitus:
Non-pharmacologic treatment (without antidiabetic drugs)

o General advice: avoid refined sugars, soft drinks with sugar or adding sugar/honey to teas/other drinks.
o Carbohydrate intake: reduce overall carbohydrate intake. Carbohydrate sources high in fiber and minimally processed are preferred (whole grains, non-starchy vegetables, fruits, and dairy products).
o Fat: reduced saturated fat (animal fat) intake such as butter, fatty cuts of meat, cheese.
o Protein: it can be taken; protein intake requires reduction when there is a chronic kidney disease.
o Exercise: regular moderately intensity aerobic physical activity for at least 30 minutes a day, at least 5 days a week.
o Weight management: for obese and overweight individuals recommended to reduce carbohydrate intake and encourage regular exercise.
o Stop smoking: should be ceased.
o Moderation of alcohol intake: a maximum one drink for women and two drinks for men (one drink is roughly equivalent to a bottle of beer, a glass of wine).

8). Pharmacological treatment (using medication)

The treatment of diabetes mellitus aims to relieve symptoms, manage blood sugar levels and prevent complications. Treatment options include:
o Depending on the type of diabetes, medications such as insulin or oral antidiabetic drugs may be prescribed to help regulate blood sugar levels.
o The type of diabetes, the patient’s medical condition, and their response to medication are factors that determine the selection, dosage and quantity antidiabetic medication prescribed.
o Insulin therapy: People with type 1 diabetes and some with type 2 diabetes may require insulin therapy to control their blood sugar levels.
o In the presence of complications, it is necessary to use a specific medication.

9). Complications of Diabetes Mellitus:
Poorly controlled diabetes mellitus can lead to various complications, including:
Acute complications (immediate and life threatening complications):
o Diabetic ketoacidosis
o Hyperosmolar hyperglycemic state
Chronic complications (long term complication):
o Eye damage (retinopathy)
o Kidney damage (nephropathy)
o Nerve damage (neuropathy)
o Coronary artery disease
o Stroke
o Peripheral vascular disease
o Foot ulcers
o Recurrent infections
o Erectile dysfunction (inability to maintain pe**le er****on)

10). Follow-ups and Recommendations for Diabetes Mellitus
Regular follow-ups with healthcare providers are essential for managing diabetes mellitus. Recommendations for individuals with diabetes include:
o Regular monitoring of blood sugar levels.
o Regular check-ups with healthcare providers to assess overall health and manage any complications.
o Adherence to prescribed medications and insulin therapy.
o Regular eye exams to detect and manage any diabetic retinopathy.
o Regular foot care to prevent complications such as foot ulcers and infections.
o Education and support for self-management of diabetes, including healthy eating, physical activity, and stress management.

To obtain further details, please visit our health facility (Gurei Medical Center - GMC) and meet our medical experts.

In case you are interested to access our health services kindly below are our contacts:

0926148777/0928884520/0922738333.

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Public Notice On Insurance Cards G.M.C Accepts:

Although we strive to keep information current for our clients so that they are aware of changes at Gurei Medical Center, please note that the following is a list of insurance companies that has signed contract and technical services at G.M.C. It is important to note that each patient’s medical situation and insurance plan are different and Although there is no guarantee of coverage at G.M.C for other patients, you should ask your health insurance company to review their plans and consider partnering with Gurei Medical Center for easy access of health care services for your family at our facility. Also one thing you should know is that, if your plan doesn’t cover care at Gurei Medical Center, you can ask your insurance company to authorize treatment at GMC for you and your family and you claim later.

Insurances we accept at G.M.C includes:

(1). New Sudan Insurance Company Limited
(2). International Air Ambulance - IAA
(3). Trust Insurance Group - TIG

Therefore, any staff holding Medical insurance cards above can now access health care services any time at Gurei Medical Center - GMC..

Kindly note that "Gurei Medical Center is with you in your journey to better health" and the administration assure you of standard and quality health care services. Access your medical insurance services of your family at GMC.

To obtain further details, please visit our health facility (Gurei Medical Center - GMC) and meet our administration and medical experts.

In case you would like to access our health services, kindly below are our contacts:

0926148777/0928884520/0922738333.

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G.M.C & Family of Dr. Pablo is in pain. Pray for Us friends and well wishers!!!!!

Indeed Neither patients Nor G.M.C staff could NOT believe that you are gone for No return, Doctor Pablo. We are deeply hurt for your dismiss. Our hearts are broken and we will always be with full of sadness as Gurei Medical Center - GMC for having lost a knowledgeable International specialist doctor like you.... 😭 😭

As team, we do remember your words, "that you want to bring GMC to the standard and a level that will be recognized in South Sudan and world wide". Indeed within the 1 year you have been with us and since establishment of Gurei Medical Center, one could see that you have put GMC flag up and the progress was real. All patients were happy with the standardisation and quality treatment and also to see a National Health facility like GMC to grow in speed nobody could expect. You carried GMC in heart, We pray for God to give yet again another golden specialist doctor of Obstetrics and Gynaecology like you to help people our communities and South Sudan that are experiencing infertility difficulties throughout their marriages.

In the 1 year you worked with us, you were able to treat a lot of people experiencing infertility related cases and some women were able to conceive because of your super treatment. As GMC, we are happy many of our patients with infertility complications are due to give birth.

Rest in Peace our Hero, Doctor Pablo Mark.

As Gurei Medical Center, we are reaching out to well wishers, friends and our patients who know Doctor Pablo to send their contribution through GMC to help support the funeral rights and family of Doctor Pablo.

Please reach out to our reception on the below numbers for any contribution you may wish to give to the family.

Telephone contacts:

0928884520/0922738333.

Thank you!

Peptic Ulcer Disease (PUD).

When Gurei Medical Center - GMC was established , we promised to add value and become a leading and valued partner in the community. GMC would want to achieve by God's help a community in South Sudan in which all people recognize their full potential for health and well-being across their life span.

Many people in our community keep wondering What is Peptic Ulcer Disease (PUD), what causes it, what it's symptoms are, and how ulcers can be treated????

- A peptic ulcer refers to an open sore or lesion that develops in the lining of the stomach or the upper part of the small intestine, known as the duodenum.
- It occurs when the protective lining of these areas is damaged and eroded, exposing the underlying tissue to stomach acid and digestive enzymes.
- Peptic ulcers are typically caused by a combination of factors, including the presence of stomach acid and the erosion of the protective lining.
- Based on the involvement of the acid, there are two main types of peptic ulcers: gastric (stomach) ulcer and duodenal (first part of small intestine) ulcer.
- Gastric and duodenal ulcers usually cannot be differentiated based on history alone, although some findings may be suggestive.

What causes:
Several factors can increase the risk of developing peptic ulcers, including:
(1) Helicobacter pylori (H. Pylori) infection: This bacterium is a major cause of peptic ulcers.
(2) Overuse of common pain relievers: Regular use of over-the-counter (NSAIDs) drugs such as aspirin and ibuprofen can cause peptic ulcers through disrupt the mucosal permeability barrier, rendering the mucosa vulnerable to injury.
(3) Smoking: Smoking ci******es or using other to***co products can increase the risk of peptic ulcers and hinder the healing process.
(4) Excessive alcohol consumption: Heavy alcohol consumption can irritate the stomach lining and increase the risk of peptic ulcers.
(5) Stress: While stress alone does not cause peptic ulcers, it can worsen symptoms and delay healing.
(6) Family history: Genetics can play a role in certain individuals.
(7) Consuming spicy food and over refrigerated food (food which kept under the refrigerator for long time).
(8) Some chronic illness (liver disease and chronic obstructive pulmonary disease) are also associated with peptic ulcer.

How it Presents:
The symptoms of peptic ulcers can vary, but common presentations include:
a) Epigastric pain or discomfort: Burning pain in the stomach, often between meals or during the night.
b) In the case of duodenal ulcer, epigastric pain worse when the person is hungry, but it is relieved by eating or taking antacid medication.
(C) Conversely, for a gastric ulcer, consuming food exacerbates the pain.
(d) Heartburn: A burning sensation in the chest, often after eating or at night.
(e) Nausea and vomiting
(f) Experiencing a sense of fullness in the stomach after a meal (postprandial fullness) or feeling satisfied sooner than usual (early satiety).
(g) Loss of appetite: A decreased desire to eat due to pain or discomfort.
(h) Weight loss: Unintentional weight loss may occur in some cases.
(I) Dark or black stools (indicating bleeding.
How to Diagnosis:

The diagnosis of peptic ulcer disease is usually based on clinical features and specific testing. Diagnostic methods may include:
- Blood tests: These tests can detect the presence of H. pylori antibodies.
- Stool antigen testing is more accurate than serum antibody testing.
- Endoscopy: A procedure in which a flexible tube with a camera is inserted into the oesophagus, stomach, and duodenum to visualize and identify ulcers. This procedure is done when there is an indication, and used for both diagnostic and therapeutic use.
- Urea breath tests detect active H. Pylori infection by testing for the enzymatic activity of bacterial urease.
- Biopsy: During endoscopy, a small tissue sample may be taken for examination under a microscope to check for H. pylori infection or other abnormalities.
- Complete blood count (CBC) is performed when there is highly suspicion of anemia.
- Imaging tests: X-rays or CT scans may be ordered to assess the severity or complications of the ulcers.

What are Alarm signs:

Alarm features that warrant prompt intervention and indictors that a patient should undergo further investigation for cancer are the following:
1) Advanced age (>55years)
2) Previous gastric surgery (surgery performed on stomach)
3) Unintended weight loss
4) A continuous or recurrent occurrence of vomiting over an extended period of time (persistent vomiting)
5) Bloody tingled vomiting that resembles coffee grounds in appearance (Hematemesis)
6) Difficulty of swallowing (dysphagia) or pain while swallowing (odynophagia)
7) A lower than normal amount of haemoglobin in their blood, but the cause of the anemia cannot be readily identified (unexplained anemia).
8) Lump or swelling that can be felt in the abdomen (palpable abdominal mass)
9) Swelling or enlargement of lymph nodes (lymphadenopathy)
10) Yellowish discoloration of body tissues, including the skin and eyes (jaundice)

How It Is Treated:
The treatment of peptic ulcers aims to relieve symptoms, promote healing, and prevent complications. The treatment of peptic ulcer varies depending on the causes and clinical presentation:
a) If H. Pylori test shows a positive result, a combination of three medications, known as empiric triple therapy, is typically prescribed to eliminate the bacteria and decrease acid secretion.
b) On the other hand, if the test is negative, medications like proton pump inhibitors (PPIs) or H2 blockers are given to reduce stomach acid production and support the healing process.
c) In severe case, intravenous proton pump inhibitors or H2 blockers can be used for rapid response.
d) Antacids: These medications can provide temporary relief by neutralizing stomach acid.
e) Lifestyle modifications: Avoiding trigger foods, reducing stress, quitting smoking, and limiting alcohol consumption can help manage symptoms and promote healing.
g) In complicated cases, therapeutic endoscope and urgent surgery are treatment options.

Complications:

If left untreated or poorly managed, peptic ulcers can lead to complications such as:
- Bleeding: Ulcers can cause bleeding, which may result in anemia (low level of haemoglobin) or require medical intervention.
- Perforation: In rare cases, ulcers can create a hole in the stomach or duodenal wall, leading to a medical emergency.
- Obstruction: Scarring from long-standing ulcers can cause blockages in the digestive tract, leading to symptoms like vomiting and difficulty swallowing.
3) Patients with gastric ulcer are also at risk of developing gastric cancer.

Recommendations

If you suspect you have peptic ulcer disease or are experiencing symptoms, it is important to seek medical evaluation for an accurate diagnosis and appropriate treatment. Here are some general recommendations:
a) Follow the prescribed treatment plan: Take medications as directed and complete the full course of antibiotics if H. pylori infection is present.
b) Avoid trigger factors: Limit or avoid the use of alcohol, and to***co products.
c) Avoid over-the-counter (OTC) medication used for headache and pain reliever such as ibuprofen, Pirocxicam, and Aspirin.
d) Practice stress management: Engage in stress-reducing activities such as exercise, meditation, or counselling.
e) Follow a healthy diet: Eat regular, balanced meals and avoid foods that worsen symptoms, such as spicy or fatty foods.
f) Attend follow-up appointments: Regularly follow up with your healthcare provider to monitor progress and adjust treatment if needed.

To obtain further details, please visit our health facility (Gurei Medical Center - GMC) and meet our medical experts.

In case you want to access our health services kindly below are our contacts:

0926148777/0928884520/0922738333.

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SAD NEWS!!!!!

Dear our beloved patients, staff, colleagues and well wishers,

The administration of Gurei Medical Center - GMC is sudden to announce untimely death of our International specialist of Obstetrics and Gynaecology, Dr. Pablo Mark. The deceased passed on yesterday Friday, 29th December -2023 at 9PM CAT at Gudele Hospital after a short illness. Dr. Pablo was put on ICU at Gudele Hospital and after a short while he went to rest with the Lord.

The administration and the team of workers of Gurei Medical Center is in grief and pain for the loss of a very Brilliant Doctor for our Nation, South Sudan.

God gives and God takes, may his Soul Rest in eternal Peace!!!!!

For well wishers who would love to pay and give their condolences in person, you can contact the below number For direction:

Benson: +211920998933/+211925240349

Gurei Medical Center - GMC is a national Health facility of South Sudan. We are proud South Sudanese team of doctors who have pulled ourselves together to offer better and standard health care services to the people of South Sudan.
Give us a like on our page and follow us. As local entrepreneurs, our aim and goal is to lead South Sudan health sector and receive recognition globally. We would like to compete and lead the health sector favorably.

Gurei Medical Center Mission & Vision are very clear and we have a purpose for our country.

OUR MISSION: Through Physician leadership, Gurei Medical Center will be dedicated to improving the health of people of Joppa West & Gurei Residential Area & beyond. The health facility will provide compassionate, comprehensive, affordable, and accessible health care services to people of all ages, regardless of their economic status.

- To be in 5 years the reference quality health center in South Sudan. We will achieve this by recruiting and maintaining experienced, high quality medical personnel and support staff of different fields & expertise and ensuring that the facility make the best use of latest technology to aids it's operations.

OUR VISION: To achieve by God's help - a community in which all people recognize their ful potential for health and well-being across their life span. We work to be trusted by patients, recognized as a valued partner in the community, and creators of positive change in South Sudan and the world.

- Gurei Medical Center will work to strengthen access to Quality integrated Healthcare, by removing barriers for those with the greatest need, and developing community relationships, to enhance the future of our community's well-being.

- To be a number one and best medical center/hospital of choice for patients in Joppa West & Gurei and in the whole of South Sudan.

In case you love to access our health services, kindly below are our contacts and physical location 👇👇

The Medical Center is located opposite Jebel Dinka road. Jebel Dinka road is after GUREI PHCC (Gurei Primary Health Care center).

Kindly call the below contacts for direction and access to our premises.

Telephone:
0922738333/0926148777/0928884520

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