Tuesday, 30 December 2014
Monday, 29 December 2014
Fertility Prayer in Fertility Clinic
Today started off like any other day! I have been attending consultations in the fertility clinic all this while (as part of the requirement for my MBBS examination) but truthfully, today's encounter has left an indelible scar in my heart.
She worked into the consultation room with so much anxiety and abdominal pain. After establishing rapport with my chief, the consultant, she went on to give her history, including that of the index pregnancy.
I was chosen to do the physical general and obstetric examinations. My examination revealed a solid mass toward the supra-pubic region co-existing with a foetus in an oblique (abnormal lie).
What struck me was that the history revealed that the patient, had already been told that her baby was dead in a peripheral centre. This was the source of her anxiety.
The consultant needed to be sure, so he ordered that an ultrasound scan be other immediately. Before then, I had listened for a foetal heart sound, but the abdominal pain and the fact that the mass was an obstacle, made it totally impossible to elicit the heart sound. She was panicking and shedding tears, as she does not want to lose her baby she had waited 8-years to get. I whispered a little prayer for her!!!
I noticed a young man, I later discovered to be her younger brother, was prancing along the corridor. Though this may be a regular feature in most fertility clinics, I had never been on a team that is to manage infertility of such duration.
Ultrasound findings revealed that the solid mass was actually a leiomyoma, in red degeneration-- because of the abdominal pain.
She had to be admitted and since was near term, she would be monitored pending when she gets to 37weeks of gestational age (she was 36weeks and 1day today). The consultant assured her that since she has presented to a tertiary centre, maximum obstetric care would be given to her.
I got to find out that she could deliver per vaginam, and after 6weeks post delivery (pueperium), and she is still symptomatic, then an elective abdominal myomectomy would be done for her!!!
She worked into the consultation room with so much anxiety and abdominal pain. After establishing rapport with my chief, the consultant, she went on to give her history, including that of the index pregnancy.
I was chosen to do the physical general and obstetric examinations. My examination revealed a solid mass toward the supra-pubic region co-existing with a foetus in an oblique (abnormal lie).
What struck me was that the history revealed that the patient, had already been told that her baby was dead in a peripheral centre. This was the source of her anxiety.
The consultant needed to be sure, so he ordered that an ultrasound scan be other immediately. Before then, I had listened for a foetal heart sound, but the abdominal pain and the fact that the mass was an obstacle, made it totally impossible to elicit the heart sound. She was panicking and shedding tears, as she does not want to lose her baby she had waited 8-years to get. I whispered a little prayer for her!!!
I noticed a young man, I later discovered to be her younger brother, was prancing along the corridor. Though this may be a regular feature in most fertility clinics, I had never been on a team that is to manage infertility of such duration.
Ultrasound findings revealed that the solid mass was actually a leiomyoma, in red degeneration-- because of the abdominal pain.
She had to be admitted and since was near term, she would be monitored pending when she gets to 37weeks of gestational age (she was 36weeks and 1day today). The consultant assured her that since she has presented to a tertiary centre, maximum obstetric care would be given to her.
I got to find out that she could deliver per vaginam, and after 6weeks post delivery (pueperium), and she is still symptomatic, then an elective abdominal myomectomy would be done for her!!!
900-degree Centigrade Burns Ebola To Death?!
I have actually been wondering how could we ensure that Ebola Virus never come back again!!
I saw this cool tweet on WHO handle!! I also thought 900 degree centigrade would have been the best. See tweet below
But some still believe that heat 900-degree centigrade is not enough ooo... Maybe 1000-degree centigrade will just be okay.... see their response below;
I saw this cool tweet on WHO handle!! I also thought 900 degree centigrade would have been the best. See tweet below
Hear What FRSC Has To Say About Your Watch!!!
I got this Federal Road Safety Commission tweet about wrist watches!!!
DQB also wish our esteemed readers a safe smooth ride into 2015.
Spread the message.
Spread the message.
CMD Job; For Women or Not For Women.
A Chief Medical Director practically runs a hospital. He has to be on his toes during any accreditation exercise. So I was the least surprise when I beheld this Amazon CMD.
Being new to the health facility, I was a 3-month clinical attachment programme, I have heard a lot about her prowess and exploits. Some interns say it was because of her that their October salary was delayed. Resident doctors want to put her to the stake for her obvious role in cutting down the number meant to write the necessary post-graduate exam, that would see them become consultants.
Consultants want to have their way, as most of them are males, and get away with it!!
So I feel a gush of emotions when she walked into the Emergency Paediatric Unit (EPU).
Standing in front of me was an elegantly dressed lady, befitting of her status as CMD. She has a personality that exudes authority. Personal aides were running all around her seeing to her every request as regards the accreditation visit by the Medical and Dental Council. She had everybody on their toes. After doling out the appropriate instructions to those concerned, she quietly got into her chaffeur-driven, government-plated SUV, and zoomed off.
And while there is a substantive Head of Department for Paediatrics, she took charge and left things as it should be. That was when I fell in love with her administrative acumen. I thought she was a fine CMD. As for the accreditation, the Paediatric department got a good grade.
Some of my colleagues believe otherwise. I still hold; that Amazon CMD is still the best for this Job. After all first impressions matter too.
Being new to the health facility, I was a 3-month clinical attachment programme, I have heard a lot about her prowess and exploits. Some interns say it was because of her that their October salary was delayed. Resident doctors want to put her to the stake for her obvious role in cutting down the number meant to write the necessary post-graduate exam, that would see them become consultants.
Consultants want to have their way, as most of them are males, and get away with it!!
So I feel a gush of emotions when she walked into the Emergency Paediatric Unit (EPU).
Standing in front of me was an elegantly dressed lady, befitting of her status as CMD. She has a personality that exudes authority. Personal aides were running all around her seeing to her every request as regards the accreditation visit by the Medical and Dental Council. She had everybody on their toes. After doling out the appropriate instructions to those concerned, she quietly got into her chaffeur-driven, government-plated SUV, and zoomed off.
And while there is a substantive Head of Department for Paediatrics, she took charge and left things as it should be. That was when I fell in love with her administrative acumen. I thought she was a fine CMD. As for the accreditation, the Paediatric department got a good grade.
Some of my colleagues believe otherwise. I still hold; that Amazon CMD is still the best for this Job. After all first impressions matter too.
DQB #WednesdayDelight; Be Ready!
In the first edition of DQB #wednesdaydelight last week, we saw a Madonna University Student go home with our #WednesdayDelight Prize.
Read more about winner here
This week we play be and on point. Be ready between 5pm - 6pm on wednesday. Remember it is for loyal Doctors Quarter Blog Readers, with the fastest fingers... keep playing!!!
More soon!!!
Read more about winner here
This week we play be and on point. Be ready between 5pm - 6pm on wednesday. Remember it is for loyal Doctors Quarter Blog Readers, with the fastest fingers... keep playing!!!
More soon!!!
5 Ways Marijuana Won In 2014
5 Ways Marijuana Won In 2014 Read all about it here!
Funny article. However, active substance in canabis hold a lot of hope for cure of Alzheimer's disease.
Funny article. However, active substance in canabis hold a lot of hope for cure of Alzheimer's disease.
Sunday, 28 December 2014
Psychiatric Testing, A Must For Politicians - Obembe
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In an interview with Tobi Oderinde, Dr Obembe said every Nigerian should be registered to a general practitioner, who will ensure that the physical, social and mental health of Nigerians are sound.
Read full interview here.
I totally agree with Dr Obembe. In as much as you are willing and ready to serve in whatever position, then you must subject yourself to routine Mental fitness tests, considering our recent past.
Or how else do you want to explain the scaling of the National Assembly Gate by Law-Makers, if not that they may have some mental issues.
Good bless Nigeria!!!
Adult Burkitt's Lymphoma; Rare but Real!
In one of my previous post on Burkitt's lymphoma, I said, this condition is commoner in children.Read about childhood tumour here!
Here is a rare occurrence of Burkitt's lymphoma in an adult, as posted by The Lancet, enjoy;
A 64-year-old male farmer presented to our hospital in April, 2013, with a 3 month history of painless, progressive swelling of his chest wall and lower jaw, and 10 kg unintentional weight loss. On examination he had multiple lumps about 3 × 1·5 cm around the angle of the mandible, and multiple 10 × 8 cm lumps at the mid sternal region and of the left lower anterior chest wall (figure). These lumps were non-tender to palpation, hard, and tethered, with irregular contours, no tempertature changes or overlying skin changes. Blood tests were normal and HIV serology was negative. CT Chest showed a soft tissue mass 8 × 10·6 × 8 cm encasing and eroding the body of sternum with presternal and retrosternal soft tissue components (appendix), and whole-body PET CT fusion showed increased 18F-fluorodeoxyglucose (18F-FDG) uptake (appendix). Histological and immunohistochemical examination of a biopsy specimen from the chest wall swelling showed tightly-packed small round cells with high mitotic activity infiltrating fat and starry sky appearance (figure), positive for CD20, Bcl-2, Mum-1, and Bcl-6, and negative for CD10, CD3, Cyclin-D1, and TdT, with Ki-67 nearly 100%. Conventional cytogenetics showed complex structural and numerical abnormalities including characteristic t (8;14) (appendix). We diagnosed high risk group adult Burkitt lymphoma stage IV, and started treatment with modified Magrath regimen of four alternating cycles of R-CODOX-M and R-IMVAC chemotherapy. The patient achieved complete remission with disappearance of sternal swellings, normal peripheral blood counts, normal bone marrow aspirate, and no evidence of 18FDG uptake on repeat PET scan. He remained in remission at last 3 month follow-up in December, 2013.
Hope he gets well quick!!!
Here is a rare occurrence of Burkitt's lymphoma in an adult, as posted by The Lancet, enjoy;
A 64-year-old male farmer presented to our hospital in April, 2013, with a 3 month history of painless, progressive swelling of his chest wall and lower jaw, and 10 kg unintentional weight loss. On examination he had multiple lumps about 3 × 1·5 cm around the angle of the mandible, and multiple 10 × 8 cm lumps at the mid sternal region and of the left lower anterior chest wall (figure). These lumps were non-tender to palpation, hard, and tethered, with irregular contours, no tempertature changes or overlying skin changes. Blood tests were normal and HIV serology was negative. CT Chest showed a soft tissue mass 8 × 10·6 × 8 cm encasing and eroding the body of sternum with presternal and retrosternal soft tissue components (appendix), and whole-body PET CT fusion showed increased 18F-fluorodeoxyglucose (18F-FDG) uptake (appendix). Histological and immunohistochemical examination of a biopsy specimen from the chest wall swelling showed tightly-packed small round cells with high mitotic activity infiltrating fat and starry sky appearance (figure), positive for CD20, Bcl-2, Mum-1, and Bcl-6, and negative for CD10, CD3, Cyclin-D1, and TdT, with Ki-67 nearly 100%. Conventional cytogenetics showed complex structural and numerical abnormalities including characteristic t (8;14) (appendix). We diagnosed high risk group adult Burkitt lymphoma stage IV, and started treatment with modified Magrath regimen of four alternating cycles of R-CODOX-M and R-IMVAC chemotherapy. The patient achieved complete remission with disappearance of sternal swellings, normal peripheral blood counts, normal bone marrow aspirate, and no evidence of 18FDG uptake on repeat PET scan. He remained in remission at last 3 month follow-up in December, 2013.
Hope he gets well quick!!!
Saturday, 27 December 2014
Immunization against Vaccine preventable Diseases...
Immunization is the process of stimulating immunity against a particular disease. It involves administration of vaccines.
There are vaccine preventable diseases like;
Poliomyelitis caused by the polio virus
Hepatitis B caused by hepatitis B virus
Tuberculosis caused by Mycobacterium tuberculosis
Pertussis caused by Bordetella pertussis
Diphtheria caused by diphtheria species
Tetanus caused by Clostridium tetani
And a host of others according to the National schedule on immunization.
However, more vaccines are incorporated into a vaccina, hence, there are now polyvalent vaccines or trivalent vaccina. See the recommendations as stipulated by the American Association of Pediatricians, on influenza vaccine... American Association of Pediatricians guidelines on influenza vaccination.
Get yourself and your family vaccinated today!!!
There are vaccine preventable diseases like;
Poliomyelitis caused by the polio virus
Hepatitis B caused by hepatitis B virus
Tuberculosis caused by Mycobacterium tuberculosis
Pertussis caused by Bordetella pertussis
Diphtheria caused by diphtheria species
Tetanus caused by Clostridium tetani
And a host of others according to the National schedule on immunization.
However, more vaccines are incorporated into a vaccina, hence, there are now polyvalent vaccines or trivalent vaccina. See the recommendations as stipulated by the American Association of Pediatricians, on influenza vaccine... American Association of Pediatricians guidelines on influenza vaccination.
Get yourself and your family vaccinated today!!!
REVEALED!!! Why Men Are Helplessly Attracted To Big Butts - Study
Woow!! I have always wondered why men are so into big buttocks. It has nothing to do with the facial beauty of the woman, believe me. A few colleagues I asked said it's mostly due for sexual pleasure.
Is it possible that men, are attracted to bigger buttocks for reason they don't actually know truly exist?
A study on this I saw on punch newspaper came out with conclusions that will shock you.
Read about it here.
Do this article truly portray your views for why men are helpless with big butt's. If No? Then what is your reason?!!
Is it possible that men, are attracted to bigger buttocks for reason they don't actually know truly exist?
A study on this I saw on punch newspaper came out with conclusions that will shock you.
Read about it here.
Do this article truly portray your views for why men are helpless with big butt's. If No? Then what is your reason?!!
CHILDHOOD TUMOURS: FACTS AND FIGURE
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There are so fact and figures I think you should know, to help you relate with these children;
Children rare have tumours especially malignancies as compared to adults.
When ever you see or hear that a child have a tumour, especially in Nigeria, think Burkitt Lymphoma, for it is commonest childhood tumour in Nigeria.
It's incidence is high in the 'Malaria Belt', that is latitude 10' North to 15' South of the equator.
Classically, it affects children between the ages of 4 -9years; rarely before 1year or after 20years.
Burkitt Lymphoma present commonly with a rapidly growing jaw swelling, loss of dental architecture with visual disturbances.
Burkitt lymphoma is usually confirmed on histology. A "Starry Sky" appearance is seen which confirms the diagnosis.
It is truly an agonising period for both victim and care giver. They would truly need all the support they can get, especially your sincere concern and encouragement.
For more comments or advice on Burkitt Lymphoma in Nigeria, send in your comment to dremekaokolo.gmail.com OR reach us on this blog link post!!!
Preventive Medicine... Way Forward!
A professor of mine once said, "we are moving away from the era of curative medicine, into an era of preventive medicine". I believe him, for it makes sense.
The science of preventive medicine is so real and logical that when you understand it, then it cuts down the "overhead cost", attributable to curative medicine.
Preventive medicine, unlike curative medicine, is proactive in principle. It involves the staying away from the aetiologies or causes of disease condition.
In developed world, there are 3 levels of prevention. But in developing countries, there are actually 5 levels of prevention viz;
-General Health Protection
-Specific Protection
-Early Diagnosis and Prompt Treatment
-Limitation of Disability
-Rehabilitation
The proper implementation of these prevention options, would to reduction of preventable morbidity and mortality in regions, where standard hospital services are either not sufficient and affordable, or not existent. This is the way forward!!
The science of preventive medicine is so real and logical that when you understand it, then it cuts down the "overhead cost", attributable to curative medicine.
Preventive medicine, unlike curative medicine, is proactive in principle. It involves the staying away from the aetiologies or causes of disease condition.
In developed world, there are 3 levels of prevention. But in developing countries, there are actually 5 levels of prevention viz;
-General Health Protection
-Specific Protection
-Early Diagnosis and Prompt Treatment
-Limitation of Disability
-Rehabilitation
The proper implementation of these prevention options, would to reduction of preventable morbidity and mortality in regions, where standard hospital services are either not sufficient and affordable, or not existent. This is the way forward!!
Friday, 26 December 2014
Body Systems: How Many Are There!!
I was in the clinic recently and my unit consultant threw at us a very important question; HOW MANY SYSTEMS ARE THERE IN THE BODY FOR THE PURPOSE OF CLERKING A PATIENT?
I made this my assignment for this night.
Do you know how many systems are in the human body?
I made this my assignment for this night.
Do you know how many systems are in the human body?
Bubbles in the Special Care Baby Unit
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I looked into one of the incubator at one of"Our Gift", that is how I like to call them, and saw the vulnerability of our gifts, if we were not here to look over them.
The Special Care Baby Unit is an important unit in a tertiary facility, where they are nurtured till they can stand the elements. Most of our gifts are between the ages of 34 - 38weeks old, in one form of distress or another. Save for our newest gift, who is 35weeks old, others are almost due for discharge into the waiting arms of family and friends.
I like to believe they hear me, as I whisper some sweet words into there tiny ear, of course, outside the incubator.
Now and then, the mothers of our gifts would troop in to breastfeed them, or spoon food them; never bottle feeding. Most can suckle independently now; that is a good sign.
The oldest of them now have this high sounding cry, unlike when he was admitted to be treated for meconium in amniotic fluid. He has since shown remarkable improvement.
I ll spend a few more hours with them, before I rush back to my abode to open some gifts I got. After all, it's boxing day!!!
MERRY CHRISTMAS.... COMPLIMENTS OF THE SEASON!
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