₦airaland Forum

sweetkev:
My nairaland color just changed from white to black. Please peeps, how can I change the display back to normal white color.

At the top right corner of your page, you'll see a sun icon, click on it and it will switch back to the white display.

ChizzyBuna:
she was discovered in Lagos. Period

Bros, your claim was that she grew up in Lagos. I just wanted to correct that notion as she actually grew up in Owerri.

Anyway, how was she discovered in Lagos? She moved from Rivers Angels of Port-Harcout to Paris FC.

ChizzyBuna:
God saved her that she grew up in Lagos

If not, she would still be selling beans in Onitsha main market. Congratulations

Per Google:
Chiamaka Nnadozie grew up in Owerri, the capital of Imo State, and started playing football at a young age with friends in the Orji area. She attended Comprehensive Secondary School in Amakohia Uratta, where she played with male schoolmates, including fellow footballer Bruno Onyemaechi. Nnadozie also noted that she grew up on the streets of Akwakuma, Owerri, and her journey from there to becoming an Olympian is a source of inspiration.

Easy with the lies.

aribisala0:
Tolerance
people with long-term heavy alcohol use can show surprisingly low measured blood alcohol concentrations (BAC) even after drinking large amounts,

Chronic heavy drinkers develop enzyme induction, especially:

Alcohol dehydrogenase (ADH)

Cytochrome P450 2E1 (CYP2E1)

Over time, the liver becomes more efficient at metaboluzing alcohol, so the BAC rises less than expected


What you are telling us is if the BAC is low you would not suspect withdrawal

That is wrong and unsafe

That is exactly when you should
This poor understanding would unalive the patient


BAC has no value in predicting withdrawal

If you suspect withdrawal you observe and monitor using a tool like
Clinical Institute Withdrawal Assessment for Alcohol, Revised

Again you don't need BAC to tell you that a patient is comatose

Honestly you are out of your depth

I'm bored with this exercise.
You've not written anything that I could even remotely consider worthwhile, to be honest.
You've thrown around some basic science, and some factoids you've googled, but you're doing a poor job of putting it all together.

You're desperately grasping at things and deliberately ignoring the overall statement. When I tell you a blood alcohol level is useful clinical information to me, you misinterprete it to say that I would not suspect withdrawal if the BAL is low. Not what I said. I said suspicion is raised.

You don't treat humans like robots, you collect information and interprete it the individual's circumstance. Of course, the chronicity of alcohol use and its implications is factored in. I'm not making my decison on BAL alone, but it's usefel information to me.

Why do you think someone is going into withdrawal to begin with? I can only hope that you know that there's a timeline in which withdrawal symptoms start to occur. You cannot uderstand these things fundamentally and think BAL tells you nothing.

I sense you'll come back with another disjointed rebuttal, so I won't go any further with you, but I'll leave you with an excerpt from a paper from the NIH-National Library of medicine, in which BAL was used as a predictor of withdrawal severity:

"Blood alcohol level at the time of presentation or at the time of withdrawal may be a useful clinical prognostic factor to predict the severity of withdrawal, and reason to initiate more intensive pharmacological therapy. In a retrospective cohort study that assessed 185 patients admitted for alcohol withdrawal, alcohol level at the time of admission was significantly associated with withdrawal severity [4]. Severity was measured by the amount of chlordiazepoxide administered within the first 48 hours of admission, institutional withdrawal severity assessment score, and severity of tremor. This study recommended creating a threshold of 150 mg/dL on admission to help identify patients most at risk for severe adverse outcomes. In this study, patients’ BACs were measured regardless of whether the patient presented with acute intoxication or was already in withdrawal."

aribisala0:
You are the one claiming to be whatever
I don't have time for pointless talk
Is there anything sensible to discuss if not let us close

Say I get a patient that I suspect could be a chronic drinker, but he doesn't appear intoxicated and he tells me he barely drinks and just had one beer yesterday. I check for blood alcohol content and it's out the roof(yes, there are actual numbers). Now I know that not only has he been drinking heavily, he has likely gained tolerance and dependence, so my suspicion for the likelihood of alcohol withdrawal syndrome is increased, and I go ahead and initiate protocol to prevent this occurence.
Has this information on his blood alcohol level not become a useful information that influenced my clinical decision in this scenario, even though the patient did not appear intoxicated?


Yes, intoxication can have levels, ranging from subclinical to a comatose state.

aribisala0:
I am not immature like you
I will remain anonymous

Blood levels do not correlate with intoxication
People develop tolerance to Alcohol

Naive cconsumers will get intoxicated from 1 or 2 units
While a veteran would consume 15 units and drive safely

Stop showing yourself

It is unnecessary

It is obvious you are out of your depth

Anonymous? Do you know my name?

aribisala0:
Blood alcohol level helps assess level of intoxication?...?..

What are the levels of intoxication?

Is there a standardised clinical scale to measure LEVEL OF INTOXICATION?

With. Respect you don't need a blood test to measure intoxication

You are talking theory maybe from Google

That is a judgement that any bartender or traffic policeman can make you don't need to be a doctor
However for a doctor it is a purely clinical assessment

You are just rambling on about accuracy
So you have a 20% more accurate result what difference will it make in a Rehabilitation unit?

Name one thing , one single intervention that you will make based on a different less or more accurate blood result

What single difference will blood levels make

The truth is if a person appears to you to be intoxicated the blood alcohol level will not change the treatment whether in Rehabilitation or acute intoxication


The only thing you have succeeded in doing here us advertise that you are some kind of clinician somewhere
One that feels he must talk on everything even when you don't have sufficient knowledge on the issues

Thee is nothing like very high on a blood alcohol test
There is nothing like marijuana in any toxicology test
There is no chemical called marijuana
A blood alcohol level is a complex and expensive test=gas chromatography with little clinical utility
It will not make much difference to treatment plan and is very unlikely to be a routine or readily available in Nigeria ⁴

How many people have you treated for alcohol intoxication?

aribisala0:
I never claim to practise anything
I never claim not to practise anything

This is an anonymous forum

I can tell you that there is no where in the English speaking world that any laboratory reports marijuana
Drug testing has a language that us scientific and codified internationally because it is a discipline that has very significant legal implications in medicine, Forensic and sport . You might have heard of the Lausanne Declaration or of the World Anti-Doping Agency (WADA

or WADA protocols
THE BOTANICAL NAME IS CANNABIS SATIVA, NOT MARIJUANA.
THE CHEMICAL NAME. Δ9-Tetrahydrocannabinol (Δ9-THC).
Every single drug or metabolite has an IUPAC name this is reflected in the commercially available urine kits or the chromatography kits
So toxicology reports have a standard that is international . There is no chemical substance called marijuana. These days there are synthetic Cannabinoids and they,too, must be specified. They are not related to Marijuana. What I can see is a form of polymath syndrome Dunning-Kruger Effect. , the feeling that if you are a clinician you can talk on everything. You clearly are limited on this topic
Matijuana is a LEGAL term and suggest authorship of the report

I am curious to know what specific clinical advantages one gets from a blood alcohol level over a breathalyzer. Even theoretical or hypothetical
What one example of a difference would knowledge of accurate alcohol level make in terms of intervention


Leaving that to one side publishing this results is counterproductive it is not evidence of being 10 steps ahead
It is unethical

Expertise

I was referring specifically to the matter at hand whether you have special expertise in toxicology or biochemistry
We are not talking about fitness to practise or negligence

Two recent urine drug screens I ordered from two separate labs used two different terminologies in their report, one stated 'marijuana metabolites' while the other stated 'cannabinoids', I have also seen some a lot of reports state 'marijuana' .
Like I stated from the jump, I understand that the labs tested for THC levels and I understand what is being conveyed to me in the report. Where I practice, the standard urine drug test does not test for synthetic cannabinoids, I would have to order specific tests for those.


The advantage of a blood alcohol level over a breathalyzer is in the accuracy, as stated earlier. The breathalyzer is trying to estimate the blood alcohol level by measuring the breath alcohol concentration, but is limited by technical errors, physiological limitations(including individual breathing patterns, airway anatomy etc) and other biases that lead to overestimation or underestimation of the true blood alcohol level. It's generally understood that the breathalyzer is subject to multiple sources of error, and no one, in my experience, uses a breathalyzer in a clinical setting where blood testing is available. It's only advantage is that it is a rapid test.

Having an accurate blood alcohol level is quite important. It provides objective data that allows one to assess the degree of intoxication in the patient, in addition to other history and information that has been gathered. It might influence a lot of decisions that the clinician has to make; the clinician may have to look for other causes of encephalopathy, maybe only supportive care would suffice or pharmacotherapy might be necessary for intoxication, maybe the clinician has to anticipate withdrawal symptoms as the patient sobers up and start preemptive treatment for that as well. The blood alcohol level is useful information that contributes to the clinician's decison making in all of this.


I'm not in support of publishing anyone's medical records, I don't know about anyone being 10-steps ahead. Ned is not tacking any responsibilty for the records being in the public domain.

aribisala0:
There is no need trying g to show yourself
Marijuana is not a medical term
It has no meaning in medicine

Typical results might say something like:

THC positive or THC negative

Cannabinoids detected

I will ask you one question have you ever testified as an expert witness at a court or tribunal

Do not say what you read
First the reports are alleged
I don't know that they belong to Regina Daniels and you don't

You even use the phrase I am sure

You are not sure of anything
Any test has a PURPOSE
The person presenting them claim she was in Rehabilitation
In Rehabilitation a drug screen is routine.
The purpose of a rehab drug screen to to establish a baseline record

This is usually a urine test and gives a negative or positive result

So what is the purpose of doing alcohol blood levels? What does that contribute to treatment in a Rehabilitation setting

Now this so called result which is supposed to be more accurate does not give a number
Why do blood tests if you cannot give numbers only to say very high
You do a blood test and say ah the blood alcohol level is very high
What is the reference range and how high was it


That result will not Stand in any court and no expert witness will try to defend it in court
Finally the ethical question of releasing these results to the internet



A blood test for cannabis will always specify the metabolites e.g THC

always

Of course, what we're looking at above is not the actual medical report. That is a letter from the Senators rep, and it mentions at least two hospitals in addition to a rehab center that the records supposedly originated from. I could agree with some of your points if it was stated the results solely came from a rehab facility.

In the actual lab results, I expect to see real figures. If there's litigation, they'll have to provide the actual lab results.

I suspect some of our differences here might hinge on the locations in which we practice. As stated earlier , you typically test for the THC metabolites certainly, but the report can state 'positive or negative for marijuana'. At least, it's the case where I practice.

No, I've not had the 'joy' of testifying as an expert witness. I've definitely gotten some lucrative offers to provide my expert opinion in cases against other physicians, but I always turn them down.

aribisala0:
You are believing what you want to believe

Alcohol level is very rarely used for rehabilitation
What is the Point?
There is no clinical reason for that

If person arrives in a coma that would be justified otherwise that test is usually used for Forensic =legal or criminal matters
Also I doubt that any laboratory in Nigeria has that capability the reason is simple ? What is the clinical use? How many times in a year do they run blood alcohol? For what?
To establish that a person drinks alcohol? Is the person denying if so is the person a voluntary patient? Did a court order the test

The standard test would be a breathalyser test which answers the question


The main value of a blood test is in a court case?
I am talking specifically about alcohol

So did the lady consent to such a test ?

Medical reports do not cite MARIJUANA


What seems obvious is the strategizing of a Legal mind that doesn't fully understand the science.
This us a premeditated script

He us clever legally but using the wrong science and overdo

Rehabilitation centres do not necessarily test levels they run tests that answer positive or negative

Levels are tested not for Rehabilitation purposes but legal or other reasons


If Regina did not consent to these tests they have no legal value
And even releasing them sets him up for legal liability I

Because he put them on the internet. She can sue him not Just in Nigeria but in the UK where it will really hurt him


I thought this man was smart

When a patient presents with altered mental status, it is typical to do an alcohol and drug screen in addition to other tests to assess metabolic function, and also to obtain pertinent radiographic images.

These tests for drugs and alcohol can be qualitative (presence of substance) or quantitative(amount of substance).

Some of these reports on Regina Daniels originated from hospitals. If she was unconscious, I'm sure they took her to a hospital instead of a rehab facility, on that occasion.

In the hospital, blood alcohol content is a standard test. It's more accurate than a breathalyzer, the patient does not have to be conscious in the case of a blood test, but both the blood test and the breathalyzer are quantitative tests that provide useful medical information on how much alcohol the pt has consumed. It does not have to be for legal purposes.

A medical report can state that a patient tested positive for marijuana. Why not?
The test is usually looking for the THC metabolites, but the report usually simply states positive or negative for marijuana.

I sense that Ned Nwoko understands the legal ramifications of leaking someone's personal medical records. So, even while confirming the validity of the records, he has not taken any responsibility for being it's source.

This man is mad!

Bros, you sure about this thing?

After GEJ acted like a punk, conceded defeat, panicked and ran to Otueke even while results were still being tallied.

Then, Fubara allowed Wike to bully him all over the place.

A disgraced country.