₦airaland Forum

Barring any last-minute magic or miracles, the opposition party, APC(hereafter to be called "Ruling Party" and its presidential candidate, General Muhamadu Buhari (rtd), will take control of the Federal Goverment in less than 2 months' time. Also, APC will become the majority party in the House of Assembly.

Here are they changes, I truly want in Nigeria:

1)Reduction in the cost of governance. A situation where recurrent expenditures will continue to take the greatest chunk of anual budgets will represent business as usual and no change.

2)Let the good policies continue. In Nigeria we are notorious for throwing the baby along with the water after every change of government. Yes, GEJ was not all we had desired but most people believe he got some areas right. Eg, Agriculture, the positive efforts in the transport sector should be sustained, same as infrastructure: airports, roads, etc

3) Corrupt politicians must br prosecuted and jailed. Clearly this is one part GEJ failed, which led to the perception that is very corrupt.

4) APC must conduct free elections. This for me is the most important, for as experience has shown, this is the only hope of the people. But you can agree with me that prior to 2011, it was not always so. GEJ to a very great extent ensured the independence of INEC and made the votes of most people to count. Mind you, any desperate shameless govt can subdue the voice of tje people through pre, intra and post election manipulations. APC would have all been scam if they do not give the people fair elections.

Finally, this is a victory for Nigeria. This is not and individual, regional or ethnic contest. Nigerians just chose who would lead them till 2019, that is all. By tomorrow life continues....

May we never have cause to shout "change", again; but when we do, may we find the voice (Fair elections) to bring the change most people desire.

What are your expectations of the APC controlled Federal Government and Parliament? What changes do you hope for?

U will never know till u finish this book

"Staph infection" is the scam of the century.

rubii09:
Bros remove medicine from that list. Any average student with hardwork and perseverance can read medicine.

You dont seem to get the drift...

If the same "average" student should put in HALF that measure of hardwork and perseverance into other courses, he will become the best in those other courses....all other things being equal.

There is no course that does not require hardwork. But the point is, genuises dont really need much hardwork or perseverance. They operate like wizards, like magicians.

I saw a lot of them in med school

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It is possible she is allergic to something she uses in her everyday life, which she hasnt figured out yet. If that is the case, then all treatments given to her will be temporary until the source of the allergy is found and eliminated.


I had a similar experience as a corper. Nysc was the first time I would stay in a rural area. My nysc town was a very very rural community in Edo state.

From the first day of work as a doctor in a health centre, I was having serious cattarh and cough. It took me up to 4weeks to diagnose myself with allergy to Pollens/grasses - my lodge was all surrounded by thick bush, and colourful flowers with pollens adorned the hospital walkways.

I never stopped having cattarh till I left the area. I was always takin procold as often as I needed (usu during CDS and work hours and when I was expecting guests)

However, allergy/atopy is not the only possibility here. She should see an ENT surgeon, not just a GP.

Closest thing in Greek to my name

She is an example of what marriage should be.





I dont usually do this but I have to. Mods this topic is one that has positive influence on many aspects of our lives: Family, marriage, relationships and charity, yet it has been trending since mornin but hasnt made front page. Yet a thread of Tonto dike cookin indomie will be created now and makes frontpage with only 2 comments. E good so?

Been following this dispute since day 1, hoping it would soon get resolved but the direction it is headed is worrisome...

Marc my advice as a doctor is to provide details that can verify if you are so qualified.

Usually, your full name and year of graduation should be enough. Classmates are everywhere. It takes nothing away from u, rather, it makes you credible.

If I were in your shoes, I would have done exactly the same. Nothing as serious as when a "doctor's" credibility is in question and he allows it to linger.

sexynabila:
m un my early 20ths

ok. I ask cos it is common to experience this few years after the first menstrual period.

If your doctor said you are ok, then maybe you should wait, watch and see.

Psychological factors are common disturbances of menstrual cycle, especially stress caused by excessive worry. So stop worrying.

Stop worrying. Relax. Watch. Wait. And see what happens...

sexynabila:
first my period started coming late ..it was extending by 12,13 day....then for 2 months i did not see it & then it came d third month...afterwhich..it did not come for 3months & then again i saw it d next month months.. & now it almost three months & i hav not seen it again... all dis while i hv been going for test but d doctor said am perfectly fine... i dnt kw wat to do.. even though d doctor said am fine but i still tink its not normal for me to be skipping my monthly period for a long duration.... pls i still need more information from those of u in d medical field on how to go abt it. thank u!

How old are you?

shiizzy:
hi . . . . Fellow nairalanders . .i wanna knw the best drug to burn fats with minimal side effects . . .the rate @ which i'm gaining weight is unbearable . .last yr (ending) i weighed 90kg . .now i'm 100kg . .and i'm still 18

There is no short cut to lifestyle changes bro.

Join a gym. Exercise regularly. Cut down on your calorie intakes, esp the in-between meals.

Discipline.

Bashing doctors is now the in-thing for Nigerians and nairalanders.

You really expect intelligent minds to start discussions based on a heresay too?

Ok. Make una continue

Desmog21:
My brother let me enlightened you a little!

The U.S. Food and Drug Administration classifies quinine (Qualaquin) as a pregnancy Category C medication, which means it may not be safe for pregnant women to use this medication.

What Is Pregnancy Category C?
The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. Pregnancy Category C is given to medicines that have not been studied in pregnant humans, but appear to cause harm to the fetus in animal studies.

Can Pregnant Women Take Quinine?
Quinine sulfate (Qualaquin®) is a prescription medication used in the treatment of uncomplicated (mild) malaria.
Based on the results of animal studies, It may not be safe for pregnant women to take quinine.

Though many pregnant women have been treated for malaria with normal doses of quinine. Studies have looked at whether or not infants born to these women had an increased risk of problems compared to what would be expected from a normal pregnancy. These studies did not show an increased risk with quinine use.

However, there are cases of pregnant women taking very high quinine doses during the first trimester. In these cases, many of the infants were born with problems, including brain problems and abnormal limb development.

In addition, pregnant women may have a higher risk for low blood sugar (hypoglycemia) when given quinine.

Malaria can also increase the risk for miscarriage and premature labor. Therefore, it is very important that a pregnant woman with malaria be treated. Quinine is not the only treatment option for malaria; however, in some cases, it may be the best option available.

So in a conclusion, A healthcare provider will choose the best malaria treatment based on the risks and benefits of each option. A pregnancy Category C medicine, such as quinine, may be given to a pregnant woman If the healthcare provider believes that the benefits to the woman outweigh any possible risks to the unborn child.

omicron:
Quinine is not a category A drug. But it is safe for treatment of malaria in pregnancy. You should have known it means the benefit therein outweigh the risks.
It was thought to be aiding abortion historically, but that is only history. What is known now is that it is the malaria that caused the abortions.
I have not said that docs aint reaponsible for counselling patients, but patient self education is also helpful.
Lack of communication means the doctor did not counsel the patient adequately, and the patient did not ask informed questions too.
Thanks for your responses. Byebye

Your opening statement is immature, like we were when we were med students. You should have made your points without feeling so good about yourself. All you have said have already been discussed before.

The whole essay you wrote can be summarised in my initial posts, one of which i quoted above.

This is a public forum, not a Pharmacology, OBGY or Public Health lecture room.

0monnak0da:
I m afraid I must disagree with you on several grounds.
I wonder whether you practice in a jurisdiction where you are required to have insurance and what the insurers would have to say about what you have written
1. "LACK OF COMMUNICATION" that is a peculiar choice of words. The doctor has a duty to communicate unambiguously about the purpose,benefits and risks of any intended treatment.Not only that the doctor must be satisfied that the patient understands the information and is able to balance the consequences of choosing treatment or not. Failure to do this is NEGLIGENCE

2. PATIENT CAN DO SOME SELF EDUCATION . Medicolegally this point deserves no response and has been dealt with by (1) above. The responsibility lies with the doctor not just to explain but to be satisfied patient understands

3 . QUININE IS NOT KNOWN TO CAUSE MISCARRIAGE. This is very funny. Historically it was used as an abortifacient!! On this point you did not take your own advice and use the internet. I already addressed this above maybe you did not read it. Just Google Quinine + miscarriage , for even more details add G6PD to your search.
Now check the information in the SPC for quinine ; The manufacturer says and I quote "Quinine sulphate should not be used during pregnancy unless the benefits outweigh the risks"
http://www.medicines.org.uk/emc/medicine/27759
What is the LEGAL implication of this
a) the doctor should know the risks
b) the doctor should explain the risks to the patient and once again be satisfied the patient understands/is capable of understanding

Having said all the above the drug is relatively safe but what is on display is a gung-ho dismissive attitude found in Nigerian doctors that gets them into trouble abroad. It is UNTRUE to say the drug is unknown to cause miscarriage. If you had said that to this patient as her doctor you will already be liable for tens of thousands of dollars. Intellectual humility is a very crucial attribute

The woman should BE SCREENED FOR G6PD

Quinine is not a category A drug. But it is safe for treatment of malaria in pregnancy. You should have known it means the benefit therein outweigh the risks.

It was thought to be aiding abortion historically, but that is only history. What is known now is that it is the malaria that caused the abortions.

I have not said that docs aint reaponsible for counselling patients, but patient self education is also helpful.

Lack of communication means the doctor did not counsel the patient adequately, and the patient did not ask informed questions too.

Thanks for your responses. Byebye

dicefrost:
You Don't see any malpractice?? Typical 9ja doctor. A patient presents with a test result confirming pregnancy, you treat her for malaria, she ends up with a miscarriage, bleeding per vagina. You order an ultrasound hoping to detect a pregnancy that is probably less than a few week. At the end you conclude that there is no pregnancy, and send the woman home, not withstanding the test result and bleeding per vagina. What if she has retained products?.? Once again, are you sure there is no malpractice?

We do not know the LMP or EGA so we cannot say if it is correct he ordered the ultrasound when he did.

Blood tests do not comfirm pregnancy. Ultrasound did not show any retained products

The percieved malpractice by the OP is that the doctor caused the miscarriage. And that is not true.

0monnakoda:
I think the fact that doctor is prepared to discredit the pregnancy test is worrying.Even now it should be possible to confirm if she was ever pregnant. If indeed she did have a "miscarriage" you are right that the reason is UNKNOWN. We cannot say quinine is not to blame .At best we can say it is unlikely based on xyz. We DO NOT KNOW. Everything is NOT online as far as adverse reactions are concerned.New ones are reported daily. Drugs are withdrawn or discontinued for that reason. The true doctor never assumes that ALL knowledge has been .There is always something to learn. G6PD is one theoretical explanation,accidental overdose is another there are others no doubt.
G6PD individuals have partial immunity to malaria and quinine can cause miscarriages.Therefore if malaria was misdiagnosed and quinine administered unnecessarily there is a case for malpractice,IF

On the other hand ,in pregnancy symptomatic malaria has a 50% risk of miscarriage and 33% where there are no symptoms.

Like i said, it is a lack of communication between the doctor and patient.

New facts are discovered by the second, but the patients can do some self education. The information available online from WHO, CDC, Mayo Clinic, and many reliable websites is enough for such basic self education. We doctors should also take out time to educate patients at every time when possible.

Quinine is not known to cause miscarriage, and it is so considered safe. It is a myth which is even common within health professionals. Unless there are new studies to the contrary.

However, anything is possible. Maybe, that's part of the message you tried to pass across.

anitank:
But these are the things the doctor would have tried explaining to them rather than dismiss their claim about being pregnant because they hadn't gone for a scan. That's just unfair and doesn't portray him to be a good doctor.

If a urine or blood test showed the op's wife was pregnant, then she most definitely was. Besides most people don't go for a scan till after their first trimester

You are right that the doctor should have counselled her about the safety profile of the drugs prescribed. I already alluded to that in my 2nd post on the topic.

However, a positive pregnancy test is most likely suggestive of pregnancy, but not "most definitely" so. There are other conditions that can give u false positive pregnancy tests with even similar symptoms of pregancy. An example is what is called molar "pregnancy".

It is best do ultrasound in the first trimester and another later in pregancy.

0monnakoda:
I guess safety is relative so I would expect bread to be safer that quinine .What is not clear is why quinine was justified? Was there a malaria test?

lol

Op said MP was 1+ which in otherwise healthy adult is not significant. But sometimes, startin treatment based on 1+ is justified if clinical symptoms are supportive of malaria. In pregant people, you dont want to take any chance.

What is not clear is what caused her miscarriage. But from what is known, we cannot blame the quinine.

Op thinks its the quinine, but he is wrong. He should have sought for knowledge. Everythin is here online. The public is simply not doing their due diligence when it comes to medicine. Instead, they prefer the blame game in things they have not tried to understand.

I think it is lack of communication. Treating sick pregnant people is dicey and challenging. Most times you are in a dillema. It helps to tell them what is safe and what is not safe, but necessary.

According to WHO, Quinnine is known to be safe in first trimester preganancy.

It does not cause miscarriage. Rather, it is the malaria that causes miscarriage.

Coartem is not conclusively safe in early pregnancy as there are not enough data to prove its safety yet. Some new studies however, show it could be safe in pregnancy.

I do not see any malpractice here OP.

Sorry for your loss.

Bimbor change your spark plugs first and inspect the spark plug wires, as they are common causes of cylinder misfire. Then you can proceed to the other issues.

9 years using same mtn number. Seriously, in terms of data, calls and coverage, I'm yet to see a better alternative.

Overrated and overhyped. Movie is just ordinary

It's the way God made it

luvprince4real:
Thanks dear. But is it compulsory for her to commence d daily folic acid suplementation?

It is recommended. It helps to prevent certain birth defects. But it is not a law

luvprince4real:
When is an expectant mother suppose to start her antenatal programme. Plz ur advice and contributions ar needed.

After 3 months is what is generally recommended. This is because, the risk of spontaneous miscarriage drops significantly after the first trimester.

However, she can commence folic acid supplementation daily to help prevent neurological abnormalities in the foetus, such as spina bifida.

No other drugs are recommended during the first trimester, esp the 1st 10wks, except as otherwise prescribed by a qualified medical doctor

Autonomy. The doctor violated her right as an autonomous adult. There is nothing like they came as a couple.

In practice, how I handle this is first I counsel the patients separately before the test, separately after the test. If the result is favorable, no problem both can be told after I get a verbal consent. If it is a discordant result, I rest my case after the seperate post test counselling. Any consent to divulge the result to the partner must be a written one.

Even if a mother brought an 18yr old and her test is positive, no telling the mom. It is unfortunate, but that is what is ethical.

The benefit of violating a patient's right to autonomy and confidentiality far outweighs its expediency. Unless of cos, in cases where withholding such information poses danger to the community....eg Ebola patient and other reportable diseases. Not "private" matters.

That doctor could lose his license. It is usually a very serious matter and the professional ethics are clear.

I perfectly understand you.

It used to happen to me, but not anymore. I guess it stopped following one of my frequent changes of location.

In otherwise healthy adults, commonest cause is allergy, including to dust from foams and bedspread fabric. Othet causes are conditions that increase saliva production, such as pregnancy. Rarely, it could be a pointer to more serious problems affecting the muscles used in swallowing.

There are behavioural changes and pills used to control it. If you are ordinarily allergic (like me), then changing your bedspread, making sure they r free of allergens (eg dust, silk, wool) all the time will help.

Pills used in selected cases are prescription medicines.

Very sorry for your sister's situation

Her condition is psychiatric, and she would benefit immensely from a psychiatrist. It is possible that she has schizophrenia, or severe depression with schizoid symptoms. These are treatable conditions.

It is tempting as an African to see psychiatric illnesses as spiritual problems and or works of magic, but it is not always so. It is merely a mental illness.

Such conditions are not uncommon.

Coldplay007:
How is it over? Chronic Hepatitis B has no known cure...

chronic hepatitis B has no cure, but only less than 10% of healthy adults who contract Hepatitis B will go on to develop chronic hepatitis. The remaining 90% will become sero-negative, or free, of hepatitis B within six months after...

I think that is what he meant.