₦airaland Forum

[quote author=castrogee post=70529393][/quote]Log into your TLS Contact account. You will see track my application. Click it.

Bought my first car online via Inspired on nairaland here. Paid 100% before it was transported to my house by his driver. Car has been in excellent condition 5 years after. Was an easy and essentially risk-free decision then as Inspired Autos reputation was perfect at that time, before he started experiencing issues few years after. Many people I tell I bought the car online, paid 100% before delivery and have never met the seller up till now, don't believe. First thing about online deals is seller's reputation. If it's in doubt, never pay before delivery. There are very few with such reputation. Inspired was such then, untill allegations of fraud came in.

sweetgold5:
I am really enjoying this platform.

Pls I also submitted my application 30th of July its going to be 15 working days tomorrow and I got a mail today from VISAINFO. SHEFO that my application is not straight forward so they can't meet the stipulated time they usually process application so I still need to wait cos its still under process. (This is the 2nd mail I am receiving from them the 1st one was they have received my application and its under process). I applied for a standard visitor visa (Non Piority) and this is not my first application I have been given their visa more than 3 times.

I dont know whats happening oo... Pls has anyone seen this kind of mail and what was the end result..... Pls what should I do.....do I need to call them?

Pls kindly respond.
Thanks.

Got same mail on 13th working day. Today is 25th working day, nothing yet. Called twice and it didn't help.

Comprehensive Mathematics. Very self explanatory, you don't need a teacher. I Finished it in one long hols (2 months) and Maths was even clearer. Never had below a B since then. This was way back in 2000 or so (18 years ago). I believe it should still be same now as such books never really change.

soloqy:
Thanks for your response. Please Lagos to Enugu used to be around 7hrs journey when the roads were good,give and take, like what can one expect now considering these areas that are bad on the road?

Also the rains have started, someone said the roads turned to muddy slippery slopes, how true?

Thanks.

About 8 hours give and take. Rains have not really come so much. When they do, the bad part in Umunya will be slippery rather than dusty, bit still motorable

soloqy:
Please what is the current state of the Onitsha-Awka-Enugu Express road?

Is it motorable at all?

Please someone who knows should please respond .

Passed there yesterday. It's motorable. Umunya-Awkuzu part still bad and dusty but quite motorable(40km/hr average). After night mile is bad too, but all in all its quite motorable.

hagiosfemi:
Doctors, I am a med student and I wonder why MCQ que papers are retrieved from us after exam?

They are retrieved cos they are recycled from time to time.

One moment in time by Whitney Houston

slimjosh43:
Can we chat on WhatsApp:

I'm afraid, no. Please, contact me via PM. Thanks

Mhizify:
Good day Dr.
Please how long does an egg stays before it goes off?

Generally 24 hours

Omojudy:
He is. He retired as such recently from luth. No wasn't diagnosed as cervical incompetence, I only insisted on it being placed in my last pregnancy despite luth saying otherwise. Progesterone in that dose he said was to attack d polyp, didn't want to injure d uterus was his statement, I googled it and it seems it's possible.

Ok.

Focus on the polyp and fibroid then.

Get a second specialist opinion about the best way to manage them esp considering your eight miscariages. I would favour a more definitive approach as opposed to a conservative one.

All the best

Damsel21:
@nelszx,omicron. It so painful both ofu and other doctors in d Ouse has refuse to acknowledge my msg.anyway prior to my previous question I have done d p,test it was positive,but dis morning I saw a trace of blood went to so scan,d doctor said am having threatened abortion and place me on franol and pcm and bed rest pls will that be enough to keep my pregnancy intact ,is there any other thing I need rmto do?
Nelszx,omicron pls talk to me
Thank you

Hi, I have not been on the thread for a long time so not responding to you was not deliberate.

How old is your pregnancy?

The best treatment for threatened abortion is bed rest. This bed rest entails suspending most physical activities. This is hard to keep but try as much as u can. Avoid intercourse until your doctor clears you.

Review the need for the Franol with your doctor. It has no role in managing threatened abortion unless there are other reasons it is prescribed for you.

The commonest causes of early miscarriage are genetic causes, factors that are ordinarily out of our control. As such, even with the best possible care, pregnancies that are genetically destined to abort will abort. However, do your part and hope for the best.

All the best

Omojudy:
Thanks.
So what do u think about the progesterone treatments he gave towards the polyps? Plus he had an evacuation done after these results and particles were taken for histology with similar results. Think i should go for another hsg or tvs?
I intend seeking treatment elsewhere this month. He just came highly recommended from my last doc after a failed cerclage so we have been swallowing his insults on the basis of how far we have come, time wasted and money spent with him

I do not yet understand the need for the progesterones, perhaps more info is needed.

You brought up the issue of failed cerclage. This means that you had been diagnosed with cervical incompetence. That, plus the polyp and submucous fibroid mean the chances of a 2nd trimester miscarriage are very high.

You did not say if your doctor is an obstetrician/gynecologist. That is the most important thing.

All the best

Omojudy:
I would appreciate your diagnosis. Have had eight miscarriages, non intentionally terminated. Rhesus positive. No take home baby yet. Pregnancy loses at 14 weeks each time. I am at my wits end. Doc I am using now isn't proffering answers, rude, money conscious, proud. And most importantly slow without apology. For the polyps he gave progesterone Iv, tab and insert. Acirclovir for Parvo virus he said, treated with injection, never told us the name for syphilis and test later came out negative. Has been treating with different things for ecoli, still all coming positive, gave magnesium sulphate Iv recently. He was about to give go ahead to try conceive then asked for my husband's complete man test results, I hadn't done it, then he says no, not time to try yet cos we have to be sure what fertility drug to give u. If the tests results would come out in a month it won't have been a problem but from his anticidence, it will be a minimum of three months to see this result. Some Tests since January still not out, and they will reply non challantly, "no kit".
Pweew I am tired.

Hi, I'm sorry for what you have been through and I encourage you to keep hope alive. Eight miscarriages is such a significant history medically.

Your description of your doctor makes me wonder if you still consult him. Is he a gynaecologist? And what is he managing you for?

There are many differential (possible) diagnoses for recurrent second trimester pregnancy losses. Your scan and HSG results already point to the likely causes in your own case.

The endometrial polyp and submucous fibroid both are occupying the cavity(space) where the baby develops, so they can account for your miscarriages. You should also exclude cervical incompetence, a condition whereby the cervix opens up prrmaturely usually in the second trimester in the absence of pains, although this is less likely considering the history you gave and your radiologic results.

My advice? Get another gynaecologist. You may be offered treatment for the polyp and the submucous fibroid. If possible, have them removed via hysteroscopy rather than via open surgery. I am optimistic you will take home your next baby once you get the treatment you deserve.

All the best

This too

ProfOrlando:
Hello medics, my uncle in Ghana just sent me some medical textbooks for my 200l because of the present high price of medical books in Nigeria due to the rise in the value of dollar, but he sent me Harper's illustrated biochemistry and charteajea medical biochemistry instead of the lippincott and vasudevan I requested for. Please medics, How good is that charteajea biochemistry textbook ? I'll really appreciate your answers

Although it is now a decade I was at 2nd MB class, Harper's was the first choice Biochem text. A typical Lange textbook, it was very concentrated though.

Lippincot is known for its simplicity, but Harper's, when read carefully, will prove better resource.

It is similar to the Last Vs Keith Moore question

I have not heard of Charteagea before now.

When the inept govts are serious, it isnt just the Primary Health that will improve, but virtually everything else.

Did u follow the budget at all? How much was budgeted for the Teaching Hospitals, the NPHCDA? How much for the state house clinic? Believe your politicians at your own peril.

More doctors from Nigeria practise abroad than at home. The ones at home are all gearing to move. Nobody has a right to stop them from pursuing their goals. It isnt only the economic realities of the 80s that are repeating in history, the historical exodus of skilled proffesionals that occurred that period is already unfolding. The effects can only be appreciated in the future.

Doctors are willing to work in the rural areas. Many rural private hospitals have a hustling, hardworking doctor there. Same cannot be said of govt health centres. The reasons are never far-fetched. The solutions aint rocket science, as with other socio-infrastructural issues in Nigeria.

allycat:
Which doctors again, the ones that are routinely called bastards, murderers, quacks and all kinds of names especially on social media in Nigeria. While people like me are advising my younger collegues to get out of the country and find places where their services will be appreciated: some are advocating more suffering for them. My advice get all the caring, good, expirienced doctors from other countries who are no interested in money and are not half baked to come and man the rural, hospitals. At least unlike we Nigerian doctors foreign doctors don't like money or comfort and will maybe work for free.

perfectly expressed. The hypocritical attitude of the Nigerian public toward health professionals in Nigeria is nauseating.

firstlady4:
Please Dr. Omicron, help me out I asked this question two weeks ago no reply.

Hi,

I cannot interpret the hormone profile now as I don't comprehend the reference ranges given. I will check the corrrect ranges later tomorrow or so, and get back to it.

The culture is insignificant. No signs of infection.

The scan showed a right ovarian cyst. Normally, this should not cause any alarm unless it fails, or has failed, to disappear after about 3 months.

There is also a non-uniform myometrial echo pattern. This is not enough to make any diagnosis, but it is not the normal pattern. It could be a misjudgement from the sonographer, perhaps blood vessels within the womb. It can also suggest adenomyosis, a condition whereby the the cells from the lining of the womb, grow within its muscle layer causing infertility, painful and heavy menses. It is better to redo the scan, by a more experienced or qualified personel.

All the best

folash:
Hi doc Omicron and Matrix199 can u pls help interpret this result.
The uterus is bulky (AP diameter 5. 46cm), empty and anterverted with regular outline and seen returning homogeneous echopattern.
The endometrial plate is seen and intact.
There are two ovoid shaped hypoechoic intramural solid masses with smaller seedlings measuring 2.89cm × 2. 12cm and 2.03cm × 1. 36cm seen in the fundus and posterior uterine segment respectively indicative of uterine leiomyomas.
The right ovary is remarkably larger than the left normal sized ovary and both are seen with peripherally arranged rudimentary follicles arranged in a "string of pearls" pattern indicative of polycystic ovaries.
right ovary: 4. 50cm × 3. 31cm × 2. 41cm; volume=18. 74cm
left ovary : 3. 43cm × 3. 57cm × 2. 71cm; volume= 10. 02cm
There is no significant fluid collection seen in the pouch of douglas

Ok.

The uterus has small fibroids within its muscle layer. This should however not cause problems (except maybe pains during pregnancy) as they are small and within the muscle, rather than in the cavity.

The right ovary showed features of Polycystic ovaries, a condition whereby small small egg follicles fill the ovaries without any of them maturing, hence no ovulation.

If you have other features such as appearance of masculine hairs (beards, chest hair, upper thighs, etc), deepening of voice, scanty menses or irregular menses, along with the polycystic ovaries, they point towards Polycystic Ovarian syndrome (PCOS)


In summary, the scan showed small insignificant fibroids, and features suggestive of PCOS.

All the best

Chili89:
Hello doc, I went for a scan todays which is suppose to be 8weeks but scan says I'm 9weeks. My LPM was 4th of dec. Though there's a heart beat but I'm super worried. Is everythn ok?

Hi,

If it is just the difference in the gestational age then no need to worry. You may repeat the scan at 20weeks to check for any foetal anomaly. This should be routine, and does not suggest that there is something wrong with your baby

You have nothing to worry about

All the best.

bamiyo05:
Hello Doctor, when can I go for hormonal test? and again can a raptured appendix block the fallopian tube?

Hi,

Hormone profile is done between CD 3-5, except progesterone which is done on day 21 (in a woman with a 28-day regular cycle).

Yes, ruptured appendix can cause tubal blockade, after it has caused peritonitis - an inflammation of the thin membrane covering the internal abdominal organs.

All the best

Debbie2872:
Dear Doctor,

I carried out the HSG test but later results confirmed that but tubes are blocked.
So what are the possible alternatives for unblocking.

Thanks,

Hi,

Blocked tubes can be treated by tuboplasty- a surgery to repair the tubes- while hydrointubation, an unfavoured procedure whereby solutions are used to flush open the tubes, might help in partial blockade. The success rates of these procedures are unfortunately not good.

Most gynaecologies will advise IVF as soon as tubal blockade is comfirmed.

Let a gynae review your HSG and advise you individually.

All the best

Orente21:
tanx doc. Its just dt i had cramp,swollen and sore breast,lost of appetite,and high temparature. So i thot dey were implantatn signs after ovulation.I felt i dnt ovulate regularly,bt wen i visitd d doc,he said,my cycle is stil normal range. So i wonder y am nt pregnant yet.bin tryin 4 few months nw. Al d same,tanx doc.

Ok

Don't worry then. If you try a few more months without success, then you may start investigations starting with semen analysis.

But for now, just be normal and you will take in.

ilesanmioo:
Thanks God Bless you. Sorry you didn't comment on the size of the foetus, is that a normal range or bigger. Thanks God bless you real good doc

You are welcome

The weight is slightly bigger than expected, but it is not enough to worry about as the measurement was subjective, and the final weight of the baby is what is important.

Keep the blood sugar within limits and the baby might not be too big to cause a problem.

All the best

ilesanmioo:
Hi Doc, pls what do u advise for a woman who is 31weeks pregnant, scan shows fetal weight of 1.9kg, diagnosed with gestational diabetes(controlling with 6unit insulin twice daily 70\30) fasting for past 3weeks has been 75 to 95(75 been the lowest, and the highest been 95). Can she go ahead with. Normal delivery, her doc intends to remove her cerlage @37weeks. Her after meal 1hr has been between 100 and 140, occasionally 150(very rare). Does GDM stop vaginal delivery.

Hi,

No, GDM does not stop vaginal delivery. Unless there are other indications for CS, a woman will GDM will be allowed vaginal birth. In labour, the only difference is that your blood sugar will be monitored and insulin drip or injections given as required. And the baby would be monitored very carefully from the time of birth for signs of distress or low blood sugar.

Your blood sugar control has been very good.

Normally, women with GDM are induced at 38wks but since you are carrying a cerclage, 37wks is ok.

All the best

Orente21:
Pls help me,i beded cd 8,10,12, had high temperature in d mornin on cd 14, bed again cd 15,17,19. I had serious cramps and breast sore cd 24,25. I thot it was implantn.bt sadly Got my af on cd 28. What could b wrong wit me. B4 i get,i visitd hospital last month,was nt check bt placed on antibiotic,and told to start clomid nxt cycle. Bt i blv i ovulate bt implantatn didnt occur. Sorry 4d long story.

Hi,

There is not enough from your history to suggest that something is wrong with you. Perhaps, you are overly anxious.

The symptoms you felt are unspecific, meaning that they do not specifically indicate a condition or problem. Generally, they could be seen in normal cycles during the second half of the cycle (ovulation - mesnses), or they could be part of the Premesntrual Syndrome (PMS) or pregnancy (which you have ruled out), while some could be a side effect of clomid.

Your days of bedding were in order (though you missed day 13), but even in perfect circumstances, coituss on the ovulation day does not guarantee conception for reasons not known.

Do not become too anxious, continue your clomid (as prescribed by your doctor) and keep trying. It will yet work.

All the best

Babyrex:
Hi doctor,
I am 25, my period has stopped since July 2015. Took hormonal test and all was normal except progesterone which was 0.2
Placed on primolut-N, noticed that my period comes after using the drug, but doesn't show up the following month. It has happened twice already.
I am a single lady and need your help. Tnx

Hi,

If you bleed following Primolut-N treatment, but do not bleed after treatment, it means that you are low on the hormone progesterone. This in turn means that you are not ovulating, as progesterone is mostly produced following ovulation.

So, the first stage is to diagnose the cause of your lack of ovulation. The commonest cause of lack of ovulation is PCOS, but there are other less common causes such as high prolactin.

Since you are apparently not ttc, and if it turns out to be PCOS, you may require extended treatment with a combined oral contraceptive, as this has been shown to help in PCOS as well as in absence of ovulation for which no cause is known.

However, you should not take any hormonal treatment, including oral contraceptives, until you have seen your doctor, and until you have been properly diagnosed.

All the best.

The dilema of the physically abused wife.

I'd also like to see a pic depicting the dilema of the verbally abused husband.

Abuse is abuse. Let us all co-live with mutual respect and civility

Spirit1:
Again the original article was about first year medical students, not medical students in general.
If the article was about 4th year Nigerian medical students, it will make sense.

Am not contesting that you don't read all those books if you are going to take USMLE, but you don't take USMLE in first year medical school in Nigeria and therefore the article is flawed as directed to the readers.

The topic of the write up is obviously an error, but you are still wrong in your understanding.

Those books are the REGULAR, NORMAL textbooks any medical student reads. After medical school, they serve mainly as reference texts. USMLE and PLAB are read with special materials particular to the exams, such as past questions, tutorials and exam-focused books. They are exams written by doctors already not med students. No one reads Robbins and co just for USLME, except for reference.

Next time, avoid speaking about specifics when your knowledge is mainly general.