₦airaland Forum

bushdoc9919:
That's largely because we do not have the needed equipment to do much....and in some instances....the patient is too poor to afford the stuff.

I have just come off call duty at the private hospital where I work. overnight...we had an elderly woman with a bleed in the brain due to stroke. Ideally...she would have been in a teaching hospital within minutes of the stroke...and a neurosurgeon would have operated in hours. But....she went to a small ill equiped private clinc....and by the time she got to our hospital.....it was 16 hours....vital time wasted. (And sadly....she had to leave because of funds.....).

Then there are the limited number of specialsts in Nigeria. We have just 4000 specialists for a population of 150million. (uk has two specialist family physicians for every 1000 people...and they say they do not have enough!).

Then there is the limited diagnostic equipment. Many patients die of hemorrhagic stroke in Nigeria not only because we have limited number of neurosurgeons....but because we don't have access to CT scans at our hospitals....so we cannot take quick medical decisions that would save lives.

I know some docs have bad attitudes.....but we are working under very bad conditions. During youth service....I had to treat a severely anaemic malarial child....in a rural hospital with limited facilities....and with the nearest teaching hospital 4 hours away....in the dead of night with no light. Would you blame me and the nurses there if the child did not make it?

Nigeria needs an increase in funding for health care....especially for training more medical people...and for primary and secondary health care (part of the reason why our teaching hospitals are so overwhelmed is that they see cases that should be seen at the PHC!)

Absolutely correct analysis.

And thousands of Nigerian trained health care personnel have either left the country to work elsewhere or some work in Nigerian banks.

The health of a nation is the government's responsibility, but our government has absolutely no responsibility.

The problems run deeper than just healthcare. Even in our so called "cities", how many homes can call for an ambulance to get transported from your home to the hospital in the case of an emergency?

And if you have your own private vehicle to get to the hospital at night, you have to fear for armed robbers or even police officers themselves!!!

What is Nigeria spending its money on

deloon:
[s]Teacher, this was your previous post:



And what I schooled you on was that the aortic valve does not circulate blood rather it stops blood from flowing back to the heart.
http://biology.about.com/library/organs/heart/blaorticval.htm
The issue here is the function of the aortic valve which you wrongly stated the above and now you are back to display your a knowledge of anatomy which is irrelevant to the subject. Plus you'd be talking about Nigerians being loud about things they do not know of which you are a perfect example.[/s]

You tried to school me on the function of the aortic valve You clearly don't realize that the blood supply to the heart is from the aorta and not from inside the heart!!!

Dude, If you do not understand what I posted and how the aortic valves provide blood to the coronary circulation, please stop trying to argue!!!

The information that was given to GEJ, obviously by good Doctors is correct information.

And I only disagreed with the post that said it was false information.

The Docs who informed GEJ knew what they were talking about, and there's loads of information online about valvular heart diseases(if you would understand it)

fostermd:
You are wrong!aortic valve controls the flow of blood to the systemic circulation that's is the whole body except the lungs .it prevents the back flow of blood into the left ventricle.infact,when the valves are diseased in aortic incompetence that is when blood flows back into the heart (left ventricular chamber).in aortic stenosis ( narrowing of the aortic valve) there will be restriction of the outward flow.
Please be sure of your stuff before posting

I didn't want to get into a medical argument about this.


The coronary arteries originate from the aorta around the aortic valve cusps. The valves form the aortic sinus. If the valve is dysfunctional, flow into the cusps are affected resulting in poor coronary circulation.

In stenosis, they block the coronary arteries because they are stiff, in regurgitation, they don't pool enough blood to supply the heart.

http://www.vhlab.umn.edu/atlas/physiology-tutorial/coronary-circulation.shtml

https://www.google.com/?gws_rd=ssl#q=symptoms+of+aortic+stenosis

deloon:
You are dead wrong.
First of all, the aortic valve is a "valve". It's function is to stop blood from flowing back to the heart from the aorta.

Edit ****
Dude I just checked your profile and discovered you are most active in the Health section.
I hope you are not a doctor.....

I didn't want to get into a medical argument about this, but since you called me out, let me school you.

Nigerians tend to be loud, even about things they do not know.

The coronary arteries originate from the aorta around the aortic valve cusps. These are called aortic sinuses. If the valve is dysfunctional, flow into the cusps are affected resulting in poor coronary circulation.

Google is your friend http://www.vhlab.umn.edu/atlas/physiology-tutorial/coronary-circulation.shtml
https://www.google.com/?gws_rd=ssl#q=symptoms+of+aortic+stenosis

olrotimi:
RIP to the dead lady though first I should point out RESPECTFULLY to Mr President and for information of the general public, the aortic valve isn't the valve that circulates blood to the heart, the aorta takes blood from the heart to other parts of the body (except the lungs) thus the aortic valves prevent back flow of blood or regurgitation of blood once it leaves the heart.
Again, am happy UCH now offers open heart surgery, hopefully our leaders would do more to improve the standard of health care in the state and federal hospitals. It goes without saying that death doesn't ask for your name before she strikes, death comes for both the rich and the poor.
@posters snitching on GEJ for not fixing the health sector, yes he should take some flak for it but let's be objective, what has past leaders done to improve the health sector? Buhari's PTF? OBJ's VAMED? All have been white elephant projects without man power development. You don't buy a 64 slice MRI when you don't have the personnel on ground to run it. Thats putting the cart before the horse.

I like to respectfully inform you that the aortic valve circulates blood to the heart!!!

I don't understand how a court will have the capacity to authorize a vaccine

Tailor dey reair car?

Everything just dey upside down for Naija!!!

MubarokX:
And u gave Ur myopic assessment based on what facts... U siddon for Ur house dey talk say the boy 'obviously must have had a ruptured spleen/organ'... do u know the meaning of the word 'obviously' and 'must have'...

Thank you. You just echoed my thoughts.

The problem with all of Nigeria is over sabi.

Very misleading headline and article.

The article clearly states that they do not know the exact number of diabetics in Nigeria because we are horrible at keeping records but very good at making speculations.

And of course, we are quick to react before finding out the details of a situation.

Wonderlands:
guy....... e nor make sense abeg. just shut up already. u disturbing

I am disturbing

You haven't seen anything yet

People like you will stir up $h*t but can't handle the heat.

There are lots of things in this world bigger than you!

Wonderlands:
i rebuke it to you un Jesus name!

Lol. Hypocrite. Now you know Jesus.

Jesus doesn't know you!!!

You are lucifer's lover and he will have fun with you and your family!!!

Wonderlands:
i dont believe in your fetish shango rubbish. but since you like fire; may it burn you and your family like roasted chickens

Lucifer torment your soul and your family for eternity!!!

Wonderlands:
And God will also punish your father too becos he sperm didnt fertlize your brain to give you sense.

Shango fire your mama, papa and ur whole generation!!!

Bloody lunatic!!!

Wonderlands:
like you forgot your sense in your mum's womb

God punish your father!!!

Wonderlands:
shame on you, not us.

You are exactly the kind of homo habilis that I was referring to.

Thanks for showing up!!!

I think it is a shame that other countries are doing more to contain this outbreak than our African brothers!!!

If we are not trying to help ourselves and continue to let our Governments rob us blind, how can we expect other countries not to look down on us and discriminate.

Shame on us!!!

http://www.caribbean360.com/news/cuba-now-biggest-single-medical-force-in-african-ebola-battle

AprilTwo: In one of the Hospitals, My file got missing and they asked me to restart my test.


I'm 23

Nothing, just the chest pain. Which I think it affects my growth.


Can I say all the time? Because I feel it whenever I have my mind there. And it pains me down to the back.


I feel it deep inside the Heart Region.


I only notice my heart beats faster when at rest.


I feel dizzy most times, and my eyes gets red.. I mean very red.


Nope.. Just that my breathing is irregular when I lie down. And my Left is getting weak day by day.


49 - 51. Remember I'm 23. Underweight.


Could it be Coronary Artery Disease??

God bless you. Kindly reply sir/ma.

Coronary artery disease which can give you Angina (essentially the same thing) is extremely rare in young people.

The commonest cause of coronary artery disease is artherosclerosis (hardening of arteries). This happens over a long period of time therefore, it is usually found in much older people. This is why I doubt that you have coronary artery disease.

However, there are other causes of coronary artery disease in younger people which are rare. One of these is drug use.

So, first of all, stop worrying yourself about Angina or coronary artery disease.

Also, you do not have any risk factors for artherosclerosis.

Also, constant chest pain for months is most certainly not coming from the heart.

Are you taking any prescription medication or herbs or street drugs? Your symptoms could be a side effect of any of these. (Stop taking aspirin!!!)

Do you drink caffeinated beverages? e.g coffee, mountain dew or red bull? These can also explain your symptoms.

You sound like you are very anxious and the awareness of your heartbeat could from an anxiety disorder.

I suggest that you stop taking any herbs or supplements, find a way to relax. Choose a sport that you like and exercise everyday, get enough sleep and focus on eating a healthy diet.

If I would recommend any test at all, I would say you should check your blood count to make sure you are not anemic. Anemia can givve you palpitations(awareness of your heartbeat or heart racing), make you feel dizzy, tired etc. Any body in your family with sickle cell disease? If you are anemic, and you do not have sickle cell disease, you can take over the counter vitamin supplements (From a chemist/pharmacy)

Your ideal weight can only be correctly assessed when compared to your height. There are lots of online resources for this. Search for body mass index.

AprilTwo: Hi Docs, I need your help. I created a thread few months ago about Chest Pain, which I treated Angina for a while and I didn't see any changes. Someone said it's likely to be Coronary Artery Disease. I still can't find cure or drug for 5years I've been going through this.

I'm broke, and have low-income.

Pls where in Lagos can I do these tests; XRay, ECG, ECHO and CT Scan of Blood Vessels at a very cheap price.

If anyone does it, pls can you help a Nairalander? I'm dying in silence.

CC: adeoladrg
Ziga
Lomaxx
Deols
Lagusta.

Not every chest pain is related to your heart. Therefore, not every chest pain is angina.

Also it is highly unlikely for you to have persistent angina for that long without any progression of the problem.

Also the fact that the treatment that you have already gone through did not work means you probably have another diagnosis that is not being treated.

How old are you?

What other medical problems do you have?

When do you get chest pain?

What part of your chest specifically is it located?

What makes it worse? Exercise? Food?

What other symptoms do you feel when you get the pain? Belly pain? diarrhea (watery stool)? Nausea? Do you have a lot of gas?

Are you short of breath without doing anything? Any swelling in your legs?

How much do you weigh?

I truthfully doubt that your pain is related to your heart, but there is no way to know for certain without knowing your risk factors.

However, if your symptoms are as severe as it seems, you should be in the emergency room.

Angina is a warning sign of an impending heart attack. And it wouldn't hang around for many months without any progression.


PS. I didn't realize somebody else replied to your question.

And I basically echoed him. I doubt that you have Angina, and unfortunately, all the tests you want to do might be a waste of your money.

zeb04: yeh that's it.he fought back(he retaliated) he wasnt trying to defend himself. There are certain ways things shld be handled. No matter how we try to downplay it,he was wrong(she was wrong to) and they shld both face the consequence.


I am not trying to be biased BT I don't knockout someone and I call it defense.

Trayvon Martin was killed and they called it self-defense.

It all depends on who is doing the interpretation!!!

Just saying.

Everybody has a culture.

And all cultures are inter-related.

You will hardly find any culture that is completely unique.

Take language for example. It is an example of culture. And it has evolved over many years. And all language is derived from other major languages.

African Americans have a culture. It might be derived from multiple other cultures based on their history and ultimately evolved to be unique.

If you are going to do something, you might as well do it well.

First washing hands with less than enough water will not keep you hands clean but instead spread the germs allover your hands.

Water filters produce too little water flow fr hand washing.

Also, the contaminated water is being collected in bowls. So if the Ebola virus is actually washed into the bowl, everybody who comes after will be potentially exposed to the virus in the bowl from water splashing into the bowl.

Ignorance is worse than stupidity.

This setup will spread more germs.

Also, there should be government building agencies that should enforce certain codes.If you are going to build a washroom, spend the money and build a washroom.

And not this ridiculous thing.

Volunteers can be paid.

Sometimes, they get free meals, sometimes they get cash.

But money paid is generally not commensurate with their efforts. (Just like other Nigerian health workers)

And if you read the article, you would see that they were promised money and life insurance packages.

Until we all see that the greed and poor management skills of our leaders is our downfall, everything will continue to rot.

stingbreed: Coffee wakes you up in the morning and keeps you alert throughout the day, but how does its magic ingredient actually work?
The first thing to know is that part of your natural tiredness comes from a molecule called adenosine, which is produced by your body while it chugs along through the day. "While you sleep, the concentration of adenosine declines, gradually promoting wakefulness. Meanwhile, the more adenosine that builds up, the sleepier you feel.

Your morning coffee is able to hijack that process because caffeine looks a lot like adenosine to your brain cells:

Because of its similar shape, caffeine can bind to the adenosine receptors in your brain. Once the caffeine is locked into adenosine's rightful spot though, there is no way for the adenosine to stick around — which prevents it from building up and making you sleepy.

Without the molecule that usually induces exhaustion, "our natural stimulants run wild," Joseph Stromberg writes in Smithsonian. The result? You feel wide awake — at least for a while.

But all good things must come to an end, and your brain quickly wises up to your tricks.

When the adenosine is continually blocked from binding to its receptors, your body eventually creates more receptors — which means you need even more caffeine to plug them up. This can make kicking your coffee habit increasingly difficult, and make you need more and more caffeine to stay alert.

"When you try to quit drinking coffee or miss your daily intake, you might experience some withdrawal symptoms and feel more tired than you would have before you ever drank coffee."

But caffeine does more than just block adenosine. It can also pump up your levels of adrenaline and boost your mood — "the exact same thing cocaine does, just to a lesser degree,"

This article was on yahoo.

You should include the source of the article, so people don't start to think it is your material.

Be careful before you get sued for plagiarism.

http://www.businessinsider.com/how-does-coffee-affect-your-brain-2014-8

aztruth: well said

However your colleagues in Nigeria need to understand that a prescription order means just the same as Ordering things from a supermarket or something. It does not mean ORDERING PEOPLE.
IT REFERS TO ITEMS, CALL THEM DRUGS OR LAB TEST NOT People.

For instance writing a prescription order for drugs to a pharmacist is not the same as Ordering A PHARMACIST

Agreed.

PHYSICIAN'S ORDERS

The most common way of delegating authority is to write an order in a hospital chart or otherwise formally record orders for PEs. The physician may write the order in person, or a nurse may enter it in the chart at the physician's direction. Formal orders are valuable for clarifying the delegation of authority in that setting though they are less commonly used in private offices.
Standing orders, which include protocols, are a special case of written physician's orders. A standing order is an order conditioned upon the occurrence of certain clinical events. The important characteristic of a standing order is that all the patients who meet the criteria for the order receive the same treatment. A common use of standing orders is in public health clinics that treat specific diseases. A venereal disease control program will use the Centers for Disease Control (CDC) protocols for antibiotic dosages. Once the specific venereal disease is identified, the nurse administers the antibiotics as specified by the CDC protocol and authorized by the physician directing the clinic. In this situation, the CDC protocol is a standing order from the medical director, and the conditional event is the diagnosis of a specific venereal disease.
It is important to differentiate standing orders from preprinted orders: orders that the physician uses repeatedly and has photocopied to save the trouble and potential errors of rewriting each time they are used. Although the orders are the same for all patients, they are not standing orders because they are not conditional. The physician, not the nurse, determines whether the printed orders will be used in a given case. Unlike a standing order, until the physician incorporates the printed order into the chart, the nurse cannot initiate treatment. Preprinted orders are a useful tool, but they can lead to problems if a patient requires a variation in the usual printed order. These variations must be carefully marked on the orders and the nursing staff notified.
Direct orders are voice orders that are given directly to nonphysician personnel. Sometimes these orders are documented in the medical records, but usually they are carried out at once and not recorded. For example, when a surgeon directs the operating room nurse assisting in a procedure, some of the surgeon's orders will be documented, but most will not. Documenting the individual orders is not a problem in this situation because the physician is directly supervising the nurse's work. The satisfactory completion of the nurse's work will be documented as part of the operative report.
In office practice, neither the voice orders nor their satisfactory completion will necessarily be documented in the patient's chart. This makes it difficult to determine whether the physician has given a direct order, or the nonphysician personnel are acting out of routine. Unless these routine actions are carried out according to a strict protocol, the physician will not be able to ensure that the proper nursing functions have been carried out. If the physician is sued over a question about the nurse's actions, there will be no record to establish what was done to the patient.

Source http://biotech.law.lsu.edu/Books/lbb/x417.htm

aztruth: If truely the Drs considered everyone important like you outlined there would be no problem at all. As a matter of fact no one would even be contesting their headship of hospitals

Wish all Drs think at least like you do about team work.

One correction though: It is not right to say Drs give ORDERS to be followed by others. That thinking is not correct and it's part of the problem destroying the health sector. What happens in the health sector is passing on work to the professional who is responsible.

A DR IS NOT ORDERING A LAB SCIENTIST TO CARRYOUT LAB TEST NEITHER IS THE LAB SCIENTIST ORDERING THE DR TO PRESCRIBE WHEN HE SENDS A SENSITIVITY TEST RESULT TO HIM. IT'S CALLED TEAM WORK OR PASSING THE BALL.

LIKE THE EXAMPLE YOU GAVE, WHEN A TEAM MATE PASSESS THE BALL TO ANOTHER IT IS NOT REGARDED AS AN ORDER NEITHER IS IT CONSIDERED AS RECIEVING INSTRUCTIONS. ALL OFFENSIVE TERMS AND MENTALITY SHOULD BE TAKEN OUT OF HEALTH.

LETS THINK LESS OF OURSELVES AND MORE OF HOW WE CONTRIBUTE TO THE WELL BEING OF PATIENTS

TRUE, SOME PLAYERS ARE SO CENTRAL TO A TEAM EG MESSI OR RONALDO, YET, THEIR PASSESS TO FELLOW TEAM MATES ARE NOT CONSIDERED ORDERS neither do the star players see it as such

I agree with your principle as well.

I do not work in Nigeria, so I can tell you that I have seen both sides.

The places I have worked (outside Nigeria), when a Doc prescribes or writes an instruction or whatever he wants, It is called a physician order.
So, Lab tests, medications etc are called physician orders.

So, referring to Docs instructions as orders is nothing new and that is what it is called in the part of the world where I work, that Nigerians are trying to emulate.

When I write an "order" here, it has to be performed. If it is not done, the Pharmacist or lab scientist or nurse would appropriately call to let me know if they have recommendations that might differ from mine. However, I still have the final say regarding what is done because I stand as the coordinator of care between all health workers involved and the patient.

A Doctor is trained as a diagnostician and coordinator between other healthworkers and that is why the curriculum overlaps with so many other's. A lot of people have been chanting a Doc can't be a jack of all trades, but he is. Not master of all. But he is the jack of all trades.

Regardless of what we want to cal it. That is order/instructions or anything. We should not create chaos ad we should play our parts in the care of our patients.

And this is the biggest issue I have with everything going on. Even when we work as a team, there is still a process, otherwise there is no team.

Ego is a personality trait, and a lot of people believe Docs have big Egos. Maybe true, maybe not. However, regardless of how you feel about your teammate's personality, we still have to perform our duties.

datribune: d chemists take care of nigerians when doctors abandon them & go on their never-ending murderous strikes. They've been on strike for some weeks now. Ask urself what will happen if dis chemists go on a one-day strike?.
d law must always be followed & is being followed. There ar probably more poorly trained, second rate quack doctors than unregistered chemists.

Ignorance and mediocrity is going to be the downfall of Nigeria.

datribune: This is exactly d problem. I take it dat u ar probably a nigerian doctor as d instinctive arrogance in ur post is true to character. Grow up & cut dat crap about salt. Reserve ur advice on ignorance 4 ur misguided self wit an overblown ego & an exaggerated sense of self-importance. d nigerian doctor wit his archaic, half baked training is nothing more than a glorified first aider. What pathetic nonsense! Can u imagine dat dis greedy money mongers often compare themselves to foreign doctors who ar growing limbs 4 d limbless & performing many medical wonders in line wit their calling & hippocratic oath. Dude, in today's nigeria, d street chemist is more relevant & does more 4 d average nigerian than ur overhyped, always-on-strike, greedy selves. I tell u authoritatively dat as things stand today in nigeria, dis chemists ar far more important & dedicated & hav more integrity than ur overhyped, arrogant selves. They hav always stood by & taken care of d nigerian people when u guys go on ur conscienceless, greedy, murderous, never-ending strikes.

I bet this is your personal opinion.

There are people who believe HIV, Ebola or Polio don't exist.

And everybody is entitled to his own opinion.

However, we must all follow the law or we get into trouble.

I foresee a future where both unauthorized prescribers aka "killers" as well as the people who patronize them will be penalized.

ottizz: One of the best posts I have seen recently regarding the doctors' strike. This is the kind of progressive spirit that is needed in the medical profession today. Health care is about teaming together to achieve the ultimate goal, which is having the patient's care at heart. There is no way a patient can feel safe in any government hospital today because the people that have the responsibility of taking care of them cannot even work together. I keep saying this, no one is more important in the deliverance of health care to an admitted patient, including the cleaners. How quick a patient gets well is directly related to the weakest link in the health care delivery process. You should respect each other, form a fist, and get the government to her knees. And maybe, this solidarity will push the government to improve the facilities, amongst other things. Everybody wins when they work together.

Unfortunately, there is no order without laws.

While everybody should work as a team, all professionals receive training which limits them to certain responsibilities.

One big problem I have seen across board is that a lot of Nigerian health workers do not even know what their responsibilities are.

And when they are told to do their parts, they feel like they are being ordered.

If that re-education is not done, it will be almost impossible to get the warring factions to team together and have a common goal.

Copied from a brother...

If Nigerians are as ignorant as bathing with salt water to prevent Ebola, I do not expect them to understand the grave danger of the resident doctors' strike.

And they wouldn't understand the ignorant decisions being made by our leaders also!!!

olimeh13: ... Guy, y e b say una too dey yarn fg... Wetin b una contribution to the growth of nigeria

Who else we wan yarn

You? or my Uncle?

aztruth: OVERWORKED WHILE ON STRIKE?

My guy, why you dey talk like this now. If they weren't on strike, would they be underworked

The strike is to change the status quo.

What is your beef

aztruth: ARE YOU PUBLICLY AGREEING THAT SOMEONE ELSE IS IMPORTANT EVEN IN A SURGICAL OPERATION BESIDES THE DOCTOR?
I DON'T THINK SO

IT'S NOTHING MORE THAN A SANCTIMONIOUS ATTITUDE: PRAISE TO ME AND ERRORS TO OTHERS

I REMEMBER A LEGAL CASE IN WHICH A DOCTOR HELD THAT IT WAS NOT HIS JOB TO CHECK HIS PRESCRIPTIONS FOR PROBLEMS BUT THAT OF A PHARMACIST. THEREFORE PLEADING THAT THE PHARMACIST BE HELD RESPONSIBLE FOR HIS PRESCRIPTION ERROR THAT KILLED A PATIENT. AFTER THE COURT SESSION AM SURE HE WOULD TELL THE PUBLIC THE HE IS RESPONSIBLE FOR ALL ASPECTS OF PATIENT CARE AND THAT THE PHARMACIST KNOWD NOTHING BUT HIS JOB SHOULD BE RESTRICTED TO DISHING OUT TO PATIENTS THE DOCTORS COMMAND

If Docs didn't think anybody else was important, they would do everything by themselves. Which is not the case. A lot of team members have a problem with doing what the Doc says because "they are taking orders from him and they know more than he does".

Everybody in their mind knows more than GEJ, but he is our president, and until that changes, we have to take orders from him.

What is the sense in wasting resources like that? (Having Docs do everything) Economically, it costs too much to train a Doc, to have them doing certain things. It is like employing a university professor to teach a nursery school or a employ a hotel manager only to have him/her serve food.

Everybody is important, and each member has a role to play. Most Docs are only saying that other players should play their part.

Michel should play no 10
Enyeamma should stay at the goal post
Musa should stop falling etc.