Binti wa pwani

Kenyan...I love my country.

[Binti wa pwani @Chipmunkb1]

Do you remember when you joined X? I do! #MyXAnniversary

[The Away Fans @theawayfans]

"Don’t worry lads we’re down hill next half"

[Binti wa pwani @Chipmunkb1]

https://t.co/4KRVFHiczI This post is shared via TikTok Lite. Download TikTok Lite to enjoy more posts: https://t.co/3S1EEf1XYv

[Binti wa pwani @Chipmunkb1]

I found a trending short drama that's gone viral on DramaBox!
https://t.co/LCwvftA6hl

[Binti wa pwani @Chipmunkb1]

¡Los dramas cortos en DramaBox son muy emocionantes! ¡Ven a verlos conmigo!
https://t.co/6cLZKbHdqu

[Binti wa pwani @Chipmunkb1]

Drama pendek di DramaBox sangat seru, ayo tonton bersama!
https://t.co/1ERL4TQ1Zu

[Binti wa pwani @Chipmunkb1]

@OmbetaC 😄😄

[Binti wa pwani @Chipmunkb1]

@KBCChannel1 We don't want stringy people in power. If he can't buy himself a car with all that wealth, what better changes will he do to the ministry assigned to him?

[Binti wa pwani @Chipmunkb1]

@MrRightke Of course Africans will go for Raila n they will tell u ', whatever an old man sees while seated a young man can't see'.

[Binti wa pwani @Chipmunkb1]

@bozgabi No. No rewashing, no rewinding.

[Binti wa pwani @Chipmunkb1]

@Itumbi_Denis We want professionals who have relevant degrees for the posts offered.

[Binti wa pwani @Chipmunkb1]

@FauzKhalid By the end of the day the losers are their ( Gen Z ) parents. Peaceful maandamano, police should not interfere bullshit!.

[Ahmednasir Abdullahi SC @ahmednasirlaw]

The Finance Bill has left Parliament and is on the President's desk. H.E @WILLIAMSRUTO SHOULD NOT ASSENT to the bill. He must send it back to Parliament. He must reduce the wasteful expenditure and cut government expenditure. He must also forgo the punitive taxes that define the bill. Lastly, the President must listen to the national consensus that the Finance Bill is oppressive and cruel to all Kenyans. President Ruto, please give concession. It will not show weakness. It will show leadership. Listening to the will of the people is true leadership

[Dr. AK 🇮🇳 @docakx]

💥Smith 𝘦𝘵 𝘢𝘭. reported draining a world record of 41 𝗹𝗶𝘁𝗿𝗲𝘀 of ascitic fluid in a single paracentesis session of a patient with decompensated cirrhosis.

How much Albumin would be needed in this case to prevent post paracentesis circulatory dysfunction ? 🧵 Read on👇

A 🧵 on important points to consider while performing Large Volume Paracentesis (LVP)

𝘏𝘰𝘸 𝘮𝘶𝘤𝘩 𝘢𝘭𝘣𝘶𝘮𝘪𝘯 𝘪𝘴 𝘵𝘰 𝘣𝘦 𝘪𝘯𝘧𝘶𝘴𝘦𝘥 𝘥𝘶𝘳𝘪𝘯𝘨 𝘱𝘦𝘳𝘧𝘰𝘳𝘮𝘪𝘯𝘨 𝘓𝘝𝘗❓️

𝘞𝘩𝘢𝘵 𝘪𝘴 𝘵𝘩𝘦 𝘮𝘢𝘹𝘪𝘮𝘶𝘮 𝘢𝘮𝘰𝘶𝘯𝘵 𝘰𝘧 𝘢𝘴𝘤𝘪𝘵𝘪𝘤 𝘧𝘭𝘶𝘪𝘥 𝘵𝘩𝘢𝘵 𝘤𝘢𝘯 𝘣𝘦 𝘥𝘳𝘢𝘪𝘯𝘦𝘥❓️

🛑Large Volume Paracentesis(LVP)
is arbitrarily defined as a paracentesis with >5 L of ascitic fluid drained.

In patients undergoing LVP, the use of albumin is crucial to prevent a further reduction of effective arterial blood volume, which may precipitate postparacentesis circulatory dysfunction (PPCD).

The clinical manifestations of PPCD include renal impairment, including HRS, dilutional hyponatremia, hepatic encephalopathy and death.

Albumin infusion is particularly important if more than 5 L of ascites are removed to prevent the development of PPCD.

Paracenteses of a smaller volume(<5L) are not associated with significant hemodynamic changes and albumin infusion may not be required.

Although there has not been a dose‐response study on albumin use with LVP, the administration of 6‐8 g of albumin per liter of ascites removed has been recommended.

💥For example, after the fifth liter, approximately 40 g of albumin should be infused, and after 8 L removal, the amount of albumin given should be approximately 64 g.

It has been held that there is no limit for the amount of ascites that can be removed in a single session, provided an appropriate amount of albumin is administered.

However, the risk of PPCD increases with >8 L of fluid evacuated in one single session.

A study showed that by limiting the LVP volume to <8 L per session and providing a higher than recommended dose of albumin (9.0 ± 2.5 g per liter of ascites removed), renal function and survival may be better preserved over a mean period of 2 years despite the development of PPCD in 40% of patients.

In patients with hemodynamic instability (systolic blood pressure <90 mm Hg), hyponatremia (serum sodium <130 mmol/L), and/or the presence of AKI, albumin infusion should be strongly considered for paracentesis of a smaller volume.

LVP is a safe procedure even in the presence of coagulopathy. In a study that included patients with an international normalized ratio of >1.5 and a platelet count of <50 × 109/L, only 1% of patients experienced minimal cutaneous bleeding after LVP.

Therefore, elevated prothrombin time or thrombocytopenia is not a contraindication for paracentesis, nor is transfusion of clotting factors or platelets recommended.

Possible exceptions may include patients with disseminated intravascular coagulation or uremia with thrombocytopenia.

1/3 👇 𝘾𝙤𝙣𝙩.

[Binti wa pwani @Chipmunkb1]

@Itumbi_Denis He is raising taxes instead of closing the corruption gap. This still will be zero work. We ain't going anywhere!!!

[Binti wa pwani @Chipmunkb1]

@calvinokello4 Just as you have said, he will win 2027 and step down after 10 yrs of service. Now ask yourself, who will be his successor?

[Ahmednasir Abdullahi SC @ahmednasirlaw]

They ALWAYS MISS THE POINT!
This 25 years old WAR/STRUGGLE/JIHAD to reform the courts is not about Grand Mulla. It never was! It never will! This is about the very existence of Kenya! It is whether we will have a functional country or allow judges to decide on how much BRIBE they are given. It's about the rule of law! It's about judges auctioning justice. It's about accountability. It's about ensuring that the weak and venerable get justice. It is about holding the rich and powerful to account through a functioning court system. It's about a judiciary that delivers for Kenyans. ..mambo ni mingi!!!

[Journal of Brown Hospital Medicine @BrownJHM]

Diagnosis? (Medinaz academy) #MedX

[Binti wa pwani @Chipmunkb1]

@NCKenya @Kmtc_official @KESNNUR @CHAK_KENYA @NursesMidwife @NursinginKenya @nnakenya @Kenya_PNA @Kenyamidwives This portal is so frustrating. Will access next year maybe

[Ahmednasir Abdullahi SC @ahmednasirlaw]

The Shilling to the dollar was controlled/fixed during the tenure of Gov Njoroge on orders from President Uhuru and was overvalued by 35%. That process became untenable and led to shortage and the rebirth of the black market, which showed the true value. 145 to 150 to the dollar is Today's market value. No one can do anything about that. If you want the shilling to appreciate then increase exports, expand the manufacturer base, reduce imports and stop governors, judges and CSs, PSs, state corporations officials from stealing public money.