Davies

Medical Doctor🩺😊| Manchester United🔴
Curious about medicine, life & everything in between

[Orekelewa @TheUnagi_]

Need this Sublingual nifedipine practice to die a quick death. Please abeg.

[Nobleman @thenoblejames]

The next okpa woman wey I go catch ehn

[𝕀𝕋𝔸ℂℍ𝕀 𝕌ℂℍ𝕀ℍ𝔸 ⚛ @joshibza]

There is no dignity in suffering, and medicine is not martyrdom. Nobody should be Ambu-bagging a baby with recurrent apnea for six hours and calling it heroism. That is not standard care. That is waste, exhaustion, and predictable harm dressed up as virtue.

The standard is simple: when apnea is recurrent and you cannot stabilize the child on conservative measures, you intubate, you mechanically ventilate, you secure the airway, and you do your actual job not perform a six-hour manual-resuscitation circus while the unit runs on vibes and prayer.

Six hours of Ambu bagging is total rubbish because:

- It burns out the doctor who should be thinking, not pumping a bag until their arms fail.
- It abandons other neonates who also need attention one baby gets a marathon, the rest get neglect.
- It does not fix recurrent apnea; it delays definitive management.
- The outcome you’re gambling with isn’t “grateful parents on Twitter” it’s hypoxic brain injury, cerebral palsy, and a lifetime of disability because oxygenation was treated like a stamina contest.

No junior doctor will tell you six hours of Ambu bagging was a good experience. It’s a bitter, traumatic experience nobody should have to witness or repeat. Praising it doesn’t elevate medicine it normalizes dysfunction and tells owners of broken units: “Keep understaffing, keep missing ventilators, keep praising manual heroics we’ll clap instead of fix.”

Stop applauding exhaustion.

Stop romanticizing what should never happen in a functional neonatology unit.

Call the owners of that unit facility managers, hospital administration, state health leadership to equip, staff, and protocolize: working ventilators, trained personnel, and clear escalation to intubation and mechanical ventilation on time, not after six hours of manual bagging for likes and pity posts.

Praising a doctor who Ambu-bagged for six hours isn’t respect. It’s complicity in a trash system that leaves no room for improvement because everyone’s too busy clapping martyr theatre instead of demanding dignified, standard neonatal care.

Do the needful. Intubate. Ventilate. Fix the unit. Or shut the unit.

Anything else is noise and the baby pays the price.

[The_Chioma_Adanna @Alexxandrianah]

The only advantage of being in Neonatal ward in pediatrics is that I use those babies as free therapists. I feel so much better after talking to them 😂😭

Another upside is that they can keep my secrets too 😂

[Dr. Christon A.K Rweshakyira @Dr_Chris_Twine]

As a Senior Consultant, the reason I haven't raised my voice is simple:
When the interns are gone, I will gladly show up at 5AM, clerk 80 patients, draw the blood, and run the night calls myself.
I am superhuman. Obviously.

As a Senior Nursing Officer, the reason I am silent is obvious:
I have no problem running three wards alone, fixing lines, tracking vitals, delivering babies, doing the paperwork.
I don't need hands. I have dedication.

As a Policymaker, the reason I haven't spoken is elegant:
The interns are a budget problem I solved by terming the students.
My children are not doing internship in Uganda, after all.

As a Patient, the reason I haven't complained is clear:
Even if the doctor cutting me open has worked 36 hours without food, just cut me open and take the baby out.
Hunger sharpens the hands. Everyone knows this.

As a Citizen, the reason I am unbothered is rational:
None of my children is a medic.
I have my pastor.
The system runs on miracles. Always has.

This policy is brilliant.
Let's all stay quiet and watch the magic happen.

[Dr Ihab Suliman @IhabFathiSulima]

What is this and how effective?

[Premier League @premierleague]

A season for the history books 📖

@manutd's Bruno Fernandes is @EASPORTSFC Player of the Season ❤️

[Manchester United @ManUtd]

Sir Matt Busby Player of the Year ✅
United Players' Player of the Year ✅
FWA Footballer of the Year ✅
Premier League Player of the Season ✅

That's our Bruno 🐐

[s. @mat_kar_yaar]

'How do we check the plantar reflex in an amputated foot?’ has been at the top of the list of questions that the Medicine HOD really likes to ask.

[Dr. Emma Okore @EmmaOkoreMD]

A DOCTOR HAS THE RIGHT TO REFUSE TREATING A PATIENT.

Let me say it again: a doctor can say no.

I know the narrative. 'You took an oath. You're here to serve. Every patient deserves to be attended to.'

And yes—that's true, most of the time.

But there are conditions where refusal is not just allowed—it's necessary.

Here are 8 situations where a healthcare provider can ethically and legally refuse to treat:

1️⃣ Physical or verbal abuse – The most common reason. No doctor should endure abuse while trying to save lives.

2️⃣ Outside their specialty – You cannot force a surgeon to treat your skin rash. That's what referrals are for.

3️⃣ Patient insists on unnecessary treatment – Drug seekers, health anxiety without illness, demands for harmful procedures—doctors can say no.

4️⃣ Malingering – When a patient fakes illness for secondary gain, with proper documentation, refusal is justified.

5️⃣ Unable to pay (non-emergency) – Hospitals are not charities. In non-emergency cases, payment can be required upfront.

6️⃣ Infectious disease without proper PPE – A doctor cannot be forced to risk their life without protection.

7️⃣ Fatigued, sick, or grieving – Impaired judgment puts patients at risk. Doctors are human beings, not machines.

8️⃣ Personal reasons (not discrimination) – A doctor can refuse to perform an abortion on moral grounds, for example. But not on grounds of race, gender, or religion.

---

The oath we swore was to do no harm. That includes protecting ourselves, maintaining boundaries, and practising within our limits.

If you learned something today, like, share, and follow for more insightful posts.

[Dr. Christon A.K Rweshakyira @Dr_Chris_Twine]

Doctors sometimes look calm during emergencies.
But inside their minds, hundreds of clinical possibilities are racing at once.
Calmness in medicine is trained chaos management.

[Nic ⭐️ @nchls_b]

Sometimes life gets so serious you can’t even check on your friends you just have to hope they’re fighting back against life too

[Pharaoh👳🏾‍♂️👑 @MrMekzy_]

The best way you can ever repay your parents is by giving them nothing to worry about when it comes to you. You’re not on drugs, you’re doing the right things, you’re living a healthy lifestyle, you’re taking care of your responsibilities. That’s the best thing you can do ever do for your parents.

[Dr. Yonni @kiddiewise_]

💔🕊🕊🕊
It is with profound sadness that I share the sudden loss of our colleague, Dr. Uchenna Onyenuche, Consultant Paediatric Nephrologist at Bingham University Teaching Hospital. He passed away last night following a brief illness.

May the Lord grant comfort to his family, especially his young wife and children, and to all of us who mourn this painful loss.

[Dr. Yonni @kiddiewise_]

As a doctor in Nigeria, no emergency case should make you skip your meals.
I repeat, NO EMERGENCY CASE SHOULD MAKE YOU SKIP A MEAL.

When you die, you might not get a full 1 minute silence.

I am so heart broken because I just lost a seasoned senior colleague 💔

[Dr POPOOLA 🌐⚕️ @popoolaadaniel]

We've gotten to the point that some labs now tell patient relatives that if truly the blood being demanded for is an emergency, the doctor would come him/herself to get the blood.

Shebi you all have seen what the profession is being turned into bah.

Weldone Medical Elders 💔

[Elizabeth🥳 @Deseiye_]

I once helped someone apply for a job I really wanted.

We both went for the interview.

They got it. I didn’t.

I won’t lie — it hurt.

But months later, that same person called me and said,
“They’re opening another position. I recommended you.”

This time, I got the job.

What felt like a loss… was planting a seed.

Never regret helping someone grow.

Have you ever lost something that later made sense? 💛

[Honor 😎🛸 @AjanakuOluwash2]

So, I’m here to open the light on the occurrence happening in university of Ilorin, college of health sciences. It’s going be a long thread, so follow through to get the full gist.

[Haji Siyamuddin ANSARI @DrsansariOrd]

✅ Why Ondansetron is often preferred over Metoclopramide in hospitals for nausea & vomiting

In hospital practice, the choice is mainly based on safety, tolerability, and reliability.

Let’s compare clearly.

🧬 1️⃣ Mechanism of Action

🔹 Ondansetron

5-HT₃ (serotonin) receptor blocker

Acts on:

Chemoreceptor trigger zone (CTZ)

Vagus nerve in gut

➡️ Very effective for:

Post-operative vomiting

Chemotherapy-induced nausea

Acute hospital nausea

🔹 Metoclopramide

D₂ (dopamine) blocker

Also weak prokinetic (↑ gastric emptying)

➡️ Useful mainly in:

Gastroparesis

Reflux-related nausea

⚠️ 2️⃣ Side Effects (Main Reason for Preference)

🚨 Metoclopramide → More CNS Side Effects

Because it blocks dopamine in the brain, it can cause:

❌ Acute dystonia (neck twisting, eye rolling)
❌ Akathisia (restlessness)
❌ Parkinsonism
❌ Tardive dyskinesia (long-term)

➡️ These are common in:

Young patients

Elderly

IV use

⚠️ Very problematic in emergency/ward settings.

✅ Ondansetron → Much Safer CNS Profile

Ondansetron does NOT block dopamine.

So:

✔️ No dystonia
✔️ No extrapyramidal symptoms
✔️ Better tolerated

Main side effect:

Mild QT prolongation (rare, monitored in hospital)

💊 3️⃣ Predictable & Strong Antiemetic Effect

Ondansetron:

Works fast (IV/PO)

Reliable in most causes of vomiting

Works even when stomach is not emptying

Metoclopramide:

Less reliable

Depends on gastric motility

Fails in many hospital cases

➡️ Doctors prefer a drug that works in most situations → Ondansetron.

🏥 4️⃣ Suitable for Critically Ill Patients

In hospitalized patients, many already have:

Brain injury

Stroke

Parkinsonism

Electrolyte imbalance

Metoclopramide can worsen neurological symptoms.

Ondansetron is safer in:

✔️ ICU
✔️ Post-op
✔️ Oncology
✔️ Emergency

📊 5️⃣ Quick Comparison

FeatureOndansetronMetoclopramide

Main receptor5-HT3D2
CNS side effectsVery lowHigh
Dystonia risk❌ No✅ Yes
Hospital use✅ Preferred❌ Limited
Safety profileHighModerate

🧠 Exam / Clinical Pearl

> Ondansetron is preferred because it is equally effective but causes far fewer extrapyramidal and neurological side effects than metoclopramide.

✅ One-Line Integrated Answer

> Ondansetron is preferred in hospitals because it blocks serotonin receptors, provides strong antiemetic action, and lacks dopamine-related extrapyramidal side effects seen with metoclopramide.

[Abdull Ibrahim, MD @Yantumakii]

Back during my House Job days, we became so proficient at diagnosing Typhoid perforation that we didn't need an ultrasound scan (USS) to assess a bowel perforation. In the rare cases where diagnosis becomes dicey, we usually employ plain abdominal x-ray.

Whenever the surgical team was called to the A&E to review a patient, we knew how to diagnose it, prescribe medications, and list the surgical items to procure, so the patient could undergo an emergency exploratory laparotomy (Exlap) without wasting much time. This approach helped the patients, as early surgery has been shown to improve overall survival rates from perforation.

Throughout the months I spent in that department, not a single case of wrongful diagnosis was recorded. Typhoid perforation was like bread and butter to us—we saw at least one patient every day, and sometimes up to five in a single day.

Now, someone is claiming that we should have delayed each of those Exlaps until we could get abdominal CT scans to confirm the diagnosis—which, by the way, is the standard. But what about patient survival? How much does an abdominal CT cost? In this part of the country, one could spend a whole week trying to get a CT done, even if they have the money.

Evidently, some people only hear about resource-poor settings in PowerPoint presentations. They don't know what's actually obtainable in those environments. Worse still, they're not willing to listen and learn from those on the front lines of service delivery in resource-constrained settings.