iDocTab

Informative, Innovative and Infinite medical content for All | by @pagingdrevans

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Mifepristone & Misoprostol Dosing Chart

- Misoprostol is SAFE below 28 weeks EVEN with history of Cesarean Delivery.
- Avoid vaginal route if there is vaginal bleeding.
- Misoprostol is not recommended in women ≥28 weeks gestational age with a prior Cesarean Delivery.
- There is NO Maximum dose of misoprostol. If an abortion is not complete after 5 doses, you may continue additional doses or rest for 12 hours and start again
- SL/PO route is associated with more side effects.
- Misoprostol is not contraindicated in grand multipara.

Source : FIGO

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A mother's report about her 3-month-old baby 'Daktariii, mtoto wangu alishindwa kupumua after nimempea UJI leo saa kumi' is a heartbreaking reminder of how health illiteracy remains one of the biggest health challenges in our communities.

At just 3 months, a baby’s digestive system isn't ready for solid or semi-solid foods like uji. Introducing them too early can lead to choking, digestive issues, or even more serious complications.

World Health Organization recommends that babies be exclusively breastfed or formula-fed for the first six months of life, and solid foods, including porridge, should not be introduced before 6 month

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Lymphatic filariasis: Treatment

- Monoinfection - Single dose of Dethylcarbamazine (DEC) 6mg/kg

- Patients with tropical pulmonary eosinophilia due to W. bancrofti infection are treated with 14 to 21 days of DEC (6 mg/kg/day).

- Doxycycline (200 mg/day for four to six weeks) is also added to reduce pathology in mild to moderate cases

- DEC is contraindicated in patients coinfected with onchocerciasis, or patients with loiasis who have high microfilarial loads due to the risk of severe adverse events.

Mass drug administration (MDA) using various regimens of DEC (single dose and medicated salt), ivermectin, and albendazole remains a cornerstone for public health control.

Source : uptodate

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Why Filariasis Hides from Daylight Diagnosis

Microfilariae of Wuchereria bancrofti exhibit nocturnal periodicity, migrating to peripheral blood between 10 PM–2 AM, aligned with the feeding pattern of mosquito vectors (Culex, Anopheles, Aedes).

Daytime blood draws may miss them due to sequestration in the pulmonary vasculature, leading to false negatives.

Microscopy using Giemsa-stained thick and thin smears remains the gold standard in low-resource settings.

For improved sensitivity, antigen detection (CFA tests), PCR assays, or ultrasound (filarial dance sign) can be used.

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Artesunate Dosing for Severe Malaria

Route: IV/IM

Initiation Doses: At 0 hours, 12 hours, and 24 hours

Maintenance: Then once daily for a maximum of 7 days

Dosage:
≤20 kg: 3 mg/kg per dose
>20 kg: 2.4 mg/kg per dose

Transition to oral therapy (typically Artemether-Lumefantrine) 8–12 hours after the last dose, once the patient can tolerate oral intake.

Paeds guidelines MoH

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5 Ds of Amputation

1. Dead – Limb has necrosis (dead tissue) due to gangrene, ischemia, or severe infection, making recovery impossible.

2. Dying – Limb has critical ischemia with no possibility of revascularization, amputation may be necessary to prevent systemic complications.

3. Dangerous –Limb poses a serious risk to the patient's life, such as in aggressive infections (e.g., necrotizing fasciitis) or malignancies.

4. Damaged – Severe trauma, such as crush injuries or non-reconstructable fractures, where limb function cannot be restored.

5. Dysfunctional – A limb with severe deformities, chronic pain, or loss of function that significantly affects quality of life and mobility.

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What is Pes Anserinus Bursitis?

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What is the "Aubergine Sign"?

The "aubergine sign" (also known as the "eggplant sign" or "eggplant deformity") is a clinical hallmark of a fractured penis. It refers to the external appearance of the penis after the injury, characterized by -

1. Swelling and bruising: The penis appears discolored, with purple or dark blue bruising due to subcutaneous hematoma formation.

2. Deformity: The penile shaft becomes bent or curved, resembling an aubergine (eggplant) in shape and color.

Loss of erection: The injured penis is flaccid and painful.

This deformity arises from the rupture of the tunica albuginea, the tough, fibrous layer surrounding the corpora cavernosa.

Hemorrhage beyond the tunica albuginea produces the swelling and bruising characteristic of the aubergine sign.

Image source Europe PMC

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Diarrhoea and Vomiting

Dr. S.K Ratemo touches briefly on Gastroenteritis. More on TheDocTab Youtube Channel.

Video shot and edited by @pagingdrevans.

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Okay, it's late... but Happy New Year anyway! Let’s make 2025 count.

What’s the most important Health issues we should prioritize for discussion this year?

- theDocTab2025

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DO NOT SUTURE ANIMAL AND HUMAN BITES

- Irrigate it copiously, dress and leave it open to drain.

- Examine it everyday for any signs of infection

- Treat all the infected Wounds

- If NO signs of infection, Delayed Primary Closure can be done within 72 hours after the injury.

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@AO_issak Big congrats, you deserve it, Doc! 🌟

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To the medics graduating today,

You’ve mastered the art of surviving on coffee and determination. Now, it’s time to heal the world. Welcome to the calling!

Congratulations🩺🔥 #KU56thGraduation

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@GingerrrTea Great job, keep soaring! 🚀

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@UoN_FHS @OSANJOGeorge Bravo to all the graduates. Welcome to the profession! ✨

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@DrGMwanzia Hats off to you, Doc! 🎉

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@anniewambu @v_mw3nde_ Cheers to the new doctor in town! 🩺🌟

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@UoN_FHS @CASTROJASPER4 @thedoctorKC @AnumC16 @ElishuaNgina @uonbi Well done, doctors! Your hard work has paid off! 👏

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@wangeci_muthima Hats off to you, Daktari 🎩