@Ngugi_eric

Have faith. Work hard. Never give up.

#AAL IIZ WELL!! 💯😉

[Profesa Ochieng Odongo @OchiengOdongoKE]

I have always had this dream of running my own PRIVATE CLINIC ✅

See GOD🍊✅

Thank you vere much for your attention to this MATA🍊✅

[Derby Pancreaticobiliary & Robotic AWR Unit @DerbyPBunit]

𝙇𝙖𝙥𝙖𝙧𝙤𝙨𝙘𝙤𝙥𝙞𝙘 𝙍𝙚𝙥𝙖𝙞𝙧 𝙤𝙛 𝙋𝙚𝙧𝙛𝙤𝙧𝙖𝙩𝙚𝙙 𝘿𝙪𝙤𝙙𝙚𝙣𝙖𝙡 𝙐𝙡𝙘𝙚𝙧 𝙬𝙞𝙩𝙝 𝙋𝙧𝙞𝙢𝙖𝙧𝙮 𝘾𝙡𝙤𝙨𝙪𝙧𝙚 & 𝙊𝙢𝙚𝙣𝙩𝙖𝙡 𝙋𝙖𝙩𝙘𝙝

Presentation:
🔵1 day history of sever upper abdominal pain
🔵Smoker and excess ETOH
🔵CXR
➡️Pneumoperitoneum
🔵CT
➡️Perforated duodenal ulcer
🔵Time from ED➡️theatre 3 hours

Operative Approach:
🔴Thorough peritoneal lavage
➡️Lap washout allows for thorough removal of intra-abdominal contamination
➡️Modern OR table tilting can provide better view then open in select cases
🔴If fragile tissue then omental patch only
➡️This approach is a modified version of Grahams patch repair
➡️When suitable, we prefer primary closure with patch after
🔴For large perforations kocherisation of duodenum may be indicated
🔴Convert to open if:
➡️Large ulcer
➡️Associated ulcer bleed
🔴H. Pylori eradication therapy on discharge
🔴OGD in 6-8 weeks to confirm healing

Key Points:
🟢Timely intervention critical
🟢Lap approach in EGS should be encouraged
🟢Compared to open, advantages of lap are:
➡️Reduced pain
➡️Reduced LOS
➡️Reduced incisional hernia rate
🟢Trainees should be exposed to lap EGS early to develop skills and confidence

#FOAMed #GITwitter #MedEd #SurgEd #EGS #SoMe4Surgery

[Joel Jiranï @Kemboi67]

Lakini that part where Sifuna moves around with a proper injection is goated.

He has been standing on our side tangu kitambo.

[JaPrado. @Dr_AustinOmondi]

PPH can humble even a professor in Obstetrics and Gynecology. One case can bring the entire theatre to a standstill.

[Premier League @premierleague]

Hat-trick hero 🔥

@ManUtd's Bruno Fernandes is your Player of the Matchweek for his match-winning performance vs Ipswich 🌟

Watch his highlights here 👉 https://t.co/kRcoQJeEGp

[Manchester United @ManUtd]

The best player in the @PremierLeague.

[Kobi @UTDKobi]

This week:

Bruno PFA player of the year
First win of the season
Bruno Fernandes Hattrick
Kobbie Mainoo masterclass
Baleba unveiling

I’m finally at peace

[(fan) Trey @UTDTrey]

Me shamelessly joining forces with Lamine Yamal who I’ve hate watched all his life

[(fan) Trey @UTDTrey]

Someone said Gabriel was trying to win a corner 😭😭😭

[Manchester United @ManUtd]

BRUNO FERNANDES. RECORD-BREAKER.

[Dr Onimisi @sportsurgeonng]

Today I caught my Medical Officer reading Davidson’s Principles of Internal Medicine instead of orthopaedic textbooks 😭😂

After all my motivational talks about fractures, joints, ligaments, arthroscopy, and the beauty of endoscopic spine surgery… he still chose medicine

I am considering disciplinary measures like tell him to write “bone is life” 500 times. 😆😆

Or should I forgive him?

#orthopaedics #medicine

[(fan) Trey @UTDTrey]

Saw someone say “Casemiro has been better than Rice this season”

I don’t know why our fans do this everytime, Rice is in a UCL final and about to win the league.

If you think I’m going to sit here and say Casemiro has been better than Rice then you’re ABSOLUTELY RIGHT. CRY😂

[E. Mujuni. MD. @mujuni_emmy]

Dear MOs, COs et al,
That patient you keep writing for “continue treatment” in the chronic care clinic might actually need a specialist review 📝

[Kreative Doctor ⚕️ @the_grafixmedic]

POV: how sodium, potassium, and calcium felt after leaving the periodic table and joining physiology.

[Mighty Mohammed @The__Vyrus]

Doctors in Nigeria 🥺

[United Pride @UtdPride]

I think I have seen it all. Manchester United fans are crazy😭😂

[Mr. Kinuthia Pius. @Belive_Kinuthia]

@edwinsifuna Nairobi County mambo sio mzuri. Clinical Officers and Doctors are in their 28th days strike. This week nurses too are downing tools.

Wewe instead of trying to address this you're busy talking about Tanzania and national politics

[@Ngugi_eric @NgugiEric2]

@moneyacademyKE What is a billion? Sad!

[@Ngugi_eric @NgugiEric2]

@sebas_arruarana @UofC [email protected]

[@Ngugi_eric @NgugiEric2]

@UTDTrey 😂😂😂😂😂😂