Wakesho

M.D.

[Kenya Medical Association @KenyaMedics_KMA]

When law meets clinical practice, healthcare providers need clarity.

This 📅 Wed, Jun 24 | 7 PM EAT: "Abortion, Clinical Decision-Making and the Law: Understanding the Court of Appeal Decision and Its Implications for Reproductive Healthcare Providers."

https://t.co/DSTx0ww3Q2

[Keith Siau @drkeithsiau]

The early bird catches the worm. What is happening here?

[Kenya Medical Association @KenyaMedics_KMA]

Hats off to intentional fatherhood, the work of raising a child toward healthy independence: not by removing every obstacle, but by building capacity through love, wisdom, faith, courage, and example, until responsibility is embraced and dependence naturally fades.
#FathersDay

[Dr. Priyam Bordoloi @DocPriyamMD]

Treating numbers instead of patients is a massive clinical trap👇

• ​The 80/50 Danger: A BP of 80/50 can mean two completely different things. If the patient is 65, pale, breathless, and confused, he is in Shock. His organs are actively starving for oxygen and we have minutes to start IV fluids and pressors.

• ​The 80/50 Normal: But if that 80/50 is a young 25-year-old woman sitting comfortably and scrolling through her phone? That is just her physiological baseline. Many young, healthy women have chronically low BP. If she is asymptomatic, it’s not an emergency.

• ​The 200/120 Trap (Asymptomatic): If the high BP patient feels fine, it is not an emergency. We actually phased out the term "Hypertensive Urgency" because it made doctors panic. Now we call it Severe Asymptomatic Hypertension. Their brain has adapted to this high pressure over years. If you rapidly drop it to 120/80, you will literally cause an ischemic stroke. We take days to lower it safely with oral meds.

• ​The 200/120 Crisis (Emergency): The only time that 200/120 jumps to the front of the line is if there is active end-organ damage. Crushing chest pain, sudden weakness or breathlessness means it's a true Hypertensive Emergency (like a heart attack or torn aorta). Then we use IV drugs.

​The Golden Rule: The monitor only gives you a number. The patient tells you the emergency. Never treat a blood pressure reading without looking at the person attached to the cuff.

​Hi, I am Dr. Priyam. I break down complex medical science and advocate for Evidence-Based Medicine. Follow me for more clinical truths.

[O Negative Foundation-Kenya @Onegfoundation]

Thank you @DonorCC

[Science & Nature @Sci_Nature0]

NASA’s Artemis II Reveals the Basin in Full
For the very first time, the mysterious Orientale Basin has been fully photographed. Thanks to Artemis II, humanity now sees the Moon in unprecedented detail, reminding us of the endless wonders beyond Earth. 🛰️

[Arsal @arsalfeed]

After a 10-day journey around the Moon, traveling nearly 700,000 miles and re-entering Earth’s atmosphere at extreme speeds, the crew is finally back.

The last time humans went this far and came back was during the Apollo era… over 50 years ago, in 1972.

Think about that for a second.
A machine leaves Earth, goes all the way to the Moon, loops around it, and comes back safely with humans inside.

Huge congratulations to NASA and everyone involved.

Next step… landing and building on the Moon.

[theadeolamii__ @adeolamii__]

I am thinking about every engineer who missed a birthday. Every astronaut who kissed their kids goodbye not knowing. Every person who spent a career on one small piece of this mission. Artemis II didn't happen in 10 days. It happened over thousands of quiet, unglamorous ones. That's the real story
Weldone team 👏💜

[ABC News @ABC]

BREAKING: Astronauts Christina Koch, Victor Glover Jr., Jeremy Hansen and Reid Wiseman are beginning to exit the Orion capsule after a successful Artemis II splashdown.

[letsdoit ATS @VibeDesiDaily]

@BarackObama @NASAArtemis A full journey recap !!
Welcome Home Brave Crew !!🫡🫡💪

[Barack Obama @BarackObama]

What the Artemis II astronauts did over the last 10 days was a testament to their bravery. And the fact that they traveled farther from Earth than anyone ever has, re-entered our atmosphere at more than 24,000 mph, and splashed down safely was a testament to human ingenuity. Thanks to everyone at @NASA for making this mission possible, and for taking us along for the ride.

[Dr. Priyam Bordoloi @DocPriyamMD]

5 years back, I saw something that still hasn’t left me.

A pregnant woman came in.
Healthy. Smiling.
No complications throughout her pregnancy.
No “high-risk” label.
No warning signs.

The kind of case where the whole family walks in expecting just one thing:
a baby’s cry.

Her labour progressed well.
Everything looked routine.

And then…

something happened so fast
that it didn’t even feel real.

She suddenly said:
“I can’t breathe.”

Not mild discomfort.
Not anxiety.

Real breathlessness.
The kind that makes everyone in the room freeze for half a second
before panic takes over.

Her breathing became rapid.
Her face changed.
Her body started trembling.

And within moments
she collapsed.

The room flipped instantly.

From:
“Almost done.”
To:
“CALL FOR HELP.”

From:
“Everything is fine.”
To:
“START CPR.”

Machines started beeping.
Oxygen was rushed.
Lines were placed.
Drugs were pushed.

Seconds felt like minutes.

And then the unthinkable happened.
Despite everything…
she couldn’t be saved.

And then came the part that shattered everyone.

The family saw a perfectly healthy pregnant woman walk in…
and a dead body come out.

They didn’t ask politely.
They didn’t process slowly.
They exploded.

“How can a healthy woman die like this?!”
“There were NO complications in the entire pregnancy!”

“You doctors have killed her!”

Some were crying.
Some were shouting.
Some were blaming anyone they could see.

And honestly…
I couldn’t even blame them.
Because to a normal person, this doesn’t make sense.

A normal pregnancy.
A normal delivery.

And then sudden death?
It feels impossible.
It feels like someone must have “done something wrong.”

But the truth is…

sometimes medicine witnesses something terrifying:
A body can collapse like a switch has been turned off.

I was just a new intern then, I asked my seniors and that day, I learnt the name of that nightmare.

"Amniotic Fluid Embolism"

And that’s when it hit me:
We take pregnancy for granted because we only see the “happy ending.”
But behind the scenes, a woman’s body is walking a tightrope every single day…
and sometimes, everything can change within seconds... without any warning.

[Thee Comfort O.🌸 @comfortomovre]

10 difficult but necessary conversations to have with your partner before 2026.

(I do these often with my clients in counselling and it always yields rewarding results):

[Mastering the Differential 🩺 @MTD_MED]

🧠 Beckwith–Wiedemann syndrome

🔑 Clues
• BIG baby (macrosomia)
• BIG tongue (macroglossia)
• BIG organs (visceromegaly)
• LOW sugar (neonatal hypoglycemia)
• HIGH tumor risk (Wilms tumor, hepatoblastoma)
🧬 Cause
Imprinting defect at chromosome 11p15 →
↑ IGF-2 expression ± ↓ CDKN1C (p57) tumor suppressor activity
⚠️ High-yield association
Hyperinsulinism → recurrent neonatal hypoglycemia
📌 Bottom line
Overgrowth + hypoglycemia + embryonal tumors = Beckwith–Wiedemann syndrome

[DocXus @docxusofficial]

Bullous Tinea Manuum

It is a dermatophyte infection of the hand presenting with vesicles/bullae

Etiology:

- Dermatophytes (most commonly Trichophyton rubrum, T. mentagrophytes)

- Often associated with tinea pedis (“two feet–one hand” pattern)

Pathogenesis:

- Fungal invasion of stratum corneum → inflammation → vesicle/bulla formation on palmar skin

- Hyperkeratosis + scaling due to host immune response

Clinical Features:

- Unilateral involvement (classically one hand)
- Tense vesicles/bullae on palms or sides of fingers

- Scaling, erythema, fissuring
- Associated tinea pedis/onychomycosis
- KOH prep: branching septate hyphae

Treatment:

- Topical antifungals: azoles or allylamines (e.g., terbinafine)

- Oral therapy for extensive/bullous disease: terbinafine or itraconazole

- Treat coexisting tinea pedis/onychomycosis

- Keep area dry; avoid occlusion

FAQs:

1. Is it contagious? → Yes, spreads via contact with infected skin or surfaces.

2. Why only one hand? → Dominant-hand exposure + coexisting foot infection commonly produce “one-hand–two-feet” pattern.

3. How to confirm diagnosis? → KOH microscopy, fungal culture if needed.

[Keith Siau @drkeithsiau]

@Ham_Ba_Li Thanks for teaching me a new eponym! 🙏🤣🙇🏻‍♂️

https://t.co/YTtZYMF0LY

[Amimi❤️ @Dr_Meenerh]

Doctors, remember, the Hippocratic Oath doesn’t just talk about patients.

It also says:
“I will attend to my own health, well-being, and abilities in order to provide care of the highest standard.”

You can’t pour from an empty cup.

[Dr sthanu subramanian @drsthanus]

Fluid stewardship in septic shock.

Dr. Catherine Beni @totalbodydolor

[Kimuzi @Kimuzi_]

Hamjui mahali Kuna shida nyinyi. Just sit down and read. This is the land law. Hapa Kuna shida kubwa Sana.

This is now the Law.

[Eddy J. Gutierrez, MD @eddyjoemd]

Do you provide IV fluids to your patients? If so, please read this article in its entirety. 🎩 tip to the author.
https://t.co/Sfr6vCn6le