The Nigerian Association of Resident Doctors should not have to beg for what has already been agreed upon. The Federal Government signed a deal on the Professional Allowance Table, and now it wants to abandon it. This is not governance; it is betrayal.
Our resident doctors are the last line of defence in hospitals that are already collapsing. They work gruelling hours, in impossible conditions, for pay that insults their sacrifice. And now, the government seeks to take away the little that was promised? The Tinubu administration must demonstrate commitment to the issues: 19 months of unpaid Professional Allowance arrears; promotion arrears gathering dust; a Medical Residency Training Fund stuck in bureaucratic limbo; and a government that treats its doctors as an afterthought and remains unconcerned as they flee the country in droves.
Every doctor Nigeria loses to the UK, Canada, or Saudi Arabia is a failure of leadership, not a failure of patriotism. You cannot ask people to serve a nation that refuses to honour its own word.
I stand with NARD. Pay what you owe. Honour what you signed. Or explain to 200 million Nigerians why their hospitals will go dark on Tuesday. -AA
Trigeminal Neuralgia (TN): Clinical Features & Management
→ Trigeminal neuralgia = sudden, severe paroxysmal facial pain along trigeminal nerve distribution
→ Classically due to neurovascular compression at the trigeminal root entry zone → focal demyelination → ectopic firing
Pain characteristics
→ Unilateral facial pain (most common)
→ Electric shock-like / stabbing / shooting pain
→ Lasts seconds to 2 minutes (can cluster in bursts)
→ Recurrent attacks with pain-free intervals
→ May have facial grimacing/tic during attacks (“tic douloureux”)
→ No persistent dull pain between attacks in classic TN (constant pain suggests atypical/secondary causes)
Distribution (which division?)
→ Most commonly affects V2 (maxillary) and/or V3 (mandibular)
→ V1 involvement can occur but is less common
→ Pain follows a clear trigeminal dermatome (not crossing midline typically)
→ Bilateral symptoms are uncommon → think secondary TN
Trigger factors
→ Triggered by light touch (“trigger zones”)
→ Common triggers: chewing, talking, brushing teeth, washing face, shaving, cold air, smiling
→ Patients may avoid eating/cleaning due to fear of attacks
Etiology / pathophysiology
→ Most common: vascular loop compression (often superior cerebellar artery) at root entry zone
→ Secondary causes to consider:
→ Multiple sclerosis (demyelination)
→ Tumor/space-occupying lesion (CPA tumors), vascular malformations
→ Post-herpetic neuralgia and dental causes can mimic but have different pain patterns
Associated findings
→ Classic TN: normal neuro exam, no sensory loss
→ Sensory deficit (numbness), weakness, or other cranial nerve findings suggest secondary trigeminal neuralgia
→ Consider MS especially in younger patients
Red flags (need MRI / further evaluation)
→ Age < 40 years
→ Bilateral facial pain
→ Persistent numbness/sensory loss or objective neuro deficits
→ Hearing loss, vertigo, facial weakness, other cranial nerve signs
→ Pain that is progressive, continuous, or poorly localized
→ Suspected tumor/MS → MRI brain with attention to CPA + trigeminal nerve
First-line treatment (medical)
→ Carbamazepine = first-line
→ Oxcarbazepine = common alternative (often better tolerated)
→ If partial response or intolerance:
→ Gabapentin / Pregabalin, Baclofen, Lamotrigine (specialist-guided)
→ Monitor for adverse effects (sedation, dizziness), and for carbamazepine: hyponatremia, leukopenia, liver issues
→ Avoid abrupt stopping; titrate dose based on response
Refractory management (if meds fail or side effects are limiting)
→ Microvascular decompression (MVD)
→ Best long-term option when vascular compression is confirmed and patient is a surgical candidate
→ Percutaneous procedures (pain relief but can cause sensory loss):
→ Radiofrequency rhizotomy, glycerol rhizolysis, balloon compression
→ Gamma knife radiosurgery (non-invasive option; relief may be delayed)
Key differentiators (high-yield)
→ TN: brief, electric shock, triggerable, dermatomal, pain-free intervals
→ Dental pain: localized tooth tenderness, continuous ache, worse with hot/cold bite
→ Post-herpetic neuralgia: burning pain, allodynia, history of shingles, more continuous
→ Cluster headache: orbital/temporal pain + autonomic signs (tearing, rhinorrhea), longer attacks
Provision for the Hereafter.
Mukhtasar Zadul Ma'ad.
By Imam Ibnu Qayyim.
This book include Sirah, fiqh & other aspects of the Prophet(SAW) life.
Price: ₦30,000.
Location: Kano.
Kindly repost if you come across this please.
There's a reason why Allah chose the best lineage for his prophet(SAW). Because that was the norm of the Arabs at that time.
Sheikh Prof. Sani R/L captured it in his seerah book.
Well done mk.
We all know civil servants with children and relatives abroad. They are your neighbours. You invite them for Harvest, and make them Chairman of the Committee (with stolen taxpayer funds)
Many of you were educated with funds stolen from taxpayers. Many of you are stealing taxpayer funds to send your children abroad to school.
Very few civil servants today in 234, apart from maybe the top honcho, can qualify to buy a N100m house on a commercial mortgage template. Yet we have serving Ministers driving Rolls-Royce. Yet it's harder to find a civil servant with children schooling in Nigeria.
We are talking of billions allegedly to educate kids of a single family, while kids are roaming, looking for remnants to survive on
We excuse the corruption because we want our turn.
Like they say, one day everybody go chop breakfast.
As long as Nigeria remains as its—Nigeria- Federal Character must be applied in sharing resources.
This is even if everyone from Kaduna upward is a goat and has no brain. He must share in the resources irrespective of how others downward feel about it.
And for the disintegration, I am 100% in support of regionalism and cant wait for regionalization of Nigeria.
I prefer we all go separate ways sooner than later so we continue suffering in our Afghanistan-like regions and others continue enjoying their London-like regions.
For now, everything must be shared equitably, whether anyone likes it or not.
Stay safe, brother.