Dr Tukur Garba Gada

ABUSITE/ Physician/Clinical Hemato-Oncology ABUTH/BOBA/Activist/ 2016 Fellowship of the the w@WashFellowship, @Illinois_alma

[Dr Tukur Garba Gada @tkgarba]

@thenaijaimgdoc Had a similar situation in 2012 while on a flight ✈️ to India with my late Dad, I summoned courage and offered my service. I can still remember the smile 😊 on his face that day. Looking at his son saving life onboard in the midst of Asians.

[Dr Tukur Garba Gada @tkgarba]

@BashirSZuntu @ubasanius Don't worry Bashir, we know how indebted you are to SUS. But tsakani da Allah kai ma ka san sai a hankali kawai.

[DrAishaMustapha @DrAishaMustaph1]

Dear doctors and dentists in Kaduna State,

Serving our Association has been one of the greatest privileges of my professional journey. The opportunity to serve as your Secretary during the pandemic taught me lessons that have stayed and will be used.
#Aisha4NMA

[Dr Tukur Garba Gada @tkgarba]

@___Bils Tohm

[Dr Tukur Garba Gada @tkgarba]

@___Bils Tohm shikenan

[Dr M Shujat Rasool @DrMShujat]

I told him, before answering that, let’s first understand what these two tests actually measure.

ESR (erythrocyte sedimentation rate) is an indirect marker of inflammation. It simply tells us how quickly red blood cells settle in a test tube over one hour. The faster they settle, the higher the ESR.

CRP (C-reactive protein) is different. It’s an acute-phase protein made by the liver, and it rises rapidly in response to inflammation, especially when stimulated by IL-6.

In many inflammatory diseases like rheumatoid arthritis, bacterial infections, vasculitis, and inflammatory bowel disease, both ESR and CRP are elevated.

So why is SLE different?

The main reason ESR is high is that patients with active SLE often develop hypergammaglobulinemia, and fibrinogen may also increase. These proteins make red blood cells stick together in stacks called rouleaux, so they settle faster, giving a high ESR.

Now the interesting part.

Despite active inflammation, CRP is often normal or only mildly elevated. That’s because type I interferons (especially IFN-α), which play a central role in SLE, suppress CRP production by the liver. So the CRP response is blunted, even when the disease is active.

My advice for all of you👇

If a patient with known SLE suddenly has a markedly elevated CRP, don’t assume it’s just a lupus flare. Think infection first. Of course, severe serositis, inflammatory arthritis, or myositis can also increase CRP, so always interpret the result in the clinical context.

Take home message:

High ESR with a normal or mildly elevated CRP is a classic laboratory pattern in active SLE. Understanding why is much more valuable than simply memorizing it.

[Dr. Shiv_Kumar @Dr_Shiv_kumar_]

🔻Dawn phenomenon: Body naturally releases hormones before waking up :- liver makes more glucose hence the high morning sugar. (No low sugar during the night.)

🔸Early morning surge of GH, cortisol & catecholamines (≈4–8 AM) → ↑ hepatic glucose output → fasting hyperglycemia. No preceding nocturnal hypoglycemia.

🔻Somogyi effect: Too much insulin at night leads low sugar while sleeping and body overcorrects by releasing glucose :- high morning sugar.

🔶Excess night time insulin taken → nocturnal hypoglycemia → rebound release of counter-regulatory hormones → morning hyperglycemia.

Check 3 AM blood glucose
Low = Somogyi
Normal/High = Dawn phenomenon

#MedX #NEETPG

[Dr Tukur Garba Gada @tkgarba]

@Ahmad_Gogel Talauci bala'i ne. SP ya duba mai gaskiya.

[Dr Tukur Garba Gada @tkgarba]

@Black_Dee99 @Zbabankumbo That means you don't understand English!

[Dr Tukur Garba Gada @tkgarba]

@DanKatsina50 Ai in dai bandit ne aka kashe ba wani gruesome kawai a sa mana mu kara tsine mai.

[Ahmed Kotb @AhmedKo45911157]

Refractory iTTP management

Exclude infection/drug causes.

Add Caplacizumab (if not given).

Intensify immunosuppression: Rituximab ± cyclosporine/vincristine.

Refractory cases: Bortezomib/Daratumumab or splenectomy.

[Ahmed Kotb @AhmedKo45911157]

#TTP Management (High-Yield)

PEX + steroids + caplacizumab immediately.

Early rituximab.

Refractory: Intensify immunosuppression (rituximab/bortezomib/cyclophosphamide).

Remission: Monitor ADAMTS13; preemptive rituximab if <10%.

[Ahmed Kotb @AhmedKo45911157]

TMA Differential

TTP: ADAMTS13 deficiency→ urgent plasma exchange

aHUS: Complement-mediated→ eculizumab/ravulizumab

Secondary TMA: HELLP, STEC-HUS, malignant HTN, autoimmune disease, transplant, drugs, cancer

Pearl:Rule out TTP first, then treat aHUS early to preserve renal

[Ahmed Kotb @AhmedKo45911157]

Cancer-Associated #Thrombosis

DOACs (apixaban, rivaroxaban, edoxaban) preferred over LMWH/VKA in most cancer

GI/GU cancers or GI lesions:Prefer LMWH due to mucosal bleeding risk with DOACs

Warfarin is the least preferred

balance thrombosis vs bleeding risk,drug interactions

[Dr Tukur Garba Gada @tkgarba]

@Abdool85 Shi da yace ba ruwanshi da birni. Ya fara running helter-skelter kenan. Ko gadar Dubai zai yi, shi ya sani.

[Aisha Hamman @AyshaHamman]

Please, if you are a student in any higher institution and you are subjected to sexual harassment by a lecturer or any staff member, there are legal ways to address it.

The Independent Corrupt Practices and Other Related Offences Commission (ICPC) has treated sexual harassment in schools as sexual corruption and abuse of office, especially where someone in authority demands sexual gratification in exchange for academic favour. This may fall under Sections 8 and 19 of the ICPC Act.

There is also the Sexual Harassment of Students (Prevention and Prohibition) Bill, which has been passed by the National Assembly and is awaiting presidential assent.

If signed into law, it prescribes a prison sentence of 5 to 14 years, without the option of a fine, for educators convicted of sexual misconduct.

But please, as angry as these cases make us, do not resort to beating anyone.

Once you physically attack an accused person, the case can quickly shift from sexual harassment to assault, causing hurt, or unlawful violence. You may end up becoming the person facing criminal liability.

Document your evidence. Report to the institution. Petition ICPC, the police, or other relevant authorities.

Do not resort to jungle justice.

[Hon. Mohammed Bello El-Rufai @B_ELRUFAI]

‘Now is the time for patience. Don't force the pieces. Store them away.’

[Dr Tukur Garba Gada @tkgarba]

@TaxHours I hear say he recited the old national anthem. Man don get dementia.

[Dr Tukur Garba Gada @tkgarba]

@IsaAshiruKudan Our Governor 2027 In Sha Allah.

[Dr Tukur Garba Gada @tkgarba]

@Aashfinn @dr_zacksss Gaskiya.