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CLINICAL EXAMS

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He is a very good, sharp and smart guy. The night before he had gone through all the cases, read all the folders and had approached all the patients.

“Who is candidate 119?” the Chief Resident asks. You have just 45 minutes to clerk, examine, and present your patient, your time starts now. She assigns him to bed number C7. ” oh that baby” he said. He was being managed for bacterial meningitis.

Clerking starts; “Madam where una from?” he asks, which kind question be that every person dey ask me this kind question you no see the mark for my face, she says pointing to her tribal marks. She finally tells him where she is from, howbeit reluctantly.

He explains to her his whole one year depended on how she cooperates with him, he tells her that his life depends on how she responded to him. He then gets a polythene bag that has in it 2 packets of biscuit and a packet of fruit drink juice and gives it to the child, he then gives the mum #500 to pledge his unalloyed loyalty.

The woman calms down and suddenly becomes semi cooperative, the child as well is glued to him as he eats the biscuit.

Madam wetyn carry you come clinic? he asks; Na sickness na, she replies. He explains to her that sickness is vague, she then cuts him short. Why una sabi ask question well well for this hospital.

15 minutes gone asking questions that lead to no where in particular, 15 minutes gone waiting for answers scarcer than snow in the Sahara desert.

He remembers the case, he had gone through her case note before. In fact he knows everything about the child, despite his biscuit, packet of fruit drink juice which the child is now devouring  and the #500 he gave to her mum, she can hardly break a smile and it is obvious she is not ready to cooperate with him.

 

He runs to his Chief resident to inform her of his predicament. She angrily scolds him and tells him he is not serious and says “oh is it because you can’t make a common diagnosis, will you get out of here, lazy students”

Desperate times call for desperate measures,  he said to himself, well I know the case. He writes a full clerking and examines the child. The woman agrees to all he wrote down and makes a deal to agree with all he says in front of the examiners. His diagnosis is resolving bacterial meningitis.

He is getting ready for the examiners and hoping everything goes according to plans. Just as a white haired man and another examiner shows up, the child started stooling and the mother in turn started crying.

She says with a loud voice “since we come this hospital this pikin dey shit 6 times every day and in dey shit everything wey enter in belly and na this small doctor give am biscuit and juice wey in just chop”. He felt an earthquake around him.

His examination starts from there; for this baby stooling the consultant asks well let me not pre-empt you he said. Present your full clerking.

The medical student knew of course, that the things chasing him from the village where now present and resident in the hospital.

Okay he presents, the consultant asks are you sure of what you are saying. The mother of the child now replies. Na wetyn in tell me say in wan write.

At this moment the consultant stands up and walks away. The medical student has been condemned for a crime he did not commit, an innocent man declared guilty and has been sentenced to medical detention for three months, three months of hard labour.

In fact, it was now clear to him now, that not all things that flies at night are witches he said to himself, I just met one now.

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5 Comments

5 Comments

  1. Avatar

    Stanley Kalu

    July 29, 2017 at 9:34 pm

    A true picture of medical school travail…but determination always leads to success

  2. Avatar

    Stanley Kalu

    July 29, 2017 at 9:37 pm

    A true picture of medical school travail…determination always leads to success

    • Avatar

      Ovundah

      July 30, 2017 at 4:19 pm

      Thank you for your comment Stanley .

  3. Avatar

    Ikonwa Christian

    July 30, 2017 at 11:30 am

    …True story of a typical medical school exams especially clerking and presentation with its associated subjective nature

    • Avatar

      Ovundah

      July 30, 2017 at 4:16 pm

      You can say that again, Christian.

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Medical Republic

What’s the big deal about kerosene poisoning?

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By Ovundah Nyeche

Many times I jokingly tell my friends I have triplets. Well when you have 3 children which includes twins below the age of 5 what else is that called? Lol

Truly speaking, many times I do my reading and prepare for many of my seminars and presentations at work or even in the library, because once daddy steps inside house na full time work don start.

Remove your eyes from your kids and boom something…

We try our best to keep our home as safe as possible, but with kids, safety is also of the Lord.

Years ago, while doing my NYSC in Ekiti State, an unconscious child was brought into the hospital with a crowd following him.

My duty was to wake up the child by fire or by force, unfortunately, those who brought the child were not giving me any useful information.

How long has this child being unconscious… Today!
Fever… Kosi!
Trauma to the head… Kosi!
Vomiting… Kosi!
Convulsion… Kosi!
Last meal… Recently!

It was obvious my talk was taking me to no where, I had no glucometer to check the child’s blood sugar who was barely 3 years old, I decided to treat as a case of cerebral malaria, and I set up everything.

On a 2nd note, the smell from the child’s mouth was somehow, somehow… It was smelling kaikaish.

No…. Wetyn pikin go dey do with Kaikai?

No information was coming forth…

Treatment started and boom grandmother shows from nowhere with an empty Kaikai bottle…

My little patient had looted one full bottle of alcohol and the effect was him lying on the bed unconscious…

Few minutes after commencement of treatment… He was awake.

Handling children is not beans and this brings me to a very important topic “Kerosene Poisoning”.

Wetyn be Kerosene Poisoning?

I am sure we all know what kerosene is, kerosene poisoning without getting too technical is harm as a result of accidentally drinking kerosene.

Kerosene poisoning is very common, as many homes still make use of kerosene and unfortunately kerosene looks like water and unlike petrol is stored in attractive containers, many times bottled water containers or even soft drink bottles.

It is the commonest form of poison amongst children.

Then?

Usually when it happens parents panic and have to do things.

Some of the things include giving the child palm oil, palm kernel oil, crude oil, olive oil, groundnut oil, or putting their fingers inside the child’s throat.

Why?

They do this to neutralize the kerosene, but most especially so the child can vomit the kerosene gulped.

Facts.

Kerosene is poorly absorbed through the gastrointestinal tract (GIT) and the fear is in the kerosene getting to the lungs and this usually happens when the child vomits.

Medical people call this “aspiration pneumonitis”, which is big grammar for the lung tissue reacting to the kerosene in the lungs.

This reaction can lead to fever, the child being breathless, cough, as well as noisy breathing.

The kerosene can also affect the heart, GIT or even the brain or bone marrow.

What do I do then?

  • First don’t panic.
  • Secondly don’t allow the enemy to use you.
  • Thirdly, do nothing at home, yes including suggestions from neighbours except the neighbour is a qualified doctor.
  • Fourthly, halele, go to a hospital, irrespective of the quantity of kerosene swallowed.

In the hospital, the child would be observed, and if needs be a Chest X-ray would be requested and treatment given to the child as needed.

Don’t play a doctor if you are not one, life is not Nollywood.

How do we prevent this?

Let’s call it the 4 As

reduced Accessibility : Hide all kerosene from children. Keep if far from children.

reduced Attractiveness: Don’t store kerosene in attractive containers, and lock the containers properly.

reduced Availability: If you can don’t use kerosene, apart from the issue of poisoning, the issue of burns is a story for another day. Also use only quantities needed.

increased Awareness: Now you have heard tell others.

Again what do I know?

This is the end of my story.

#HearWord #HearWordseries

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Medical Republic

Presentations: 58th Annual General Meeting and Scientific Conference of the NMA Rivers State.

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The well attended conference which held in the NMA House Port Harcourt, had 3 Scientific sessions as well as Panel discussions.

Presentations which were presented include:

Environment and Health: Confronting Challenges in a Sustainable Way
by
Professor Precious N. Ede
Institute of Geosciences and Space Technology
Rivers State University
Nkpolu-Oroworukwo, Port Harcourt.

Health Care Financing: Confronting Challenges in (Achieving) Universal Health Coverage and Service Delivery

by

Dr. Anikara S. Atamunotoru

Health Financing Specialist, USAID Health Finance & Governance (HFG) Project.

 

Human Resources For Health: Pillar Of Health Systems Strenghtening

by

Dr Claribel Abam

Pioneer Executive Secretary, R/S Primary Health Care Management Board, 2011-2015

The Keynote address: Health Delivery in Rivers State: A Situational Analysis was presented by Dr Charles Ibiene Tobin-West a renowned Public Health Specialist.

 

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Medical Republic

Abstracts for the NMA Rivers State 58th Annual General Meeting and Scientific Conference.

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List of Abstracts Accepted for Oral Presentation

SNO ABSTRACT No TITLE PRESENTER
1 NMA/ABS/2018/01-OR Audit of patients aged 60 years and above presenting in a tertiary Hospital in south-south Nigeria Bell-Gam HI

 

2 NMA/ABS/2018/03-OR The Cost Effectiveness of Including Hepatitis C Antibody Screening in Routine Antenatal Tests-A Single Centre’s Experience Dan-Jumbo A
3 NMA/ABS/2018/08-OR Endoscopic posterior urethral valve excision using hysteroscopic scissors- Colworths experience. Ovunda Jack  Omodu
4 NMA/ABS/2018/13-OR Association between cooking fuels and peak expiratory flow rate among rural women in the Niger-Delta. Ofori S
5 NMA/ABS/2018/24-OR Improving Child Survival in Nigeria And the Revised Ten Steps to Successful Breastfeeding Alice Nte
6 NMA/ABS/2018/25-OR Prevalence of Gallstone Disease in Patients with Type 2 Diabetes Using Ultrasound in Port Harcourt, South-South Nigeria. UGBOMA E.W
7 NMA/ABS/2018/28-OR The Quality of Public Sources of Drinking Water in Oil Bearing Communities in The Niger Delta Region of Nigeria Omosivie Maduka
8 NMA/ABS/2018/29-OR The International Code of Marketing of Breastmilk Substitutes: Its Implications to the Nigerian Medical Association Alice Nte
9 NMA/ABS/2018/30-OR Arthroplasty-The Braithwaite Memorial Specialist Hospital Experience. Friday Aaron

The International Code Of Marketing Of Breast milk

Prevalence of Gallstone Disease in Pxs with Type II DM

Posterior Urethral Valve

NMA 2018 Oral presentation

Improving Child Survival In Nigeria And The Revised

Drinking Water Quality in Niger Delta

AUDIT IN 60YEARS AND ABOVE PPP BELL-GAM & AMADI (4)

The Prevalence of HCV Among pregnant women Oral Presentation

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