Mint Stethoscope – A Guide for New Doctors

Official ebook release poster

It is so exciting to see this book released finally.

I wish I had this guide before starting my house job journey but I remain grateful for all the guidance I gathered from different sources.

We at Health Hub Africa present our contribution to making the path easier for those coming behind us. We must end the cycle of undue suffering. The rigours of medical practice are enough to deal with. Young doctors do not have to face extraneous ones that do not help their overall growth, care delivery and wellbeing.

The radiant cover page

It has been shown that many who get disillusioned with medical practice feel that way due to the lack of support or proper guidance during their crucial first year. By sharing this free ebook, you are investing in the career of young doctors and by extension strengthening the Nigerian healthcare system.

List of contributors

Well done to everyone who made this a reality. It was an honour to be the contributing editor of this work.

Help share word by using this picture, the Twitter hashtag #HouseOfficersGuide and the download link bit.ly/mintstethoscope.

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Dr Mariam Toye

Editor

Living Free of Pain – World Sickle Cell Day

Excruciating pain, drinking a lot of water, frequent hospital admissions, breaks from school or work and dealing with many restrictions to a normal life forms the perception of sickle cell for most of us. While these are present in many cases, the truth is that with adequate care, people living with sickle cell do lead wholesome and fulfilled lives. World Sickle Cell Day was first marked on June 19th 2009 after being recognized in December 2008 by the United Nations General Assembly as a disease of public health concern.

Sickle cell is a chronic condition commonly found in people of African, Mediterranean , Middle East and Indian descent. It is a group of disorders in which the biconcave red blood cell structure (picture the Trebor sweets of your childhood) is distorted into a sickle shape (like the sickle used in farms , crescent or the curve of a question mark). The biconcave structure of normal cells make them flexible to navigate smaller vessels. The distortion affects the ability of these cells to carry oxygen to different parts of the body leading to them being deprived. The abnormal shape makes the cells rigid and unable to navigate small blood vessels in the circulatory system. This gives rise to the joint and other severe pains experienced by sickle cell patients.

Cause

The molecule , haemoglobin is the part of the red blood cell that carries oxygen. Sickle cell disease is caused by a genetic mutation which gives rise to Haemogblobin S or Haemoglobin C. The expression of the heamoglobin types make up the genotype of a person. Examples of geneotypes are AA, AS, AC, SC or SS. Sickle cell genotypes are SC and SS. AS and AC are carriers.

A child has sickle when she inherits the S or C gene from both parents.

Signs and Symptoms

These begin to show in early childhood and range from mild to severe among people affected. In most cases, the recurrent bouts of illness is often the first time the child’s genotype is identified. This can be especially traumatic for children who may not be able to express their feelings clearly. The younger ones among them are irritable – cry incessantly due to pain. Episodes of pain and other symptoms are also known as sickle cell crisis.

The sickled cells break down faster than normal red blood cells leading to anaemia. Anaemia in turn leads to breathlessness, weakness in addition to slowed growth and development in Nigeria.

Because the tissues of the body’s organs are starved of oxygen, they begin to show signs of damage. Among these complications are vision loss, bone degeneration, kidney damage, heart failure and poorly healing wounds on the legs (leg ulcers). If left untreated some of these complications can lead to death.

Diagnosis
Sickle cell can be suspected from the symptoms above but it is confirmed with genotype and other other clinical tests.

Treatment
Water – a cardinal part of managing this disease is for the patient to drink or be infused with adequate amounts of water. Sometimes, up to 3 litres per day. This aids circulation and helps reduce the joint pain.

Medication – Sickle cell patients take medication daily to prevent malaria, keep up their vitamin levels. This prolongs the life of the red blood cells and helps new ones to form. However, iron supplements does not help patients with sickle cell as the anaemia found in them is not due to a deficiency of iron. Antibiotics are given to clear existing infections. Hydroxyurea has been shown to improve symptoms significantly in sickle cell. This is usually prescribed by doctors experienced in the treatment of sickle cell. Since severe please (crisis) is often what brings most patients to the hospital analgesics are a major part of the treatment.

Blood transfusion is given to patients whose anaemia is severe to increase their blood levels. This is usually done in severe cases to save their lives.

Hip and other replacement surgery in case of fractures due to bone degeneration.

Recurrent cases are managed by haematologists who are medical experts in blood disorders. With adequate and timely treatment, many sickle cell patients lead fairly normal lives.

Cure
Sickle cell can be cured with stem cell or bone marrow transplant. This option remains inaccessible to most patients due to the high cost, the challenges of securing a matching donor and risk involved. However, many survivors have been cured with this procedure.

Prevention
People with AS, AC , SC and SS genotypes are advised to marry those with AA genotype. This prevents the incidence of their child having the disease. In many marriage registries and even religious bodies, a genotype test and counselling is increasingly becoming one of the criteria for the intending couples.

Growing Stronger With Sickle Cell
Adequate hydration as explained above reduces the frequency of crisis. Also, keeping warm in cold weather helps to prevent the joint pain and chest pain which is worsened by cold. Places or activities that lead to reduced oxygen levels should be avoided. These include high altitiudes and strenous activities. Improved hygiene helps to prevent infections and can be a lifesaving habit in this regard.

Counselling for patients and their carers is very important as the disease can take a toll on mental health. This helps them choose a healthy diet, regular water intake and practise all the the coping mechanisms above. Support groups have also been very helpful in helping patients stay strong.

For decades, we have had people with sickle cell attaining great heights in different fields of human endeavour. We must continue efforts to ensure that less children with sickle cell are born by ensuring genotype testing in couples. But for those who are living with the condition, practising these tips above helps them to lead normal lives.

Written by Dr Mariam Toye (@TheMariamToye on Twitter)

Passenger – Commuting in Lagos in the rains

Rain in Lagos is a leveller. It has the power to upset your plans and make you want to cancel the whole day. But we can’t let the weather stop us. We get up, pack our books, laptops and other stuff in waterproof lining, get a sturdy umbrella, strong shoes and match on to face a new day.

This Keke was empty and I loved the upholstery (some Lagos kekes are masterpieces of decoration.) I couldn’t resist a picture with my companion for weeks now. I knew it would fit her perfectly and frankly doing this made the gloomy morning a lot brighter. Would you believe it was raining just outside? Gratefully, the breeze did not carry this darling away.

How do you handle the stress of your morning rush?

Social Media Ethics For Health Professionals – How working to solve a problem birthed a book

Social Media Guide For Health Workers

“In today’s world of putting out thoughts and opinions online in a flash, how does a health professional maintain a profile within the limits of ethics?

In recent times, there have been concerns about how some health workers post content on social media. This made it imperative for some of us at Health Hub Africa to come together and work out a way of salvaging the situation. The general theme on this forum is to avoid complaining about problems that pop up everyday or surround us. Rather, we work on providing a solution or even put forward proactive ones to other problems we think can be nipped in the bud by observing trends before they become a menace. These deliberations developed gradually until we had a book on our hands!

Dr Ayomide Owoyemi, Dr. Ronald Kelechi Ikpe, Foluke Olaniyi-George, Olusegun Abraham, Weyinmi Erikowa-Orighoye, Iyewande Dipeolu M.D. and I are happy to present this ebook to you.

It is an honour to finally be able to do so

You can now download (for free) the Social Media Guide for Health Workers ebook using these links

http://Bit.ly/smhguidefull
http://Bit.ly/smhguideabridged

It is our hope that it helps health professionals leverage on social media while staying within the limits of ethics. This will protect not only their patients but themselves and the general public.”

Dr Mariam Toye

A page from the book on good social media conducts

REVIEWS

“Knowing what not to do is equally as important as knowing what to do.” ~Steve Harvey

For medicine, it might be more important, if the first thing you must know is to do no harm. This guide contains well written instructions for putting your exquisitely manicured foot forward. It not only tells you what not do with very relatable examples, it explains in just 18 pages how to optimize your social media to the benefit of your career.”

Dr Ifeoma Ndigwe

How to avoid unethical conduct on social media

This instructional manual details how transformation in technology especially in our social engagements has fed directly into the practice of modern health care; shedding light on its mismanagement and how to make the best of this modern innovation.

Considering the misconduct of health services in social media spheres, this book aptly brings to one’s remembrance the oft-ignored moral codes that form the pillars of medicine as a discipline. The information therein is all-encompassing, easy to understand and addressed in relatable social media colloquialisms.

It also properly recognizes and delineates the nuances in the different social media platforms. By illustrating actual examples of some gaffes, it brings to life the reality of this trend. I must commend the effort put into bringing this to fruition. It is an important recommendation for all health care workers: the social media savvy and naive alike.


Dr Balogun D.I

Illustrations of improper conduct

Social Media Usage for Health Workers is an easy-to-read guide. I like the way Mariam Toye and her team make it so relatable, giving examples which are very relatable and ethical dos and donts which are easy to understand and follow.

Medicine is a delicate profession where you would want to be mindful of what you say to protect the Identity of your patient but at the same time use this New Age Avenue/Market, which is “The Social Media” to educate the public. So, if you don’t want to say anything online that you wouldn’t want plastered to your face on a billboard like Erin Bury says; as a health professional, please use this guide!”

Dr Rebecca Solomon

World Bicycle Day

Cycling engages the different muscle groups, keeping you active, strong and mentally healthy.. It reduces cost of transportation.. And by cutting back on fossil fuels spent on short distances, it helps protect the environment.

Try it for short trips to school, nearby work, to get groceries etc. Bicycle lanes by city councils will help encourage this too. Let’s end our dependence on cars for everything.

#WorldBicycleDay

What Exactly is Lupus? – 10 facts to mark World Lupus Day

Goodreads review

“Am I dead yet,”…Diagnosed during her high school years, the author decided to keep a personal diary of her confusion, fear, and challenges of being diagnosed with Lupus. Lupus, also known as Systemic Lupus Erythematosus (SLE) is a disease that can affect many different body systems, including the joints, skin, kidneys, blood cells, heart, and lungs.

Facts about LUPUS

1.Full meaning Systemic Lupus Erythematosus or SLE

2. It is an inflammatory autoimmune disease caused by genetic abnormalities.. This means that the body’s defence attacks its own cells, tissues and organs.

3. Women are affected in 90% of cases.

4. Symptoms include feeling of unwellness, fatigue, fever, rash, joint pain, loss of appetite and weight loss.

5. Its rash is unique in the way it spreads, flatly across the bridge of the nose and cheeks in a butterfly pattern. Hence the symbol on campaign posters.

6. SLE causes damage to the kidneys, heart, nervous system and other organs.

7. People affected experience intervals of wellness and this is part of why the ongoing damage to vital organs becomes life-threatening.

8. Doctors make a diagnosis of lupus with the presence of 11 criteria

9. Treatment involves medication to reduce inflammation, steroids and in severe cases, chemotherapy. This is carried out by a specialist who is called a rheumatologist.

10. People living with SLE can reduce the severity of symptoms and progression of the disease by avoiding direct contact with sunlight, using their medication as prescribed and seeing their doctor for close monitoring.

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If you learnt something new from this post, kindly share.

Dr Mariam Toye

Founder and Editor at OumissaInspire