IBIYEMI Oluwaseun, M.D.

I have successfully completed my one-year mandatory medical internship at one of the most prestigious and highly coveted training hospitals in Nigeria for postgraduate programs. I rounded off my training in gastrointestinal surgery, a subdivision of general surgery.

So this person is asking about Preexposure prophylaxis (PrEP - vaccination before dog bite for protection). What we usually discuss is the Post Exposure Prophylaxis (PEP - vaccination after dogbite). The World Health Organization's 2018 position paper gives clear directions on this. Rabies preexposure prophylaxis (PrEP) is recommended for individuals at occupational risk, including laboratory workers handling lyssaviruses, veterinarians, wildlife handlers, and travellers to canine rabies-endemic regions where postexposure prophylaxis may not be readily accessible. It should also be considered for communities in remote endemic areas where dog bite incidence exceeds 5% per year or vampire bat rabies is known to circulate. The current WHO primary schedule consists of two doses administered on days 0 and 7, either as 0.1 mL at two intradermal sites or as one full vial intramuscularly into the deltoid. This two-dose regimen replaced the older three-dose schedule, and a routine one-year booster following primary vaccination is no longer recommended. Ongoing boosters are advised only for those with continued, high-risk occupational exposure. Where feasible, serological monitoring is preferred over empirical booster administration, with a virus-neutralising antibody titre of 0.5 IU/mL or above considered protective. In India, the National Guidelines for Rabies Prophylaxis 2019 (issued by the National Centre for Disease Control [NCDC], Ministry of Health & Family Welfare, Government of India) are followed. These guidelines recommend a three-dose PrEP primary schedule on days 0, 7, and 21 (or 28), given as one full vial intramuscularly (deltoid or anterolateral thigh in children) or 0.1 mL intradermally (one site) on each visit. This is the key difference from the current WHO 2018 recommendation of two doses only (days 0 and 7). The 2019 Indian guidelines have not yet been formally updated to adopt the WHO two-dose schedule, although some tertiary centres and experts in India may discuss or use the shorter regimen based on supporting immunogenicity data. Booster recommendations per the Indian 2019 guidelines : No routine booster is recommended after primary PrEP for the general population or travellers. For individuals with continued high occupational risk, serological monitoring of rabies virus-neutralising antibody titres is advised (every 6 months for the first 2 years for laboratory staff handling live virus, and every 2 years thereafter for other high-risk groups such as veterinarians and animal handlers). A single booster dose (IM or ID) is given only if the titre falls below 0.5 IU/mL. This provides more specific monitoring intervals than the WHO’s general “where feasible” approach, though both guidelines share the same protective titre threshold and the principle of avoiding unnecessary empirical boosters. Immunocompromised individuals require a third dose between days 21 and 28 (per WHO) and should receive full postexposure prophylaxis including rabies immunoglobulin if subsequently exposed. Indian guidelines align on careful assessment and management for immunocompromised persons. PrEP does not eliminate the need for postexposure prophylaxis after a bite, but it significantly simplifies it. Both WHO and the Indian 2019 national guidelines agree completely on this point. Wound care remains the immediate priority regardless of vaccination status: thorough washing with soap and water for 15 minutes, followed by application of a viricidal agent such as povidone-iodine. A previously vaccinated person (after completing PrEP) then requires only two vaccine doses, on days 0 and 3, with no rabies immunoglobulin. An unvaccinated person requires a full vaccine course plus immunoglobulin for Category III exposures. If re-exposure occurs within three months of completing a full postexposure course, wound care alone suffices.

When you've had a good list and and a fab trainer

@P_r_iince I'm here for this!

Just facts. If you are willing to test it out. I'll drop 2 Million Naira. You provide the Midwifery student and a professional Examiner would provide the questions. 100 stamdard MBBS MCQs and 7 essay questions (2 compulsory questions and pick 3 of remaning 5). You Down?

🤣🤣🤣

Of all the speciality to mess with, you choose to mess with a Neurosurgeon?

Vasoprin is NOT an antihypertensives medication. It does not reduce the blood pressure.

Emergency: Patient brought in gasping for breath, chest pain, and palpitations. ECG: Tall tented T-waves. Labs: Potassium 6.9, Creatinine 11. ​Me: (After pushing Calcium Gluconate, Insulin-D, and nebulizing) He’s stabilized for now, but he was nearly in cardiac arrest. His potassium is lethal. Is he on any new medications? Did something change? ​Son: No doctor, everything is same. Only his regular BP medicine (Nifedipine 30mg) finished 3 days ago. ​Me: So he hasn't taken any BP medicine for 3 days? ​Son: No, no, I am very responsible. I gave him mine! It’s all for "Pressure" only, so it will work. ​Me: What did you give him? ​Son: I have Telmisartan 40mg. I saw his old dose was 30mg three times (90mg). He was looking very "weak," so I thought 90mg was too low. ​Me: ...And? ​Son: I gave him my Telmisartan 40mg three times a day. 120mg total. Higher dose means more power, better control. ​Me: (Staring at the ECG) You gave 120mg of an ARB to a Stage 5 CKD patient? You basically fast-tracked him to a cardiac arrest. ​Son: But 120 is more than 90, Doctor. Why are you getting angry? It's at least better than not having any antihypertensive, right? Me: 👇

@abassajayi Congratulations sir 🎉 See as degree hot pass thermometer 🤲

Alhamdulillah I have been board certified by the West African college of surgeons as a fellow in Neurosurgery. MBBS MSc MIAD MRCS FWACS

Let us clarify something here, This is for the sake of public education. 1. Paying 119k consultation fee to see a gynaecologist is *not* ridiculous. This is a very fair charge to see a specialist in a private clinic setting. 2. It takes about 15years of medial school and postgraduate education to become a gynaecologist. You can’t see a specialist and pay peanuts. It costs time, money and a lot of work to become a gynaecologist. 3. Many of you gladly pay 500k for wig, you have no problems with 150k for bridal makeup that nobody notices, which will wash away in 3hours and you can even casually pay 50k to tie gele at wedding but you draw the line at paying less than 120k to see a gynaecologist for your healthcare. If you can spend premium money on ephemeral things like wig and makeup, pls kindly prioritise your health, dear Nigerians. 4. The only way you can see a specialist and pay cheap or pay nothing is if the service is subsidised or funded by the government or by NGOs. This is why government hospitals are cheaper, or sometimes free, compared to private hospitals. You may pay nothing as an end user but someone else is actually covering the true costs of that service. 5. This takes me to my final point: Marie Stopes in Nigeria is a non-profit NGO that is heavily funded by donor grants and international organisations who subsidise the actual costs to make it cheap for you the end user. It is a bad argument to compare Marie Stopes (funded by NGO money) to a private clinic gynaecologist that relies solely on being run by patient’s fees. The actual cost in Marie Stopes will be far higher if not for the donations of good people and organisations who ensure the doctors are well paid and you won’t need to pay high for treatments or consultation. I know life is tough in Nigeria and people find accessing good healthcare very expensive for the average person, however this is not the gynaecologists fault. This is the governments fault who have impoverished us, made us poor, failed to maintain the public hospitals and who have made people’s earnings so little that they can’t afford healthcare. I hope this explanation is helpful.

NASA uses Greek mythology names because they’re symbolic, powerful, and tell a story. Artemis is the goddess of the Moon, hunting, wilderness, and protector of women and children. She’s also the twin sister of Apollo, which is why NASA paired the names Apollo is the god of the Sun, light, music, prophecy, and healing. Not only NASA though. Science generally also uses them Hypnosis from Hypnos Morphine from Morpheus Panic from Pan Even other planets; Mercury fastest planet (named after the swift messenger god) Venus brightest planet Mars red = war vibe Jupiter biggest planet Neptune deep blue color Even some missions like the Juno mission. Juno was Jupiter’s wife. Some other interesting naming is a mix of the Roman gods like the month names January from Janus (two-faced, looking past & future) March from Mars July from Julius Caesar August from Augustus Some are from Numbers September from septem = 7 October from octo = 8 November from novem = 9 December from decem = 10 Interesting right?

The money did not correlate with the massive news o 😂

Pain is your father selling his only dress shoes to pay your JAMB form. You see him at your matriculation in slippers. He’s smiling so wide you almost don’t notice. You notice. You go on to study Medicine. Six years. He calls every Sunday. “How is my doctor?” You’re not one yet but you never correct him because the way he says it keeps you going. Final year. You’re almost there. He starts coughing in October. By December you know enough to know it’s bad. You don’t tell him what you suspect. You just go home, sit with him, watch football you don’t care about. He dies in February. Four months before your graduation. You collect that certificate and somewhere in the crowd your mother is crying and ululating. And you’re just standing there in that gown thinking; he sold his shoes. He never got to see this. He never got to hear me call him back and say, "I’m the doctor now". You go back to your room and cry, deeply, loudly but not a single tear drops.

As a pharmacist or pharmacy student, have you ever wondered why children 6–20 kg are given 3 mg/kg/dose of artesunate while adults get 2.4 mg/kg/dose? Logically, the pediatric dose should be lesser, so why is it higher for this medication and perhaps, several others?

For space lovers. Some interesting space movies you can see this weekend: 1. Apollo 11 2. Apollo 13 3. First man 4. Martian 5. Interstellar Any other recommendations?

Physics man!

Mathematics and Physics dey cry

Math and Physics is crazy man The Timing, Angle everything is perfect!!!

Today we remember Aisha Bello Mustapha. A legendary NTA broadcaster and renowned anchored the 9 PM Network News in the 1990s and 2000s. She served at NTA for 35 years, eventually becoming General Manager of NTA Parliament before retiring in 2022. She passed away on December 10, 2023 Rest in Peace 🕊️

The argument that the earth is flat should no longer exist. There is overwhelming evidence proving that the earth is spherical and this has been well established. It shouldn't be up for debate because science has moved passed this. It's time we fully lay the argument to rest.