Friday, 19 September 2014

The Abuja Healthcare Directory

 

This is the online copy of the 2012 Abuja Healthcare Directory. Your repository of information about specialist doctors and hospitals in Abuja. 

The directory is due for a major revamp and we will be asking QUALIFIED, REGISTERED doctors and REGISTERED hospitals in Abuja to participate in the new edition scheduled for publication before the end of 2014.

The new directory will be distributed FREE of charge to the general public in Abuja so placing VITAL information about you and your practice in the hands of people who need to know. 

Nigerians need help and this is a critical resource to ensure information about GOOD healthcare facilities and health care providers are easily available.

Please contact me as follows:

Dr Biodun Ogungbo
Consultant Neurosurgeon
SFIA: SPINE FIXED IN ABUJA
Tel: 07082350074
Email: Ogungbo@icloud.com

Let us work together!

Monday, 15 September 2014

How do we improve radiology reports?



Radiology reports are appalling in Nigeria and it underscores the paucity of training for radiologists. Some of the radiologists who report MRI and CT scan of the brain and spine are untrained in neuroradiology. They dabble, moonlighting in the many diagnostic centres, reporting on scans they know nothing or very little about.

There is a radiologist in Abuja who is so bad as to be criminal. His reports are so abysmal you wonder if he needs glasses or suffers from glaucoma. His brain and eyes are certainly not connected. This one is particularly horrible he should be certified as fit for a lobotomy. I cannot remember the last time he got the diagnosis right and someone should put him out of his misery. But, his health is actually not the problem. It is the profound risk he puts ordinary Nigerians to that is important.

The fact is that doctors rely on the reports to make a diagnosis and guide treatment. We rely on the reports to know if the patient should be referred to a specialist or not. In essence, the reports can be the difference between life and death for the patient. MRI and CT scans are so expensive that the quality of the report is equally as important as the quality of the imaging. Since, many imaging centres utilise poor quality equipment, the radiologist has to be particularly astute. To have bad equipment and a bad radiologist therefore compounds the problem.

Take for example; arthritis of the spine can lead to pressure on the nerves in the back. The nerves supplying the legs, private parts, bladder and the anus can be under pressure. MRI scan showing such pressure must be correctly diagnosed and indeed flagged as an EMERGENCY problem that requires urgent treatment by a spine surgeon. Delay in diagnosis and treatment can lead to permanent damage to the nerves making the patient incontinent of urine and faeces. It can affect sexual function, cause untold pain and even paralysis of the legs.

The radiologist must correctly diagnose this. Therefore, for a radiologist to not even see that nerves are under pressure is a big problem. For a radiologist to not highlight the severity of the condition is a bigger problem. Finally, for a radiologist to misdiagnose it as infection and therefore send the doctors down the wrong treatment path is the biggest problem of all.

There are pertinent issues of course that bedevils medical practice in Nigeria. There are also special problems related to the practice of radiology through our diagnostic centres. Some of these issues are as below:

Information
One problem is that radiology requests are often deficient in information that will help the radiologist. Many do not state the correct age of the patient preferring to write ‘ADULT’ in the column for age. Yet, many diseases are age related. Secondly, full history and suspected diagnosis are often missing, so without adequate information, the radiologist sometimes needs a crystal ball or the services of a clairvoyant to make the right diagnosis. Garbage in, garbage out!

Communication
There is disconnection between the radiologist and the radiographer. In many centres, the radiographers do the imaging and send the patient away. The radiologist then comes later to report on what may be inadequate or incomplete imaging. Other types of images that may have helped are then nigh impossible since the patient has already left the building. Of course, fresh imaging often means additional costs that may be unaffordable for the patient. So, radiologists make do with inadequate examination to the detriment of their reputation and the patient.

Secondly, of course and more important is the recognition of urgent cases and diagnosis. The radiographer and the radiologist need to be able to recognise cases that are emergencies and flag this up immediately. Conditions such as pneumothorax (air in the chest cavity outside the lungs), massive stroke and bleeding into the brain sometimes require immediate attention. There is therefore a duty of the radiology personnel to highlight these conditions with despatch. Delays often lead to loss of limbs and life.

Collaboration
It is rare for radiologists to phone the referring doctor to ask for more information. It is also rare in private practice especially for them to ask for feedback from the surgeon. This is sad, does not improve learning and perpetuates ‘quackery’ in radiology. Feedback from the surgeon and more important from the pathologists should be integral parts of the process for making the right diagnosis for the patient. Many teaching hospitals encourage radiology meetings between departments just to facilitate this level of collaboration and learning. It is vitally important but sorely lacking in private diagnostic facilities.

What are we to do?
How do we improve radiology reporting and share expertise, experience in a way that stimulates and improves quality of care for the majority of our patients? How can specialists provide feedback for radiologists and help improve their practice? How do we do this without bruising some over inflated egos? Especially in those without perception!

What are we to do in order to save lives?




















Friday, 5 September 2014

Dangerous barbers and the dandruff scam



I went to the barbing saloon recently to get a haircut. Usually, when I go, I take my own shaving kit with me and so avoid any risk of catching head lice or even Hepatitis. God forbid! Anyway, that is not the story I want to relate to you. The hair cut was performed efficiently but after the barber succeeded in making me handsome (to my amusement), he did the following:

First, the barber got a hot wet towel from a small oven in the shop. He then proceeded to slap this hot towel on my head without warning. It was hot enough to make me jump up, slap his hand away and exclaim. Seriously, what has barbing become? Why do I have go to the shop to get a burn on my head? There was no communication at all and he did not even check if the temperature was suitable for me. I supposed he used his own calloused hands to judge the temperature!

He still used it to clean my head, wiping off the bits of hair and then he proceeded to perform a hand massage of my scalp and neck. I thought that was good and I almost fell asleep with the pleasure of it. That was until he put one hand on my head and another under my chin. He was about to twist my neck before I shouted. I was so mad! How dare a barber try to twist my neck (unsolicited) and without prior warning, as part of the simple act of shaving my head? I admonished him severely and warned him never to do this again. It is certainly not part of hair cutting and does not take into cognizance the huge risks involved.

For example, I may have a bad neck with cervical spondylosis, or a previous neck operation or even just a weak neck. And apart from being a surgeon who operates on necks, I watch movies where peoples’ necks are twisted leading to their demise. It is believable that the barber could one day, perform this neck twisting act and render his client paralysed or dead. A N500 hair cut should not send you to the emergency room or to the morgue.

This brings me to another point in the hair-cutting industry and this relates to the dandruff scam perpetrated by hair dressers and barbers. Dandruff is not a disease but simply dry scalp. It is dry skin that flakes off the head and is not really a problem. It is also not curable. Since it is not a disease, in the first place!

According to Wikipedia, Dandruff is a common scalp disorder affecting almost half of the population at the post-pubertal age and of any gender and ethnicity. It often causes itching. The severity of dandruff may fluctuate with season as it often worsens in dry weather. Those affected by dandruff find that it can cause social or self-esteem problems, indicating treatment for both psychological and physiological reasons. Most cases of dandruff can be easily treated with specialized shampoos. There is, however, no true cure.

No cure for Dandruff
This is the basis of the scam! When barbers and hair dressers say that you have dandruff and ask if they could treat it for you, they make is sound as if they can make it go away. That the exorbitant price you pay to have your hair washed with shampoo and creamed is justified. As if once they have done the treatment, it won’t reappear the very next day!

Dry scalp like dry in other part of the body is part of life and happens to a lot of people. People who use soap a lot and especially in the hot weather we have in Nigeria suffer from dandruff and dry skins. Those who suffer from eczema and allergies perhaps suffer the more. It is no reason to spend your hard earned money on the scam perpetuated by big business selling shampoos, lotions and potions purported to cure dandruff.

You may have seen the image of that gorgeous woman on the billboards all over the country selling shampoo for dandruff. No matter how pretty you think she is, remember what she is selling is not a cure for dandruff and all part of the scam. Shampoos, soaps, creams and moisturizers are temporary treatment and not cure for dandruff. It is part of your makeup and not a condition to worry about at all.

Finally, please be careful at the barbers shop and even at hairdressers. People have been maimed and injured in these places mostly by this trial and error behaviour and barbers especially doing things they feel add quality to the service. But, which may be fairly harmful. Burns, allergic reactions, cuts, rash and transmission of deadly infections are all possible at the hairdressers.

Be careful.

NB: Please share your bad or good experiences at the barbers with me. Simply write in to the discussion column and let us share the information and advice widely.