faithful2911:

PrEP is 99% effective.
In certain studies where 1000 people were administered PrEP, they all came out negative after high risk exposures.

ceaser:


Stop misleading people. Very soon you'll start arrogating treatment of patients to yourselves. Who sees the patients?(who does a patient consult when ill?) Even you as a scientist, I put it to you that when you or your kids feel unwell, who do you take 'em to visit in the hospital? The doctor or your fellow scientist? Who requests the test? By the time the test is ready, is it the person who performs it or the person who requests it that rightfully informs the patient of his/her test result?

I know you have heard of pathologists before but you will conveniently evade the truth in order to satisfy your whims and caprices.

@ Bellotelli and every other unbiased reader, for now do not take his word or mine for it. Rather, conduct your own independent investigation on who the Pathologist is and who a medical lab scientists is. Then make your informed choice of knowledge. Do not let anyone bamboozle you with their clout chasing, trying hard to change people's perception of themselves and trying so hard to make themselves what they are not.

Why would a Medical Lab Scientists tell a patient the result for chrissakes? That's seriously unethical and a patient who knows his/her right can sue that scientist for going outside his job description. Do you know that to ensure confidentiality, test results when ready are usually stapled/enveloped when handed over to the receiver until it gets to the physician?

HIV tests are certainly already stapled/sealed/enveloped at the point of receipt and if the physician realises that the seal is broken by the time the result gets to him, then he can rightly raise an eyebrow to that irregularity, especially if the bearer of the test result is not the patient.

Again I say this, quit misleading people. Your lies can only go on for so long, the infallible truth will trump it in no time.



@ Bellotelli, that up there is exactly the danger inherent in the irregularity of that medical lab scientist's claim.

You see, medical tests is at best a guide and is not meant to be used alone as diagnostic criteria. It requires being combined with well grounded clinical skills that the doctor has before a definitive diagnosis is arrived at. In fact, medical/clinical acumen alone is often enough/ethically allowed to make diagnosis than medical tests alone without clinical acumen backing. This is because medical practice is to a large extent based on general clinical condition of the patient and also on epidemiology (simply put, common illnesses among specific population), so a doctor in a local community in let's say a place like Koko with very limited health facility can safely assume that a patient coming with complaints of fever, headache and vomiting likely has malaria, treat him/her for that a the patient gets better. In the same vein, a patient in/travelling from Lassa, Benue state coming with fever, headache with or without unusual bleeding in the peak months of Lassa fever outbreak will first be taken as a potential case of Lassa fever before considering malaria fever and treated along that line too. Medical tests may need to be carried out to determine if it's Lassa or ordinary malaria, but even in the absence of test facilities, the doctor may safely treat Lassa symptoms and get it right.

Test results are not 100% error proof. Lab scientists as the name rightly implies, are basically trained laboratory scientists. In contrast, the doctor like the scientists is trained in both laboratory processes, in Clinical acumen and a number of other health relevant stuffs.

That is why in terms of clinical condition of the patient, if a PCV test result tells a doctor that the patient is anaemic (short of blood), the doctor will look (fully examine) the patient to determine if the stigmata suggestive of anaemia are in that patient. He must have done this before even requesting for the test so it's just a second look. If the patient features say otherwise, then the doctor will seek a repeat test result either from the same facility or from a different testing facility.

This is the stark difference between "test driven" ideology and "medical driven" ideology.

Medical lab scientists will tell you that you have Low Sperm Count (even if the scientist is hard pressed to reveal the test result to you before you get to your doctor, the correct way to say it should have been "you MAY have low sperm count, but your doctor will determine if that is the case".) if your test result shows such. Meanwhile there are several pre-analytic, analytic and post -analytic events (events between the point of collection of the sperm sample up till the point you are issued your result) that may bring out a false positive result. Because that is the only work they assert, a lab scientist believes so much in the test that he/she will insist you have that disease without minding other vital statistics.

The health provider in that private clinic (who may truly be a doctor that has failed to update himself enough to be in tune with current trends, but more likely a lab scientist posing as a medical doctor - which is very epidemic) ignored the fact that there can be "false positive" test result and so he instructed the patient to go to the General hospital to start treatment. Meanwhile the doctors at the general hospital must have properly taken a comprehensive patient history (to determine risk assessment), clinical examination (to determine features suggestive of HIV infection) and repeat test (which must have been negative) and then juxtaposed it with the test he brought from that private clinic to conclude that the patient was not HIV positive.

I took the time for the comprehensive write up just for the sake of the general readers here so as to help 'em avoid the pitfalls that ravages the health sector in that country Nigeria, such nonsense that does not happen in places with standard best practices.

bmlsbmls:

point of correction, a doctor has only basic knowledge about laboratory practices. you seriously can't compare a physician with a medical lab scientist when it comes to laboratory practices. In fact, a doctor might find it hard to perform ordinary pcv test

ceaser:


Ha! Bro, what are you saying nau?

@ bolded is all direct opposite of the truth.

Haba, diaris God o.

Ordinary PCV that is done as an emergency investigation in side labs attached to the wards manned by the doctors that make rounds in that ward. Something that you don't need more than a lancet, capillary tube, plus/minus centrifuge and a microhaematocrit reader.

All basic investigations that are conducted in the laboratory can be capably conducted by a doctor. It's an integral part of the medical curriculum with block postings dedicated for it.Then the more advanced ones are the purview of the pathologist/laboratory physician (who is also a doctor that has undergone postgraduate training in advanced medical laboratory practices and it's applicability with clinical knowledge in patient treatment.

This includes all four major arms of the medical laboratory.

bmlsbmls:

all basic investigations can be performed by doctors?? what about e/u/cr?? most physicians can't even handle a microscope except for those in pathology dept

ceaser:


I'm glad we are in agreement as regards PCV being walkover for most freshly graduated doctors. You rightly know that conducting PCV does not require the use of a microscope. That notwithstanding, postgraduate doctors in Medicine, O & G, Paediatrics, Family medicine and a few others have laboratory postings programmed in their training schedule. They have additional adequate exposure to the use of microscopes and other basic laboratory processes during such rotation. This is in anticipation of the fact that they will always come across cases that require input of laboratorians at various points in their consultations and such knowledge can come in handy as quick interventions pending the time they get adequate review from their colleagues in the clinical laboratory - the pathologists. You know that practicing modern medicine requires some multidisciplinary approach.

E/U/C can be seen to be in the purview of laboratorians including pathologists who are those trained in postgraduate laboratory medicine, therefore a non-specialist physician will not be condemned if he has no proficiency in it.

@bolded. That settles it. Doctors in pathology dept are laboratory physicians as you rightly know. So this point and the paragraphs before it buttress the points I've been trying to pass across way back.

bmlsbmls:

Initially, u made it seem like a general physician can proficiently work in the laboratory. I guess that settles it. I respect physicians a lot, but I dislike like it when they claim to know something that's not related to their field of expertise.

ceaser:


Stop misleading people. Very soon you'll start arrogating treatment of patients to yourselves. Who sees the patients?(who does a patient consult when ill?) Even you as a scientist, I put it to you that when you or your kids feel unwell, who do you take 'em to visit in the hospital? The doctor or your fellow scientist? Who requests the test? By the time the test is ready, is it the person who performs it or the person who requests it that rightfully informs the patient of his/her test result?

I know you have heard of pathologists before but you will conveniently evade the truth in order to satisfy your whims and caprices.

@ Bellotelli and every other unbiased reader, for now do not take his word or mine for it. Rather, conduct your own independent investigation on who the Pathologist is and who a medical lab scientists is. Then make your informed choice of knowledge. Do not let anyone bamboozle you with their clout chasing, trying hard to change people's perception of themselves and trying so hard to make themselves what they are not.

Why would a Medical Lab Scientists tell a patient the result for chrissakes? That's seriously unethical and a patient who knows his/her right can sue that scientist for going outside his job description. Do you know that to ensure confidentiality, test results when ready are usually stapled/enveloped when handed over to the receiver until it gets to the physician?

HIV tests are certainly already stapled/sealed/enveloped at the point of receipt and if the physician realises that the seal is broken by the time the result gets to him, then he can rightly raise an eyebrow to that irregularity, especially if the bearer of the test result is not the patient.

Again I say this, quit misleading people. Your lies can only go on for so long, the infallible truth will trump it in no time.



@ Bellotelli, that up there is exactly the danger inherent in the irregularity of that medical lab scientist's claim.

You see, medical tests is at best a guide and is not meant to be used alone as diagnostic criteria. It requires being combined with well grounded clinical skills that the doctor has before a definitive diagnosis is arrived at. In fact, medical/clinical acumen alone is often enough/ethically allowed to make diagnosis than medical tests alone without clinical acumen backing. This is because medical practice is to a large extent based on general clinical condition of the patient and also on epidemiology (simply put, common illnesses among specific population), so a doctor in a local community in let's say a place like Koko with very limited health facility can safely assume that a patient coming with complaints of fever, headache and vomiting likely has malaria, treat him/her for that a the patient gets better. In the same vein, a patient in/travelling from Lassa, Benue state coming with fever, headache with or without unusual bleeding in the peak months of Lassa fever outbreak will first be taken as a potential case of Lassa fever before considering malaria fever and treated along that line too. Medical tests may need to be carried out to determine if it's Lassa or ordinary malaria, but even in the absence of test facilities, the doctor may safely treat Lassa symptoms and get it right.

Test results are not 100% error proof. Lab scientists as the name rightly implies, are basically trained laboratory scientists. In contrast, the doctor like the scientists is trained in both laboratory processes, in Clinical acumen and a number of other health relevant stuffs.

That is why in terms of clinical condition of the patient, if a PCV test result tells a doctor that the patient is anaemic (short of blood), the doctor will look (fully examine) the patient to determine if the stigmata suggestive of anaemia are in that patient. He must have done this before even requesting for the test so it's just a second look. If the patient features say otherwise, then the doctor will seek a repeat test result either from the same facility or from a different testing facility.

This is the stark difference between "test driven" ideology and "medical driven" ideology.

Medical lab scientists will tell you that you have Low Sperm Count (even if the scientist is hard pressed to reveal the test result to you before you get to your doctor, the correct way to say it should have been "you MAY have low sperm count, but your doctor will determine if that is the case".) if your test result shows such. Meanwhile there are several pre-analytic, analytic and post -analytic events (events between the point of collection of the sperm sample up till the point you are issued your result) that may bring out a false positive result. Because that is the only work they assert, a lab scientist believes so much in the test that he/she will insist you have that disease without minding other vital statistics.

The health provider in that private clinic (who may truly be a doctor that has failed to update himself enough to be in tune with current trends, but more likely a lab scientist posing as a medical doctor - which is very epidemic) ignored the fact that there can be "false positive" test result and so he instructed the patient to go to the General hospital to start treatment. Meanwhile the doctors at the general hospital must have properly taken a comprehensive patient history (to determine risk assessment), clinical examination (to determine features suggestive of HIV infection) and repeat test (which must have been negative) and then juxtaposed it with the test he brought from that private clinic to conclude that the patient was not HIV positive.

I took the time for the comprehensive write up just for the sake of the general readers here so as to help 'em avoid the pitfalls that ravages the health sector in that country Nigeria, such nonsense that does not happen in places with standard best practices.

Bellotelli:

See.. I know some of you want me to test positive, but y'all will be disappointed

adekS1:
l don't want to dignify your arrogance and ignorance with a long epistle as you av done.
Your take home point is that every professionals you see in the hospital (be it not pharmacists,Medical lab Scientists and so on )work independently of eachother except a Dr who most times need the input of everyone bfr he can make a good diagnosis,treatment and management(if he ia not a quack sha).
I will repeat this again,a Medical lab Scientist by training can interpret the result he took his time to analysed and not just a Dr who can.how will Cook a food you can't taste or eat.

Its not every test a Dr must interpret for you when a medical lab Scientist is more knowledgeable than him in this aspect of lab tests he is well trained for.
Who need a Dr interpretation for a pregnancy test or HIV test and some other routine tests.
Medical lab Scientist are licensed by MLSCN to interpret result for patients.in fact there are some tests you don't need the input of a Dr,just do the test and go straight to the pharmacist,base on your result a pharmacist will give you drugs,be it malaria or typhoid or pregnancy that needs to be enrolled for ANC among others.
I will advice you to stop ignorantly misleading the ppl.the world is not where it use to be 20yrs ago.
The earlier you wake up to this fact the better,dont you see that its shameful for some of our nollywood directors that will show where a Dr is saying in a movie scene that we av conducted this TEST on you ma and see that you are pregnant.
The question is when did a Dr start doing lab test,or una don turn to "gbogbonise"(jack of all trade, master of none).

Psych412:
really



thanks