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MBBS Student | Medical Laboratory Scientist | MPH (Epidemiology)
Evidence-Based Medical Education
Clinical Insights • Public Health • Simplified Medicine
📍 Hargeisa, Somaliland

25/04/2026

𝗣𝗲𝗿𝘀𝗶𝘀𝘁𝗲𝗻𝘁 & 𝗜𝗻𝘁𝗿𝗮𝗰𝘁𝗮𝗯𝗹𝗲 𝗛𝗶𝗰𝗰𝘂𝗽𝘀

Most cases = 𝗡𝗢 𝗗𝗥𝗨𝗚𝗦
➤ Short duration (48 hours

Intractable hiccups
➤ >1 month

𝗙𝗶𝗿𝘀𝘁 𝗦𝘁𝗲𝗽 (𝗠𝗢𝗦𝗧 𝗜𝗠𝗣𝗢𝗥𝗧𝗔𝗡𝗧)

𝗧𝗿𝗲𝗮𝘁 𝘂𝗻𝗱𝗲𝗿𝗹𝘆𝗶𝗻𝗴 𝗰𝗮𝘂𝘀𝗲

Common causes:
➤ Gastroesophageal Reflux Disease
➤ CNS: stroke, tumor, infection
➤ Diaphragmatic irritation (pneumonia, subphrenic abscess)
➤ Post-operative state
➤ Metabolic: uremia, hyponatremia, hypocalcemia
➤ Drugs: steroids, benzodiazepines, chemotherapy

𝗪𝗵𝗲𝗻 𝗧𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁 𝗜𝘀 𝗡𝗲𝗲𝗱𝗲𝗱

Persistent (>48h) OR distressing hiccups

𝗚𝗼𝗹𝗱 𝗦𝘁𝗮𝗻𝗱𝗮𝗿𝗱

Chlorpromazine = 𝗧𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁 𝗼𝗳 𝗖𝗵𝗼𝗶𝗰𝗲
➤ 25–50 mg PO / IM / IV
➤ Only FDA-approved drug
➤ Side effects: sedation, hypotension

𝗠𝗼𝗱𝗲𝗿𝗻 𝗣𝗿𝗮𝗰𝘁𝗶𝗰𝗲 𝗣𝗿𝗲𝗳𝗲𝗿𝗿𝗲𝗱

Baclofen = 𝗙𝗶𝗿𝘀𝘁 𝗰𝗵𝗼𝗶𝗰𝗲 (clinically)
➤ 5–10 mg TID (titrate)

Gabapentin = 𝗔𝗹𝘁𝗲𝗿𝗻𝗮𝘁𝗶𝘃𝗲 / 𝗘𝗾𝘂𝗮𝗹 𝗳𝗶𝗿𝘀𝘁-𝗹𝗶𝗻𝗲
➤ Especially useful in central/idiopathic cases

𝗔𝗹𝘁𝗲𝗿𝗻𝗮𝘁𝗶𝘃𝗲𝘀
Metoclopramide = 𝗨𝘀𝗲𝗳𝘂𝗹 𝗶𝗳 𝗚𝗘𝗥𝗗
➤ 10 mg PO / IV

Haloperidol
Pregabalin

𝗦𝗲𝗰𝗼𝗻𝗱 / 𝗧𝗵𝗶𝗿𝗱 𝗟𝗶𝗻𝗲 (𝗟𝗶𝗺𝗶𝘁𝗲𝗱 𝗘𝘃𝗶𝗱𝗲𝗻𝗰𝗲)

➤ Valproate
➤ Nifedipine

𝗦𝗶𝗺𝗽𝗹𝗲 𝗕𝗲𝗱𝘀𝗶𝗱𝗲 𝗠𝗲𝗮𝘀𝘂𝗿𝗲𝘀

➤ Breath holding / Valsalva
➤ Drinking cold water
➤ Swallowing sugar
➤ Avoid large meals, alcohol

Short-duration hiccups (

Xanuunka macaanka iyo Dhiraynta Bukaanka !Waxa jira oo magaalada hargaysa laga Helayaa xaruumo ku shaqeeye daawooyin her...
07/04/2026

Xanuunka macaanka iyo Dhiraynta Bukaanka !

Waxa jira oo magaalada hargaysa laga Helayaa xaruumo ku shaqeeye daawooyin herbal ah kuwaaso ugu sheega dadka in ay macaanka kaga Bogsanayaan !

Waa yaab Kalee dadku waxay u aaminsanyiin sida dhakhtarka ay u aamineen si ka darran wallow Intaan arkay mid dhakhtar ahi ku jirin dadkaas o ay yihiin dad Lacag karaadinaya !

Waxan u soo joogay Qof bukaana oo ku jira xaalad la idhaa ( Diabetic KetoAcidosis) oo qofka macaanka leh ku keeni karta cawaaqib xumo ilaa Dhimasho.

Waxa kale oon sheeko ku Maqalay Odey inta sidaaso kale loogu idhi waad ku bogsanaysaa oo joojiyay kiniinadii macaanka uu u dhintay dhibaatoyinkii uu ka dhaxlay oo ay ugu waynayd in keliyuhu fadhiisteen.

Hadaba waxa is weydiin leh dhirta ma lagu daweeyaa Xanuunka macaanka ?

Maya, Macaanka laguma daweeyo dhir mana jirto wax laysku raacay oo la idhi ha lagu daweeyo. Sidaa awgeed qof kasta waxa saaran baraarujin ah in dadka waayeelka ama Reer-miyiga ah ee u gacan galaya dhiraynta Umadda laga qabto si aanay Dhibaato intaa ka weyn ula kulmin.

Wasaradda caafimaadka maxaa la gudboon ?

Waxa la gudboon in ay ka war hayso dadka keenaya herbalka ama dhirta ee dadka ugu sheegaya in ay daawo ka tahay xanuunka iyagoo kaga furanaya Lacagta ay haystaan.

Waa in la adkeeyo shuruucda dawada iyo cida bixinaysa si looga badbaado dhibta mustaqbaliga ah ee ka iman karta daawooyin iyo dhir si qaldan loo siiyay qof aan u baahnayn.

Ka hartagaa ka fiican daawaynta !

05/04/2026

Persistent hiccups: lasting > 48 hours
Intractable hiccups: lasting > 1 month

Treatment
1) Gold Standard (Exam Answer)

Chlorpromazine (TOC)
• Only FDA-approved drug for hiccups
• Dose: 25–50 mg PO (or IM/IV if severe)
• Highly effective but limited by sedation, hypotension, anticholinergic effects

2) Preferred First-Line (Modern Clinical Practice)

Baclofen
• 5–10 mg TID
• Often first choice in persistent/intractable hiccups
• Better tolerated than antipsychotics

Gabapentin
• Effective in idiopathic or central causes
• Increasingly used as first-line

3) Alternatives (when first-line or chlorpromazine cannot be used)

Metoclopramide
• 10 mg PO/IV
• Particularly useful if associated with GERD or gastric distention

4) Other Options (2nd / 3rd line)

• Gabapentin (if not already used)
• Haloperidol
• Pregabalin
• Nifedipine (limited evidence)
• Valproate (limited evidence)

5) Treat Underlying Cause (MOST IMPORTANT)

Always evaluate for:

• GERD (most common cause)
• CNS lesions (stroke, tumor, infection)
• Diaphragmatic irritation (pneumonia, subphrenic abscess, hepatomegaly)
• Post-operative state
• Metabolic causes:
• Uremia
• Hyponatremia
• Hypocalcemia

Simple bedside measures for acute hiccups

• Breath holding / Valsalva maneuver
• Drinking cold water
• Stimulating nasopharynx (e.g., swallowing sugar)
• Avoid large meals, alcohol, sudden temperature changes

MRCP

TALO DADKA MACAANKA LA NOOL[ ] Macaanku waa xanuun ku yimaada khalkhal ku dhaca qofka unugyadiisa xakameeya sonkorta dh...
31/03/2026

TALO DADKA MACAANKA LA NOOL

[ ] Macaanku waa xanuun ku yimaada khalkhal ku dhaca qofka unugyadiisa xakameeya sonkorta dhiiga oo loo yaqaan ( insulin ) taaso ama yaraata ama aan laba soo Saarin.

Xanuunka macaanka waa xanuun Lala noolaan karo hadii loo xakameeyo si sax ah. Hadaba si loo xakameeyo maxaa loo baahanyay ?
Waxa loo baahanyay in uu qofku sameeyo cabbir joogto ah maalinkii 1 mar ilaa 2 Goor oo intaa aanu dawada qaadan ah sidoo kale waxa loo baahanyay in uu qofku la socdo 3 billeha shaybaadhka la qaado ee la idhaa ( HBA1c ) kaaso ka caawinaya qofka in uu ogaado 3 dii bilood ee u danbeyay Sonkorta dhiiga ku jirtaa inta ay maraysay.

Waxa jira waxyaabaha qaar uu qofku iska ilaalinayo sida sonkorta IWM, marka la idhaa sonkorta qofku ha iska ilaaliyo loogama jeedo wada jooji sonkorta e waxa jirta mid loogu talo galay qofka macaanka leh sida ( diet ) sonkorta la idhaa Badanaa waxa laga helaa goobaha caafimaadka ( pharmacy) .

Hadaba waxa jira waxyaalaha qaar hadii uu qofku isku arko ay tahay qasab in uu dhakhtarka u tago sida:-
[ ] Kaadida oo Xoor badan yeelata ama keliyo xanuun
[ ] Cabbirka maalinlaha ah oo aan 300mg/dl ka soo dagayn.
[ ] Daawada uu qaato hadii uu ka shakiyo in aanay waxba u tarayn.
[ ] Araga indhihiisa hadii uu isbedal ka dareemo.

Waxa aan kuso xidhayaa macaanka waa laga hortagi karaa hadii qofku Isla socdo oo 3dii bilood ilaa 6dii bilood u mar iska eego ( HBA1c ), waana lala noolaan karaa hadii qofku talada dhakhtarka iyo dawadaba si fiican u qaato.

Abdiaziz omer ✍️

28/03/2026

Latest High-Yield Updates regarding Antimicrobial ( Very important Revision)

❗ Fluoroquinolones: Reduced use due to rising resistance; Azithromycin is now preferred for diarrhea

❗ Candidemia: Echinocandins are first-line therapy (not Fluconazole)

❗ Cryptococcus: Always requires induction and consolidation therapy; Drug of choice (induction): Amphotericin B + Flucytosine, followed by Fluconazole for consolidation/maintenance

❗ Mucormycosis: Requires urgent treatment with Amphotericin plus surgical intervention

❗ Gonorrhea: Higher-dose Ceftriaxone (500 mg IM single dose; 1 g if ≥150 kg) is now recommended

❗ ESBL organisms: Carbapenems (e.g., Meropenem) are the treatment of choice

❗ Brain infections: Always consider combination therapy; Vancomycin + Ceftriaxone (± Ampicillin depending on age/risk factors)

MRCP UK

Vitamin DMaxaa sababay in Vitamin D ga somalidu mar walba hooseeyo ?Xitaa Somalida qurba joogtaa waxaa jirtay xog laga s...
08/03/2026

Vitamin D

Maxaa sababay in Vitamin D ga somalidu mar walba hooseeyo ?
Xitaa Somalida qurba joogtaa waxaa jirtay xog laga sii daayay 5 sanno ka hor mar la waraysanayay oo ay ka hadlaysay gabadh la idhaa DR. Rhonda Patrick waxay sheegtay in Somalida Sweden dagan ay leeyiin ( Severe vitamin deficiency ) oo ah in vitamin D goodu aad u hooseeyo.
Sidaa Si lamida waxan eegay 3-4 tii bilood ee u danbeeyay dad gaadhaya tiro ahaan 18 qof oo kala ah (12) dumar ah oo noqonaysa 66.7% iyo (6) Rag ah oo noqonaya 33.3%. Hadaba dhibtu waxay ka jirtaa in wadarta guud ee 18ka qof ahiba uu Hooseeyo oo Waliba u 70% ka hooseeyo 15ng/ml sida caadigaana Laga rabo ( 30-100ng/ml ).
Jaan-tuskan yar waxan u soo qaatay wacyi ahaan Si uu qof waliba uga war hayo xaddiga Vit-D ee jidhkiisa maadaama oo Vit-D keeni karo amaba Keeno Daal Joogto ah, Burbur ama Lafaha Qofkao o daciifa, Caruurtana ay ku Keeni karto (Rickettsia) Oo noqonaysa WegdoX ad dhaaf ah.

Bahda caafimaadkana waxa aynu weydiinaynaa bilaa shaybaadh ma siin karnaa vitamin-D ( supplement ) ama taageero ahaan mise waa maya. Sabab ?

Mahadsanid

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